Help may be too late for Somalis on brink Long starvation weakens immunity OPERATION RESTORE HOPE

December 07, 1992|By Newsday

NEW YORK -- For many of the Somalis closest to starvation, the U.S.-led military intervention might simply be too late.

According to relief experts and medical specialists, the famine in Somalia has now gone so far that the worst cases might only be saved with intravenous feeding, which would be impossible to ++ set up on a large enough scale, soon enough, to do much good.

After weeks and months of starvation, the experts said, the human body's energy reserves get so low, the immune system becomes so weak, and the fluids become so unbalanced that intervention is often too late. This is especially true in the youngest children.

"They may not be physically able to lift a spoon and feed themselves, or even chew," said Zoe Kopp, deputy director for primary health care at CARE in New York. "Every single system of the body is affected" by starvation, and "these people are getting nothing. They have no energy to burn, their muscles just erode away."

While there is no precise count of how many Somalis have starved, it is estimated that about 300,000 have died and a million or more are at risk. The Bush administration estimated that about 1,000 Somalis are dying each week.

J. D. Deming, of the U.S. Agency for International Development in Washington, said "the situation is so grim that what we're sending in is Unimix, a sort of Bisquick for the starving. It's a very potent powder made of different grains."

The agency also sends corn and sorghum, which are less likely to be stolen than the more popular -- and salable -- rice, beans and cooking oil. But, while Unimix can help keep children alive, Mr. Deming said, as a rule "the adults won't eat it."

Also, if it is not mixed properly with water or goat's milk, he said, Unimix is dangerous. "A glob of Unimix will sit in a kid's throat and kill him," he said. "So you can't just go out there and put a big lump of this high-powered stuff in his throat. If you don't dilute it enough, they choke."

Rehydrating, getting body fluids up to normal, is also necessary and may require intravenous feeding, which is expensive and difficult.

Also, "it's hard to start again on solid foods when someone has been starving to death," said nutritionist Sharron Dalton of New York University.

Mr. Deming, who worked recently in Somalia, recalled that "old men and women, after walking for three days, chewing only on animal skins, are dying right outside the feeding centers." In such cases even the food that is available comes too late.

"Those poor souls," lamented Ms. Dalton. "These people are not only tremendously malnourished, but they are suffering from dehydration, as well."

In the face of starvation the human body begins shutting down, )) slowing its metabolism, dropping its temperature, decreasing the pulse rate. Also, Ms. Kopp explained, "the body's normal defense is that it stops feeling hungry. They stop having an appetite," which makes it even more difficult to resume feeding.

As starvation continues, the body is, in fact, consuming itself, taking energy from muscle tissue in order to preserve vital

organs such as the kidneys, heart and brain. Then, as nutrients such as potassium, calcium and sodium run short, organs begin failing. Death soon follows.

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