Last year 200 million children did not get enough to eat, yet it would be cheap and easy for the world to feed them all
Swing both arms up and clap your hands. Arms down and up. Clap! Down and up! Clap! You are singing all the while or, in my case, humming as I move my hips to the beat of the song and the clapping and dancing. Every once in a while, the beautiful young Malawian woman next to me has to stop with laughter. Literally, she has to stop dancing so she can rest her hands on her knees, bend over, and laugh. She seems to be laughing both at me and with me – this grey-haired white woman clapping and dancing.
That October 2016, I was with the director and co-director of Soils, Food and Healthy Communities (SFHC), a nonprofit group working with this village in northern Malawi. Their goal is to reduce childhood malnutrition through sustainable agriculture. Laifolo Dakishoni, Lizzie Shumba and I had been met on a dirt road by some dozen women wrapped at the waist by the brightly coloured chitenge of southern Africa, and an equal number of men in trousers and shirts, all singing, clapping and dancing a traditional greeting.
On my part, I had been urged to join in. Join in, they had said. I love to dance. So I did.
In 2000, SFHC began as an alliance between staff members at the nearby Ekwendeni Mission Hospital and social scientists in Malawi and Canada. Malnutrition was distressingly high among this area’s smallholder farmers, who suffered from drought, the AIDS epidemic, and a withdrawal of government subsidies. The lack of government programmes, which had once included cheap chemical fertilisers and pesticides, could be traced to the International Monetary Fund’s demand that Malawi reduce social services so as to repay its international loans.
Malawi was and still is one of the poorest countries in the world. Some 80 percent of the population grow their own food on small plots of land. More than 80 per cent do not have electricity. According to the World Bank, the annual GDP per capita is $637, compared with the world’s current annual GDP per capita of $10,918. But Malawi has also pioneered historic research in the prevention and treatment of childhood malnutrition and is home to many successful programmes like SFHC. I have been interested in the subject of hungry children for more than 30 years. This can be traced to the birth of my daughter, when I became the mother of all children, feeling that aggrandizement and joy. Surely if I have one job in life – if we have one job as a species – it is to feed our children.
Yet one in four of the world’s children under five are damaged physically and mentally due to a lack of food or nutrients. A quarter of the world’s children. We know this because the World Health Organization (WHO) makes a valiant effort to record the height and weight of children under the age of five. Almost all children, no matter their race or ethnicity, follow the same growth pattern in their first years of life. Genetic potential – what makes one person tall and one person short – kicks in later. Beginning in the womb, the body and brain grow rapidly and have a high need for nutrients. Without nutritious food, a period of faltered growth will result in a condition called stunting – below the standard of height set by WHO. Stunting is considered irreversible. A stunted one-year-old becomes a stunted 10-year-old becomes a stunted adult.
Stunting is shorthand for a range of problems: impaired immune system, impaired organ function, impaired cognition. Stunted children are sick more often. They may have learning disabilities or cognitive problems. They may have emotional problems. They do less well in school. They do less well at work. Later in life, they are more at risk for diabetes, heart disease, stroke and obesity.
A stunted child is too short for her age. A wasted child – another terrible term – is too thin for her height. Anyone can become wasted at any age if deprived of food. The body begins to cannibalise itself, eating up any remaining fat, eating muscles and parts of organs to feed other more essential organs, raiding vitamins and minerals from one part of the body to give to another. The body gets smaller. The heart gets smaller. The body begins to disappear.
In 2021, WHO estimated that 149 million of our young children are stunted and another 45 million wasted. (Some 39 million children under the age of five are overweight, which is now seen as a form of malnourishment.) Most undernourished children live in Africa or Asia. Most live in rural areas. Most live in relatively peaceful countries.
The problem isn’t enough food. The world has plenty of food. The problem is poverty, sexism, racism, tradition, disease, lack of sanitation, war, conflict, politics and more. The complexity of all that can seem overwhelming.
For every $1 spent on nutrition, society gets back an average of $16
And so familiar. Hunger has been with us forever. Four thousand years ago, someone made the striking comment on the tomb of the provincial governor Ankhtifi: ‘All of Upper Egypt was dying of hunger to such a degree that everyone had come to eating their children.’ In 585 BCE, the Biblical famine of Jerusalem made a vivid impression: ‘Their visage is blacker than a coal; they are not known in the streets; their skin cleaveth to their bones; it is withered, it is become like a stick.’ In the 19th century, an eighth of the people in Ireland starved to death or died of disease. In the 1980s, the world saw a series of famines highlighted on television, the images of skeletal children seared into our global consciousness.
That familiarity can work against our capacity for change. The good news is that the 21st century has seen a revolution in how we prevent and treat childhood malnutrition. After considerable trial and error, beginning with the efforts that followed the Second World War, we now know what to do and how to do it.
Putting aside our first visceral response – these are our children – we also know why we should. For every $1 spent on nutrition, society gets back an average of $16. Twice, in 2008 and 2012, economists at the Copenhagen Consensus declared that feeding mothers and children was our single best social investment. The World Bank, too, has done unnerving cost-benefit analyses that include the return in productivity when we give them Vitamin Aand the economic boost of reducing anaemia in young women. Overall, reducing childhood malnutrition means significant savings in health costs and an uptick in GDP.
Environmentally, a healthy Earth requires healthy children. Reducing child death and malnutrition is directly related to reducing population growth: when parents know their children are going to survive and flourish, they tend to have smaller families. Moreover, helping smallholder farmers feed those families is all about a sustainable agriculture that mitigates rather than increases the climate crisis. Biodiversity is also connected to malnutrition; wildlife thrives only when the people living next door to wildlife are thriving, too. The goals of the humanitarian and the environmentalist are aligned.
Of course, the COVID-19 pandemic has made everything worse. Suddenly, we have more hungry children now. But the pandemic has also taught us the importance and relative ease of spending money on global health. The pandemic could, if we choose, be a catalyst for change.[…]
Edited bySam Dresser
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