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After the Famine

How a $5 gift in 1972 changed my life—and others' lives as well

By Keith West • Illustration by Joel Nakamura

Human history is full of famine.

The Irish famine, the Ukraine famine, the Chinese famines… countless famines over the millennia. Yet, when I landed in Bangladesh in December 1974 and saw people starving to death, it was surreal. This was not how human society is supposed to be.

I was, at the time, a U.S. Army major and registered dietitian on a brief leave to work with Concern. I knew about food, nutrition and health, and could surely help, I thought. Then I realized how very little I knew.

Modern famines are complex and related to a host of interlocking events like crop failures, food system and market failures, civil disruption, unaccountable governance and conflict-all superimposed on already fragile states. Many people perish but some actually benefit. The poor sell everything they have cheap. The rich buy, cheap.

Prior to my 1974 arrival in Dhaka, rumors that the rice crop would fail had set off speculative hoarding. This caused soaring food prices and, for the poorest masses, starvation and migration. That crop did not fail, but by the time I arrived the damage was done. I was not prepared for what I saw: a mass of humanity, outside the plane, inside the airport, on the grounds everywhere. They had no reason to be there other than to escape hell. I made my way slowly along streets teeming with people to the Concern house in Dhaka.

Unprepared as I was, I knew I was meant to be there. As a child, I had pondered over maps while my mom would sigh, "Thursday's child has far to go."

I gravitated to nutrition at Drexel University because my older brother had studied it and then joined the Army because a recruiter had been looking for food and nutrition majors.

While based at Fort Dix's Walson Army Hospital, I was moved by a short news article about amputee freedom fighters in Dhaka being retrained for careers in food service. So I sent a $5 donation to Concern and received an invitation to visit. Knowing I had to make that journey someday, I took a posting on Okinawa to get nearer to my destination. Finally, I convinced my commanding officer that attending a dairy conference in India and working with Concern in Bangladesh aligned with our military's expanding role to help solve nutrition problems around the world.

What I encountered in Bangladesh changed my views about nutrition and my life. I visited Concern's feeding and food-for-work programs in vast encampments near Dhaka. I saw people eat famine foods-roots, barks, plants, flowers and leaves-and spent time with amputees as they prepared meals at the Sher E Bangla Hospital. I left with a question pounding at me: Now that I've seen it, what do I do about it? I finished my tour of duty and joined Concern in Bangladesh to do surveys, train staff and set up food-for-work programs that brought dignity with critical sustenance.

I've been going to Bangladesh ever since. The country has changed in many ways for the better. The nutrition priorities have also evolved. The Hopkins-Bangladeshi research project JiVitA, begun in 2000, now focuses on quality of diet, food security and protecting each generation's "human capital." For example, a poor quality diet can lead to micronutrient deficiencies that thwart health in pregnancy, impair child growth and development, and potentially increase risks of chronic disease. Through our rural research network of 800 staff covering more than 600,000 people, we work with Bangladeshi institutions to develop and test locally produced food supplements as well as assess cognitive capacity and disorders that may have nutritional underpinnings. We keep the next generation in mind, knowing that women need good nutrition not only when they are pregnant, but even before they start to conceive children, as they go through puberty.

That seemingly insignificant $5 check I sent off in 1972 turned out to be a rich investment in my future and my ability to work at improving sustenance in a country to which I am forever indebted.