July 13, 2003
Why People Still Starve
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 has fallen to 36, one of the lowest figures anywhere, according to the World Health Organization. Tuberculosis cases have doubled in the past 10 years, and an estimated 16 percent of people ages 15 to 49 have H.I.V./AIDS, though with little testing going on, few of them know it. Nearly 500,000 children have lost one or both parents to the virus, according to the United Nations. In the villages, where AIDS is seldom discussed, people call it ''government disease,'' because it seems to spring from the city.
For the poor, conditions began rapidly deteriorating in the early 90's, during the last days of the ''Lion of Malawi,'' Dr. Hastings Kamuzu Banda, the Western-trained physician who was the nation's dictator for 40 years. Tobacco is Malawi's only major cash crop, and the doctor amassed a fortune by granting himself valuable licenses to grow it. At the same time, his government benefited from the foreign aid of prosperous friends. The West applauded his steadfast anti-Communism; South Africa admired his tolerance of apartheid. Banda ruled -- ruthlessly and myopically -- until 1994, long enough to take himself well into his 90's and senility.