TELEVISED IMAGES of starving Ethiopians in 1984 jolted the world to humanitarian action. The response was swift, generous and as high-profile (remember "We are the World"?) as charity gets. But an estimated million people starved to death anyway.
Among those who died were the ones we had seen on TV: the children with swollen bellies and mothers unable to feed their babies, whose horrifying, physical embodiment of imminent death -- right before our eyes -- saved the lives of so many others by forcing us to care.
If nothing else came out of that catastrophe, we pledged that such a thing would never happen again. But history is repeating itself 20 years later because famine threatens not only Ethiopia, but its neighbor Eritrea as well.
The numbers today dwarf those of 20 years ago. In recent months, more than 13 million Ethiopians have been relying on food aid for survival. More than half of Eritrea's 4.3 million people have been in the same situation. Put simply, the famine in the Horn of Africa is the greatest humanitarian crisis facing any region in the world today. But it's a crisis that has largely escaped the world's notice.
Having overseen my agency's response to the 1984 crisis, and having visited both Ethiopia and Eritrea recently, I can say with certainty that the current situation is worse. While you may not be seeing on TV endless lines of dying people waiting for food, what you will see if you go into villages and look into families' homes are people too weak to walk in search of food or water, families who have either sold their livestock or watched it die and now have nothing left at all: no food, no water, no medicines, no personal belongings, no mattress to sleep on.
As I write these words, women and children, in particular, are at great risk. This is happening in spite of a generous and pro-active response from the U.S. government and Congress in providing food aid. The humanitarian response has been much more effective than in the past and better coordinated than the 1984 famine response. These efforts have saved lives.
But without clean water and medicine, food alone is not enough. Famine kills more people through disease than actual starvation, as basic illnesses such as measles and diarrhea exploit immune systems weakened by malnutrition. An immediate and massive infusion of clean water supplies and medicines, along with a sustained commitment to providing food if the current harvest fails, can save lives now.
Beyond today's emergency, though, how do we prevent famine from coming back, so in five years I'm not writing these same words to call attention to the next crisis? Because if we don't change the way we address poverty in this region, it will happen again, and soon. And it will be worse. The scale, intensity and frequency of famines in the Horn of Africa are increasing. This quickening famine cycle is eroding people's ability to recover. More and more people are affected each time.
We must treat the root causes of famine, such as poverty and lack of development, rather than purely the symptoms, such as hunger and disease. This can be done through significant investments in long-term development: in health, education, agriculture and water.
The overwhelming majority of Ethiopians and Eritreans live in rural areas and are susceptible to drought and crop failure in a way that many of us cannot comprehend. In Ethiopia, for example, more than 80 percent of the population live on less than $1 a day, according to the U.N. Human Development Report. One dry season or bad harvest equals disaster. Investment in irrigation, tools and fertilizers will go a long way toward helping farmers become self-sufficient, but access to markets is also essential. Increased funding for health care and education would empower people for generations to come.
In the long term, such investments would pay for themselves because emergency needs in the region would diminish. We've seen this approach work elsewhere in the world. We can do it in the Horn of Africa. But will we?
For the hungry in the Horn of Africa, a meal is often followed by worrying about when the next one may come. The people of Ethiopia and Eritrea deserve no less than our immediate and sustained commitment. Because by the time the familiar images of famine appear on our TVs, it will already be too late.
Ken Hackett is president of Baltimore-based Catholic Relief Services.