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BMJ 2001; 323 doi: (Published 29 September 2001) Cite this as: BMJ 2001;323:759
  1. Edwin Martin, previously general practitioner,
  2. Peta Martin, previously health visitor
  1. Bedford
  2. Cranfield, Bedfordshire

    It has been Eid, the Muslim festival, in Arhiba recently. People greeted each other, there was a great deal of noise, children were everywhere, and there was a perceptible lightening of the spirits.

    Nothing much else changed. Arhiba, where we work, is the poorest area of one of the poorest countries in the world. The rate of undernutrition in the Somali area of the horn of Africa is 78%, compared with 68% in Afghanistan and 52% in North Korea (figures from the United Nations). In Arhiba the rate is about 90%. Twenty per cent of all children we see are so severely undernourished that they would probably die without special feeding; 26% of children in any case die before they are five years old.

    Children suffering from kwashiorkor consult us every …

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