This is not 'natural selection': east Africa is in the grip of a famine emergency | Phoebe Williams | Opinion
Earlier this month Adam Gartrell’s article flashed up on my phone screen as I walked between hospital wards in which critically unwell children are congested three-to-a-bed in rural Kenya.
The title (“Ignorant and ugly: Australian social media attitudes to an African disasterâ€) stopped me in my tracks â€" a combination of surprise that the devastation I am bearing witness to each day was reaching our isolated nation’s news cycle, and utter sorrow to see it had conjured such abhorrent comments on social media. It painted our nation as one in which our citizens are devoid of empathy, or ubuntu.
Currently vast areas of east Africa are in the grip of a famine emergency, with 16 million people on the brink of starvation and in desperate need of food, water and medical treatment. By contrast, in Australia our supermarkets groan with choice; water pours freely from a tap leaving us oblivious to its scarcity elsewhere and free, high-quality medical care is a basic human right. It seems for many it is impossible to relate to the millions of people existing â€" not living, just existing â€" in deplorable and desperate conditions on the other side of the world.
That this famine has been caused by the strongest El Niño on record, driven by western carbon emissions and crazed capital consumption which burns through natural resources our governments have, quite literally, pulled from under the feet of African people, seems an irony too complex for many to comprehend.
Plundering oil from Nigeria, gold from west Africa and diamonds from the Congo under legal systems established in the colonial period which continue to leave African nations one step behind, we trap the continent in poverty. Following centuries of exploitation, how can these countries generate their own gross domestic product? Without a functional national economy, building infrastructure â€" roads to transport emergency food supplies, schools to educate the next generation, adequately staffed health systems equipped with life-saving drugs â€" remains impossible.
Gartell’s article exposes the fact that the comfort of our well-resourced lifestyles seems to act as a barrier to exercising empathy. As an Australian paediatric doctor working in Kenya, I have the opportunity to connect with the children and families behind the statistics on a daily basis. Each day I observe the parent-child bond that I know well as a mother of four children: that deep, primitive yearning to love, protect and care for your child. On the ward where I work, mothers and fathers rotate in shifts around the clock to swat the flies from their children’s comatose bodies, sitting in plastic chairs for hours on end willing them to open their eyes, squeezing their hands and massaging their arms with desperation, hoping their child will be one of the lucky ones to survive.
One of the common themes in the vitriolic responses to articles about the famine describes this as a process of “natural selectionâ€; nature’s way of punishing African people for having too many children.
So let me share the story of one of those multiparous women. Nancy shuffled into our ward cuddling the sixth child she had borne, within an hour of his birth. She was still fragile from the recent delivery. Her first five children had not survived childbirth. Her tiny frame and small pelvis, the consequence of her own malnourished childhood, obstructed labour as her babies tried to enter the world. This common condition, treatable with a simple caesarean section in Australia, is a death sentence in Kenya where access to emergency obstetric care and a fully functioning operating theatre is almost impossible.
This baby boy lay seizing in her arms â€" his tiny brain overcome by birth asphyxia or a lack of oxygen suffered due to his similarly obstructed and prolonged entry into the world. While an entire neonatal team would greet this child in Australia and invest hundreds of thousands of dollars into his care to provide the best possible outcome, we tried desperately to treat him with the restricted resources we had.
Five days later, Nancy’s baby is alive but remains too weak to breastfeed and continues to lie motionless and unresponsive in his mother’s arm. Her breast rests in his mouth almost permanently, as she so desperately wills her only surviving child to take his first suck.
Malnutrition is responsible for approximately one-third of the admissions to our ward, and once a child is malnourished, they are more likely to die from any cause. Starving children have lost their appetite, and lie lifeless in their shared hospital beds with their bones protruding, skin sagging and limbs swollen.
Baby Alice was one of the first children I powerlessly watched die slowly and painfully over a number of days. Her 11-month-old frame â€" weighing that of a normal newborn baby in Australia â€" was overwhelmed by anaemia, which remained untreatable due to a lack of blood available for transfusion. As a two month old, she had developed gastro-oesophageal reflux â€" a simple condition managed by competent GPs in Australia â€" yet with no access to basic medical care, she had never gained weight. She lived for nine more months in agonising and hungry pain. Her mother stared at me the day before she died, obviously sensing the concern in my eyes as I reviewed her and asked in perfect English: “She will be OK, won’t she?†I could barely respond; uttering a feeble “pole sanaâ€. I am so sorry â€" we are doing all we can. Pole sana.
Queues are a permanent fixture at the market in town. Maize flour, the country’s staple food, is almost completely depleted from the nation’s supply, leaving children and adults alike starving and desperately waiting for a supply truck to arrive. Last week a two-week-old baby girl arrived on the ward screaming with inconsolable hunger, her mother’s body too depleted to continue to produce breast milk. She had been forced to feed her newborn daughter watered-down porridge which her tiny immature gut rejected with profuse vomiting and diarrhoea. As we worked to save her hypoglycaemic baby, her culpability that her own body had been unable to sustain her adored child was palpable. Her baby shares a bed with a two-year-old child who whimpers all day and night, her body in agonising pain due to multiple fractures that have beset her brittle bones as a consequence of severe vitamin deficiency.
On a daily basis, a cacophony of crying starving babies, moaning seizing toddlers, and the deep, primitive wail of a parent who has helplessly watched their child die fills the hospital grounds. The parents falsely believe everything that can be done is being done, oblivious to the vastly juxtaposed medical care their child would receive had they been born on another continent. The fortunate parents have their children slip away, hidden under a sheet protecting them from mosquitos, during the quiet of the night; the less fortunate parents bear witness to violent, shuddering seizures and listen to their children scream with delirium as they succumb to a lack of oxygen or overwhelming infections for which adequate antibiotic treatment â€" overprescribed to a point of resistance in nations like Australia â€" is simply not available.
As our government dedicates a pitiful portion of our annual federal budget towards assisting in this crisis, I feel powerless to address the multitude of problems and systemic issues which cause crises such as these. The international literature is conclusive that improved levels of female education almost perfectly correlates with better health in their offspring; yet so many mothers are clearly well educated, answering my broken Swahili questions with perfect English responses. Climate-impacting carbon emissions are likely the responsibility of the west, yet multilateral agreements to address climate change consistently fail. And despite the end of colonialism, Africa has never been able to free itself from domination by the west and continues to be exploited by international trading agreements and big businesses. This has allowed individual officials to become wealthy while the region remains stuck, selling its natural resources inappropriately cheaply to foreign investors. We brandish the corruption and cite it as a reason to avoid making donations, forgetting Australia’s own slide down the International Corruption Index.
The fragile situation in Kenya will likely deteriorate further as upcoming elections threaten to plunge the nation into disarray, elucidating tribal tensions which are the consequence of the continent’s historical arbitrary division into distinct countries by European powers, which violated centuries old African empires. A nation of over 42 different tribes were forced to come together under British rule, and the ongoing instability this causes is a further example of the west’s continuing responsibility for destabilising this fragile continent.
Most days the overwhelm is immense, but child by child, we do all we can. I won’t read the social media comments this article provokes â€" my brittle soul is already burdened with fitful sleep filled by the cries of dying children, waking in the darkness to process if there is anything more that could have been done.
But while the shackles of Africa’s colonial past continue to bear the continent down, I hope that at least one Australian will try to understand the multifactorial causes behind crises such as this famine.
There is an old African concept â€" ubuntu â€" which simply translates as “human kindnessâ€, but its scope really extends to (in the words of Liberian peace activist Leyman Gbowee) “I am what I am, because of who we all areâ€. We are one human race, more interconnected than we can even realise. While we may feel removed from this crisis in the safety of our island home, we are nonetheless part of a global community. May Australians fill their hearts with ubuntu, exude compassion and humanity in the face of this crisis, and show humanity to others.
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