Famine

FAMINE, a term used both to denote the sensation accompanying a particular physiological state of the organism (see Starvation) and, in a social context, to denote a mass phenomenon characterized by a prolonged insufficiency in satisfying the food needs of large population groups. In its most pronounced form, this phenomenon is a companion to various kinds of socioeconomic upheavals that cause a sharp decrease in the quantity of basic, customary foodstuffs of mass consumption entering general distribution, most often grain products, and consequently, fodder products for feeding domestic livestock (crop failures, wars and other natural disasters, e.g., earthquakes, floods, heavy rains, snowstorms that destroy herds of livestock, etc.). However, this characteristic is not the only and unconditional one for defining the concept of F. as a bio-social phenomenon, and the boundary that would allow determining the moment when F. becomes a social disaster remains completely elusive. On one hand, even with the most pronounced natural disaster, not all population layers in the affected area actually suffer from famine; on the other hand—under capitalist economy and the class stratification inherent in it—there are everywhere, always and inevitably categories of the population that cannot satisfy their food needs to the proper extent and react to this with increased morbidity and mortality. This circumstance corresponds to the fact that the intensity of socio-pathological phenomena reflecting fluctuations in population nutrition conditions undergo changes regardless of the presence of a recognized natural disaster in a given place. The work of Russian statisticians has shown that fluctuations in grain prices in consuming provinces, depending on crop failures in producing areas, were accompanied (before the war) by fluctuations in the level of birth rate, mortality and morbidity of the population. In places affected by crop failure, it is self-evident that socio-pathological indicators are particularly high: here there is always increased morbidity, especially from acute infectious forms ('famine typhus') and certain specific ones (e.g., scurvy, edematous disease), increased incidence of tuberculosis, increased mortality, which, combined with a simultaneous decrease in birth rate, almost invariably leads to a decrease in the total population. All these factors, however, do not affect the entire mass of the population in the affected area uniformly, but in a certain and strictly sequential dependence on the economic power of individual layers. The quantitative and qualitative expression (intensity and character) of the aforementioned socio-pathological phenomena, in the final analysis, is determined by the level of economic and cultural development of the country, the phase of its economic development and a number of other incidental conditions; among them it is usually very difficult to note any main or, better said, immediate factor determining the moment of sharp shift (occurrence of disaster). These factors can be completely different for different places and times. Thus, for an agricultural country with a low degree of economic culture, the meteorological factor has dominant importance; with high economic development, its importance is neutralized by the presence of reserves and accumulations among the population. For a purely industrial country, international complications, cessation of product deliveries, internal economic crisis in industry or the sum of factors determining moments of intensification of class struggle (the famine of English miners in 1926) are of great importance. In view of the considerations presented, the history of mass famines in the USSR and the West presents a very diverse picture of changing events, not subject to any generalized definition either in time or territory, although famines as a natural disaster have accompanied humanity in all parts of the world in ancient times, the Middle Ages and in the period of modern history. In Western Europe, chronicles note mass starvation of the population for a number of years in almost all European countries, and these mass famines were observed cyclically, periodically. Some famines, associated with crop failures and wars, led to the death and extinction of broad masses of the population. In the 19th century, famine as a natural disaster in Western Europe is already observed as a rare phenomenon: it is overcome thanks to the successes of science, tech7 nique, rationalization of agriculture, successes in international transport, trade, etc. All this, however, in no way weakens the importance of natural famines in the colonial countries exploited by Western Europe, where from time to time famine death is a factor strengthening the power of the metropolis. Russia in its historical past is known as a country of famines. Starting from the times of Yaroslav (early 11th century), chronicles testify to years of famine, and apparently to particularly severe years, and not just 'shortfalls'—during the 11th-17th centuries; in the time of Boris Godunov in 1601-03, Russia experienced an especially cruel famine with manifestations of cannibalism; in the 18th century—34 years of famine; in the 19th century—about 40 years of famine. If in the Middle Ages in Western Europe F. was noted periodically, on average every 10 years, and in Russia every 13 years, then in the 19th century—in Europe F. occurs as an isolated phenomenon, and in Russia—every 7-10 years. In the pre-Petrine era, the ruling nobility attributed the main cause of famines to nature, 'the wrath and will of God.' It was advantageous for the tsarist government to basically maintain this version, despite the fact that both revolutionary parties and liberal and radical intellectuals declared in the press, in all sorts of commissions analyzing Russian famines, at zemstvo, medical (Pirogovsky), Free Economic Society congresses, etc., that crop failures alone in no way could explain the disasters of Russian famines and all their socio-pathological consequences, depending on causes of a general political nature that determined the low level of general economic culture of the population. And the very degree of crop failures, resp. the low degree of yield depended on general political and economic causes. A specific feature of our past famines should be considered that the consequences and horrors of F. from crop failures depending on insufficient amounts of atmospheric precipitation were borne precisely by the masses of the poorest peasantry of grain-producing provinces, which usually were suppliers of products to the entire country and for export to the West. In the figurative expression of Prof. L. A. Tarasevich (at one of the Pirogovsky congresses), our peasantry was in a state of constant 'national disease'—undernutrition (chronic incomplete starvation), and it took only a slight deterioration for all the horrors of F. to begin, similar to how a person standing in water up to their neck only needs a slight rise in its level to start drowning. Among the famines of the 19th century in Russia, the 1891-92 period should be noted; among the famines of the 20th century—the 1906-07 period, and as a synthetic result of the historically developed economy, aggravated by imperialist, civil wars and the blockade of revolutionary Russia, was the F. of 1921-22, which covered 35 provinces with a population of about 90 million, of which up to 40 million people were starving, i.e., on average almost 45% (in Ukraine 50%, in some provinces 80% and more). The number of people who died from famine and its consequences in 1921-23 should be taken as approximately 5 million people. In most starving provinces, mortality exceeded the birth rate. Famine struck the child population with particular severity, and besides the huge mass of children dying from starvation, the survivors bore the stamp of starvation in the form of weakened physical condition and development (delayed growth, based on destructive changes in bones and cartilaginous epiphyses, a sharp violation of the activity of the endocrine system, in particular the glands of the sexual system). 'Famine' morbidity in 1921-23 was colossal. The incidence of typhus (famine) reached unprecedented dimensions; but still the main forms of 'famine' morbidity of this period are disorders of general metabolism ('edematous disease'—Oedemkrankheit). Before these diseases, scurvy retreated to second place. Some data (from the extensive survey of the Central Statistical Administration) indicating the colossal increase in mortality in starving provinces are given in the following table. Name of localities Number of deaths per 100 members of surveyed families per year 1919-20 1920-21 1921-22 Ulyanovsk province . Chuvash region . . Yekaterinoslavsk province Voronezh province Stavropol province Saratov province . Orenburg province Don region . . . Sverdlovsk province Crimea....... Tatar Republic . . Bashkiria ..... Samara province . . 2.5 1.7 1.6 2.8 3.3 1.9 M 4.3 2.4 1.9 2.4 2.8 2.8 2.2 4.0 3.3 4.8 2.6 6.7 3.6 6.9 2.3 7.6 4.1 7.9 3.1 8.3 2.6 8.4 4.7 9.4 3.9 10.4 4.1 12.3 2.4 12.4 4.0 13.9 In some provinces in the famine year 1921/22 mortality was five or more times higher than in 1919/20 economic year.

Indeed, for earlier years there is undoubtedly some undercounting due to deaths in those years being forgotten. Nevertheless, even assuming a significant correction for undercounting, based on mortality coefficients from the pre-war period, it must still be acknowledged that the magnitude of mortality in some provinces increases by 3-4 times. This same investigation shows that such a large increase in mortality is observed for the economically weaker part of the population. For example, here are the figures for the Voronezh province (1921-22). Groups of farms Number of deaths per 100 people per year Multi-crop..........

23.2 Mortality among the landless is 10 times greater than among those with multiple harvests. The Famine of 1921-22 caused an unprecedented 'famine refugee crisis' due to people fleeing from starvation, in search of work and bread. This refugee crisis emptied 10-20% of households and farms. Huge contingents of orphaned children created a whole problem of 'homelessness' (see Homelessness), the resolution of which will require enormous efforts from the state in the coming years, as well as the need to eliminate the consequences of the physical weakening of the masses of famine-stricken children. Unfortunately, the scientific study of famine as a socio-biological phenomenon has received little attention to this day. There could be no question of scientific research on Famine before the 19th century. The history of Western European famines is even poorly developed, from which sufficient materials on the 'epidemiology of famine' in time and space could be drawn. Only Virchow in 1848 first established the correct socio-biological approach in the study of 'famine typhus'. In the second half of the 19th century, experimental hygiene (the schools of Font and Rubner) began to study the phenomenon of 'starvation' and resolved a number of fundamental questions about the normal nutrition of individuals and collectives under various conditions. But these scientific studies do not cover the problem of mass, popular famine as a socio-biological disaster, nor the 'epidemiology of famine,' nor the biological essence of it, nor the social pathology of F. Only in journalism and belles-lettres are there pages of strong and deep analysis of individual and group experiences related to F. In pre-revolutionary Russia, political conditions did not allow for the free and broad setting of scientific research work on the essence of Russian famines from a socio-biological point of view; nevertheless, zemstvo economic statistics accumulated rich material for the characterization of Russian crop failures, their causes, their regular dynamics. This statistics and these research directly or indirectly revealed the political-economic roots of Russian crop failures and famines, revealed the constant, chronic 'famine budget' of the Russian peasantry and established the regular periodicity of our crop failures and famines, the interdependence of crop failures, mortality and morbidity, epidemicity. The capital works of Dr. Arkhangel'sky for the period 1844-63, Pokrovsky for 1870-96 established this regularity, this 'iron law' throughout Russia; the works of Drs. Shingarev, Kurkin and others reinforced this regularity with a number of monographic works on individual regions. A number of sociologists, economists and publicists deepened these statistical-economic works with an analysis of the socio-political, class essence of the phenomena of Russian periodic crop failures and famines. The works of Plekhanov ('The Ruin of All Russia', 1892) and a number of brilliant journalistic articles by Lenin in legal and illegal literature are devoted to this topic. From the point of view of medical and socio-biological research on the question of famine in Russia, considerable material has been accumulated, mainly as a result of the historical Famine of 1921-23. This material clarifies the 'epidemiology of famine,' the regularities of its spread in space and time, among different social groups and classes of the population, as well as its spread among nationalities and national minorities. Rich material has been accumulated on the nature and spread of 'famine' epidemics and diseases—epidemiological and clinical material, rich sectional material on F. (works of Stefko and others), material on the effect of F. on physical constitution (works of Ivanovsky and others), on the neuro-psychic constitution of man, on degeneration. New rich and valuable material has been collected on cannibalism during famine. The extraordinary multifacetedness and complexity of the problem of F. as a bio-social phenomenon affecting literally all sides of the life of the individual and the collective does not allow for an exhaustive review and analysis of these materials. Here one can only attempt in the most concise terms to outline some basic and indisputable conclusions from the numerous and multifaceted works done and reduce them to the following general provisions: 1. Insufficient or unsatisfactory nutrition of large groups of the population is an essential factor of its morbidity, weakening of physical development, mortality and birth rate, and moreover a factor acting selectively on the economically least secure layers of the population. 2. The significance of this factor for each segment of time and place is subject to fluctuations, depending on fluctuations in the level of economic and cultural condition of the population as a whole and its individual layers. 3. Sharp exacerbations occur in periods of economic shocks caused by one or another event in the life of the people, but even then the law of selective action by degree of economic stability of groups is preserved. These phenomena have been named famines. 4. In the recent past of Russia (as well as at the present time in the colonial possessions of the West), such exacerbations, most often directly caused by meteorological factors, had deep roots in the historical past. 5. Under the dominance of natural-meteorological factors, with the defeat of large areas by crop failures, F. with all its economic and biological weight always fell not only on the poorest, least affluent classes of the population, but also, under equal other conditions, on the backward in economic and cultural respect nationalities, and in connection with this, first of all—on agricultural groups of national minorities (Tatar-Bashkir and other population). 6. Crop failures and famines, fundamentally violating the economy of the country and the economic equilibrium of the population, first of all reflected fatally on the biology of the population, giving high 'famine' mortality, specific morbidity ('famine edematous disease', scurvy, 'night blindness,' dyscrasias, metabolic diseases, etc.), 'famine' epidemic morbidity (mainly typhus), sharp changes and decreases in physical development of children and adults, sharp phenomena of physical and moral degeneration. 7. The character of the 'epidemiology of famine' is still far from being studied, especially along the line of interdependence of crop failures with the appearance and development of one or another 'famine epidemics' (some famine years in some places are accompanied mainly by scurvy, others by typhoid epidemics). 8. The psycho-physiology of famine remains also almost untouched in terms of study. The struggle with famine in pre-revolutionary Russia was purely palliative in nature and was expressed mainly in the system of issuing grain loans—seed and food, 'famine' loans (about 30 pounds per consumer). The categories of consumers in turn were extremely limited and did not include large groups of truly starving people. The procurement of grain loans was carried out either by the government itself (usually by contract method) or through zemstvos. The government loan system was predatory-exploitative, since it was carried out by contract method; such a characteristic and disgraceful operation was the famous 'Gurko-Lidval' procurement in the famine campaign of 1906-07, when, in connection with grain procurements, members of the government involved in huge embezzlements and bribery were implicated, enriching themselves at the expense of the people's suffering. The entire system of government assistance was accompanied by a system of guardianship, supervision, struggle and persecution of zemstvos and public organizations, since in the eyes of the government the living shadow of F. was revolutionary sedition (and zemstvo and especially public organizations in the eyes of the government harbored this sedition). Of the public organizations participating in the struggle with F., the largest were—the Red Cross, Pirogov Society, Free Economic and Moscow Agricultural Societies and a number of public committees for aid to the starving locally. The Red Cross was only an auxiliary organization of the government. Other public organizations revealed the energy of the revolutionary and radical intelligentsia, but within the circle of their philanthropic activities, by their class nature, with limited rights and possibilities, with meager material resources collected by public and private donations, under constant government persecution—were deprived of the possibility of alleviating the fundamental needs of the starving population. Naturally, after the October Revolution, measures to combat F. acquired a completely different direction, scope and character. The Famine of 1921-22 befell the Soviet republics after the imperialist and civil wars in the midst of a cruel, iron blockade. The country was shaken in all its socio-economic foundations; it was only approaching its revolutionary revival, extremely weakened in its material resources, and had to overcome the consequences of F. with incredible difficulties and tension of all forces, with the mobilization of the entire state apparatus, all public society under the leadership of a specially created authorized body—the Central Committee for Aid to the Starving (Ts. K. Pomgol). The most important work fell to the People's Commissariats for Food and for People's Commissariat of Health.

Unfortunately, to this day no summary has been made of the measures carried out by the Soviet government during the famine of 1921-1922. This summary would have presented a grand picture, on the one hand, of the unprecedented needs of the starving population and the extraordinary difficulties in satisfying them, and on the other hand, of the unprecedented revolutionary energy, tension, and will of the revolutionary people to overcome F. The state provided extensive assistance by supplying the population with grain and seed materials, organizing canteens, public, timber procurement and other works, organizing resettlement, etc. In the line of medical aid, the People's Commissariat of Health developed intense activity: in the famine districts and provinces, the medical and preventive organization was expanded and strengthened; in these famine districts, there operated 999 medical districts, 1,485 feldsher points, 1,305 hospitals with 64,091 beds; daily, 92,060 rations were issued in these hospitals; in addition, 611 children's hospitals were functioning, in which 36,438 children were cared for; under the Narkomzdrav, a permanent Pomgol Commission operated, which conducted a number of major research expeditions. All these data refer only to the period of 1921-22 (from the beginning of the famine campaign until August 1, 1922), and this list of measures by no means exhausts the subject, nor does it cover the measures of 1922-23 and the activities of the 'Commissions for Combating the Consequences of Famine', the Red Army, and children—both through voluntary material participation and by applying their own living forces. In the face of the difficulties experienced, the assistance of foreign public forces and organizations—primarily American, Nansen's commission, the international Swiss organization for child aid, etc.—acquired significant importance. BME, Vol. VII. In terms of their nature, content, and direction, measures to combat famines can be grouped into the following categories. 1. Elimination or weakening of the fact of mass undernourishment itself (delivery of products and organization of distribution, which under the class structure of society presents difficulties in differentiating the needy). This also includes the organization of public works and evacuation of the population, which reduce the contingents in need of direct food aid. 2. Elimination of the consequences of F. (medical-sanitary anti-epidemic and curative aid, economic aid for restoring destroyed farms, elimination of child homelessness, etc.). 3. Elimination of the very causes and circumstances that cause mass famines (system of preventive measures).—This last, most important and essential category of measures lies primarily in the sphere of the general economic policy of the country, aimed at the rational change in the nature of production and distribution of the country's food resources (rationalization of agriculture, land policy, industrialization, collectivization, agronomic aid, raising the cultural level of the population, a broadly based state system for studying and utilizing the country's productive forces, etc.). Only in conjunction with all this does the system of preventive measures of a more specific nature, aimed at changing local conditions and features, such as the spread of drought-resistant plant varieties, changes in land cultivation methods, the application of irrigation systems, etc., acquire great importance. In relation to famine catastrophes in industrial centers, the system of preventive measures lies in the sphere of food policy, which also comes down to the tasks of production, transport, storage, processing, and distribution of food resources (see Nutrition). The system of class rations applied by us during military communism fully met the tasks of providing for groups of the population that were most in need and at the same time were the most active elements in the construction and struggle for socialism. In the overall complex of measures, the role of health organs belongs to carrying out preventive and corrective activities for the purposes: a) combating diseases, phenomena of decreased vital resistance, deterioration of the physical condition of the population (strengthening medical-sanitary aid, mobilization of medical personnel, evacuation of patients, etc.); b) caring for children (medical-nutrition points, supply of dietary foods, clothing, evacuation of starving and homeless children, organization of appropriate auxiliary pedological and medical institutions); c) studying questions of nutrition in general and substitutes for food in particular; d) sanitary education in the field of personal and public food hygiene, etc.

M. Gran, A. Molokov.