Over time, members of populations affected by famine or “invisible” chronic hunger face increasing health problems and mortality rates associated with chronic and acute malnutrition. People in all age groups become susceptible to caloric, vitamin, and micronutrient deficiencies that can lead to diseases like beriberi, scurvy, general ill health and increased mortality rates. Humanitarian food aid, if it is available, primarily includes pulses, cereals, and vegetable oil. 

 

Basic caloric needs were defined by UNHCR, UNICEF, WFP, and WHO in 2002 as 2100 kcal per day for persons with no underlying health conditions or stressors engaged in light physical activity in an ambient temperature of 20 degrees Celsius.

 

While basic caloric needs can be met by a general food ration containing these ingredients, a simple caloric intake is not sufficient for maintaining health over time or living and working in more extreme or active conditions. Poor nutrition can create a spiraling situation in which affected individuals are unable to function normally and work to contribute to their own recovery.

 

Common deficiencies for populations affected by chronic hunger or famine are difficult to assess, and have several causes. This means that specific nutritional deficiencies are not universal and can be specific to a particular group or even an individual.

 

In general, deficiencies and related diseases are associated with Vitamin A, iron, iodine, zinc, potassium, magnesium, vitamin c, riboflavin, and niacin. Many of these vitamins can be added to grains, oils, and salt as fortification. Some, like vitamin C, cannot because they break down when exposed to oxygen or heat. Foods that are rich in micronutrients can help in addressing some of these deficiencies. These include pulses, groundnuts, red palm oil, fruits, and vegetables. Vitamin supplements can also be given to affected persons, but availability is a challenge, as is reaching the appropriate persons who need them. 

 

Other long-term interventions include helping affected populations establish gardens, livestock, and access to local food sources. Aid that allows for choice and agency in food selection improves dignity. A combination of fortified rations and fresh foods can go a long way to improve nutrition over time and to increase the dignity and enjoyment of foods. 

Problem: Populations affected by lack of food security and chronic hunger tend to suffer from a wide variety of diseases related to chronic malnutrition and nutrient deficiencies, including stunting, acute disease like scurvy and beriberi, and high mortality rates. There are many challenges in ensuring food aid are available and acceptable to these persons. 

 

Severity: Prevalence of malnutrition and disease in populations affected by chronic hunger remains high despite attempts at interventions. This is partly due to the complexities involved and the fact that needs change based on multiple variables. There is also discrimination in the allocation of resources. Populations affected by hunger in Africa tend to receive fewer and lower quality resources than those in Asia and eastern Europe.

 

At particular risk are pregnant women, infants, the elderly and those suffering from diseases. Children may be affected by poor growth and disease. In some populations, the importance of breastfeeding or nutritional intake for young children is not well understood or culturally accepted. 

 

Causes: Basic causes of malnutrition in populations affected by chronic hunger include bias in distribution of food aid, lack of access to food in general (i.e., food volume and content is inadequate for the affected population or individuals lack financial resources sufficient to acquire nutritionally dense foods), complexity of identifying affected populations and challenges addressing specific nutritional needs, which can vary by region or among members of a group.

 

Humanitarian food aid sent to affected areas often does not include adequate micronutrients and vitamins needed to stave off deficiency diseases. There are difficulties with including some micronutrients due to their instability or susceptibility to breaking down when exposed to heat or air. Fortification of cereals is best done in the country where aid is received due to the instability of some vitamins, but local infrastructure may be inadequate to achieve this. 

Information was gathered from publications primarily set forth by the WHO and UN and scientific journal articles. Information gathering and research methods surrounding the prevalence and outcomes of malnutrition in populations affected by chronic hunger are sparse and inexact. There is no central entity conducting research, and aid workers often gather information in the field. The methodology is not standardized, and there are problems with the data. Some groups suffering from the effects of malnutrition tend to be excluded from the results studies that are conducted. Children, specifically measurements of their growth rates over time, are often used as a proxy for a larger population, which is inexact at best. The methodology has also changed significantly over time. 

 

Mekong Valley Foods gratefully acknowledges the research and analysis of Amy Wilder in compiling this report.