Ethiopia's latest drought-driven famine seems familiar at first -- infants with pot-bellies suckling the emaciated breasts of mothers too tired to wave away flies crawling across their lips.
Then you notice that the countryside, the fields of banana and pineapple, is lush and green, damp from rain, with cattle and goats nibbling the foliage.
PHOTO: REUTERS
Yet some villages seem to be replaying the grim images of 1984, when 1 million people starved and the world vowed that it would never happen again. The rock musician and campaigner Bob Geldof returned this week to highlight the disaster and plead for assistance.
Has nothing changed? Has all the attention, money and effort of the past 18 years produced only deja vu? Is Ethiopia destined to endure the same horror, generation after generation?
But this crisis is different. Its causes and solutions are removed from 1984 and there is no talk of another Live Aid charity rock concert, because there is no need. An elaborate aid machine is delivering food and averting mass starvation.
Some 1.15 million tonnes of food aid have arrived and more is coming. Unicef feeding centers are treating malnourished children and their mothers. The bad news is that this intervention will not solve a crisis with roots so deep that there is hunger amid abundance.
Bjorn Ljungqvist, head of UNICEF in Ethiopia, said: "Around 14 million people are affected by drought, of which 12.5 million need food support, of which 3.5 million are very critical and verging on starvation."
Scant rains over the past three years have turned crops to dust, especially in the north. When the recent rains turned the south verdant it was too little too late for this planting season.
Weather (and a military dictatorship waging war) was also blamed for the 1984 hunger, but this time other causes weigh more heavily, according to a UN emergency report.
"This lush landscape hides a famine that, although widely attributed to last year's drought, is the result of structural deficiencies, scarcity of land, overpopulation and lack of development," the report says.
As the population has grown to more than 67 million, the land has been divided into smaller plots, but farmers lack the skills and capital to make it productive. Those who borrowed money for seeds and fertilizer have been ruined by collapsing coffee prices.
As poverty deepens, coping mechanisms falter. No longer can your neighbor lend cash, or your cousin give surplus maize. The analogy the aid agencies use is a person neck-high in water: a slight ripple is enough to overwhelm them.
Under such conditions, children drop out of school -- almost half never see the inside of a classroom -- ensuring that the next generation will be as badly educated as the previous was.
Those not killed by malnutrition are stunted, physically and intellectually.
The vicious circle spins fastest in the case of HIV/AIDS. Scarce food is expensive, so the poor skimp on quality and quantity. A shortfall in protein accelerates full-blown AIDS for those infected with HIV.
HIV and hunger are so intertwined that there is a term for it: New Variant Famine. In southern Africa the virus leads the famine; in Ethiopia it is the reverse, said Mr Ljungqvist.
Throw in malaria and other diseases, and the result is a chronically enfeebled population.
Like many African governments, Ethiopia's has ducked leadership on HIV/AIDS. More than 2 million people are now infected, with the number expected to rise sharply.
No amount of food aid will make those problems go away, something Geldof understands, but that is what he focused on.
Nineteen years ago it seemed simple: feed the hungry.
Now that is considered the first step on a journey longer than most imagined.
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