In a dust-blown clinic on the southern edge of the Sahara desert, scores of women crowd into a bunkerlike structure, clutching children with emaciated limbs and listless eyes. They have come to have their babies weighed. It is a tradition known to every parent. Here, the tradition has become a nightmare.
The medical staff take an infant named Bintow from the arms of his mother and place him in a black harness attached to a hand-held scale. He shrieks at the sudden discomfort, thrashing his arms and legs. His stomach bulges, all of his ribs are visible. The child is 10 months old. He weighs 9 pounds.
Bintow is lucky, as far as it goes. He is so badly underweight that he will receive an emergency ration: two weeks' worth of enriched cornmeal and oil. Only a third of the estimated 200 children at the center that day will receive care. There is simply not enough to go around.
"People get upset, but we can only help a few of them," said the head of the feeding center, Ibrahim Chalaré of the British charity Islamic Relief. Like most aid organizations, his center depends on international donors to feed the hungry children waiting outside. They do not have nearly enough. The numbers coming to the center have already doubled from the month before, he said.
Nearly 3 million of Niger's 12 million people currently face acute malnutrition. Most of them are children. In some areas, emergency feeding centers are already admitting 1,000 children a week. Childhood hunger is a perennial problem in this landlocked country on the southwestern edge of the Sahara; however, it is very unusual to be seeing so many acute cases so close to the harvest season. The hunger season has come early.
This will be news to most Americans, who, if they've heard of Niger at all, know it only for its unwitting role in last year's "Plamegate" scandal. The West African nation, one of the poorest in the world, made a rare media appearance after the Bush administration claimed -- falsely -- in the run-up to the Iraq war that Saddam Hussein had attempted to buy uranium there.
Today, despite the looming food shortages, Niger has passed again into obscurity.
In fact, the current crisis is a holdover from last summer, when images of starving babies from Niger were seen briefly on television screens across the U.S. and Britain. The ongoing hunger crisis in Niger is not due to war, a crazed dictator or a natural catastrophe. The problem is more straightforward: prolonged and severe poverty. This means that even a relatively small shock can leave millions on the verge of disaster. That is what happened in 2005, when a mild drought and locust infestation left more than 4 million people facing death and debilitating malnutrition. Aid agencies had been warning of an approaching hunger crisis for six months beforehand, but it wasn't until the correct visuals were displayed -- pictures of starving babies -- that the world took notice and the U.S. and other rich countries suddenly started sending money and food.
But a month later, Hurricane Katrina knocked Niger out of the news cycle. The donations disappeared as quickly as they'd arrived.
Call it the 15-minutes-of-fame cycle of starvation.
Severely weakened and indebted from last summer's near-famine, millions of rural people -- especially children under 5 -- are once again in dire straits. Both American and European aid officials saw it coming but did little to stop it. By this May, the United Nations' emergency food agency, the World Food Programme, had collected only $14 million of the $37.3 million necessary to continue its feeding programs. Now this year has brought more drought, crop failure and famine. "Children are already falling into acute malnutrition. The aid money and food will arrive too late," said Johanne Sekkenes, who heads the Medecins Sans Frontieres operation in Niger. Last year, MSF had its largest infant therapeutic feeding program ever in Niger -- a striking fact, given that the organization usually operates in war and disaster zones.
It is not just Niger. Across Western and Southern Africa, more than 16 million people are currently facing starvation or debilitating malnutrition. Most of them are children. Once again, the hunger in these countries is not simply a result of the war, natural disaster or despotism that most Americans equate with Africa. The main culprit is apathy. Rich countries, including the U.S., simply do not fund the food-stability and long-term development aid programs that would help bring these people back from the brink of catastrophic hunger.
If this is news to you, it's no coincidence. Based on pure numbers of lives affected vs. column inches, this was easily the most under-reported story of 2005. It is already shaping up to be the same in 2006. Every day, according to the World Food Programme, 25,000 people die of hunger around the world. So far this year, more than 3.5 million have already died from a lack of food and the illnesses that come with it, like diarrhea.
Hunger is not a constant. It is expanding dramatically. At the beginning of the decade, 334 million were in extreme poverty. According to the most current estimates, that number will rise to 471 million by 2015.
The problem, say development experts, is that the percentage of people without the basic means to support themselves has snowballed. Developed countries don't pay much attention until a tidal wave hits. Meanwhile, the more mundane condition of extreme poverty has been allowed to fester.
The United States, the world's largest donor, spent $1.4 billion in emergency aid in Africa last year, but only one-tenth that much in long-term development. "The system of foreign aid is very political," said Andrew Natsios, the former administrator of the U.S. Agency for International Development. "Does it make sense? No."
The lack of attention to the crisis is a reflection of the apathy by the public, media and governments concerning the No. 1 cause of death in the world.
Hunger results in more deaths than HIV, malaria and tuberculosis combined. About three-quarters of the 25,000 people who die a day from hunger are women and children. Yet hardly anyone seems to be paying attention.
"We're afraid that Africa's food crises are becoming accepted as 'normal,'" said James Morris, who heads the World Food Programme, in a speech before the U.N. Security Council in 2005. Most African countries received less than half, and sometimes only 10 percent, of the emergency food aid they requested from rich countries.
It is often worse for a starving child to live in a country at peace and with a stable government, because war-torn countries attract most of the funding, said Morris. The hundreds of millions suffering from simple poverty are overlooked. Meanwhile, sites of horrendous conflict like Darfur, in Sudan, receive media attention, but usually only of the "it's horrible and there's nothing we can do about it" kind.
But in the case of peaceful Niger, and its neighbors in Western and Southern Africa, there is something that can be done -- and relatively cheaply, at that. In the seven countries in Southern Africa facing a hunger crisis, for instance, the WFP needs $637 million to feed Southern Africans for the next three years. So far it has only half that amount. The absence of that money is catastrophic: In Zambia, food distributions were halved in the week before Christmas.
To put these millions of dollars in perspective, the cost of the occupation in Iraq is more than $150 million a day. So five days of war, a work week, would feed more than 12 million people for three years. Instead, over the last few months the Bush administration has reneged on about $100 million that it had promised to food aid charities.
The money is there to be spent. But American priorities are focused more on fantasy than on reality. Consider: The Pentagon recently allocated $300 million to fund a propaganda operation to plant news stories favorable to America in the foreign press. Yet if that money had gone to food and development programs, there would be no need for propaganda programs.
Why is it important for the WFP and other relief organizations to receive funds before a hunger crisis is full blown? To break the cycle of hunger. If the funds the WFP asked for had arrived in time, they could have been used to intervene in the crisis before hunger became widespread and even to help people become self-sufficient. Much of the money would have gone to help farmers buy seed and fertilizer for the coming harvest season. The rest was supposed to provide for vitamin supplements for severely malnourished infants and nursing mothers, feed children in hundreds of schools, and provide for emergency drugs and rehydration solutions for hunger-related diseases, especially cholera.
It is not food alone that Africa needs, but without it, massive problems like HIV/AIDS are made even worse. While HIV/AIDS has finally received badly needed attention, the indifference to providing food undermines much of the work that is being done to combat the disease. Retroviral drugs are at last available in Africa, but without proper nutrition they do little good.
"You can be talking [about adding] another eight or 10 years to people's lives with decent nutrition and basic medical care," says Dan Mullins, a WFP worker in West Africa. "If you are talking about adults with young children, it makes the difference between dying when your child is 8 and when they are 14."
Without assistance, chronic poverty snowballs, and hunger with it, says Dr. Edward Clay, a senior researcher at the Overseas Development Institute in London. Year after year, he said, "people are that much more vulnerable. The underlying problem is the insidious growth in poverty."
Niger is a case study for this dynamic. Despite a record harvest in the fall, millions of families are again facing food shortages because the food crisis last year forced them to sell off livestock and go into debt to stay alive. By this spring millions of villagers had already exhausted their food stocks. Down the road from the feeding center, a village elder said that in the aftermath of the shortages last year, grain prices are already double what they normally were at this time. "We don't have any stored-up food," he said, displaying a nearly empty grain bin.
When asked why they had not given more food aid in the face of the oncoming crisis, American and European officials in Niger say that food aid should only be a last resort. It is far more effective, they said, to give money for long-term development.
Unfortunately, this rhetoric does not reflect reality. Foreign aid from rich nations goes almost entirely to military support or disaster relief. Little attention is paid to the aid programs that would help Africans head off catastrophe. In the crucial months before a hunger crisis peaks, food aid is almost completely ignored.
Emergency relief often seems to benefit the donors more that the beneficiaries. As with most things in the twisted world of international famine relief, the term "food aid" itself is duplicitous. The United States, for instance, gives by far the most food aid of any country. But that's not quite what it seems. While most of the world gives aid agencies cash that they use to buy food locally, 99 percent of the food aid provided by the U.S. is purchased from American farmers at market prices and is then shipped overseas on U.S.-registered vessels. (The vast majority of container ships are registered in countries like Liberia and Panama; the U.S.-registered container ships used in the feeding program are almost an anachronism, kept alive in part because of this aid program.)
By general consensus, U.S. food aid is inefficient and overpriced, and can be damaging to the African economy. The Financial Times called the American type of assistance "a subsidy programme for rich world farmers," such as American agro-giants Cargill and Archer Daniels Midland. According to the Organisation for Economic Co-operation and Development, based in Paris, this kind of direct food aid can take five months or more to arrive and costs 50 percent more than if the assistance had been given as cash used to buy food locally; also, it tends to undercut local markets. If the assistance had been provided as cash, it would have added $750 million to the approximately $4 billion in food aid already donated by rich countries.
Under increasing pressure to reform its food-only aid approach, last year the Bush administration tried to get Congress to pass legislation allowing for one-fourth of American emergency assistance to be delivered in cash instead of as processed crop purchases. Andrew Natsios, former head of the USAID, argued passionately for the legislation, saying that the U.S. would be able to provide twice as much food for the same money because of the savings on transportation alone.
But even with the administration behind it, the proposal went nowhere. It was killed by agribusiness, the shipping industry and the farm-state congressmen who control food aid. The chairmen of the committees, Sen. Saxby Chambliss, R-Ga., and Rep. Bob Goodlatte, R-Va., received nearly $1 million and $500,000, respectively, from agricultural interests. Ironically, they had lobbying assistance not only from agribusiness giants and shipping companies, but also from charity aid agencies such as Catholic Relief Services and CARE. Why? Because the aid agencies sell much of the food they receive to pay for other programs such as healthcare and development assistance that they provide to impoverished nations. Once food aid goes from being backed by special interests and becomes a normal budget line item, it is that much likelier Congress will cut it.
It was a "coalition of self-interest," said Ed Fox, the head of legislative affairs for USAID.
Jeffery Sachs, the eminent economist who heads Columbia University's Earth Institute, echoes the views of many experts globally who believe the money is there to break the cycle of hunger in Africa, but that the funds are misdirected. "Africa alone in the world lives and dies on food aid because its agriculture is broken, and the donors have contributed to that," he said. The first step, according to Sachs, is to provide food aid before people start starving, and to give them the resources to help them provide for themselves.
The world's richest countries could prevent these recurrent crises with aid directed toward helping the poor grow the food they need to live, by providing subsidized seed, fertilizer and irrigation. "They say we are against subsidies, we are for the market approach. It's absurd, it's cruel, and it's the most inept misapplication that I've seen. These people do not know what they are doing on the ground, and it's a disgrace," said Sachs.
Another key factor, much neglected, is education, especially for women. Literacy rates in Niger are among the lowest in the world. More than half of girls have had no school; only 9.4 percent of women are literate. "If girls go to school, they will have less children, better jobs, and less disease," said Carol Añonuevo, a senior researcher at the UNESCO Institute of Education who is conducting a study of sub-Saharan Africa.
Another development specialist, Peter Timmer, notes that Africa has never received the kind of long-term agricultural development assistance that helped reduce poverty in Asia and Latin America in the 1960s and 1970s. "Neither the donors nor the countries themselves have tried that kind of massive investment in rural economies," said Timmer, who taught development economics for two decades at Harvard. While the U.S. spends hundreds of millions on emergency food aid in Africa, it only devotes a small fraction of that to long-term development. "That's a crazy set of priorities," he said.
What is needed is a mix of both emergency aid -- to feed people before they become acutely malnourished -- and long-term agricultural development assistance, so they can provide for themselves. What does long-term development look like? Here's one case study: The Red Cross gave small cash grants to 5,000 households in 88 villages. The women to whom the money was given used it to buy food, pay off debts and buy livestock and clothes. In one village, the women pooled their money to buy an ambulance to get to the nearest health center, which was otherwise a several hours' walk through the desert. The "ambulance" was a donkey cart. At least it did what it was supposed to do.