Sir, - May I offer a word of comment on the drought and developing famine in Kenya? The health situation is quite unique. In previous famines epidemics of infectious diseases have followed the famine, as the history of the Irish great hunger shows, but in Kenya today and the horn of Africa generally, an AIDS epidemic has preceded the famine and because of reduced immunity has opened the gates to such diseases as cholera, T.B. (400% increase in three years), Hepatitis B (300% increase in one year) and viral pneumonia.
Such a unique triple disaster of AIDS, famine, and famine fevers requires new thinking. The present Government policy of supporting only long-term, sustainable development is entirely reasonable in ordinary times but this new and ominous sequence of events surely demands immediate intervention. If not, and the present trend continues, the impact on demography may be considerable.
In general terms it is not a question of short-term or longterm aid. Africa needs both, delicately balanced. - Yours, etc.
Joseph Barnes, MD, Royal College of Surgeons in Ireland, 123, St Stephen's Green, Dublin 2.