Hungry Season

An Ethiopian mother and child wait for a health care worker to examine the child. Fifty percent of all Ethiopian children are chronically malnourished.

Entering a therapeutic feeding center for the first time is unsettling. Therapeutic feeding centers are for young children suffering from severe malnutrition. Three staff from Bread for the World Institute visited such a center in rural Ethiopia at the height of the “hungry season,” the period before the next harvest when food is most scarce. The center was a few hundred kilometers from Ethiopia’s capital city of Addis Ababa, and it was a Spartan environment. The room where the children were treated was bare except for blankets spread across the concrete floor. There were a dozen children there that day, their mothers sitting beside them. They had carried their children here on foot, some walking from more than 10 miles away.

At therapeutic feeding centers, children receive Plumpy’nut, a veritable miracle food that restores them to life. The peanut butter paste comes sealed in a foil package smaller than a Pop Tart. The mothers feed those strong enough to keep swallowing the Plumpy’nut, and these children soon have peanut butter smears on their chin and lips. If you view the scene out of context, it couldn’t be more timeless: a mother feeding her child. But this is a meal that most families are spared. The super-fortified food has only one purpose: to keep deathly ill children alive.

Small children can tolerate no breaks from the nutritious diet they need. Children under 2 are the most vulnerable of all to malnutrition. Malnutrition at an early age kills millions of children every year—it is implicated in a third of all deaths of children younger than 5—and leaves survivors with lifelong physical and mental disabilities.¹ Their suffering costs money too: countries with high levels of child malnutrition lose an estimated 2 to 3 percent of their Gross Domestic Product or GDP.²

What we see in a therapeutic feeding center are the grimmest cases. Malnutrition is pervasive in poor countries. In the villages where the children who come to this center live, it is likely that every boy and girl is chronically malnourished. The U.N. Children’s Fund (UNICEF) estimates that 50 percent of all Ethiopian children under 5 are chronically malnourished, meaning they lack adequate vitamins and minerals for good physical and mental development.³ As they grow up, they will be prone to illness, do poorly in school, and earn less income as adults than they would have otherwise, and then their own children face a higher risk of repeating this cycle.

Malnourished women give birth to malnourished babies. They also face an increased chance of dying during childbirth.⁴ Malnutrition increases the likelihood that a pregnant woman who is HIV-positive will pass the virus on to her baby.⁵ The World Health Organization estimates that 40 percent of women worldwide are iron deficient.

All women, not just those with children, are at risk when food is scarce. A 2009 study by the International Food Policy Research Institute (IFPRI) found strong correlations between malnutrition and gender inequality across the globe.⁶ Women suffer twice the rate of malnutrition of men. Nor are children spared: girls are twice as likely to die from malnutrition as boys.⁷

The U.N. Millennium Development Goals (MDGs), universally recognized benchmarks of progress in human development, clarify the unbreakable connection between women and children. Women and children make up the majority of poor and hungry people.⁸ Reducing hunger and poverty is MDG 1. Other goals include reducing child mortality (MDG 4), improving maternal health (MDG 5), and promoting gender equality and empowering women (MDG 3), including enrolling more girls in school.

Where there is hunger and poverty, there is almost always poor access to maternal and child health care, more girls out of school, and other problems related to the MDGs as well. The connections work in a positive way too: for example, in a study tracking the years 1970 to 1995, increases in women’s education were associated with a 43 percent reduction in child malnutrition.⁹ Information on how all developing countries are doing on the MDGs is available starting on page 158.

From the 1960s through the early 1990s, hunger rates were falling. Since the mid-1990s, hunger and malnutrition have been on the rise. Policymakers, facing daunting 21st century challenges like climate change and swelling populations in poor urban areas of the developing world, must not stand still as global food security continues to erode.

About a billion people in the world are hungry, in part because of misguided policies forged by rich governments, poor governments, and multilateral institutions alike. For too long, agriculture has been neglected and food security has been treated as an automatic byproduct or dividend of economic growth. The policies have it backward: food security must come first. It leads to a more productive population, which then creates and sustains economic growth. The good news is that today’s policymakers are realizing and trying to rectify the mistake.

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