Listless, emaciated children wait for water to arrive by donkey. Their mothers rest nearby, too exhausted to speak. Tiny graves are chiseled out of bone-dry earth to hold the famine’s youngest victims. That is what Mary Robinson, then-president of Ireland, found when she visited Somalia 19 years ago. Images of suffering haunted her for years: “I never got Somalia out of my system,” she said.

Now, the Horn of Africa is again in the grip of famine. When Robinson returned to Somalia earlier this year, “Everything was even worse” than in 1992. At the National Press Club on Monday, October 17, Robinson issued an eloquent plea to address the crisis in Somalia, which has already claimed 40,000 lives. “How can we allow that to happen in the 21st century?” she asked. “It’s a black mark for all of us.” The event was part of a series of discussions organized by the Institute’s Aspen Global Health and Development program, titled “7 Billion: Conversations that Matter.”

Women, Reproductive Health, and Fertility.

It is not enough to respond to the current crisis, Robinson said. To prevent a recurrence, we must also address long-term health and development challenges. That means bolstering governance and security. And, perhaps most important, it means unleashing the power of women. Women are critical to the future of Somalia, said fellow speaker Walid Abdelkarim, principal officer and team leader for Somalia at the UN Department of Peacekeeping Operations. “The most important element is the ability of the household to grow,” he said, “and that’s about the woman who nourishes and runs the household.”

But today, too many Somali women are caught in a deadly cycle of poor health and high fertility. A Somali woman faces a 1-in-14 chance of dying in childbirth—in developed countries, the risk is about 1 in 7,300. With the eighth-highest birthrate in the world—the average family has seven children—most Somali women lack the means to choose the number and timing of their children. According to the Population Reference Bureau, only 1 percent even have access to modern contraception.

High fertility and rapid population growth have compounded Somalia’s existing outsized challenges. Even before the current famine, one-third of young Somali children were underweight, according to UNICEF. The population of this arid, war-torn land, now at almost ten million, is expected to grow by one-third by 2025—and could more than double by mid-century.

The Environment.

The causes of Somalia’s famine are complex and deep-rooted. Two decades of civil war have left the country in a state of anarchy—its resources plundered and its people in desperate poverty. And, while crop-killing droughts are common in this part of Africa, climate change may be making them worse. The last eight years have been the hottest on record, said Robinson. And, to the extent that Somalia’s problems are made worse by climate change, “We are the ones who must change,” said Robinson. Affluent countries “are profiting from overuse of the commons,” she said, adding that developed countries must reduce their greenhouse-gas emissions and help developing countries tap renewable-energy sources. Otherwise, drought may become a fact of life in places like Somalia.

Governance.

But famine is never caused by the weather alone. Nor is it “just about the absence of food,” said Abdelkarim. Access, politics, and security all play important roles. And governance is key: “Even a very bad government is better than no government,” Abdelkarim observed. But, since the collapse of Siad Barre’s regime in 1991, Somalia has effectively been without a central government. Poor governance has enabled the plundering of Somalia’s resources. Al Shabab, the Al Qaeda affiliate that controls much of southern Somalia, runs a lucrative charcoal trade that has decimated the nation’s tree cover. Refugees now pay a small fee just to sit in the shade of the few remaining trees, Abdelkarim said.

Other drought-ravaged countries in the Horn of Africa have fared better than Somalia. In Ethiopia and Kenya, governments avoided tragedy by resettling refugees and dispensing food reserves. Those interventions demonstrate that famine is not inevitable, even in times of severe drought. Robinson quoted the Nobel prize-winning economist Amartya Sen, who famously observed, “No famine has ever taken place in the history of the world in a functioning democracy.”

Solving Somalia and the Costs of Inaction.

To end the Somali famine—and prevent the next one—it is crucial to respond to immediate humanitarian needs while addressing broader underlying causes: a growing population, a ruthlessly arid environment, an absent political system, and especially the crucial role of women, said Geoff Dabelko, who directs the Environmental Change and Security Program at the Woodrow Wilson Center. Ensuring access to reproductive-health services, including voluntary family planning, could help break the cycle of poor health and high fertility that entraps so many Somali women. And it would slow the rapid population growth that makes Somalia’s problems harder to solve. Addressing this problem can’t wait, Dabelko said. “Family planning is not something to worry about once you get wealthy and peaceful.”

In a time of widespread economic crisis, it will be difficult to muster the resources to help Somalia. But the cost of inaction could be even higher. “Failed states are too dangerous to leave alone,” warned Robinson. She noted that Somalia’s anarchy has spawned a fleet of ruthless pirates, who are terrorizing one of the world’s busiest shipping lanes. In an ever-more globalized world, she said, “No country is so isolated that it doesn’t have impacts.”

Laurie Mazur is the editor of “A Pivotal Moment: Population, Justice and the Environmental Challenge.”

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