People not directly affected by the food crisis in Southern Africa still faced serious health risks like cholera and dysentery, with HIV/AIDS adding to the problem, the World Health Organisation (WHO) told IRIN on Thursday.
Without proper focus on these problems, the current figure of 12.8 million vulnerable people could escalate. Up to 60 million people living in the six worst-affected countries are at risk of suffering even more from associated health problems.
Zimbabwe, Zambia, Mozambique, Lesotho, Swaziland and Malawi have been red flagged by the World Food Programme (WFP) for urgent food aid.
Rayan Bu-Hakah, a medical officer in WHO's Department of Emergency and Humanitarian Affairs, said reduced government health budgets meant that when sick people managed to get someone to take them to a health centre, the facility could be unmanned or have no drugs.
In Zimbabwe, 24 percent of health workers' posts were vacant and 73 percent of health facilities had no drugs, she said.
As the crisis unfolded in the region, there would be more sick people, less people to take care of them, less supplies and less vaccines. This was compounded by dangerous practices like drinking unsafe water and increased prostitution.
During previous droughts and famines, it had been found that starvation was not the only cause of death and insufficient attention to the health sector had increased fatality rates, she said.
This year Malawi saw 926 people die of cholera by May, compared with over 300 for the same period last year. Last year there were less than 3,000 cases in total, but this year the figure shot up to over 33,000.
"Those who are in need of food are affected by everything, and their chance of dying is increased," Bu-Hakah said.
With HIV/AIDS escalating at an alarming rate in Southern Africa, health facilities would come under even greater pressure.
This echoes an earlier warning by Dr Yusuf Chellouche, WHO Acting Resident Representative in Malawi.
"When there are food shortages people's hygiene considerations go down – they are trying to fill their stomachs and will eat anything. They get infected with cholera, then diarrhoea. When they have diarrhoea the body doesn't absorb nutrients and this creates malnutrition. It's a vicious circle," he warned in May.
Recent surveys of children in Malawi's worst hit areas showed that global malnutrition between January and March of this year rose to 19 percent in some places, Bu-Hakah said
"This is acute but it didn't rise because children died," she said.
Studies also found that though the number of people going to maternity units for delivery had decreased, the mortality rate had increased. On investigation it was found that because there were no prenatal facilities, undetected problems caused complications and there was no proper training to work through complications. This was made worse by a lack of supplies and a body weakened by hunger, Bu-Hakah said.
She warned that some malnourished people seeking help at hospitals had been turned away by hospital staff who said "they weren't sick, they were hungry".
"People without adequate food have a low immunity and could die of diarrhoea and acute respiratory infections," she said.
"This highlights the need for urgent attention for health facilities."
Bu-Hakah said the WHO urged that attention be given to the health, nutrition and water sectors, to avert a crisis. Ongoing epidemiological surveillance would spot trends and differentiate between endemic diseases or a dangerous outbreak.