Nicholas Kristof: Starving children don’t cry

The world had pretty much licked famine, until 2020.

Starvation is agonizing and degrading. You lose control of your bowels. Your skin peels off, your hair falls out, you hallucinate and you may go blind from lack of vitamin A. While you waste away, your body cannibalizes itself: It consumes its own muscles, even the heart.

Yet Abdo Sayid, a 4-year-old boy so emaciated he weighed just 14 pounds, wasn’t crying when he was brought to a hospital recently in Aden, Yemen. That’s because children who are starving don’t cry or even frown. Instead, they are eerily calm; they appear apathetic, often expressionless. A body that is starving doesn’t waste energy on tears. It directs every calorie to keep the major organs functioning.

Abdo died soon after arriving at the hospital. A photographer named Giles Clarke, a friend of mine whom I met on my last trip to Yemen, was there again and captured the scene.

His photographs are painful to witness, but many families, including Abdo’s, allow photography — indeed, want photos to be circulated — because they hope that the world will understand that children are dying needlessly of hunger, and that help is desperately needed to avert more child deaths.

The world had pretty much licked famine, until 2020. The last famine declared by United Nations authorities was in a small part of South Sudan for a few months in 2017 — but now the U.N. warns that famine is looming in Yemen, South Sudan, Burkina Faso and northeastern Nigeria, with 16 other countries slightly behind in that trajectory toward catastrophe.

“Famines are now back,” said Mark Lowcock, the U.N. humanitarian chief. “It will be a horrible stain on humanity for decades to come if we become the generation to oversee the return of such a terrible scourge. This is still avoidable.”

We have been privileged to live in a thrilling epoch in history in which child mortality has plunged, disease and famine retreated, literacy soared and human well-being skyrocketed.

At this time of the year I normally counter all my gloomy columns by writing that the previous year was the best in human history, by such metrics as the share of children dying by the age of 5. But 2020 was not the best year in human history. It was an annus horribilis, and UNICEF warns that the result may be 10,000 additional children dying each month from hunger.

The setback in developing countries has been exacerbated by passivity, paralysis and indifference in the United States and Europe, and in international organizations like the World Bank.

The biggest cause of the global crisis is the coronavirus pandemic, but only indirectly. Outside of the rich world, the casualties are not octogenarians with the virus so much as children dying of hunger because of economic disruptions, or middle-aged adults dying of AIDS because they can’t get medicines.

The capital of human suffering today is arguably Yemen, which the United Nations calls the world’s worst humanitarian crisis. As we celebrate the new year, Yemeni children like Abdo are dying of hunger.

Yemen’s suffering is complicated. Always poor, the country has been shattered by a war and blockade by Saudi Arabia, with backing from the United States under both the Obama and Trump administrations. (Obama officials have acknowledged, not as candidly as they should, that this was a mistake.) Misrule by the Houthi faction, backed by Iran, has compounded the suffering, as have both cholera and the coronavirus — and donor countries are focused on their own problems and averting their eyes.

So Abdo died.

If you simply look at coronavirus numbers, you might think that poor countries had dodged a bullet. Developing countries have generally avoided high mortality from COVID-19, particularly in Africa.

But that may be changing with a tide of new infections, and in any case the indirect effects have been devastating, so that a pandemic of a coronavirus has been followed by pandemics of hunger, disease and illiteracy. Lockdowns meant that casual laborers had no income, and tuberculosis patients couldn’t get medicine. Campaigns to battle malaria, polio, AIDS and vitamin A deficiency were left in disarray.

The repercussions are endless. The United Nations warns that poverty and disruptions from the pandemic may push 13 million additional girls into child marriages. Disrupted campaigns against female genital mutilation may result in 2 million more girls enduring genital cutting, the U.N. said, while reduced access to contraception may lead to 15 million unintended pregnancies. The World Bank says an additional 72 million children may be pushed into illiteracy.

“We are increasingly talking about a lost generation, whose potential may be permanently quashed by this pandemic,” said Angeline Murimirwa of Camfed, which supports girls’ education in sub-Saharan Africa.

An expert panel crunched the numbers and estimated that under even a “moderate” scenario of what lies ahead, an additional 168,000 children will die from malnutrition because of the consequences of the coronavirus. Think about that: Abdo times 168,000.

Many others will survive, but with lifelong intellectual impairment, or in some cases permanent blindness, caused by deprivation in 2020 and 2021. This toll is worsened because of indifference in the rich world.

“The magnitude of the problem is an outrage, but it is even more outrageous that there are powerful, proven solutions that are not being delivered at scale,” said Shawn Baker, the chief nutritionist at the U.S. Agency for International Development.

Some poor countries will be able to vaccinate at most one-fifth of their populations in 2021, suggesting that the pandemic will continue to ping around the globe and smother poor countries. Partly that’s because the United States and other rich countries, at the behest of the pharmaceutical company lobby, refuse to waive patent protections to allow poor countries access to cheaper vaccines.

Gayle Smith of the One Campaign calls for three kinds of measures to help: greater efforts to distribute the vaccine globally, debt relief and assistance from wealthy countries.

The paradox is that 2020 may still be one of the five best years in human history, by such measures as the share of children dying or the proportion of people living in extreme poverty. If the world moves aggressively to address the crisis, the year could be remembered as a blip. But the nightmare is a prolonged crisis in poor countries and a turning point — on our watch — that ends the march of progress for humanity.

Nicholas D. Kristof | The New York Times (CREDIT: Damon Winter/The New York Times)

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