Life after Famine or Starvation
Life after Famine or Starvation
Context
Many newly arrived refugees from Gaza and Sudan are arriving in Australia after experiencing profound hardship. Many have experienced starvation for many months or years. This experience has a big impact on your physical health and mental health.
- What the body goes through during starvation: The body uses up fat stores, then muscle, reduces metabolism, alters hormones (including those controlling growth, reproduction, thyroid, etc.). These changes help survival in the short term but cause damage if prolonged.
- Physical and mental health consequences: Alongside physical issues (weakness, changes in heart rate, immune suppression), famine often brings trauma, loss, grief, anxiety, and fear. Healing must include both body and mind.
This article will focus on physical recovery from the experience of famine.
Re-Nourishing Your Body: Short, Medium, and Long-Term Effects
When your body has been severely under-fed, re-feeding (giving food again) must be done carefully, and follow-up with a healthcare professional should be done over weeks, months, and even years after the experience.
| Time Frame | What to Watch For | What to Do / Seek Help |
| Short Term (first few days after eating) | If someone hasn’t eaten properly for a long time, suddenly eating too much can cause dangerous changes in the body’s salts and fluids. This is called Refeeding Syndrome, and it can be life-threatening. Not everyone is at risk of this. The risk is higher for: children, pregnant or breastfeeding women, people with pre-existing conditions such as heart disease or kidney disease. | If you are eating for the first time after long starvation, this should be done using special medically formulated food in a hospital setting. Vitamins should also be given including thiamine. This can be life-threatening if not done correctly. If you have lost more than 10% of your weight, haven’t eaten much for 7 days, or have vomiting or diarrhoea, you must see a doctor immediately. |
| Medium Term (weeks to months) | Body stores of iron, vitamin B12, folate, calcium, vitamin D may be very low. Anaemia, fatigue, immune problems, and poor wound healing are common. Bone health begins to be impacted. Menstrual cycles may have stopped. | 1- See a doctor to get blood tests. 2- Eat a balanced diet: plenty of protein (meat, fish, legumes), vegetables, fruits, dairy or alternatives, whole grains. 3- Try to get weight back slowly 4- For women, track menstrual health. 5- Take vitamins with clinical guidance, e.g. thiamine and multivitamins. |
| Long Term (months to years) | Bone health is often affected. For some women, it may take longer than a year for menstruation to return, with impact on fertility Low iron, low B12, Low folate, and other issues may persist for a while. | 1- Regular GP visits. 2- Nutritional plan from a dietitian. 3- Bone DEXA scan, especially for women or older people 4- Continue a diet rich in calcium (dairy or fortified alternatives), vitamin D (sunlight / diet / supplements as advised), protein, and weight-bearing activity (walking, gentle exercise) 5- Monitor for new symptoms (e.g. bone pain, fractures, continued fatigue) and seek medical review 6- Menstrual return is a sign of hormonal health; if periods don’t resume, see a GP or gynaecologist |
Health Professionals Who Can Support You
Recovering fully often requires a team. Here is a list of some professionals who can help:
- General Practitioner (GP): In Australia, a “family doctor” is your first person to contact and the person who will coordinate all your referrals to other clinicians. They may order blood tests , scans (such as a bone scan) and continue to monitor your health over years
- Dietitian / Nutritionist: Expert in planning what and how to eat safely. Can help with meal plans that suit you. Ensures you get enough protein, vitamins, minerals
- Endocrinologist: If there are hormonal issues (e.g. thyroid), they assess and treat those
- Gynaecologist: For women who have had menstrual disruptions, fertility concerns, or reproductive tract problems. They can investigate underlying causes and support recovery
- Hospital care / Emergency Department: If you are ever worried, if you have urgent concerns, or if you are experiencing worrying symptoms (such as sudden shortness of breath, confusion, extreme fatigue, or abnormal heart rate), go to emergency immediately
For all clinicians you see, it helps to bring any medical records you have, explain your history of starvation, weight loss, symptoms, and dietary changes. If language is a barrier, ask for an interpreter.
Effect on Children
Children may experience delayed puberty, low bone density and might have weaker immune systems. Young infants, babies, or those who are exposed to starvation in utero will need closer monitoring and special medical formula to support their healing.
In order to support children who have been exposed to famine, it’s very important that you see a Paediatrician and other health professionals to monitor and support healing.
Mental and Social Healing
Healing the body is deeply connected to healing the mind and finding community. This takes time, and it’s normal to feel many different emotions: grief, fear, anger, loss of identity, alienation, and hope.
- Trauma from famine and displacement: Many people will have witnessed loss of loved ones, violence, illness, and have had to flee. This contributes to anxiety, depression, post-traumatic stress. It can also affect sleep, appetite and concentration. Studies show high rates of mental health conditions among refugees.
- Social isolation and culture shock: Moving to a new country means new language, different culture, possibly different food, climate, social norms. That adds to stress.
- Ways to begin healing:
- Counselling / Mental Health Services
- Peer & Community Support: Connecting with others from your country or similar journeys can reduce isolation. Sharing stories, community meals, and cultural practices help create connection.
- Practical supports: Learning about the health system, using interpreters, getting financial, housing, social support helps reduce stress so you can focus on health.
- Mind-body practices: Rest, gentle physical activity when able, sleep, traditional practices (prayer, meditation, storytelling) or whatever gives you comfort.
It’s ok to ask for help. Healing may take months or years. You are not alone; there are people and services who want to help you heal both body and mind.
Sources
1- Nutritional support and refeeding syndrome in critical illness; van Zanten, Arthur Raymond Hubert; The Lancet Respiratory Medicine, Volume 3, Issue 12, 904 – 905
Tânia Amorim, Anamil Khiyami, Tariq Latif, Pouneh K. Fazeli, Neuroendocrine adaptations to starvation, Psychoneuroendocrinology, Volume 157, 2023, 106365, ISSN 0306-4530, https://doi.org/10.1016/j.psyneuen.2023.106365.
Accessed from: https://www.sciencedirect.com/science/article/pii/S0306453023003438
2- P Paudyal, N Purkait, J Fey, Mental health resilience among refugees and asylum seekers: a systematic review, European Journal of Public Health, Volume 33, Issue Supplement_2, October 2023, ckad160.1628, https://doi.org/10.1093/eurpub/ckad160.1628
https://www.who.int/news-room/fact-sheets/detail/refugee-and-migrant-mental-health