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This is how you starve to death…

1985 February 8
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by Paul Vallely

This is what happens when you starve to death: at first there is hunger and a craving inside which after two or three days turns to a pain. But the obsession with food does not last long. After four or five days the gnawing pains subside and the stomach wall begins to shrink. This is a process which can happen repeatedly in situations where food arrives only at rare intervals.

Even the thinnest person has just beneath the skin layers of sub-cutaneous fat. At the next stage the body begins to live off these reserves. How long they will last depends on how healthy you were to start with. In the affluent countries we often try to reach this stage by design; we call it slimming. If you are an African whose body has been weakened by years of poor diet and intestinal parasites this stage may last three weeks, or four perhaps. If you are getting a little food, no matter how meagre the supply, this could spin out the whole process for many months.

Eventually though your body runs out of fat and begins to live off the substance of the muscles in your thighs, buttocks and upper arms. In a desperate attempt to stay alive you are consuming your own body.  As if in revolt at this unnatural act, your body erupts in all manner of warning symptoms. Your tongue begins to ache, sores appear at the corner of your mouth, your gums start to bleed or your hands and feet  begin to swell. So does your stomach; in children, often aggravated by parasites, it becomes huge.

At this stage the hunger begins to eat into your brain.  You have become too tired to work or make much effort to search for food. You have, by now, lost all interest in the idea of food anyway. You become irritable. Occasionally you fly into a real rage, for no reason at all.  You find that you are unable to concentrate. You are becoming a different person.

About now, if you are a woman, you stop menstruating.  Your body can no longer consider the possibility of reproduction.  In any case you long ago lost interest in sex. There is little milk left now in your breasts for your infant.

Now your hair loses its colour and sheen. It goes soft and falls out in handfuls. Your skin begins to take on a piebald texture. A stranger could now count your every rib from ten yards away, and the tv cameras come much closer than that. Your upper arms have shrivelled to the width of your forearm, in which you can now see the two parallel bones and the ligaments which join them. Your elbows and wrists stick out like huge comic bulges in comparison. So do your knees, on legs which look like broomsticks covered in skin.  Now you really know what is meant by the expression “skin and bone”. It is all you are. Not that you care much.  Your mind has gone past the stage of irritation now. You are overcome with an undefinable sadness. Your eyes have become glazed and a seductive apathy has seeped through every fibre of your body.  As starvation takes its final grip you lose interest in everything, even in your own baby who is dying on your lap as you sit motionless, on the ground.

The aid workers who arrive do not seem to understand this. They keep trying to force you to eat the milky porridge they offer.  They keep putting the spoon in your hand and guiding it to the baby’s mouth.  When they turn to the next sufferer you let it fall from your fingers. It falls to the dry soil and the flies buzz around; it does not enter your mind to wave them away. You do not even notice that they are crawling around the baby’s eyes and over his face, which is shrivelled now like a little old man’s. You sit and stare at nothing. All about you the world goes about its business. You watch through an impenetrable window. You will probably not actually die from malnutrition itself but the wasting has lowered your body temperature and increased your vulnerability to the most minor of infections. Death, when it comes, will be a blessed release.

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