World Health Organization
13 June 2002
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The deadly equation
( Malnutrition + Poverty + food shortage )x HIV/AIDS x Diseases
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Access to health services
DEATHS
The Southern Africa humanitarian crisis represents a wake-up call. It is not just another
food crisis. It is an acute humanitarian emergency that has erupted over and above a
chronic crisis. Suddenly, more and more people are dying, more are becoming sick,
increasingly malnourished , and on the move. It is suddenly like a downward acceleration
of a slow process that had been going on for some time, about which we were but now
are not succeeding in stopping. And with one year after another year of erratic rains, poor
management and lack of preparedness and surveillance, we find ourselves confronted
with a humanitarian crisis.
With reduced rainfalls over two years, people have not produced enough maize which is
their main staple food. They have not been able to stock it, to exchange it for cash and to
purchase what they need. They have started to sell their goats and other assets… With
HIV/AIDS, productive adults in the household became ill, unable to work, needed
attention and costly medicines. Many died, leaving their children either alone or with
elderly grandparents. Widows could not cultivate land and could not feed the orphans and
the family more than one meal a day. Some people ate green maize, herbs and roots, and
have been drinking and cooking with unsafe water.
Eventually, many children, adults and pregnant women became ill with diarrhoea,
cholera, or malaria. When able to reach a health facility, they would be considered lucky
if they found a health worker to look after them properly and even luckier if they could
get some medicines to cure their illness. Health workers like many others, have moved
to places where the situation is better. Prices of maize when found, have risen beyond the
reach of nearly 70% of the population.
More pregnant women have died during child birth, unattended by trained staff. Many
are HIV positive and don't know it. Many babies are born small, underweight and
approximately half of the children in Malawi are stunted, short or have not grown
adequately because of chronic reduction in food intake. When their parents became too
sick, or because they were needed as an extra hand to bring in money or food to the
household, they dropped out of school and were forced into child labour, exploitation and
prostitution for girls.
Those who have not been fed properly for the past few months are more exposed to
diarrhoea, respiratory illnesses, malaria and tuberculosis. If HIV positive, they develop
AIDS quickly and become exposed to opportunistic infections. Hospitals are
overwhelmed, and health staff are overworked and badly paid. The system for the
detection of outbreaks has also suffered and the cholera outbreak was detected very late.
The people in Southern Africa are not just hungry. They are also suffering. More of them
are dying, dying in their homes, unable to get to a health worker to help them. The
children, the future population are becoming too weak and more vulnerable, with too
many responsibilities at an early age. We need to make sure that we can break the deadly
equation, reverse the trend, save and preserve as many lives as possible.