Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
International Federation of Red Cross and Red Cresent Societies - 4 June 2003
Juan Manuel Suarez del Toro*
But the hunger was not the crisis. It was but a symptom of a new and pernicious process consuming southern Africa. HIV/AIDS is interacting with food insecurity, poverty, common disease and mismanagement to bring a region to its knees. Millions are dying as a consequence and all the food aid we can muster will not save them.
A sad, but legitimate, question is now on the lips of the reader. Where are the bodies? The television images are missing, the ones that define disaster in Africa. There are no skeletal figures traipsing across the landscape, no agonizing evidence of malnutrition, no hunger camps, no endless lines of fly-eyed, wasting children. God forbid, they may come again, but those are yesterday's images. AIDS has changed the human landscape. Perhaps for a long time to come.
Today's disaster is a silent one and most of those dying are dying at home. A ubiquitous disaster has befallen them. There is no escape, so no mass migration is happening, except to the places where people were born. Care can be found more easily there, and the funerals will not be expensive.
The disaster unfolding in front of us is that of community erosion, the slow but inexorable destruction of southern Africa's social fabric. HIV/AIDS is driving it, a killer on its own, but now, with others, a malignant force weakening and undermining the ways in which people bounce back from adversity using age-old coping mechanisms.
Poor access to health care, the accelerated spread of tuberculosis, malaria and other disease, an appalling absence of safe water and sanitation, uncontrolled urbanization and ineffective agriculture are among the aggravating factors. If something is bad, HIV finds it and joins forces. An axis of evils is emerging. It is an alliance of ills, all quietly interacting, feeding and exploiting one another.
You need not look far to find them. But you need to look, and the thinking and analysis of humanitarian response must change. Food aid may have saved more than 14 million lives but it only postponed a disaster. It did nothing to address the causes, or the wider, threatening context.
Life is becoming unsustainable. Farmers fall ill with AIDS, wives leave the fields to nurse them. Fewer hands mean less food, and coupled with drought, may bring famine. But rain or no rain, there is poverty. The farmers die, leaving wives infected and penniless, wondering how to feed their children and pay for their education. They cannot afford seed or fertilizer, cannot work the land as they used to. And they agonize over their children's future. Who will care for them when they are orphaned?
Probably the eldest of them. Southern Africa already counts some 3.2 million children orphaned by AIDS, many of them in child-headed households where neither tomorrow's meal nor education is certain. Schools exclude them when they cannot pay the fees, buy exercise books and uniforms. One generation is dying of AIDS, the next denied the right to succeed.
What is happening is unprecedented, and doing business as usual will not halt it. The humanitarian world is deep in uncharted territory, and the map from the past will not guide us through the future. No one knows what really lies ahead except, somewhere, an apocalypse.
But clearly policy - that of donors and governments as well - has begun to lag behind the emerging challenges. A new paradigm is needed. The Red Cross and Red Crescent is calling for a consortium of partners to intervene in a way that will result in the long-term rehabilitation of communities.
Forget dealing with the challenges separately. HIV/AIDS rules that out. There is need of an integrated community-level response, a comprehensive package of measures to curb a patchwork of problems. We need a coalition of peaceful forces, with a United Nations mandate.
The Red Cross and Red Crescent has itself taken a new and long-term approach to the crisis in southern Africa. There is no exit strategy at the end of a one-year food relief operation. Instead, the International Federation is now committing to a strategy that combines food security with integrated community care involving HIV/AIDS prevention, the provision of safe water and sanitation, health services and the promotion of economic self-reliance. All we need now is for donors and governments to match our commitment.
* Juan Manuel Suarez del Toro is President of the International Federation of Red Cross and Red Crescent Societies
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