With yet another famine in the Horn of Africa, perhaps it’s a good time for a few words about famine measurement.
People have a right to adequate nourishment and to be free from chronic hunger (see article 25 of the Universal Declaration). Starvation is an extreme form of violation of this right (and is obviously also a violation of the right to life). So we obviously want to know the existence and extent of cases of starvation. There are individual cases of starvation – a elderly person who has lost her mobility and social network may starve abandoned in her flat – but most cases involve large scale famines. Let’s focus on the latter.
The problem is that death by famine or starvation is difficult to identify. People suffering from extreme malnutrition often don’t die of hunger but of diseases provoked by malnutrition, such as pneumonia or diarrhea. Since those are diseases that can have other causes besides malnutrition, it’s often difficult to count the number of people who have died from malnutrition. Their body weight may tell us something, but you can’t go about weighing corpses on a large scale.
Hence it’s difficult to determine whether or not a famine has occurred or is occurring. When does widespread suffering of hunger become a famine? Not every food crisis or widespread occurrence of malnutrition leads to famine-type starvation. A famine is obviously characterized by mortality caused by malnutrition. So we must look at mortality rates, but given the difficulty of establishing whether deaths are caused by malnutrition or other factors, how do we decide that a certain mortality rate is caused by malnutrition and is therefore the symptom of a famine? It’s difficult.
And yet, it’s common to find newspaper reports about “an outbreak of famine” is this or other part of the world. Ideally, we only want to declare a famine when a famine is actually occurring or about to occur. False alarms are not only silly but they create indifference. Fortunately, people seem to have overcome some of the difficulties and have agreed on a non-arbitrary way to determine that there is a famine going on:
- when overall mortality rates in a region are extremely high, or high compared to the baseline – which may itself be high already, perhaps because of a war (a mortality rate of at least two people per 10,000 per day is usually considered part of the evidence of famine conditions)
- when this is combined with survey indicators about low food availability and malnutrition (a rate of malnutrition – ratio of weight to height – among children age six months to five years above an average of 30% is the usual measure here)
- when there is anecdotal evidence (perhaps also from surveys)
- and when there are proxy measures such as below average rainfall
then you can build a useful measurement and a more or less scientific way of ascertaining that a food crisis has passed the famine threshold.
None of this should be understood as implying that food crises which don’t reach the famine threshold are unimportant and don’t deserve attention or assistance. It only means that it’s a good thing to distinguish real famines from lesser crises and to avoid crying wolf.
One problem with the measurement system presented above is that it’s no help in preventing a famine. It’s difficult to turn it into a probability index rather than a threshold index. It tells you when a famine has occurred or is ongoing, not when there’s a risk of famine. When mortality rates are high, you’re already late, perhaps too late.