Hunger Is Afghanistan's Biggest Killer

(Nov. 6) -- Death by violence has become tragically commonplace in Afghanistan -- for Afghans, foreign troops and aid organizations alike. But a far more efficient killer stalks the Afghan people: hunger.

An estimated 25 times as many Afghan citizens die every year as a result of hunger and poverty than from violence, according to a United Nations Security Council report. And as winter descends on the country, experts say, the death rate is bound to shoot up even further.

The issue of Afghanistan's hunger crisis rarely comes up amid the debate about escalating the military presence of the U.S. and its allies. But if Afghanistan is a notorious "graveyard of empires" and a crucial battleground for stanching international terror, that's partly because it is also one of the world's poorest countries.

Currently, 7.4 million Afghans, about one third of the population, are "food insecure," according the United Nations World Food Program; another third of the population is on the borderline to that status. An estimated 1.2 million children younger than 5 and 550,000 pregnant or lactating mothers are at risk of falling into severe malnutrition. The country has the third highest child mortality rate in the world: More than 300,000 children 5 and younger die each year.

While the debate and the dollars focused on military security, food security has been a low priority. In 2007, the amount the U.S. spent on agricultural development in the country was less than 1 percent of what it spent on its military efforts, according to the British-based charity Oxfam.

And while emergency feeding programs are being readied for millions of people, they barely address the underlying poverty that keeps Afghans at the edge of disaster.

"It is not enough really," said Dr. Zarmina Safi, director of the Public Nutrition Department of the Afghan Ministry of Public Health. "The upcoming winter will be a time of hardship. In many provinces the roads will be blocked by snow, and it will be difficult to deliver food."

The problem isn't so much a lack of food as it is the country's intense poverty, said Emily Levitt, an international nutrition consultant who does work for the World Bank. In many parts of the country, the markets are stocked with food, but people do not have enough money to buy it, she said. "It is a cash famine."

The severe poverty is one of the reasons people go to fight for the Taliban, where they can earn the relatively large sum of $100 a month, Levitt said. The same pressure motivates farmers to grow opium, which earns them four times what they would earn growing wheat.

Aid workers are now preparing for the winter, which will put millions of people at risk of hunger. Another major pressure comes from returning refugees. Iran and Pakistan have forcibly sent an estimated 450,000 Afghans back across the border.

Some parts of the country are suffering from epidemics of scurvy, a normally rare disease caused by lack of vitamins that plagued crews of sailing ships in the pre-industrial age. And there are anecdotal reports of mothers giving opium to their hungry infants to keep them quiet.

More than 40 percent of the population subsists on less than 45 cents a day. Children and pregnant women suffer the most. More than half of Afghan preschool children are chronically malnourished; one in five don't reach their fifth birthday because of either common diseases or a lack of food. The country also has one of the worst maternal death rates in the world. Less than a quarter of the population has access to clean water, and diarrhea is a major killer.

Psychological trauma from the violence has a prolonged affect as well. Mothers often find that their breast milk has dried up and do not realize that if the child suckled it would return. "They are psychologically affected," said Henry J. Mdebwe, a UNICEF nutrition specialist .

The aid agencies being forced to flee the country will make an already perilous situation even worse. Currently only 60 percent of the country is accessible to humanitarian response. For the remaining 40 percent, where the fighting is the worst, aid agencies can only guess at the problems people are facing. "We don't know what is happening in those areas," Mdebwe said. "People are trapped."