idp – UAB Institute for Human Rights Blog

Worldwide Famine and its Impact

by Nicole Allen and Pam Zuber

Famine and other types of food insecurity are problems in several ways. A chronic and widespread lack of food is not only harmful to people’s health but can produce other repercussions. Unfortunately, we are witnessing many of these short- and long-term repercussions of famine and food insecurity in several areas of the world.

Yemen

Yemen is a country in the throes of a vicious civil war. Like other countries experiencing such strife, it is experiencing food insecurity as well. People who experience food insecurity do not have consistent access to nutritious, affordable food. Yemenis truly do not have physical access. Experts estimate that Yemen imports 90 percent of its food, but the civil war has closed the country’s airports to civilian flights, blocked its seaports, and created dangerous conditions within the country. Even if food becomes available, many impoverished Yemenis cannot afford it. Saudi Arabia invested billions in Yemen in early 2018 to reinforce the latter nation’s economy and the riyal, its unit of currency, but the economic status of Yemen remains precarious.

Malnutrition causes other problems. Malnourished people are susceptible to disease that requires medical intervention, and this has been the case in Yemen. The country has experienced cholera and meningitis outbreaks. These diseases can create even more malnutrition. Thus, Yemen is battling a vicious cycle of malnutrition and disease. There is another, less-discussed but still significant factor that also contributes to problems in the country: drug use. Many in the country use a drug called qat (also spelled khat). Users say the drug enhances strength and virility, which is why military leaders allegedly give it to child soldiers. Users also say it suppresses the appetite, which could make qat attractive in a country experiencing food instability. Given qat’s popularity, it is also big business for the people who grow and supply it. Qat is profitable, which could encourage people to grow and sell it instead of other crops that could feed Yemenis. But, as with any drug, struggles for control over the qat market could provide dangerous, especially in a country already experiencing political instability. The quest for profit might come before the health, physical safety, and other human rights of Yemenis.

Somalia

Long subject to periods of drought that devastate its food supply, Somalia’s food situation is bleak. According to the United Nations’ World Food Programme: “As of May 2018, 2.7 million people [in Somalia] cannot meet their daily food requirements today and require urgent humanitarian assistance, with more than half a million on the brink of famine. Another 2.7 million Somalis need livelihood support to keep from sliding into crisis. An estimated 300,000 children under age 5 are malnourished, including 48,000 who are severely malnourished and face a high risk of disease and death.” Such drought limits the crops Somalis can grow and shrinks the amount of pasture land they can use for their livestock. It also puts people out of work, preventing them from buying food and other necessities.

What little food and water there is available is a precious commodity in Somalia. People have attempted to control these scarce resources to build and consolidate power, which has sometimes led to violence and tension. People without such resources might be more willing to join violent movements because they feel as if they have no other options. Thus, famine and reduced job prospects might be breeding grounds for violent groups of people who feel as if they have nothing to lose. It could contribute to violence, unrest, and human rights violations, since people may feel that their situations are hopeless and that human life is worthless.

Nigeria

As with other countries on this list, political strife has created considerable food insecurity and other problems in Nigeria. The militant group Boko Haram has been active in northeast Nigeria since the early 2000s. Boko Haram’s name means “Western education is forbidden” in the Hausa language and the group calls for Islamic law (sharia). The group has protested secular Nigerian rule in various ways, most notably by kidnapping several women, girls, and children in a number of separate incidents and by bombing and attacking government and United Nations buildings. Boko Haram has also clashed with government representatives and multinational troops, which has killed several Nigerians, displaced others, and severely disrupted everyday life in the African nation: “[I]t is likely that significant populations remain in areas of the northeast that are currently inaccessible to humanitarian actors. Reports indicate that people fleeing from conflict-affected, inaccessible areas [in Nigeria] are often severely food insecure and exhibit signs of malnutrition,” according to a 2018 report from the Famine Early Warning Systems Network.

If Nigerians had their way, they would not only have access to food, but the means to grow it as well. Fanna Kachella is a farmer in Rann, a city in northeastern Nigeria. The ongoing political conflict has affected her livelihood, but she hopes that food assistance can help her and her family: “Not having anything much to do has been hard for us, we are used to planting our own food. I hope we will get a good harvest from the seed.” The ability to support oneself and one’s family should be a fundamental human right. Not being able to do so is denying this right. Not being able to do so can jeopardize a person’s health, dignity, ability to form and nurture a family, and interactions with others.

South Sudan

Founded in 2011, South Sudan is the world’s youngest country. But, in its brief history, it has faced many problems that are as old as time. Unlike other countries on this list, it looks as conditions may be improving, however. On August 6, 2018, South Sudan’s president, Salva Kiir, signed a power-sharing cease-fire agreement with the leader of his political opposition, Riek Machar. As part of this agreement, Machar would serve as one of the five vice presidents of the country. Political conflicts between the two men plunged South Sudan into civil war in 2013. Machar once served as Kiir’s deputy but fled the country after a dispute between the men. The two men agreed to end their dispute in 2015, but it ended in 2016 when Machar return to the country’s capital, Juba.

These personal disputes erupted into a country-wide civil war that has killed thousands of residents of South Sudan and displaced almost two million more. The political conflict and its resultant disruptions, massive displacement, economic problems, flooding, dry spells, and pests all contributed to famine conditions in 2017. According to the international initiative the IPC (the Integrated Food Security Phase Classification), “5.3 million people required food assistance” in South Sudan in January 2018, “up 40 percent from the same time last year.” The initiative attributed these food-related problems to “widespread conflict [that] continues to displace communities, disrupt livelihood activities and impede humanitarian access to vulnerable populations.” But, if the truce between Kiir and Machar holds, it could spell an end to this calamitous conflict. Perhaps it will allow people to return to their homes and grow and obtain food, reversing the food insecurity and other problems that this new nation has faced.

North Korea

Food insecurity and malnutrition have been common occurrences for decades in North Korea, another country also experiencing political troubles. The oppressive and secretive nature of the country’s government has made it difficult to determine the extent of North Korea’s many problems. But, the estimates are devastating. For example, experts believe that a famine in the country in the 1990s killed up to three million people. North Korea’s mountainous terrain and cold climate have always made agriculture difficult, and the country no longer received agricultural aid from the Soviet Union after the latter country collapsed in the early 1990s, which made farming even more difficult.

The North Korean government claims that a lack of aid from other countries continues to hurt the country. Many countries have imposed sanctions on North Korea for developing a nuclear weapons program. The countries imposing the sanctions have claimed that they did not place sanctions on food but on other goods. But, even these sanctions threaten the livelihoods of many North Koreans. If the North Koreans cannot earn enough money, they cannot earn enough to feed themselves and their families. The results have been heart-wrenching. “[H]unger remains a way of life” in North Korea, wrote Dr. Kee B. Park in a December 2017 article in the New York Times. “Forty-one percent of North Koreans, about 10.5 million people, are undernourished, and 28 percent of children under 5 years old have stunted growth. When my 4-year-old daughter visited [North Korean capital] Pyongyang in 2013, she, all of three feet, towered over children twice her age.” Park vividly explains how hunger creates immediate problems and future ones. Not having food creates insecurity that can last a lifetime. It can create physical and emotional problems that persist long after people receive adequate food if they ever receive adequate food.

What Are People Doing About Hunger-Related Issues?

Different governments are pitching in to tackle famine. The government of United States president Donald Trump pledged to donate more than $1 billion since November 2017 alone. Still, relief workers say that the governments of other countries can do more. That is if the governments even know about such problems in the first place. Relief workers say that people do not know that famine exists in many places. They say that Trump’s administration has been helpful in its humanitarian efforts. But, on the other hand, they also say that publicity surrounding Trump and the activities of his administration has overshadowed people’s knowledge about other things, including famine and food insecurity in different parts of the world. Food insecurity is also tied to political insecurity. It is no coincidence that many of the countries on this list have experienced war or other forms of political instability in addition to food problems. Many experts believe hunger and war are often inextricably linked. According to Cormac Ó Gráda, “The hope for a famine-free world depends on improved governance and on peace. It is as simple – and as difficult – is that.”

Nicole Allen is a freelance writer and educator based in the United States. She believes that her writing is an extension of her career as a tutor since they both encourage learning and discussing new things. Her degrees in creative writing, education, and psychology help her understand her target audience and how to reach them in creative and educational ways. She has written about fitness and health, substance abuse and treatment, personal finance and economics, parenting, relationships, higher education, careers, travel, and many other topics, sometimes in the same piece. When she isn’t writing, you might find Nicole running, hiking, and swimming. She has participated in several 10K races and hopes to compete in a marathon one day. A longtime volunteer at animal shelters, Nicole is a passionate supporter of organizations that help animals. She also enjoys spending time with the dogs and cats in her life and spoiling them rotten.

Pamela Zuber is a writer and an editor who has written about human rights, health and wellness, business, and gender.

Public Health Equity in Humanitarian Crises

In 1950, the office of the United Nations High Commissioner for Refugees (UNHCR), also known as the UN Refugee Agency, was created to help millions of Europeans who had fled or lost their homes during World War II. Since the creation of the UNHCR, the UN Agency for Refugees still remains the leading UN organization mandated to protect the basic needs and human rights of refugees. The unprecedented forced displacement of people, both internally and across borders, is one of the most persistent manifestations of humanitarian crises and conflict in the modern era. 65.5 million people around the world have been forced from their homes due to violence. Among the 65.6 million people, the UNHCR oversees more than 21 million refugees, over half of whom are under the age of 18. Presently, the rights of refugees are protected by the UN Convention Related to the Status of Refugees adopted in 1951, established from Article 14 of the Universal Declaration of Human Rights (UDHR). Article 14 of the UDHR recognizes the right of persons to seek asylum in other countries from persecution in their home country.

The long- and short-term effects of displacement on the masses of global refugees generate humanitarian crises for these persons. Humanitarian responses to crises focus on delivering equitable and quality public health interventions, an essential element of the larger operational framework of humanitarian aid. Public health encompasses a vast variety of components including: 1) reproductive health, 2) disease control, 3) maternal and child care, 4) psychosocial support, and lastly 5) sanitation. “Although the health needs during and after natural disasters and armed conflicts are similar, the differences arise from the political complexities of the latter, in which civilian populations serve as targets of war and human rights abuses aggravate health and protection needs” (Leaning, 2013). The main health consequences of armed conflicts are not conflict-related injuries and deaths. During humanitarian crises such as armed conflict, death is exacerbated by various direct and indirect factors, including common childhood illnesses such as diarrheal disease and severe malnutrition. The legitimate concerns of public health equity in the framework of refugees’ and internally displaced populations’ (IDPs) healthcare continues to be more complex and challenging.

Providing clean water to millions of people. Source: DFID, Creative Commons

Urban Refugees
Current global trends indicate a shift towards urban destinations for refugees and away from refugee camps. The UNHCR reports 60% of the global refugee population and 34 million IDP population live in urban environments. Urban environments provide social security for refugees. Unlike refugee camps, living in cities offers refugees the opportunity to live anonymously. Refugees residing in urban settings are not subjected to the limitations of a refugee status and camps. In urban settings, refugees have access to educational, advanced healthcare services, and employment opportunities which may not be available at refugee camps. Examples of this trend are Damascus, Syria and Amman, Jordan; both received more than 1 million refugees from Iraq alone. Furthermore, many refugees are not legally permitted to settle in urban centers, thus end up living in informal settlements and slums alongside the major urban areas. These informal settlements are typically outside the radar of government and humanitarian aid agencies, thus remaining unidentified and particularly at risk for human right violations.

Public health equity in humanitarian situations
From the public health perspective, it is much more difficult to keep track of people when they move to urban areas. This consequently makes healthcare delivery more difficult in terms of: 1) assuring refugees receive basic health care services, 2) coordinating patient referrals, 3) accessible and available health services and resources, and finally 4) managing the costs of health care services. UNHCR’s leading principles for public health assert health care services delivered to refugees by host countries should resemble and correspond with the services provided to citizens and residents in their country of origin. Minimum, yet essential, health care services must be maintained in all situations, including humanitarian disasters and mass forced migration. “This UNHCR guiding principle preserves a sense of fairness and equity between two contiguous groups of people who must, for a range of security and political reasons, be encouraged to live in this adjacency as harmoniously as possible for an indefinite period of time (Leaning, 2011).”

A coordinated system of health care delivery is more urgent in urban settings not associated with refugee camps or humanitarian relief. The urban displacement phenomenon has shifted the direction of care delivery systems to focus on establishing healthcare delivery systems supporting access to preventive health care services. Present systematic healthcare delivery issues requiring critical consideration include 1) the financing of health services, 2) access barriers to services due to unaddressed financial burdens, 3) cultural barriers, and lastly 4) and the integration of services for refugees within existing formal health systems.

Recently, UNHCR has begun to advocate for refugees to gain access to health insurance in their host country, especially in middle-income countries where healthcare systems already function for host populations. For example, in 2011, health insurance for Afghan refugees living in Iran was introduced. By June 2012, 347,000 refugees registered for health insurance. 40% of the Afghan refugees whom enrolled for health insurance were officially registered with the UNHCR. With health insurance, refugees have access to secondary and tertiary healthcare services for treatment of non-communicable diseases and other illnesses. Health insurance provides UNHCR registered refugees a second form of official documentation. Secondary healthcare services include consultant led-services with health care specialists. Tertiary care services include specialized consultative care delivered on referral from primary and secondary The Iranian government also benefits from providing health insurance to the country’s population by reducing the perennial risk of paying for the hospitalization of refugees. Refugee health insurance is successful in Iran because refugees have access to employment allowing some refugees the means to afford to pay premiums and co-payments. The UNHCR will support vulnerable persons if they cannot afford health insurance. Urban refugees need more representation and support services within the health sector.

Pēteris. Source: Pavão-Pavãozinho favela, Creative Commons.

Resource Allocation
Achieving public health equity in humanitarian crises is a complicated and challenging process. The majority of refugees do not live in refugee camps and their experiences as urban dwellers must be further investigated by academics and professionals alike. This trend holds for human societies in general; the world at large is experiencing rapid urbanization. In 1950, less than 30% of the world’s population lived in cities and towns. Presently, urban population has increased to 54% and is expected to reach 60% by 2030. Even though urban refugees have the ability to live anonymously and earn wages, living in an urban setting undermines refugees’ access to affordable and high-quality basic health care services. Future policy decisions and international aid programs regarding urban refugees must continue to adapt to the shifting demographic profiles of refugees, IDPs and the effects of global urbanization. Ultimately, public health equity problems the humanitarian community is attempting to confront can be categorized under two categories: resource allocation and decision-making. As humanitarian crises stemming from armed conflict become more common, investing in sustainable policy solutions for resource allocation in the health sector for forced migrants will prevent the suffering of these individuals on the low end of the welfare continuum.

It’s Not Just Irma and Harvey: Deadly Floods Affect Millions Around the World

map_of_southeast_asia. Source: ANHCANEM88, creative commons.

These past few weeks have been a very vulnerable time for our global community. Media has been predominately focusing on the countries and victims affected by Hurricane Harvey, Irma, and Jose, however nature’s violent outcry stormed communities all over the world- not just the hurricanes in the West. Powerful monsoons struck South Asia, affecting more than 41 million people throughout Bangladesh, Nepal, and India. In Karachi, Pakistan, devastating monsoon floods abruptly invaded communities preparing to celebrate an Islamic holiday, Eid al-Adha. Lastly, Typhoon Hato swept into the cities of Macau and Hong Kong, causing thousands of people to flee their homes.

After all of these natural disasters transpired, one concept became very clear: Mother Nature does not discriminate. Natural disasters affect the rich and poor, high income countries and low income countries, and people of all nationalities and ethnicities. Regions struck by these disasters are left with substantial amounts of infrastructural, property, and environmental damage. As a result, victims of these disaster experience traumatic consequences, such as internal displacement and food insecurity. Growing up, I believe I was too young and just overall uninformed to really comprehend what natural disasters entail, and why they are so devastating. However, now being an adult, it’s obvious to me that the reason why natural disasters are so devastating is because post-disaster damage completely compromise the dignity of human rights detailed in the Universal Declaration of Human Rights (UDHR).

Disasters interfere with a population’s economic, social, and cultural rights emphasized through 17, Article 22-27 of the UDHR. Articles 22-27 of the UDHR focus on establishing social security through people’s right to education, employment, adequate living conditions, cultural life, and leisure. Likewise, Article 17 of the UDHR establishes that “no one shall be arbitrarily deprived of his property.” Unfortunately, after a natural disaster, these rights are undeniably negatively affected.

Hurricane Katrina LA7. Source: News Muse, Creative Commons.

Right to Work

The right to work and employment is severely hindered after natural disasters due unimaginable infrastructural damage. In 2005, the US experienced public health tragedy when Hurricane Katrina devastated millions along the Gulf Coast of Mississippi and Louisiana. Two years after Hurricane Katrina, the Bureau of Labor Statistics released numerous reports on the effects of Hurricane Katrina on employment and unemployment. These statistics state: “approximately 38 percent of business establishments in Louisiana and Mississippi were within a 100-mile corridor of the path of Hurricane Katrina’s center.” From August 2005 until June 2006, Louisiana unemployment rates soared from 5.8% pre-hurricane to 12.1% post-Hurricane Katrina. In Mississippi, unemployment rates climbed from 6.8% in 2004 before the hurricane to 10.4% after Hurricane Katrina. Everyone has the right to work to “ensur[e] for himself and his family an existence worthy of human dignity”; this is ultimately difficult to achieve when opportunities for employment have literally been washed away. In the Caribbean regions, hit hardest by hurricane Irma, tourism one of the largest revenue-builders and an important source of income for many families. Specifically in Anguilla, a territory hit by Hurricane Irma, tourism contributed to 57% of the island’s GDP in 2016. Generally, travel and tourism alone contributed to about 15% of the Caribbean region’s total GDP. For the Caribbean victims of Irma, the disruption of the tourism industry is a disruption to a family’s livelihood. Natural disaster victims living in rural regions such as India, Nepal, and Bangladesh face continuous threat to work when their agriculture and crop land get destroyed and the becomes unprofitable.

Right to Adequate Living

The most noticeable human right that natural disasters discernibly jeopardize is the right to “a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…” For many survivors after natural disasters, ‘adequate living’ is no longer a reality. What happens when a family’s home is demolished in the wake of disasters such as these? Tragically, millions of people become internally displaced within their countries. The United Nations reports that about 851,000 people are displaced in India, 352,738 Nepalese are displaced from their homes, and lastly 696,169 people have been displaced in Bangladesh since the monsoons. Food insecurity also becomes an urgent need to address throughout regions affected by these disasters. Within two days after the floods, Nepal Food Security Monitoring System (NEKSAP), issued a first assessment of the damage. Results exposed that 70% of flood-affected areas are moderately food insecure or worse. Of that 70%, 42% of those regions are highly and severely food insecure.

Right to Education

Natural disasters also impede on one’s right to an education due to the damage sustained by schools and educational infrastructure. Human loss to education systems, comprising the loss of school administration personal, teachers, and education policy makers, affects the institution’s ability to deliver a quality education. UN reports affirm that in Bangladesh, 2,292 primary and community schools suffered substantial water damage. In Nepal, 1,958 schools have been ruined, thereby impacting the education of 253,605 children. In India, nearly one million students’ education have been disrupted when floods damaged 15,455 schools. Damage to schools not only undercut education in the short term, but threaten long-term educational goals as well. USAID explains “the normal processes of educational planning break down during an emergency, weakening the overall system and creating future problems in the development of an inclusive educational system.”

“Famine”. Source: Jennifer Boyer, Creative Commons

What’s next?

These events have got a lot of people asking why these disasters even occurred in the first place. Well, science indicates that climate change has become a major catalyst to such drastic weather related disasters witnessed throughout the past couple of weeks. As NASA explains “changes in climate not only affect average temperatures, but also extreme temperatures, increasing the likelihood of weather-related natural disasters.” With rising temperatures and a predicted increase in weather-related disasters, maybe the United Nations and our government should start to consider changing the definition of an internally displaced person (IDP) or a refugee to include people fleeing from natural disasters. The UN definition of a refugee is a person who , “owing to well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable, or owing to such fear, is unwilling to avail himself of the protection of that country…” Just like people running away from armed conflict, victims of weather-related disasters are also trying to escape harsh realities, including inadequate living conditions, food insecurity, no economic opportunities, and violence. A modern day example of weather-related disasters is the famine spreading across Ethiopia, Somalia, and Kenya caused by intensified droughts.

“We have moved four times in the last four months. We were trying to follow the rain – moving according to where the rains were supposed to come. But they haven’t. If the rains don’t come, none of us will survive”

– Farhia Mohamad Geedi, Oxfam

Just like Farhia and her family, 10.7 million people across Somalia, Ethiopia and are facing sever hunger. If their governments are not able to provide them with a feasible and effective solution, they have no other choice but to leave, or die. With a predicted increase in weather-related disasters such as drought and floods, more people will be living in extremely life-threatening environments that will force them to leave their home. The destruction of the consecutive water disaster have been very tragic, but there is hope for the future. Countries have begun to recognize that “their shared burden of climate-related disasters can only be lifted by universal action to address the causes of climate change.” 175 countries from all over the world have signed onto the Paris Agreement, which will focus on keeping a global temperature rise this century below 2 degrees Celsius. We as a global community have already made such positive impact by acknowledging we have a problem, now it’s time to hold ourselves accountable for progress.

Additional resource: This Changes Everything by Naomi Klein.