Deprived of food long enough, the bodies of starving people break down muscle tissue to keep vital organs functioning. Diarrhea and skin rashes are common, as are fungal and other infections. As the stomach wastes away, the perception of hunger is reduced and lethargy sets in. Movement becomes immensely painful. Often it is dehydration that finally causes death, because the perception of thirst and a starving person's ability to get water are both radically diminished.
Thousands of Somalis have already suffered this tragic end, and it is likely to kill tens of thousands more in the coming months. The famine now starving Somalia affects 3.7 million people, according to the U.N. World Food Program. Writing on his personal blog, the U.S. Agency for International Development's Edward Carr, who works on famine response, estimates that on current trends Somalia's south could see 2,500 deaths a day by August.
For all its horror, starvation is also one of the simpler forms of mortality to prevent -- it just takes food. Drought, poor roads, poverty -- all are contributing factors to the risk of famine, but sustenance in the hands of the hungry is a pretty foolproof solution. As a result, famine deaths in the modern world are almost always the result of deliberate acts on the part of governing authorities. That is why widespread starvation is a crime against humanity and the leaders who abet it should be tried at the International Criminal Court (ICC).
Historically, famines were sometimes the simple result of collapsed local food production, limited resources, and weak infrastructure to bring in food. But as infrastructure and markets have spread, the failure of local crops has become a contributing factor rather than a sufficient cause of widespread death by starvation. For example, economists Robin Burgess and Dave Donaldson have found that peacetime famine in India ended at the same time (1919) as railroad networks finally reached every corner of the subcontinent.
Infrastructure is still a barrier to famine response in many parts of the world -- studies of modern famine suggest being near a main road significantly increases the chance of survival. But roads and rail are far more widespread worldwide than they were 50 years ago, and a global famine relief industry now has significant capacity to provide food to those in need even in remote areas of the world. Humanitarian aid financed by the major donors climbed from a little over $1 billion in 1990 to $9 billion by 2008 -- a size and capacity which, even with the aid industry's well-documented faults, is enough to ensure the ability to stop mass death by starvation wherever it is allowed to operate.
Thanks to globalization, the spread of infrastructure, and the growing capacity of agencies like the World Food Program, famines have become very rare over the last 30 years. Somalia's is the first official famine declared by the U.N. worldwide since 1984. Because declaring a famine is usually the responsibility of the government (a requirement waived by the U.N. in the case of Somalia), the official count is far from exhaustive: North Korea saw somewhere between 600,000 and 1 million people die from famine in the second half of the 1990s, and Omar al-Bashir's Sudan and Robert Mugabe's Zimbabwe have seen outbreaks as well. But, in general, starvation is on the wane. According to Bill Easterly of New York University, less than three tenths of a percent of the population of Africa was affected by famine in the average year between 1990 and 2005.
So why do famines still happen at all? As the economist Amartya Sen famously observed, famines rarely occur in democratic or even relatively free societies. In fact, they don't happen any more in any country where leaders show the slightest interest in the wellbeing of their citizenry. Thanks to spreading markets and improved international assistance, famine is no longer associated merely with passive or excessively weak governance. In order to ensure widespread death by starvation, a governing authority must make a conscious decision: it must actively exercise the power to take food from producers who need it or deny food assistance to victims.