“They suffer because they have lost all hope. They walk like the blind, and they fall wherever death strikes them. No one pays attention to the corpses lying on the streets. People either step over or sidestep them and keep on walking. From time to time they are collected and buried in common pits. Seventy and more people are buried together.” 

-Ukrainian woman, describing the Holodomor in 1933 (source)

In 2008, the European Parliament formally recognized that the 1932-33 famine in Ukraine was “artificial,” and “an appalling crime against the Ukrainian people, and against humanity.” While the real number will never be known, estimates are that between 3.5 to 7 million Ukrainians died from starvation during this period, known as “the Holodomor” (“death inflicted by starvation”).  

The famine resulted from a combination of factors, among these being the Soviet policy of collective farming imposed on the population. Resistance to collectivization was brutally repressed, quotas of grain and other foods demanded from farms were increased and ultimately exported, Ukrainians were prohibited from leaving the republic in search of food or even to travel from the countryside to cities in Ukraine, and police were tasked with confiscating hidden food from homes. Altogether, these decisions to weaponize food led to massive amounts of human suffering and death, the echoes of which reverberate to today.

In 2015, Columbia epidemiologist L.H. Lumey and colleagues tested whether there was a correlation between prenatal exposure to the Holdomor and subsequent development of type 2 diabetes in adulthood (Lumey et al. 2015). Per a robust body of research known as the DOHaD hypothesis (developmental origins of health and disease), various stressors early in life can increase the risk for a compromised physiology, predisposing people to an array of health conditions. Perhaps the best-known example of this is the Dutch “Hunger winter” during the Second World War. Adults who were exposed prenatally to a Nazi-imposed famine in the Netherlands consistently show elevated risk for diabetes and schizophrenia, as well as other conditions and effects on body size. To be clear, the extreme levels of hunger during famine are not required to see the effects of prenatal deprivation on later health. Rather, such a relationship appears to exist along a continuum in a “dose response” fashion. Yet the pattern becomes more predictable at the extreme end, such as during wars and famine.

To determine whether a similar pattern existed in Ukraine, Lumey et al. obtained government data from nine oblasts (regions), with a sample of 1.4 million adults born between 1930-38, including 43,150 cases of diabetes diagnosed after age 40 years. The study design allowed the researchers to look at temporal and geographic effects, as these birth cohorts straddled the famine years, and were exposed to extreme famine (Luhansk, Kharkiv, Cerkasy, and Kherson oblasts), severe famine (Chernihiv, Khmelnytskyi, and Vinnytsia oblasts), or no famine at all (Volyn and Rivne oblasts, which were under Polish control at the time).

After adjusting for confounding variables including seasonality, the researchers found that people born in early 1934 in oblasts with extreme famine had a 1.5 times increase in the odds of having type 2 diabetes, while those born in severe famine areas had a 1.3 times increase. People born in non-famine oblasts showed no increase. Lumey et al. added that the study suggested that early gestation was “a critical timing window for determining risk of type 2 diabetes.”

The Holodomor and the Dutch famine are far from isolated cases. Though there are methodological differences and some inconsistencies in results, for the most part prenatal exposure to conflict and famine has been linked with compromised adult health throughout the world. Examples include the siege of Leningrad, the Spanish Civil War, the Biafran famine in its war for independence, France during WW2, the European Holocaust, the wars in the DRC, the Korean War, and the civil wars in Laos (for a review, see Clarkin 2019).

Could History Repeat Itself?

Could something similar happen today? Russia’s current invasion of Ukraine has been widely condemned as an unprovoked “act of aggression and human rights catastrophe” (Amnesty International) and “a clear violation of international law” and “a violation of the United Nations Charter” (UN Secretary-General António Guterres). It is telling that the oblasts exposed to extreme famine in the early 1930s are some of the same places in the news today, with massive destruction, forcibly displaced civilians, and/or likely war crimes committed by Russian troops in Luhansk, Kharkiv, Cerkasy, and Kherson oblasts. To a certain degree, history may be repeating itself.

At present, there are no reports of widespread famine within Ukraine. Most of the concern about the effects of Russia’s invasion on food has focused on the regional or global supply, as the conflict exacerbates fuel prices and hinders Ukraine’s ability to export agricultural products such as wheat, corn, and sunflower oil.

However, it is exceedingly obvious that it is Ukrainians themselves who bear the brunt of the war, with 7.1 million people displaced, millions forcibly deported to Russia, at least thousands killed, with those who remained behind facing food insecurity. A May 2022 survey of 4,700 Ukrainians conducted by the World Food Programme found that one-third of households were food insecure and had to forgo meals, decrease portion sizes, and eat lesser quality foods. In the highly affected eastern and southern oblasts, with about half of households being food insecure (see map below). Worst of all were internally displaced people in the east, with a rate of 62% (including 14% being severely insecure).

The food situation has likely deteriorated since then. There are signs that Russia has deliberately targeted the food and water supply in Ukraine, blockading ports, burning wheat fields, exporting grain from occupied Kherson’s farms to Russia, bombing fields outside of Sloviansk, stealing farming equipment, shutting off water in Mariupol, destroying hundreds of small farms and slaughtering livestock, targeting food storage sites (including grain silos, railways, and warehouses), even killing the grain tycoon Oleksiy Vadaturskyi and his wife Raisa in their home in Mykolaiv. Much like the original Holodomor, the current food shortage is an “artificial” one and an appalling crime against humanity.

Yale historian Timothy Snyder has written that such actions indicate that Russian troops are implementing a “hunger plan” concocted by Putin. According to Snyder, such a plan has three main objectives: cutting off Ukraine’s exports in an attempt to destroy its statehood, creating instability in Europe by producing refugees from areas that rely on Ukraine’s food exports sch as North Africa and the Middle East, and to be able to blame Ukraine in a propaganda war should starvation spread abroad and food riots begin.

Accusations of alleged Russian war crimes in Ukraine are extensive and heinous. The weaponization of starvation should not be overlooked among these. Article 54(1) of the Geneva Conventions succinctly states that “Starvation of civilians as a method of warfare is prohibited.” Likewise, Article 8(2)(b)(xxv) of the 1998 ICC Statute notes that “intentionally using starvation of civilians as a method of warfare by depriving them of objects indispensable to their survival, including willfully impeding relief supplies as provided for under the Geneva Conventions” constitutes a war crime in international armed conflicts.

Throughout history, war and hunger have been paired together with regularity and Ukraine is no exception. Yet it seems apparent that there is a deliberate strategy on the part of Russian leadership to exacerbate the situation and punish civilians within and outside of Ukraine by targeting the food supply. As mentioned above, there are multiple examples of such war-related food shortages having costs to health not only in the immediate term, but reverberating decades later. When tallying up all of the costs of the war in Ukraine, the main focus should be on the loss of life, the physical and mental scars, the broken relationships and families, the damaged homes and property. Yet it shouldn’t be forgotten that there will likely be other costs, including to a generation of Ukrainians who have yet to be born.

References

Clarkin PF. 2019. The embodiment of war: growth, development, and armed conflict. Annual Review of Anthropology 48(1): 423-442. Link

Lumey LH, Khalangot MD, Vaiserman AM. 2015. Association between type 2 diabetes and prenatal exposure to the Ukraine famine of 1932–33: a retrospective cohort study. Lancet Diabetes Endocrinol. 3(10):787–94 Link

And what did you hear, my brown-eyed son?
And what did you hear, my darling young one?
I heard the sound of a thunder that roared out a warning
I heard the roar of a wave that could drown the whole world
I heard one hundred drummers whose hands were a-blazing
I heard ten-thousand whispering and nobody listening
I heard one person starve, I heard many people laughing

I met one man who was wounded in love
I met another man who was wounded in hatred

And it’s a hard, it’s a hard, it’s a hard, it’s a hard
It’s a hard rain’s a-going to fall