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Starving Children Don’t Cry

For several years, each year was the best in human history. Then 2020 came along.

Nicholas Kristof

By Nicholas Kristof

Opinion Columnist

  • Jan. 2, 2021, 3:00 p.m. ET

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Abdo Sayid at 4 years old was only 14 pounds.Credit…Giles Clarke/U.N. Office for the Coordination of Humanitarian Affairs

Starvation is agonizing and degrading. You lose control of your bowels. Your skin peels off, your hair falls out, you hallucinate and you may go blind from lack of vitamin A. While you waste away, your body cannibalizes itself: It consumes its own muscles, even the heart.

Yet Abdo Sayid, a 4-year-old boy so emaciated he weighed just 14 pounds, wasn’t crying when he was brought to a hospital recently in Aden, Yemen. That’s because children who are starving don’t cry or even frown. Instead, they are eerily calm; they appear apathetic, often expressionless. A body that is starving doesn’t waste energy on tears. It directs every calorie to keep the major organs functioning.

Abdo died soon after arriving at the hospital. A photographer named Giles Clarke, a friend of mine whom I met on my last trip to Yemen, was there again and captured the scene.

His photographs, including those with this column, are painful to witness, but many families, including Abdo’s, allow photography — indeed, want photos to be circulated — because they hope that the world will understand that children are dying needlessly of hunger, and that help is desperately needed to avert more child deaths.

NICHOLAS KRISTOF’S NEWSLETTER: Get a behind-the-scenes look at Nick’s gritty journalism as he travels around the United States and the world.

The world had pretty much licked famine, until 2020. The last famine declared by the United Nations authorities was in a small part of South Sudan for a few months in 2017 — but now the U.N. warns that famine is looming in Yemen, South Sudan, Burkina Faso and northeastern Nigeria, with 16 other countries slightly behind in that trajectory toward catastrophe.

“Famines are now back,” said Mark Lowcock, the United Nations humanitarian chief. “It will be a horrible stain on humanity for decades to come if we become the generation to oversee the return of such a terrible scourge. This is still avoidable.”

We have been privileged to live in a thrilling epoch in history in which child mortality has plunged, disease and famine retreated, literacy soared and human well-being skyrocketed.

At this time of the year I normally counter all my gloomy columns by writing that the previous year was the best in human history, by such metrics as the share of children dying by the age of 5. But 2020 was not the best year in human history. It was an annus horribilis, and UNICEF warns that the result may be 10,000 additional children dying each month from hunger.

The setback in developing countries has been exacerbated by passivity, paralysis and indifference in the United States and Europe, and in international organizations like the World Bank.

The biggest cause of the global crisis is the coronavirus pandemic, but only indirectly. Outside of the rich world, the casualties are not octogenarians with the virus so much as children dying of hunger because of economic disruptions, or middle-aged adults dying of AIDS because they can’t get medicines.

The capital of human suffering today is arguably Yemen, which the United Nations calls the world’s worst humanitarian crisis. As we celebrate the new year, Yemeni children like Abdo are dying of hunger.

Yemen’s suffering is complicated. Always poor, the country has been shattered by a war and blockade by Saudi Arabia, with backing from the United States under both the Obama and Trump administrations. (Obama officials have acknowledged, not as candidly as they should, that this was a mistake.) Misrule by the Houthi faction, backed by Iran, has compounded the suffering, as have both cholera and the coronavirus — and donor countries are focused on their own problems and averting their eyes.

So Abdo died.

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Abdo, 4, was less than half the weight of a healthy child his age.Credit…Giles Clarke/U.N. Office for the Coordination of Humanitarian Affairs

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Abdo’s uncle, Yahya Abdo Zahari, and his family brought him to a malnutrition ward in Aden, Yemen, from Al Hudaydah.

Abdo’s uncle, Yahya Abdo Zahari, and his family brought him to a malnutrition ward in Aden, Yemen, from Al Hudaydah.Credit…Giles Clarke/U.N. Office for the Coordination of Humanitarian Affairs

If you simply look at coronavirus numbers, you might think that poor countries had dodged a bullet. Developing countries have generally avoided high mortality from Covid-19, particularly in Africa.

But that may be changing with a tide of new infections, and in any case the indirect effects have been devastating, so that a pandemic of a coronavirus has been followed by pandemics of hunger, disease and illiteracy. Lockdowns meant that casual laborers had no income, and tuberculosis patients couldn’t get medicine. Campaigns to battle malaria, polio, AIDS and vitamin A deficiency were left in disarray.

The repercussions are endless. The United Nations warns that poverty and disruptions from the pandemic may push 13 million additional girls into child marriages. Disrupted campaigns against female genital mutilation may result in two million more girls enduring genital cutting, the U.N. said, while reduced access to contraception may lead to 15 million unintended pregnancies. The World Bank says an additional 72 million children may be pushed into illiteracy.

“We are increasingly talking about a lost generation, whose potential may be permanently quashed by this pandemic,” said Angeline Murimirwa of Camfed, which supports girls’ education in sub-Saharan Africa.

An expert panel crunched the numbers and estimated that under even a “moderate” scenario of what lies ahead, an additional 168,000 children will die from malnutrition because of the consequences of the coronavirus. Think about that: Abdo times 168,000.

Many others will survive, but with lifelong intellectual impairment, or in some cases permanent blindness, caused by deprivation in 2020 and 2021. This toll is worsened because of indifference in the rich world.

“The magnitude of the problem is an outrage, but it is even more outrageous that there are powerful, proven solutions that are not being delivered at scale,” said Shawn Baker, the chief nutritionist at the U.S. Agency for International Development.

Some poor countries will be able to vaccinate at most one-fifth of their populations in 2021, suggesting that the pandemic will continue to ping around the globe and smother poor countries. Partly that’s because the United States and other rich countries, at the behest of the pharmaceutical company lobby, refuse to waive patent protections to allow poor countries access to cheaper vaccines.

Gayle Smith of the One Campaign calls for three kinds of measures to help: greater efforts to distribute the vaccine globally, debt relief and assistance from wealthy countries.

The paradox is that 2020 may still be one of the five best years in human history, by such measures as the share of children dying or the proportion of people living in extreme poverty. If the world moves aggressively to address the crisis, the year could be remembered as a blip. But the nightmare is a prolonged crisis in poor countries and a turning point — on our watch — that ends the march of progress for humanity.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: letters@nytimes.com .

Nicholas Kristof has been a columnist for The Times since 2001. He has won two Pulitzer Prizes, for his coverage of China and of the genocide in Darfur. You can sign up for his free, twice-weekly email newsletter and follow him on Instagram. His latest book is “Tightrope: Americans Reaching for Hope.” @NickKristof • Facebook

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I’ve to be honest and say I never heard of Pat Tierney before, but I suppose I was only 13 when he died.

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He used to drink in the Neptune, downstairs in the Flowing Tide, of a Friday night. Interesting lad who had seen a lot and done a lot. Quite argumentative, even when you were agreeing with him. He was centrally involved in the opposition, such as it was, to Prince Charles’s visit to Dublin in 95.

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Enjoyed this. Sort of thing @Malarkey might pen

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A lovely way of Padraig telling us the type of funeral that was happening without really telling us

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'Travelled"

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finally someone calling out this kind of behaviour

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Lads in Ireland might be shocked to find that media can be something other than a state propaganda tool

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That’s a great article. In the wail of all places

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The mail and the guardian seem to have swapped places lately

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Do you really think that article is well reasoned? Or is it the pleasant odour of Sumption’s ermine?

I wonder, among many facets, about this passage:

"Meanwhile, we’ve been told the policy has been to protect the NHS from being overwhelmed. It must be said that the frontline staff are beyond praise but the NHS is a public service which exists to protect our national life, not an established church. To treat its limitations as a reason for suspending our national life is a perversion of its purpose.

It also diverts attention from where responsibility lies. If hospitals are overwhelmed, it is not our fault for getting ill and needing them. The responsibility lies with successive governments which have mismanaged and underfunded the NHS for years.

The number of NHS beds has fallen continuously since 2000. Despite years of pandemic planning, the UK has by far the lowest intensive care capacity in Europe. In a bad winter, the NHS is overwhelmed even without Covid-19."

Is it actually true to say, empirically, winter flu has been (and remains, supposedly) as serious a threat to economic life as this virus? Is this contention correct or a product of specious reasoning (‘all strain on hospitals amounts to the same thing, without differentiation’)?

If so, why did this crisis not transpire in 2019, in 2009? By Sumption’s own logic, there should be such a crisis nearly every winter. But of course this logic chokes itself. Something that happens each winter, by definition, is not a crisis but an expected event.

Would it not trouble you that Sumption is effectively offering this scenario? ‘The NHS is essentially fucked for the last 20 years. So we may as well use this situation as a means of letting the hospitals be overwhelmed and moving on to Mad Max herd immunity.’ What level of public support do you believe exists, in Britain and in Ireland, for this scenario, embraced hypothetically by Sumption (who could of course sequester himself and his family in his French chateau for the duration)? At what point would anti lockdown protests become anti overwhelmed hospitals protests? Would there be rioting and looting as social order broke down? Would whatever sort of protests happened over an extended period facilitate a resumption of normal economic activity?

Then there is this passage about Boris Johnson and his (jolly good) government:

“We have witnessed constant U-turns and lurchings from pillar to post. Eat Out To Help Out was followed by the enforced closure of pubs and restaurants. Schools continued, but were then shut. There was the absurdity of tiers being relaxed for Christmas Day, only to be reimposed three days later.”

Is Sumption not implicitly acknowledging that premature attempts to OIUTF are actually counterproductive in the longer run? Then again, and rather in contradiction of himself, Sumption is precisely calling for people to start eating out again and to start drinking out again – without face nappies – same as the kango wing of the Tory Party did at the time. Remind me: how did that pressure work out?

And what about his concluding passage? Sumption goes sonorous: “The rhetoric of suppression evades the reality that we must learn how to live with disease, as our ancestors have always done.” But how are we to achieve this end? Sumption offers no concrete advice beyond vague high flown banalities about ‘liberty’, save for an implicit exhortation: this virus should not be suppressed at all, should be ‘let rip’, in the phrase.

Another sonorous banality to finish: “Then, hopefully, we can rebuild a world in which limits are placed on the power of an irresponsible state to direct people’s lives.”

Ah, dreadful state power… Alpha and omega, for a certain cast of mind. Yet would it not have to be the state that forced people to go back out to eat, to resume ‘normal life’? A fierce pancake, in the phrase.

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Yes, I think it’s well reasoned, even if he did pull his punches a little. The nhs is in a mess, they’re sending home healthy staff, reducing bed numbers on a yearly basis, opening and closing exhibition centres, playing silly buggers with government statisticians (for reasons that I’ll let you explain), unable to employ sensible measures like their counterparts in india and sweden, incapable of offering standard health care and despite having 1.2 million employees, unable to look after 67k patients.
Is winter flu as serious as this virus? I suppose this virus is a bit more serious than some of the worst flu years over the last 20. It’s hard to tell, though…what with the behaviour of government statisticians mentioned above, dodgy pcr tests etc. Either way there’s plenty of coherent argument to say that it’s in the ballpark, though it would be a shame not to mention the high proportion of people who contracted/tested positive covid while in hospital for other reasons: The polite silence around deaths caused by lockdowns will only last so long however, I’d hope!

And he criticises government u turns, I really dont see this as tacit approval of lockdowns. The fact is that western democratic governments had a plan for pandemics, they abandoned it, choked up a new one in the space of a few hours and have crashed from failure to calamity since. Maybe he’s saying something absurd about sticking to a plan rather than aping public reaction to chinese twitter videos of a man falling over and some diggers parked in a field?
He says we must live with the disease? That seems reasonable. Vitamin d has proven highly effective, so has ivermectin. The immune system worked for millions of years is seemingly working well in sweden - and seems to have been a deciding factor in the low deaths seen in Japan and China.
As for face masks, no reasonably informed person thinks they’re useful, and there’s plenty of science to suggest the opposite.
Anyhow, what will happen if we open up? Well anyone can see that the graphs follow the same trajectory regardless of lockdowns, they even follow more or less the same trajectory back in the days before incidences of flu mysteriously dropped by between 95 and 100%. Admittedly some countries and US states have fared better by not locking down. I suppose that’s where the lockdown argument really falls apart.

As for me being beguiled by ermine, not really. Priests wear collars, judges wear wigs, trans lads wear dresses and socialists wear donkey jackets. I’m cool with all of it.

(Say what you like about the daily mail- they ran a front page exposing multi million pound covid contracts awarded tender free to tory cronies. I doubt if the Irish media would do likewise…though i only ever get a glance at the oul lad’s indo)

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Okay. Thanks for detailed answer. I will try to make a few points, because I find it quite disorienting how much I am in disagreement with people in this area.

Yes, I think it’s well reasoned, even if he did pull his punches a little. The nhs is in a mess, they’re sending home healthy staff, reducing bed numbers on a yearly basis, opening and closing exhibition centres, playing silly buggers with government statisticians (for reasons that I’ll let you explain), unable to employ sensible measures like their counterparts in india and sweden

The logic here, both on Sumption’s part and on your part, is bizarre – twice over First, did ‘pro lockdown’ people – ever before this pandemic unfolded – somehow anachronistically undermine the NHS and therefore cause in advance its current inadequacies? How could this scenario, even in mere chronological terms, have transpired? Does rain come out of the ground because the ground is wet?

Second, why does the NHS’ current inadequacies somehow make it all the more ‘appropriate’ to drive the service ‘over the cliff’ altogether via overloaded virus response? This notion of appropriateness is both your tone and your logic. Are you just opposed to non private medicine? To the NHS per se? Would seem so. Which is a whole other argument. Do you feel a ‘hard rain’ should come for the NHS, via this virus, so that the NHS can be dismantled and American healthcare companies introduced into the market?

There is no point, by the way, in adducing Sweden. That boat has sailed – as even the Swedish helmsmen themselves now concede. To hark continually after a false example betrays far more than the desire for an example.

To be strict about it, there is no point in adducing nearly ever other country. They might be getting on terrifically well in Montana, say, but does this facet really bear upon the crux in 26 county Ireland: should the government have locked down, as happened, on December 24, 2020? I am not interested in cookie cut ideological biases. I am interested in pragmatic assessments of specific situations – and in learning from prior errors, as you will agree, on this front.

Is winter flu as serious as this virus? I suppose this virus is a bit more serious than some of the worst flu years over the last 20. It’s hard to tell, though…what with the behaviour of government statisticians mentioned above, dodgy pcr tests etc. Either way there’s plenty of coherent argument to say that it’s in the ballpark

This nonsense lies at the heart of what I find disorienting. Are you really asking people to believe that governments all across the planet have maimed themselves economically more or less for the craic, out of sheer capriciousness? Are you really?

So much becomes your position. If Covid-19 is only like winter flu, why did the various governments not treat Covid-19 like – well, like winter flu? Why not save themselves trillions? How do you account for such irrational behaviour? Is the prompt to such boggling irrationality a conspiracy by Big Pharma?

Now, this question is separate from whether Covid-19 is economic warfare by the Chinese. And a supposed winter flu would be a rather piddly martial effort by the Chinese, no? You would imagine the Chinese could do a fair bit better than a winter flu with frills on it

though it would be a shame not to mention the high proportion of people who contracted/tested positive covid while in hospital for other reasons: The polite silence around deaths caused by lockdowns will only last so long however, I’d hope!

More nonsense, after a fashion. True, incompetence in hospitals is an awful element. Entirely true. But there is a more coherent argument to say such infections occur because of high rates circulating in the community and the consequent near impossibility of keeping care homes and hospitals impregnable. Besides, what would happen if the NHS capsized, as you appear to covet, on the internal infections front? Would you and anyone who agrees with you be prepared to break the silence? To put up your hand and say ‘Yeah, that’s on us, for we got it wrong’? I wonder.

A core problem for the OIUTF contingent is the unwillingness to appreciate the central problem as infection rates rather than death rates. For one thing, infection rates drive – in a non lockdown situation – a rolling de facto 14 day lockdown of close contacts. There is no way around this reality. You therefore cannot resume normal economic activity while a certain infection rate persists. What is the purpose of OIUTF if not to resume normal economic activity? Is the dynamic merely reflexive anti government animus?

And he criticises government u turns, I really dont see this as tacit approval of lockdowns. The fact is that western democratic governments had a plan for pandemics, they abandoned it, choked up a new one in the space of a few hours and have crashed from failure to calamity since.

Well, Sumption implicitly recognized the connection between premature relaxation of restrictions and u turns. But then he flinched from that realization, due to ideological bias.

Maybe he’s saying something absurd about sticking to a plan rather than aping public reaction to chinese twitter videos of a man falling over and some diggers parked in a field?

Thankfully, I know not what this allusion means. Not all Twitter videos are important. Probably very very few of them are of the remotest significance.

He says we must live with the disease? That seems reasonable.

Reasonable, yes – in the vein of utter banality. A slogan is not a road map. We need specific plans around schools and universities in particular.

Vitamin d has proven highly effective, so has ivermectin. The immune system worked for millions of years is seemingly working well in sweden - and seems to have been a deciding factor in the low deaths seen in Japan and China.

I salute you for raising vitamin d and ivermectin. But a clear problem is that the logistical issues associated with vaccines would be easier with but not absent from rolling out these two resources. No magic bullets, despite your implication, lie to hand.

There are more grave problems. Vitamin d, while promising, is unproven. Face value, you have been asking people – ever before a vaccine was produced – to risk becoming seriously ill or to risk giving the virus to other people who could become seriously ill. Your position, stripped down, is of this nature. I think it is reasonable for people – at least before being vaccinated – to refuse such risk on the basis of vitamin d consumption alone.

A cognate point, albeit a more worrying point, applies to ivermectin. If I properly understand your case, which is an important one, ivermectin does not prevent a person contracting the virus. Instead ivermectin, if said person becomes seriously ill or faces death, mitigates those two prospects. By this light, I find your all out enthusiasm for ivermectin as a magic bullet quite strange. I think it is perfectly reasonable for anyone to say they do not wish to risk serious illness or making someone else seriously ill simply because there exists a drug named ivermectin, one that has still to be properly trialled and processed as regards Covid-19. I think it is perfectly reasonable for anyone, to take the prospect of such serious illness on tick, to want rather more insurance and reassurance than ivermectin currently provides.

The Sweden reference, as broached, is null and void. This obsession greatly weakens your position. There is no way in which the Swedish response constitutes a paradigm – and certainly not a portable paradigm. To give over clutching this straw would help.

Nor can China, given its non democratic nature, easily provide a paradigm for European democratic states. I am truly amazed that someone so anti government and so anti state, on supposed principle, would look to China.

As for face masks

Depends on quality of face mask. If you were correct, most surgery could never take place.

Anyhow, what will happen if we open up? Well anyone can see that the graphs follow the same trajectory regardless of lockdowns, they even follow more or less the same trajectory back in the days before incidences of flu mysteriously dropped by between 95 and 100%. Admittedly some countries and US states have fared better by not locking down. I suppose that’s where the lockdown argument really falls apart.

This stuff is utter nonsense. You are basically arguing that the 26 Counties, without a hard lockdown on Christmas Eve last, would be better off or no worse off than currently applies. I find such ‘logic’ a river from a poisoned source. No matter how healthy-looking the fish in it, I would not eat them. And going back to the spurious flu equivalence cleanses nothing.

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Say what you like about the daily mail- they ran a front page exposing multi million pound covid contracts awarded tender free to tory cronies. I doubt if the Irish media would do likewise.

I agree, naturally, about endemic corruption at the top of current Tory Party. But this issue is separate from the wisdom (or not) of lockdown measures. Not everything can be folded together if a bed is ever to be made.

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Man dear, I don’t know where to start, and there’s only so many times I can be right about everything.
BUT

There is no magic bullet…but sure if 89% of the time it works all of the time it will do rightly…and neither vitamin d nor ivermectin will kill anyone, which is a lot more can be said for vaccines or lockdowns.

AND

I’ll tell you something that hasn’t been properly trialled, processed, tried before, won a nobel prize etc: Lockdowns.

And this risk of giving it to others. The risk is still there…and the risk will be there when a bad flu comes along and kicks covid into touch. That’s life. The fact is that this is nowhere near as bad as all the experts predicted ,modelled for etc.

They didn’t all lockdown, or they didn’t all lockdown to the same degree. My point about Florida, sweden, north Dakota, Croatia etc stands.

The nhs…the uk government are spending billions on testing and tracing…spend it on something that works instead.

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Those observations are not even remotely adequate, sorry.

But we will leave it…

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A fine read. American centric but issues are universal

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Anyone subscribe to The Currency?
200 euro a year seems pricey

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There’s a lot of good stuff on it. Definitely more business focussed though.

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