THE ANATOMY OF STARVATION

The U.S. mercy mission to Somalia is a race with death for as many as a third of the nation’s remaining 6 million people. While as many as 300,000 have already died a slow death from starvation, the multinational rescue effort holds out the promise of salvation to all but those on the very brink of death. Here is a look at starvation’s insidious course, as well as the body’s remarkable powers of recuperation.

A BODY FEEDING ON ITSELF

1. When food is first denied, the body feeds on a starchy substance called glycogen, which is stored in the liver.

2. As less food is taken in, energy drops. Heartbeat, pulse and blood pressure fall.

3. The body begins to lose water and to feed on fat and muscle. Weight lost is composed of 50% water, 25% muscle and 25% fat. As water is depleted from the cells; the body shrinks. Victims take on a gaunt, hollow-cheeked look.

4. Loss of water causes an imbalance of fluids. The distended, swollen bellies typical of starving people are caused by edema, fluid collecting in the cells.

5. The human body can withstand the loss of 25% of its normal weight and survive. Beyond that, life expectancy is 30-50 days. The body’s organs begin to waste away. For example, the heart of a healthy adult weights 11 to 14 ounces; in late starvation, the heart may shrink to 5 to 6 ounces. Intestines wither, making it impossible, for the body to digest food.

6. Disease hastens starvation. Intestinal parasites--rampant in the unsanitary conditions of Somalia’s refugee camps--cause diarrhea, which in turn prevents the body from absorbing what few nutrients it takes in. The immune system begins to break down, leaving the body defenseless against other diseases.

7. Starvation has a devastating effect on mental health. Hope dwindles, and personalities slip away. A person becomes confused, disoriented and irritable. Self-preservation often leads starving mothers to snatch food from their children as panic sets in.

RESTORING HEALTH

Faced with the specter of shocking human suffering, U.S. troops may be tempted to share their rations with hungry people they encounter in refugee camps. But bringing a person back from starvation is a lengthy process. Here is a look at resuscitation and rehabilitation.

Those closet to death need resuscitation before any food can be administered. In the worst cases, starving children and adults suffer from withered intestines and cannot digest food. In this case they can be fed only intravenously. Others have lost the ability to chew and swallow.

* Doctors first given patients an intravenous drip of carbohydrates, which are used immediately by the brain.

* Dehydrated patients and children are given tiny sips of an oral rehydration solution of water, sugar and salt.

* Next, patients are fed a nutrient-intense liquid. For example, Unamix, a formula developed by the United Nations of ground maize, bean flour, sunflower oil, sugar and vegetable oil, is being distributed in Somalia where aid is available to refugees.

BABIES AND CHILDREN

* Babies born to starving mothers are premature and underweight and seldom survive. A starving mother is unable to produce nutritious breast milk, further removing any hope of her baby’s survival. Those who do survive may have a reduced IQ and suffer a host of other physical and emotional effects.

* The good news is that with proper care, even skeletal children can be restored to health without permanent brain, nerve or organ damage--although their growth may be stunted.

* For older children, several months of starvation by itself will not cause brain damage. Children who were chronically malnourished earlier in their lives may suffer such damage.