Alex De Waal’s new book, Mass Starvation: The History and Future of Famine, cannot be assessed as an enjoyable read; instead it is a book that will (and should) leave the reader unsettled, concerned and angry.“... we have come full circle, back to where we were before the invention of “Famine”, in which we understand famines as desperate societal crises, including hunger and other forms of distress, that threaten a way of life, created by the powerful, resisted and mediated by human skills and societal structures.” (De Waal 2018 p52)The author presents a well-researched account of famines, over the last two centuries and uses his research and experience, to reflect on the future of famines. His presentation of famines begins with “the year without a summer” (De Waal pg. 54), the 1816 famine caused by crop failure, due to the eruption of a volcano, in Indonesia. This was the last famine, De Waal reflects, that was caused by an act of nature. He then moves onto act one of a ‘tragedy in five acts”, which refers to the Imperial Holocausts from 1870 until 1914. These are famines caused by colonial settlers, using hunger to subjugate indigenous populations. Although he begins his reflections in 1870, he notes correctly that such famines have occurred down through the ages. However reliable data does not exist in relation to numbers affected prior to this time. Act two brings the merging of the two world wars into one extended world war from 1915 – 1950. He presents this period as the worst for famine deaths in modern history, where forced starvation was used a means of extermination or tolerated for military gains. Act three, 1950-1985, reveals one of the worst famines in history, when Mao Zedong’s ‘Great Leap Forward’ resulted in 25-30 million famine deaths between 1958 and 62. The smaller famines related to wars from 1960s onwards is set out in act four, occurring largely in war torn countries of Sub Saharan Africa.The book catalogues all recorded calamitous and great famines since 1870, estimating that over 103 million people have lost their lives through famines in this time span. Of these deaths, 77 million occurred during war or periods of political repression. He demonstrates that between 1870 and 1970 an average of about 1 million lives were lost every year due to famine. However, fewer deaths are being lost since then due to increasingly professional humanitarian responses and improvements in health care and prevention strategies, such as routine immunisation programmes—a fact that many aid agencies and donors would like global media to take more notice of. One may begin to feel relief at such progress being presented, only to have such hope dispelled by De Waal’s increasing concern on the recent increased use of hunger as a political tool. De Waal (pg. 172) summarises the basic thesis of his book as “...better politics have led to fewer famines” and better general health services have reduced the deaths caused as a result of continuing famines. Over half of all famine deaths since 1870 were actually Chinese citizens. Setting out famines in this way challenges common lay perceptions of famine deaths occurring only in Sub Saharan Africa due to a simple, ongoing lack of food. De Waal’s evidenced-based approach towards Malthusian population principles is refreshing, in a world where such perceptions continue to be cited by many academic scholars and political parties as a reason to justify limiting population size and curbing migration flows. De Waal presents evidence to show that rising population levels have not resulted
World Nutrition 2018;9(1)71in more famine and deaths. However, he does not seek to paint a happy ending, he challenges the global complacency which allows hunger to co-exist in a world with enough food for all. De Waal waits until chapter ten to discuss act five, “the new atrocity famines”. He seeks to answer the question: are we seeing “the resurgence of great famines?” (pg. 179). Chapter ten begins with the fact that in 2017 there was 70 million people in acute need of aid, an increase from 45 million in 2015. He goes on to state that there were twenty million people, in four countries (Nigeria, Somalia, Sudan and Yemen), facing the risk of famine. The people in these countries are suffering from hunger due to political decisions and conflict, not a shortage of food--a failure of political leaders to implement international laws. In act four De Waal presents the good news that famines and the deaths they led to had dramatically reduced, being localised to SSA. However, the most dramatic food shortages, due to conflict, in this decade, have occurred in the Middle East. With countries like Syria denying food and aid to its citizens as a weapon of war, while 51% of the citizens in Yemen are in urgent need of assistance that is not reaching them. Due to the role of politics in present day famines, De Waal calls for forced starvation to be classed asan atrocity, in a similar way to genocide. His book presents compelling arguments, which will fuel many a midnight debate, between scholars and students alike. However, as an academic practitioner, I find his analysis to be a welcome trumpet call, in the present wilderness of false news. This book will be of interest to aid workers, nutritionists and activists who believe that social justice approaches to development need to take precedence over neo-liberal economic growth models. De Waal’s book will become a new core reader on my list of essential books for students, as I strive to fuel the debate to support the right to food and health for all amongst the future leaders in the field of Global Public Health Nutrition.