Farayo Mutsa is slumped in the shade outside Nsanje district hospital, gently holding his daughter, Azineyi. Her wrists are barely thicker than an adult thumb and her mouth is stained purple where nurses have applied zinc oxide cream to her sores. She looks six months old; she is three years.
Mutsa, 33, planted maize, rice and bulrush millet, but the rains never arrived and he had no crops to bring home last April. He survived on the pittance he earned from working as a traditional "African doctor" but his unguents could not protect his daughter from the hidden hunger that threatens the lives of 5 million people in Malawi.
Last week the entire country was declared a disaster area by its president. Aid agencies warn that nearly half the country's 12 million population could starve in the next six months without massive and immediate food donations. So far, it has not been forthcoming. The UN World Food Program still needs US$76 million to feed 2.9 million Malawians until the harvest in April.
Sheila Sisulu, deputy executive director of the WFP, described international inaction over Malawi as "deplorable."
While the British government aims to feed 2.2 million Malawians through a voucher scheme in 16 districts, it is not enough.
"We know governments only act when they see children dying on their TV screens, but once the damage is done it's very difficult to undo," said Peter Smerdon of the WFP. "It's much harder to fund an emergency and prevent massive loss of life than stop one happening."
Oxfam said on Oct. 18 that Malawi was one of the "less visible crises" that governments had "virtually ignored."
Mutsa, typical of several million subsistence farmers who farm on an average of just 0.4 hectares yet make up 85 percent of Malawi's agricultural production, cycled 50km to bring his daughter to the hospital in Nsanje, in the far south of Malawi, where four nurses work in its nutrition rehabilitation unit.
They have no specialist equipment, just a set of scales hanging in the outside shelter where families sit during the day, making clothes and toy balls from old sheets. There is silence; the children are too ill to cry. Weighed and measured, they are given watered down milk and porridge to build them back to health. Many have sparse blonde hair and swollen legs, a sign of the protein deficiency disorder kwashiorkor, or pitifully thin limbs, indicating marasmus, a form of acute malnutrition.
A survey of similar units across Malawi found a 29 percent increase in admissions in August compared with the same month last year. In the worst hit regions, there were 40 percent more malnourished children being treated in hospitals.
Outward appearances are deceptive. Malawi's plains are tinged with green and there is still food in the markets. Livestock is not dying and Nsanje hospital is not yet besieged by the starving. But people's supplies have run out and, weakened from eating just one poor meal a day, they will have no more crops until April's harvest.
Hungry Season
Even then, the situation may not improve. With the price of maize spiralling, many farmers cannot afford to buy seed or fertilizer to plant crops for next year. The "hungry season" that usually starts early next year and ends with the harvest has already begun.
"In January it will be worse because there is a lot of hunger and no way to survive," said Maria Musa, who has brought her child to Nsanje hospital.
Local people blame the food shortages on drought and a bad harvest. Analysts are more critical of Malawian President Bingu wa Mutharika. Recent spending has included US$475,000 on a limousine.
On Oct. 18, opposition members of parliament debated a new law to bring about his impeachment. Aid agencies fear that the political crisis will discourage donors and detract from the government's limited ability to help its people.
"We had erratic rainfall but it was by no means a disaster situation," said Rafiq Hajat of the Institute for Policy Interaction.
"People are now lethargic and listless because of starvation. They don't have seeds or fertilizer. How on earth are they going to plant for next year?" Hajat said.
One of the president's campaign promises when elected last year was subsidized fertilizer. According to Hajat, it never materialized, lowering yields for small farmers who have become dependent on chemical fertilizers.
Their productivity has also been hindered by the commercialization of ADMARC, a government-funded organization which previously provided tools, seed and fertilizer and a market for farmers to sell their produce. While it still offers some subsidized maize, it has been dismantled in many areas.
"Malawi should be the bread-basket of southern Africa," Hajat said. "We have fertile soil, we have plentiful water. There is no reason why we should be starving."
HIV/AIDS
HIV/AIDS has worsened many cases of malnutrition. Malawi has one doctor per 100,000 people, the lowest of all 177 countries in the latest UN human development index, yet 14.4 percent of adult Malawians have HIV/AIDS. The pandemic has killed or incapacitated many parents of working age.
Mutsa's wife is dead and, staying with their only child in hospital, he wonders how to grow next year's crops.
"I don't have enough money to plant crops this time around. I'm not sure how I can help my child. This is the time when farmers till their fields, yet I am in hospital," he said.
Fifty kilometers away in the Shire valley, 1,700 people are quietly queuing under kina trees outside a distribution center run by the charity Goal. Village committees have decided who most needs a 50kg sack of maize. Clutching a ration card, Tembo Nsawaka has been queuing for six hours.
"I eat once a day, in the evening," he said. "All the family is hungry, all the time."
The 50kg sack he can collect from the center once a month only lasts his wife and five children two weeks, he said. So he survives by diving for nyika, black and bitter-tasting water-lily tubers at the bottom of the Shire river. It is a hazardous task. Alice, a local woman, sells five tubers for 2 kwacha (less than US$0.02) to the crowds waiting for maize.
"One person in my village died because of a crocodile but I haven't any choice," she said. "Sometimes when I am in the water my body feels weak because I've got no food but I still have to do it."
In another region, it has been reported that women and children have resorted to frying and eating termites.
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