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As the body starves, its immune system begins to fail. The malnourished fall prey to waterborne infections and suffer diarrhoea, which causes devastating dehydration. Other communicable diseases – which today could include Covid – also ravage communities. The most common cause of death in a famine is disease, not starvation as such.
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In most famines, there’s a margin of uncertainty in predictions, because people may be able to find unexpected sources of food or money. In parts of rural Africa, grandmothers may know about edible wild roots and berries or migrant workers may find creative ways of sending cash to their families. In Gaza, Israel knows every calorie that’s available. In 2008, the coordinator of government activities in the territories calculated every aspect of Gaza’s food production and consumption, in minute detail, and extracted the “red lines” needed to keep Palestinians on what it called a “diet”, just short of starvation.