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PubMed2000

The political economy of complex emergency and recovery in northern Ethiopia.

During the 1980s Ethiopia experienced the effects of conflict, drought and famine on a scale far greater than many CPEs elsewhere. In May 1991, after the decisive defeat of the military dictatorship of Mengistu Haile Mariam by the Ethiopian Peoples' Revolutionary Democratic Front (EPRDF) and after decades of civil war, drought and famine, Ethiopia faced the prospects of peace and of much needed development. This paper explores both Ethiopia's experience of conflict and humanitarian intervention in areas of Tigray held by the Tigray Peoples' Liberation Front (TPLF) during the 1980s, and its experience of post-conflict rehabilitation and reconstruction in the 1990s. It first deals with the roots of the conflicts within Ethiopia: political marginalisation, heavy state intervention and highly extractive relations between state and peasants, inappropriate and failed development policies, ethnic identity and the politicisation of ethnicity. The Mengistu regime's counter-insurgency measures are then contrasted with the policies and programmes of the TPLF, Ethiopia's most effective opposition movement and the leading element in the EPRDF, and its achievements in mobilising popular support: its establishment of democratically elected structures of local governance and its famine relief distribution programme.

Disasters↗
PubMed2000

Calorie restriction and aging: a life-history analysis.

The disposable soma theory suggests that aging occurs because natural selection favors a strategy in which fewer resources are invested in somatic maintenance than are necessary for indefinite survival. However, laboratory rodents on calorie-restricted diets have extended life spans and retarded aging. One hypothesis is that this is an adaptive response involving a shift of resources during short periods of famine away from reproduction and toward increased somatic maintenance. The potential benefit is that the animal gains an increased chance of survival with a reduced intrinsic rate of senescence, thereby permitting reproductive value to be preserved for when the famine is over. We describe a mathematical life-history model of dynamic resource allocation that tests this idea. Senescence is modeled as a change in state that depends on the resources allocated to maintenance. Individuals are assumed to allocate the available resources to maximize the total number of descendants. The model shows that the evolutionary hypothesis is plausible and identifies two factors, both likely to exist, that favor this conclusion. These factors are that survival of juveniles is reduced during periods of famine and that the organism needs to pay an energetic "overhead" before any litter of offspring can be produced. If neither of these conditions holds, there is no evolutionary advantage to be gained from switching extra resources to maintenance. The model provides a basis to evaluate whether the life-extending effects of calorie-restriction might apply in other species, including humans.

Adaptation, Physiological↗
PubMed1996

Flux analysis and control of the central metabolic pathways in Escherichia coli.

The growth of the bacterial cell involves the co-ordination of the fluxes of carbon into a considerable diversity of products that are the components of the cell. Fortunately the monomers from which the cell's polymers are made are themselves synthesised from a relatively small group of precursors that are the products of the central metabolic pathways. This simplification renders cell metabolism accessible to flux analysis, a method for handling experimental data to derive metabolic fluxes. Through such analysis of the growth of Escherichia coli ML308 on 11 single carbon sources in batch, turbidostat or chemostat culture general patterns are discernible. Most significant among these are that growth on different carbon sources is achieved without any obvious enzyme acting as a regulator of metabolic flux, except when acetate is the sole source of carbon. In this case a junction is created at which iso citrate dehydrogenase (ICDH) and isocitrate lyase (ICL) compete for their common substrate and this competition is resolved by partial inactivation of ICDH to match flux through ICL and this balance limits growth rate. In this sense, flux through ICDH and ICL is 'rate-limiting'. Uptake of six of the remaining carbon inputs exceeds the capacity of the central metabolic pathways (CMPs) to sustain flux to the precursors required for growth and the CMPs are balanced by excretion of acetate. Restriction of carbon uptake by chemostat progressively diminishes growth rate and acetate excretion until acetate excretion is prevented. For the four remaining carbon sources, uptake is apparently restricted and the products are biomass, carbon dioxide and water. Carbon sources feeding the phosphorylated parts of the CMPs flux relatively more carbon to precursors (Pre-C) than CO2 when compared with carbon sources which feed into the non-phosphorylated pathways. Pre-C/CO2 ratios for the former are 1.73-3.91 and for the latter are 0.46-0.78. Flux analysis of all 11 carbon sources shows that there is an overabundant supply of 'energy' (ATP + [2H]), generated by the CMPs, in all phenotypes and conditions down to a glucose chemostat at mu of 0.72. This excess energy is a thermodynamic inefficiency which must be dissipated as heat. E. coli ML308 probably evolved in circumstances of 'feast' and 'famine'. The two strategies selected (excretion of surplus carbon and restriction of mu) would appear to be defences against 'feast'. Presumably there are defences against 'famine'. These are not made obvious by flux analysis but allosteric control of irreversible enzymes would protect pools of essential nutrients from rapid depletion on the sudden onset of 'famine'.

Acetic Acid↗
PubMed2004

Eating, exercise, and "thrifty" genotypes: connecting the dots toward an evolutionary understanding of modern chronic diseases.

Survival of Homo sapiens during evolution was dependent on the procurement of food, which in turn was dependent on physical activity. However, food supply was never consistent. Thus it is contended that the ancient hunter-gatherer had cycles of feast and famine, punctuated with obligate periods of physical activity and rest. Hence, gene selection in the Late-Paleolithic era was probably influenced by physical activity and rest. To ensure survival during periods of famine, certain genes evolved to regulate efficient intake and utilization of fuel stores. Such genes were termed "thrifty genes" in 1962. Furthermore, convincing evidence shows that this ancient genome has remained essentially unchanged over the past 10,000 years and certainly not changed in the past 40-100 years. Although the absolute caloric intake of modern-day humans is likely lower compared with our hunter-gatherer ancestors, it is nevertheless in positive caloric balance in the majority of the US adult population mainly due to the increased sedentary lifestyle in present society. We contend that the combination of continuous food abundance and physical inactivity eliminates the evolutionarily programmed biochemical cycles emanating from feast-famine and physical activity-rest cycles, which in turn abrogates the cycling of certain metabolic processes, ultimately resulting in metabolic derangements such as obesity and Type 2 diabetes. In this context, we postulate that perhaps a crucial mechanism to break the stall of the metabolic processes would be via exercise through the regulation of "physical activity genes," some of which may also be potential candidates for the "thrifty genes" of our hunter-gatherer ancestors. Therefore, the identification of such "thrifty gene" candidates would help provide insight into the pathogenetic processes of the numerous physical inactivity-mediated disorders.

Biological Evolution↗
PubMed1991

Rapid assessment of health needs in mass emergencies: review of current concepts and methods.

The increase in the number of natural disasters and their impact on population is of growing concern to countries at risk and agencies involved in health and humanitarian action. The numbers of persons killed or disabled as a result of earthquakes, cyclones, floods and famines have reached record levels in the last decade. Population density, rampant urbanization and climatic changes have brought about risk patterns that are exposing larger and larger sections of populations in developing countries to life-threatening natural disasters. Despite substantial spending on emergency relief, the approaches to relief remain largely ad hoc and amateurish, resulting generally in inappropriate and/or delayed action. In recent years, mass emergencies of the kind experienced in Bangladesh or the Sahelian countries have highlighted the importance of rapid assessment of health needs for better allocation of resources and relief management. As a result, the development of techniques for rapid assessment of health needs has been identified as a priority for effective emergency action. This article sketches the health context of disasters in terms of mortality and morbidity patterns; it describes initial assessment techniques currently used and their methodological biases and constraints; it also discusses assessment needs which vary between different types of disasters and the time frame within which assessments are undertaken. Earthquakes, cyclones, famines, epidemics or refugees all have specific risk profiles and emergency conditions which differ for each situation. Vulnerability to mortality changes according to age and occupation, for earthquakes and famines. These risk factors then have significant implications for the design of rapid assessment protocols and checklists. Experiences from the field in rapid survey techniques and estimation of death rates are discussed, with emphasis on the need for a reliable denominator even for the roughest assessment. Finally, the importance of adapting normal epidemiological and statistical methodologies to crisis situations is underlined in order to rationalize the recurrent and substantial expenditures made in response to natural disasters today.

Disasters↗
PubMed1986

Consequences of hunger for individuals and societies.

Famine and the manifestations of acute hunger that result are an unnecessary disgrace to our global society and serious in their political, economic, and social consequences. Probably more damaging is the chronic undernutrition that afflicts such a large proportion of the populations of developing countries and the hidden hungers of iron deficiency, avitaminosis A, and iodine deficiency disorders that are enormously widespread. Famine in the modern world is almost invariably superimposed on chronic undernutrition that is not solved with emergency relief. Adaptation to this undernutrition requires a reduction in physical activity needed for household and community improvement as well as work output. Iron deficiency interferes with cognitive performance, resistance to infection, and capacity for work. Other nutrient deficiencies add to the damage to the individual and society. Prevention of famine and hunger is not primarily a technological issue, but a moral, political, and social one.

Adaptation, Physiological↗
PubMed1993

Age and sex differentials in mortality during two nineteenth century population crises.

"The exceptionally detailed Finnish materials are used to examine age- and sex-specific mortality in different regions during the country's last famine, the Great Famine of the 1860s. This is compared with another mortality crisis, the 1808-09 War. The results show that in cases when multiple infectious diseases were responsible for elevated mortality, the increases for different age categories were, by and large, proportional to the levels prevailing during normal times. However, excess mortality showed more variability for children. Furthermore, age- and sex-specific social behaviour (specifically large-scale temporary migration) during the crisis period shaped the age patterns and sex differentials in mortality." (SUMMARY IN FRE)

Behavior↗
PubMed1991

A strategy for reducing numbers? Response.

I am not particularly knowledgeable on the subject-matter of this article; but would like to make brief comments from the broad economic point of view. The concept of a demographic 'trap' is not sound. For one thing, this concept completely ignores the possibility of 'trade' in food by implicitly assuming that the capacity of a community to support its population depends on its own output of food through appropriate economic policies. There were many predictions of disastrous famines in India in the early 70s on the basis of considerations such as those advanced by Dr Ding. Amartya Sen has argued, quite plausibly, that famines occur because of maldistribution of food and lack of adequate 'safety nets' rather than a decline in total food output. Sen is referred to at 1 place in the article; but somewhat out of context. The conclusion that if the birth rate does not fall, the death rate should also not be allowed to fall is repugnant. Look at the countries of Latin America; population growth is high, but there is no 'entrapment'. The so called 'trap' can, of course, occur because of failure of economic and social policies and international economic policies. However, there is nothing inevitable about it (at any given rate of population growth). The author's plea for greater information and public education in respect of demographic trends and consequences is valid. There is also an urgent need for a new thrust in family planning programs on wider economic and social grounds. However, this case is quite independent of the 'entrapment' theory.

Asia↗
PubMedDate not supplied

Phosphorus and mankind's problems today.

The unprecedented increase in the worldwide population of humans--a growth which has been underway for two centuries and has been continuously accelerating--seems to be a root cause of many of the problems of today, including including those treated in this symposium. Current events once more arouse fears that the probable conclusion of our present growth era will unfortunately consist of widespread death from famine, pestilence, and social disruption of various kinds (perhaps involving nuclear devices). Non-local efforts to avoid famine induced by rapid population growth seem only to delay an eventuality that will thereby finally lead to many more people starving. In this paper, phosphate pollution and soil erosion are treated as indirect results of the population boom; and some radical changes in soil and water management are suggested for lessening these problems for large populations.

Conservation of Natural Resources↗
PubMed2003

Simultaneous nitrification and denitrification using stored substrate (PHB) as the electron donor in an SBR.

The potential for PHB (poly-beta-hydroxybutyrate) to serve as the electron donor for effective simultaneous nitrification and denitrification (SND) was investigated in a 2-L sequencing batch reactor (SBR) using a mixed culture and acetate as the organic substrate. During the feast period (i.e., acetate present), heterotrophic respiration activity was high and nitrification was prevented due to the inability of nitrifying bacteria to compete with heterotrophs for oxygen. Once acetate was depleted the oxidation rate of PHB was up to 6 times slower than that of soluble acetate and nitrification could proceed due to the decreased competition for oxygen. The slow nature of PHB degradation meant that it was an effective substrate for SND, as it was oxidised at a similar rate to ammonium and was therefore available for SND throughout the entire aerobic period. The percentage of nitrogen removed via SND increased at lower DO concentrations during the famine period, with up to 78% SND achieved at a DO concentration of 0.5 mg L(-1). However, the increased percentage of SND at a low DO concentration was compromised by a 2-times slower rate of nitrogen removal. A moderate DO concentration of 1 mg L(-1) was optimal for both SND efficiency (61%) and rate (4.4 mmol N x Cmol x(-1) x h(-1)). Electron flux analysis showed that the period of highest SND activity occurred during the first hour of the aerobic famine period, when the specific oxygen uptake rate (SOUR) was highest. It is postulated that a high SOUR due to NH(4) (+) and PHB oxidation decreases oxygen penetration into the floc, creating larger zones for anoxic denitrification. The accumulation of nitrate towards the end of the SND period showed that SND was finally limited by the rate of denitrification. As PHB degradation was found to follow first-order kinetics (df(PHB)/dt = -0.19 x f(PHB)), higher PHB concentrations would be expected to drive SND faster by increasing the availability rate of reducing power and reducing penetration of oxygen into the floc, due to the corresponding increased SOUR. Process control techniques to accumulate higher internal PHB concentrations to improve PHB-driven SND are discussed.

Aerobiosis↗
PubMed2004

Aerobic phosphorus release linked to acetate uptake in bio-P sludge: process modeling using oxygen uptake rate.

The main processes involved in enhanced biological phosphorus removal (EBPR) under anaerobic and subsequently aerobic conditions are widely described in the literature. Polyphosphate accumulating organisms (PAO) are the organisms responsible for this process. However, the mechanisms of PAO are not fully established yet under conditions that differ from the classical anaerobic/aerobic conditions. In this work, we made a comparison between the behavior of PAO under classical EBPR conditions and its behavior when consuming substrate under only aerobic conditions. In addition, oxygen uptake rate (OUR) was measured in the set of experiments under aerobic conditions to improve the characterization of the process. A kinetic and stoichiometric model based on Activated Sludge Model No.2 (ASM2) and including glycogen economy (AnOx model), calibrated for classical anaerobic/aerobic conditions, was not able to describe the experimental data since it underestimated the acetate consumption, the PHB storage, and the OUR. Two different hypotheses for describing the experimental measurements were proposed and modeled. Both hypotheses considered that PAO, under aerobic conditions, uptake acetate coupled to PHB storage, glycogen degradation, and phosphorus release as in anaerobic conditions. Moreover, the first hypothesis (PAO-hypothesis) considered that PAO were able to store acetate as PHB linked to oxygen consumption and the second one (OHO hypothesis) considered that this storage was due to ordinary heterotrophic organisms (OHO). Both hypotheses were evaluated by simulation extending the AnOx model with additional equations. The main differences observed were the predictions for PHB degradation during the famine phase and the OUR profile during both feast and famine phases. The OHO hypothesis described the experimental profiles more accurately than the PAO hypothesis.

Acetates↗
PubMed1989

Nutrition and the commoditization of food in sub-Saharan Africa.

During the past decade, Africa, more than any other continent, has been associated with famine and malnutrition. The Sahelian drought of the early 1970s, the Wollo and Karamoja famines and most recently, mass starvation in Ethiopia, have followed one another in rapid succession. The term 'food crisis' continually crops up in the popular and academic press. An increasing number of researchers probe possible causes; many seek a systemic reason for the present situation. One working hypothesis is that increasing commoditization of food has undermined Africa's food systems. This paper does not purport to prove or disprove this. Less ambitiously, its aim is to draw attention to inter-relationships between commoditization and physical and social aspects of African food systems, tracing their possible effects on the nutritional status of the African population. In so doing, some of the complexities of developing food production and consumption in the transition from peasant societies to more urban-based national economies become evident. The paper is divided into three main parts: a discussion of conceptual categories and general background information about sub-Saharan African food zones and commodity and factor markets; a review of literature on rural food availability and nutrition; and a review of urban food availability and nutrition.

Africa, Central↗
PubMed2005

Starvation in humans: evolutionary background and contemporary implications.

Although there is extensive evidence that caloric restriction (CR) extends lifespan in several species the evidence base for humans is weak. We are still at the stage of applying inductive reasoning and of framing hypotheses to be tested. It is known that a genetic background contributes about 25% to the variation in human longevity, but thought unlikely that any genes conferring longer lifespan have been positively selected to do so. It is more likely that any such benefits are unintended consequences arising from other adaptations. If there is an association between CR and longevity in humans it may have been selected by previous exposures to famine. This paper briefly reviews the historical evidence on the extent and frequency of famines in human history. It is concluded that starvation has been one of the major selective pressures on the human genome and has left abundant evidence of adaptive survival traits. Many of these are mediated through effects on reproduction. However, interpretation of the possible links between these energy-sparing mechanisms and any association between CR and ageing is handicapped by an absence of data on the latter and will remain a matter of debate for many years to come.

Aging↗
PubMed2005

Community-based public health interventions in North Korea: one non-governmental organization's experience with tuberculosis and hepatitis B.

BACKGROUND: The Democratic People's Republic of Korea, also known as North Korea, is the most isolated country in the world, and has been a source of interest, politically and socially, since the 1953 ceasefire of the Korean War. While in the past year, interest has focused on the nuclear dispute with the USA, over the past decade, most interest has revolved around the economic plight of the country, the lack of funds and resources for health care, and the subsequent public health declines. North Korea's present economic and public health problems began in the early 1990s due to the gradual loss of economic support from its communist allies (i.e. after the fall of the Soviet Union and the capitalization of China), combined with an inordinate number of natural disasters (floods, famine and drought) all occurring within the same time span. These simultaneous events initiated a 'snowball effect' of severe economic depression and a rapid deterioration of the overall public health infrastructure in the country. North Korea's continued isolation and reluctance to release health statistics has left the international community uncertain of the precise extent of the public health devastation. The uncertainty of the situation has been further complicated by disparate accounts of the public health declines. For instance, the North Korean Government has estimated that approximately 220,000 people died due to famine in the 1990s, while the World Health Organization (WHO) claims that this figure is closer to 2 million. In the past few years, the willingness of the North Korean Government to engage the outside world has increased. This is reflected by the growing number of foreign aid organizations or non-governmental organizations (NGOs) that have been permitted entry into the country. NGOs have not only served to improve various aspects of the public health system but also serve as a source of 'on-the-ground' information for the outside world. This role has proven critical not only for public health purposes but for facilitating improved international relations between countries.

Altruism↗
PubMed1998

Compensatory placental growth after restricted maternal nutrition in early pregnancy.

This study examined the effects of undernutrition in pregnancy on fetal and placental growth among infants born in 1944-1946 in The Netherlands, including infants born during the war-induced Dutch famine of 1944-1945. There was an increase in placental weight, but not in birthweight, in infants whose mothers' nutrition was compromised around conception or in the first trimester of pregnancy. Therefore, the placental index was also increased. Compared to pre-famine controls, the relative increase after first trimester exposure to undernutrition was larger in the northern part of the country (5.2 per cent, 95 per cent confidence interval 1.4, 9.0) where nutritional deprivation was presumably moderate compared to the west (3.5 per cent, 95 per cent confidence interval 0.2, 7.2) where nutritional deprivation was severe. The increase in placental weight is interpreted as compensatory for the reduction in maternal caloric intake. Whereas this suggests that pregnancy undernutrition can stimulate compensatory placental growth, the latter was only seen after first trimester undernutrition, which does not affect infant size at birth. For these infants, therefore, birthweight is not an appropriate proxy measure of undernutrition in pregnancy. These factors need to be considered in future studies relating pregnancy nutrition to adult health outcomes.

Adult↗
PubMed1997

Biological markers of protein-energy malnutrition.

The biological markers of undernutrition fall into three categories: (a) those that measure structure; (b) those that measure function; and (c) indices of the above two. Ideally a marker of nutritional status should have the following characteristics: specific to nutritional status; sensitive to changes in nutritional status; reproducible; simple to measure; inexpensive and widely available. Unfortunately there are no such markers, and therefore individuals involved in the assessment of nutritional status should be aware of the advantages and disadvantages of the markers they use. For example, body composition can be assessed using sophisticated techniques that make fewer assumptions than simple bedside techniques (1). However, these sophisticated techniques (eg neutron activation, and combinations of techniques such as hydro-densitometry, water dilution techniques and dual-energy X-ray absorptiometry) are not widely available and some of them are labour intensive. On the other hand simple bedside techniques, such as those based on skinfold thicknesses can be applied widely because they are easy and quick to perform, but they are probably not as accurate as the classic body composition techniques (hydro-densitometry or water dilution techniques) or other sophisticated methods based on the assessment of multiple body compartments (1). Therefore the choice of method depends not only on the availability of investigative tools, but also on the practicalities of using them in individuals, a small group of individuals, or large groups of individuals, (eg national surveys during famine and non-famine conditions). In this brief review only some aspects concerned with simple bedside or laboratory methods will be discussed.

Journal Article↗
PubMed1995

The limit of human adaptation to starvation.

During the height of the 1992-93 famine in Somalia, data were collected from 573 inpatients at the Concern Worldwide Adult Therapeutic Centre in Baidoa, the town at the epicentre of the disaster. These data indicate that a body mass index (BMI, body weight in kilograms divided by height in metres squared) of less than 10 kg m-2 can be compatible with life, so long as specialized care is provided. Such low levels of BMI may be explained, in part, by the high ambient temperature, the tall phenotype of the Somalis, the gradual reduction in food intake and previous exposure to chronic energy deficiency. Famine oedema occurred with the same prevalence in male and female patients, but male patients had more severe oedema and a poorer prognosis at any given degree of severity. Survival from these extremes of emaciation has never before been recorded, and many of the BMI values documented here are below the level of 12, previously thought to mark the limit of human adaptation to starvation.

Adaptation, Physiological↗
PubMed1998

Mental illness and Irish people: stereotypes, determinants and changing perspectives.

The causes of psychological illness in Irish people have been identified with colonial rule and the catastrophic conditions deriving from famine in the nineteenth century. In particular, the scourge of unremitting emigration, resulting from famine, has formed a background against which speculative theories of inferiority, alienation and mental illness have been constructed. In particular, the long standing idea that Irish people exhibit higher rates of schizophrenia, both in Ireland and abroad, is discussed. Contemporary studies which suggest that these elevated rates do not correspond to international diagnostic criteria for schizophrenia are introduced. Rather, these enhanced rates may reflect a malaise which resembles schizophrenia but which is really a product of historical dispossession. The importance of these factors is underscored by the previous neglect of Irish people, considered as an ethnic minority, as well as the particular distaste which many Irish people display towards such a notion.

Attitude to Health↗