Somali girl in drought region of Ethiopia.- Scott Tong / Marketplace
Dadaab refugee camp, Kenya.- Scott Tong / Marketplace
Somali refugees, Dadaab refugee camp, Kenya.- Scott Tong / Marketplace
Somali refugees, Dadaab camp, Kenya.- Scott Tong / Marketplace
Bony cows endure famine, Dadaab, Kenya.- Scott Tong / Marketplace
Drought-ridden riverbank, Dolo Bay, Ethiopia.- Scott Tong / Marketplace
Mother and malnourished infant, refugee camp hospital Dadaab, Kenya.- Scott Tong / Marketplace
Pastoralist herder, Dolo Bay Ethiopia.- Scott Tong / Marketplace
Food distribution, Dadaab refugee camp, Kenya.- Scott Tong / Marketplace
Food rations, Dadaab refugee camp, Kenya.- Scott Tong / Marketplace
Camel carcass in drought-ridden Dolo Bay, Ethiopia.- Scott Tong / Marketplace
Dead cow, Dadaab refugee camp, Kenya.- Scott Tong / Marketplace
Shallow graves, Dadaab refugee camp, Kenya.- Scott Tong / Marketplace
The complexities of famine
Kai Ryssdal: The famine in East Africa -- if this is even possible to believe -- has taken a turn for the worst. The United Nations says tens of thousands of people have already died from starvation. And now, rains are falling and cholera has turned up in refugee camps. It has people living on the equivalent of one plate of rice a day.
The United Nations says there are going to be nine billion people on the planet by the year 2045. And so our series, Food for 9 Billion, answers the very basic question of how we're going to feed them all.
Here's one clue: Famine's a lot more than simply a drought.
Scott Tong reports from the Horn of Africa.
Scott Tong: This is a tale of two droughts.
Actually, it's just one weather pattern, in one dirt-poor part of the world. But there's a border. On the Ethiopia side, the farmers and the herders manage to endure. Whereas Somalia -- by now you've heard about the famine.
Abdi Samatar, University of Minnesota: It was as if the skin of their bodies was sticking to their bones. Inhumanly grotesque.
Sadia Ali Aden, Adar Foundation: No toilets, no clean water. The kids were half-naked.
Tony Burns, Saacid aid agency: You can go to virtually any family, living under a piece of plastic, and they will tell you they've lost one, two, three or four children.
How did famine happen? I stopped first at the biggest refugee camp on earth. 460,000 Somalis -- that's the size of Kansas City -- live in Kenya, off U.N. rations of corn, wheat, cooking oil.
Thirty-five-year-old Mahmoud Abdurahman just came.
Mahmoud Abdurahman: We had no rains, no water to farm. So we ran away.
He walked 30 days to get out of Somalia.
Abdurahman: We had to leave some people behind who got too weak. They were still alive then. But people who came afterward told us they saw dead bodies being eaten by hyenas. One of the bodies was my neighbor. It's terrible.
Abdurahman feels lucky because he has a donkey. It pulled the cart carrying his four children.
Abdurahman: But when we came, we lost one child to starvation -- our second daughter. She was one and a half.
Here, everyone talks of the worst drought in two generations. But here's the thing: Other places have drought, too -- Algeria, Peru, Texas -- but no starvation.
Andrew Natsios at Georgetown used to run the Agency for International Development.
Andrew Natsios: In very few places do people starve to death simply because there is a drought. The only time people really actually die is when there is some political complication.
"Complication" is a charitable word for Somalia. It's had no central government in 20 years. There's been internal conflict, there's been outside meddling -- from the Soviets, from the Americans, from the Ethiopians, now the Kenyans.
Out of the mess arose the Muslim extremist group. Al-Shabaab is known for radical theology, and guns. And blocking food aid.
Natsios: The Al-Shabaab movement does not want any food aid distributed because they see it as undermining their authority and legitimacy.
Western aid competes for influence. Natsios says after an earthquake in Pakistan, U.S. help rushed in. American popularity rose; Al-Qaeda's fell.
Natsios: Bin Laden was really, really upset, apparently from what the agency told me, the CIA.
It seems every Somali here has an Al-Shabaab tale. I come upon to a dusty food stall, with a radio that must be older than I am. Refugee Abdu Shan Ali owns the stall.
Abdu Shan Ali: The gunmen just came and stole my animals. They chose the fattest goats, cows and camels.
He fled Somalia two years ago, in search of help for his wife and his 10 kids. They all stayed behind.
Shan Ali: I don't know if they're alive or dead. I ask everyone who comes if they know anything about my family.
He asks to change the subject, puts a couple tomatoes on the scale.
Now the difference between drought and famine starts to come into focus. Imagine it's you: By fate, you're born into the world's poorest place. Drought comes, crops fail, food prices triple. You eat everything you have, including your seeds. Your cows and goats provide milk. But the drought kills half of them, and then gunmen come and take the rest. So you're left with two choices: flee for a refugee camp, or wait to die.
Now, the other side of the river. Same desert climate, same 105 degree heat, same drought -- different planet. This the sound of government safety net. Ethiopian men chant "we work for survive" as they dig irrigation trenches. In return, they get food and access to water.
Fifty-eight-year-old Hisak Ali Hassan.
Hisak Ali Hassan: Now we can eat breakfast, lunch and dinner. Before we only ate two times a day. We don't eat meat, but we get vegetables. And we can go into town to buy rice.
Now this is Ethiopia. Remember the famine back in the '80s? Those Live Aid benefit concerts?
Back then, Ethiopia faced what Somalia faces now -- drought and civil war. Famine then came in part because Ethiopian leaders picked military supplies over food aid -- guns over butter.
Getachew Reda: This is a country which has been a poster child for poverty and hunger.
Ethiopian foreign ministry spokesman Getachew Reda was in grade school during that famine. He recalls a beggar came up and snatched a loaf of bread out of his hands, at which point his grandmother screamed "shame on you" at the beggar. The beggar shouted back: "Shame on you, for giving a child enough food for 10."
Getachew: I have still vivid pictures of people really starving, begging. You know, that kind of thing is a thing of the past. And I think we have come to bury that past.
Ethiopia -- like many African countries -- has gradually built a series of shock absorbers for droughts. It stores water and grain around the country for emergencies. It gives farmers better seeds, and insurance for when crops fail. It's built roads to help people get to market.
The point is to weave a safety net, and to lift incomes so enough people won't ever need the net.
Economist John Hoddinott is with the International Food Policy Research Institute.
John Hoddinott: What we do know in countries which have successfully escaped hunger and famine is that they've done a whole lot of things right. And when you push on all those fronts, that's when you see famine and hunger disappearing.
Meantime in Somalia, seasonal rains have come, raising hopes for the January harvest for the farmers who are still there.
And yet in the refugee camps, the next deadly stage of the disaster has already shown up: water-borne diseases like cholera and malaria.
In East Africa, I'm Scott Tong for Marketplace.