New York Times July 13, 2003

Why People Still Starve

July 13, 2003

By BARRY BEARAK

Late one afternoon, during the long melancholia of the

hungry months, there was a burst of joyous delirium in

Mkulumimba. Children began shouting the word ngumbi,

announcing that winged termites were fluttering through the

fields. These were not the bigger species of the insect,

which can be fried in oil and sold as a delicacy for a good

price. Instead, these were the smaller ones, far more wing

than torso, which are eaten right away. Suddenly, most

everyone was giddily chasing about; villagers were catching

ngumbi with their fingers and tossing them onto their

tongues, grateful for the unexpected gift of food afloat in

the air.

Adilesi Faisoni was able to share in that happiness but not

in the cavorting. For several years, old age had been

catching up with her, until it had finally pulled even and

then ahead. Her walk was unsteady now, her posture stooped,

her eyesight dimmed. As the others ran about, she remained

seated on the wet ground near the doorstep of her mud-brick

hovel. It was the same place I always found her during my

weeks in the villages of Malawi, weeks when I was examining

the mechanisms of famine. ''There is no way to get used to

hunger,'' Adilesi told me once. ''All the time something is

moving in your stomach. You feel the emptiness. You feel

your intestines moving. They are too empty, and they are

searching for something to fill up on.''

Hunger was the main topic of our talks. Most every year,

Malawi suffers a food shortage during the so-called hungry

months, December through March, the single growing season

in a predominantly rural nation. Corn is this country's

mainstay, what people mainly grow and what people mainly

eat, usually as nsima, a thick porridge. Ideally, the yield

from one harvest lasts until the next. But even in good

times the food supply is nearing its end while the next

crop is still rising from the ground. Families often endure

this hungry period on a single meal a day, sometimes

nothing more than a foraged handful of greens. Last year's

food crisis was the worst in living memory. Hundreds, and

probably thousands, of Malawians succumbed to the scythe of

a hunger-related death.

Among those who perished were Adilesi's husband, Robert

Mkulumimba, and their grown daughter Mdati Robert, herself

the mother of four young sons. The two died within a month

of each other, unable to subsist on the pumpkin leaves and

wild vegetables that had become the family's only

nourishment. ''The first symptom was the swollen feet, and

then the swelling started to move up his body,'' Adilesi

said of her husband's illness.

It was strange the way Robert seemed to fade. Before the

start of the hungry months, it had been he who had kept the

family going, leaving before dawn each day to sell firewood

or tend someone's fields. But then work became impossibly

scarce, and Robert seemed to be using himself up in the

search for it. ''At the peak of the crisis, there was

nothing to do but beg, and you were begging from others who

needed to beg.''

As most people visualize it, famine is a doleful spectacle,

the aftershock of some calamity that has left thousands of

the starving flocked together, emergency food kept from

their mouths by the perils of war or the callousness of

despots or the impassibility of washed-away roads. But more

often, in the nether regions of the developing world,

famine is both less obvious and more complicated. Even

small jolts to the regular food supply can jar open the

trapdoor between what is normal, which is chronic

malnutrition, and what is exceptional, which is outright

starvation. Hunger and disease then malignly feed off each

other, leaving the invisible poor to die in invisible

numbers.

Nowhere is this truer than in sub-Saharan Africa, where

President Bush was recently scheduled to travel. Each year,

most nations in the region grow poorer, hungrier and

sicker. Their share of global trade and investment has been

collapsing. Average per capita income is lower now than in

the 1960's, with half the population surviving on less than

65 cents a day. It is a situation seldom noticed, as wars

on poverty are neglected for wars more animate. African

countries now hold the 27 lowest places on the

human-development index -- a combined measure of health,

literacy and income calculated by the United Nations. They

occupy 38 spots in the bottom 50.

During the past decade or so, the poorest of Africa's poor

have suffered as rarely before. Merely to survive, they

have sold off their meager assets -- household goods and

farm animals and the tin roofs of their homes. Just now,

the most urgent need is in Ethiopia, Eritrea and Zimbabwe.

But hunger has become a chronic problem throughout the

region, often occurring even under the best of weather

conditions. The World Food Program warns that nearly 40

million Africans are struggling against starvation, a

''scale of suffering'' that is ''unprecedented.''

Coincident with the hunger is H.I.V./AIDS, which has beset

sub-Saharan Africa in a disproportionate way, cursing it

with 29.4 million infections, nearly three-quarters of the

world's caseload. Very few of the stricken can afford the

drugs that forestall the virus's death work, and family

after family is being purged of its breadwinning

generations, leaving the very young and the very old to

cope.

With survival so precarious, life is lived at the edge of

nothingness, easily pushed over the side. Take Malawi, I

was told again and again -- for this land-locked,

overpopulated nation in southeastern Africa seems to be a

favored specimen of researchers. There is a relative

innocence to Malawi's impoverishment: no tyrannical

dictator currently in power, no army of goons marauding in

civil war, no disastrous weather wiping out the harvest.

And yet last year, the nation was nudged into starvation.

It happened while there was grain in the stores, if only

the poor had the money to buy it. It happened while

well-meaning people were arguing about whether it was

happening at all.

To track the origins of the crisis, my plan was this: to

find a family that had lost someone to last year's hunger

and then work my way back through the hows and whys. Though

I mostly shuttled over the narrow and soggy mud roads

between Mkulumimba, Adilesi's village, and Lilongwe, the

capital, the actual route of causality reaches beyond

Malawi's borders. It extends toward wealthier nations and

their shared institutions -- the World Bank and the

International Monetary Fund. It travels the uncertain ups

and downs of global commodity prices and currency

valuations -- and of course passes into the limited access

roads of humanity's conscience.

"The new generation are the unfortunates, because now there

is a food shortage every year,'' Adilesi said. ''Things

began getting bad when I was done with my childbearing

years. If they had been this bad before, all my children

would have died.''

In a Malawian village, guests are customarily greeted

outside and offered a mat as a seat. Adilesi's front door

faced a broad clearing that slanted down, allowing a

splendid view of cornfields and acacias and the Dzalanyama

Mountains in the distance. About 20 yards to the left was a

banana tree and the ruins of an outhouse, its mud walls

half-collapsed by a recent storm. The main house itself was

a single room, about 9 feet by 12 feet, with a roof of

bundled grass. In one corner were the ashy remnants of a

small fire. Otherwise, the room was empty but for a tin

pail, two pots, a few baskets and plastic bowls and some

empty grain sacks that could be used as blankets. Adilesi

lived in this hut with her daughter Lufinenti and 10

grandchildren. It was hard to imagine the geometry that

would allow them all to sleep in so spare a space.

''We squeeze like worms,'' Adilesi said, explaining rather

than complaining.

Thin-faced and withered, the old woman owned only one set

of clothes, a colorful wrap that went around her waist and

a faded T-shirt that showed a San Francisco street scene

and advertised Levi's 501 jeans. The lettering proclaimed,

''Quality Never Goes Out of Style.'' She had no idea what

the words meant. ''Is this something offensive?'' she asked

in Chichewa, Malawi's main language, bending her head down

so she could examine the thinned cloth. The villagers all

bought such used clothing, the discards of people from

richer nations. Children who had never seen television

unwittingly sported apparel that allied them with Ninja

Turtles and Power Rangers. Often, holes in these shirts

rivaled the size of the remaining garment. This shamed the

children, and some refused to go to school. ''I have no

idea what San Francisco is,'' Adilesi said with a smile,

repeating the words she had just been told. ''I couldn't

tell you whether it's an animal or a man.''

She did not know her age, either, but she could remember

the historic famine of 1949. She was a youngster then, that

year when the skies cruelly withheld the rains. The

undisturbed sun not only parched the cornstalks; it seemed

to melt the glue that held the village together. Neighbors,

once generous, hid away what food they had, afraid of

theft. Women sang prayers of apology to their ancestors for

any conceivable wrongdoing and begged them to reopen the

clouds. Men wandered far from their homes, disappearing for

weeks in a desperate search for work. ''We refer to it

simply as '49,'' Adilesi said.

She married Robert soon after. She can't recall exactly

when. Robert was a nephew of the village chief, and their

wedding was preceded by an evening of dancing, with the

entire village sharing in a feast of two goats, several

chickens and homemade beer. Vows were recited at the

African Abraham Church nearby. Adilesi would later bear 12

children, including 8 who lived to be adults -- an average

rate of survival in a country where half the children

suffer stunted growth and one in four die before age 5.

Robert, tall and stout, was a good provider. As a young

man, he went to South Africa and toiled in the mines. Then,

back in Malawi, he worked for the forestry department,

slashing away underbrush with his panga knife. In a village

of farmers, he was one of the few men who carried home

monthly paychecks. But that job ended four years ago, when

the government, under pressure from foreign lenders,

drastically reduced its payroll. Robert then spent more

time farming and doing ganyu, day labor.

Toward the end of 2001, after an overabundance of rain and

a disappointing harvest, corn prices leapt as high as 40

kwacha per kilo, about 50 cents, a forbidding sum for

people used to paying a tenth as much. Foraging became

necessary, as it had been in '49, as it was last year, as

it is even now. The toil was not unproductive. In the

openness of the plain, with the daily rain slapping hard at

the mud, edible leaves reached out for the taking from

small stems. They held vitamin C, some iron, some beta

carotene. Occasionally there were tubers. People could eat,

just not a balanced diet, just not enough.

Hunger, like many diseases, is often an abettor of death

rather than an absolute cause. Who really knew: was it the

tuberculosis or the malnutrition that came first, and which

of them delivered the fatal blow? But symptomatically,

starvation usually arrives with anemia and extreme wasting

and swelling from fluid in the tissue. There can be loss of

appetite, and there can be diarrhea. Robert suffered all

these symptoms. That a grown man would be among those to

succumb to the hunger was not so uncommon. Men, it was

explained to me, used up more of themselves in the

unceasing search for ganyu.

Whatever the undertow, Robert grew too weak to work. He and

Adilesi went to the government hospital, where he was

treated for malnutrition, then later treated for malaria,

then sent home. When they released him, the doctors said he

needed to eat better or he would die. Inevitably, there was

little food, so he began his capitulation, imparting final

goodbyes. ''He told me we needed to remain united as a

family,'' said Kiniel, 16, the youngest of his children.

Robert's daughter Mdati fell ill soon after he went into

his decline. She was about 30. Her husband had been a

philanderer to whom she had said good riddance, and now she

was suddenly incapable of caring for their four sons

herself. The entire family had always depended on her.

Mdati was the only one who could read and write. ''She went

to school up to the second grade,'' said her sister

Lufinenti. ''She was very smart.''

Unlike her father, Mdati couldn't keep food down when she

found something to eat. This raised a suspicion that she

had somehow been bewitched.

The family regularly attended the African Abraham Church, a

tiny red-brick building with pews and an altar molded out

of mud. As with most Christians in the area, they found

ways to blend witchcraft into their beliefs. ''Some people

protect their fields with charms, but we can't afford such

things,'' Adilesi told me. This safeguard against thievery

required the intercession of someone with magical powers, a

sing'anga. (My interpreter -- the daily intermediary

between my English and the villagers' Chichewa -- used the

word ''witch doctor,'' though a more respectful term would

be ''traditional healer.'') The family had great hopes that

a sing'anga could break the spell that gripped Mdati. They

took her to two of them.

The first, Bomba Kamchewere, is a tall, bony man with a

missing front tooth. When I visited him, he spread out a

mat of tightly stitched reeds so we could sit together

beneath his favorite tree. He had been tutored, in dreams,

by Jesus himself, he said. But even with divine insight

into the curative uses of roots and herbs, his powers had

limits. While he claimed to cure stomachaches, venereal

disease and tuberculosis, he confessed that other

sicknesses baffled him. AIDS was particularly confounding,

as was njala, or hunger, which had been Mdati's problem.

''With her case, the spirits told me I could not do

anything,'' he said. Then, somewhat shamefully, he

confessed that around that time he himself had endured

njala, quite frighteningly so. ''I went three weeks without

any solid food, and I developed some strange swelling.'' At

a hospital, the doctors recommended that he eat more, which

was advice that struck the sing'anga as less than a

revelation.

Mose Chinkhombe, a young, self-confident man with a

spacious smile, was the second healer. His home was hours

away in the village of Chiseka. To get there, the starving

Mdati, limp as a rag doll, had to be placed on a borrowed

bicycle and guided over the roads by five companions, who

took turns keeping both her and the wheels steady.

A year later, the healer still remembered her. ''My

diagnosis was anemia,'' he said as he sat in a dark room on

a half-sack of dried lime, all the while shooing flies with

an oxtail. He was in his vocational attire, a spotless

white frock and floppy hat. ''She was so weak from lack of

food,'' the healer said. ''I could treat her for this

anemia. But I told her she needed to eat enough food to

recharge her body. When she left, she had improved

slightly. But then I heard she died.'' He nodded rather

forcefully as he said this. Then, perhaps in defense of his

medical craft, he apparently felt he needed to tell me the

obvious, that the ''big hunger'' had taken a great many

lives during those dismal months.

There is a belief that when a stray black dog crosses your

path, terrible times will come, he said. ''Last year,'' he

explained, ''a black dog walked across the entire

country.''

Some 11 million people live in Malawi, though far too few

live especially long. Average life expectancy from birth