PORT-AU-PRINCE— Almost half of Haiti’s people are struggling to feed themselves as gang violence spreads across the country, with several areas close to famine, international organizations said on Friday.

Inflation and poor harvests have also helped push Haiti to its worst levels of food insecurity on record, they said.

“Rising hunger is fueling the security crisis that is shattering the country. We need urgent action now — waiting to respond at scale is not an option,” Jean-Martin Bauer, the World Food Programme’s Haiti director, said.

The Integrated Food Security Phase Classification (IPC) — an organization which sets a scale used by the United Nations and governments to assess hunger — said in a report that about 4.97 million people out of a population of about 11.5 million were facing crisis or worse levels of food insecurity.

Eight areas were now assessed to be in an emergency phase — the worst level before famine, it said.

These include the Artibonite valley, Haiti’s farming heartland, which has been badly hit by gangs expanding from the capital Port-au-Prince, rural parts of the Grand-Anse peninsula and neighborhoods of the capital such as the poor Cite Soleil district.

The Caribbean country has been gripped by violence since rival gangs unleashed a wave of attacks this month, including raids on police stations and the international airport. The conflict has killed thousands and displaced hundreds of thousands.

Regional leaders are trying to form a transitional council and Prime Minister Ariel Henry has promised to resign once it is set up. But he is currently stranded abroad, shut out of the country after making a visit to Kenya to discuss the deployment of an international security force. This has now been put on hold.

The FSB security service said ‘all four terrorists’ had been arrested while heading to the Ukrainian border, and that they had contacts in Ukraine.

The WFP said Haiti was now suffering its worst levels of food insecurity on record, with many people resorting to desperate measures and taking on more debt as armed groups take over farmlands and steal crops.

The IPC report found only 5% of Haitians had received humanitarian food aid and the WFP said that operations were “woefully under-funded.”

More than 30,000 people have fled violence and shortages in the capital in just two weeks this month, according to U.N. data, most of them people who had already lost their homes and were living in camps or with other families.

Authorities in the neighboring Dominican Republic, who have deported tens of thousands of Haitian migrants, have said they have not agreed to an air bridge announced by the U.N. to supply aid to Haiti, saying its air route is for evacuating foreigners.

Laurent Uwumuremyi, who heads aid group Mercy Corps’ Haiti arm, said gangs now control nearly 90% of the capital with basic errands impossible, key infrastructure closed, shortages in basic supplies and hospitals on the brink of collapse.

“Even in areas like Petion-Ville, an upscale neighborhood that until recently was considered safe, the population has been barricaded indoors,” he said. “If the situation deteriorates without any efforts to address the unfolding humanitarian crisis, Port-au-Prince will soon find itself completely overwhelmed.”