BANGUI, Central African Republic (AP) — In a room full of crying children, 3-month-old Francois Ngatoa doesn’t make a sound.

Lying in his mother’s arm in a swath of bright blue fabric, he is too weak to cry. His only movements are his clenched fists and tiny ribs that protrude with each breath. Dozens of children wait to be measured by aid workers but even among hungry children little Francois is alarmingly fragile.

“He had lost too much weight and so we had to come here,” Yolanolo Itimbila, a mother of four, says as she sits on the woven mat covering the floor.

A nurse’s measurement confirms Francois is down to 3.8 kilograms (8 pounds, 6 ounces) — the weight of a healthy newborn and well below the 6 kilos (13 pounds) he should ideally weigh for his age.

After three years of violence and upheaval in Central African Republic, nearly 2.5 million people are facing hunger. Families don’t know where they’ll find their next meal, and growing children like Francois are particularly vulnerable to hunger’s cruelty.

The country’s hunger figure has nearly doubled in just a year’s time, and reflects only the parts of the country where aid workers have been able to do an assessment: Violence and other obstacles have kept the United Nations from visiting some parts altogether.

Aid workers fear they are seeing only a fraction of the total cases — a feeding center run by Action Against Hunger with support from the U.N. children’s agency draws women who set off by foot at dawn with their babies strapped to their backs. Other cases, though, could be looming deeper in the countryside.

Francois’ mother wonders whether she waited too long to bring in her son. He had been small since birth but was otherwise fine until he got sick recently, she says. Now he vomits everything he eats.

The medical team decides he should go to the city’s pediatric hospital for admission, and she bundles up her belongings along with her 7-year-old son who carries an umbrella almost as big as him to shade them from sun as they walk in Bangui’s unrelenting heat.

An hour later, she brings Francois into the waiting room where the most acute cases of malnutrition are treated. Sitting on a wooden bench with other mothers she tries to get Francois to sip formula from a blue plastic cup.

Ten-month-old Sylvanie Kofeguawa is also desperately underweight at just 4 kilograms (less than 9 pounds). She struggles to open her eyes and her cries sound more like a kitten’s. Her mother eats just once a day — usually greens and a starch known as manioc. She can’t remember the last time she ate meat.

More than 300 children like Francois and Sylvanie have been admitted since Pope Francis’ historic visit in November, a sign that even with relative peace the hunger problem is intensifying.

“It’s a crisis which should never have happened because the country has the potential to feed itself,” said Parfait Onanga-Anyanga, the U.N. secretary-general’s special representative to Central African Republic.

Farmers have fled their homes for their lives, leaving fields untended. Those who want to return in many cases cannot afford the seeds and other supplies needed. Muslims who traditionally herded cattle fled the country en masse, sending meat prices skyrocketing where it can be found. Health centers were destroyed in the violence and some doctors and nurses who fled never returned.

More than 40 percent of children in Central African Republic are now considered chronically malnourished, according to UNICEF. Even if these children are eating, their paltry diets lack the vitamins and minerals they need to grow. As a result, many are too small for their age and their brain development is suffering too, said Donaig Le Du, chief UNICEF spokeswoman in Bangui.

“These are kids who are living a very precarious life in terms of food,” she said. “If one of these kids falls sick with malaria, diarrhea — whatever, since they are already very weak they can fall into severe acute malnutrition in a matter of days sometimes,” she said.

The World Food Program is working to get to some of the most unstable areas where ongoing violence kept farmers from working their fields during the last growing season. The operation is only 49 percent funded and another $46 million is needed through July to help not only those in Central African Republic but refugees in neighboring countries, according to communications officer Sayaka Sato.

At one recent food distribution in the northern town of Kaga-Bandoro, women lined up hours in advance to receive rations of rice, oil, split peas and cornmeal.

“I don’t know how we would live without this,” said Patricia Wambele, 35, of the food aid for his nine children. “We want to return home but there are militia fighters in our village.”