Fighting a famine

There are very few situations today in which a famine can be considered a purely "natural" disaster. Drought, flood and other environmental factors can of course lead to food shortage, but there are almost always human forces at work as well - such as war, forced displacement of populations, or sabotage of agriculture by the use of land mines. Helping a population survive a famine thus requires far more than simply setting up feeding centres for malnourished children. The causes of the situation must be addressed, as the same things that caused the famine in the first place will also be working to hamper the relief operation. The role of MSF is one of advocacy - which means that we use our international contacts and credibility in order to try to convince governments, rebel groups and organisations to allow free access of humanitarian aid to the affected civilian population. This does not always work, however. The political obstacles are often the most difficult to overcome. Even now, when the world has the technology and resources to ensure that no person need ever go hungry, the spectre of famine still haunts many war-affected countries. Once access to the affected population has been negotiated, the first priority is to ensure an adequate general food distribution. Usually, the minimum energy requirement of a population is an average of 2,100 kilocalories per person per day. This means about 600 grams of food per person per day. For a population of 100,000 people, the logistics of a food aid operation must therefore be up to providing 1,800 tonnes of food each month. In good conditions this may be possible, but if trucks are in short supply, or if rains have washed out bridges, or if warfare makes roads too dangerous to use, a life-threatening food shortage can easily occur. In most emergency situations it is one of the United Nations agencies, usually the World Food Programme (WFP), that is responsible for the general food distribution. A typical ration comprises a carbohydrate staple (such as rice or maize), a source of protein (such as lentils or kidney beans), and on oil, to give a concentrated source of calories. Ideally, small quantities of salt and sugar are also given, to improve palatability. MSF recommends that families should also be given a blended food, being a mixture of various flours and milk powder, which are useful for making a nutritious porridge for small children.