Peter Hermann's article on getting aid to Palestinians illustrates that conflict begets food insecurity, and that food insecurity begets the malnutrition occurring in Gaza and the West Bank ("Getting U.N. aid to Palestinians a struggle in itself," Jan. 2).
Data collected in June 2002 by Al-Quds University in Jerusalem, with technical support from Johns Hopkins University, showed that 7.8 percent of children under age 5 from 1,000 West Bank households studied were acutely malnourished, and 11.7 percent were chronically malnourished.
Malnutrition was worse in the Gaza Strip than in the West Bank. And 43.9 percent of children studied had anemia.
More than half of the children studied had eaten less than 80 percent of the number of calories they needed during the last 24 hours. Most children were able to get adequate protein. However, more than half were not getting even 80 percent of the essential vitamins or minerals (iron, vitamin A, folic acid, zinc).
And when we looked at what the mothers ate, the picture was not much different. Overall, 47 percent of the women of child-bearing age were anemic. And not surprisingly, low-income households were most adversely affected.
Malnutrition stunts development and increases the risk of illness and death.
And as The Sun points out, economic factors contribute greatly to the problems of food security.
Looking at data from 647 food retailers and 153 food wholesalers in Gaza and the West Bank, we found that about 45 percent of both groups had experienced major disruptions in supplies of high-protein foods. About 50 percent had experienced disruption of infant formula supplies. And in about 60 percent of cases the reasons for interruption of the supply of protein foods was the closure of the borders.
A major consequence of unresolved conflict is malnutrition. Similar numbers could be seen in the children of Burundi and Afghanistan, or Angola and the Sudan, or East and West Timor.
To survive in sites of conflict requires coping skills. And selling donated food is an established coping method.
For years efforts were made to curtail such practices. But we now understand that it is a beneficial strategy that allows households to vary their diets and add essential vitamins and minerals that are not readily available in the supplies of grains, beans and oil that are the normal fare of food relief.
By selling the foods that countries in Europe and North America have donated, households are able to use these food donations to meet other urgent needs that relief supplies could never reach.
Wherever conflict exists, the greatest suffering occurs among the mothers and children.
Regrettably, these hidden costs of conflict are seldom tallied. The human costs continue to quietly mount while humanitarian assistance carries on as a substitute for the making of difficult political decisions.
This "humanitarian fig leaf" is not one of modesty but of shame.
Dr. Gregg Greenough Jerusalem Dr. Gilbert Burnham Baltimore
The writers teach at the Johns Hopkins University's Bloomberg School of Public Health and provided technical support for a survey of nutritional needs in the West Bank and Gaza Strip conducted in July 2002.