Throughout 1942 and early 1943, military and political events combined with natural disasters and plant disease to place widespread stress on Bengal's economy. While Bengal's food needs rose from increased military presence and an influx of refugees from Burma, its ability to obtain rice and other grains was restricted by inter-provincial trade barriers.
Japanese invasion of Burma The Japanese campaign for Burma set off an exodus of more than half of the one million Indians from Burma for India. The flow began after the
bombing of Rangoon (1941–1942), and for months thereafter desperate people poured across the borders, escaping into India through Bengal and Assam. On 26 April 1942, all Allied forces were ordered to retreat from Burma into India. Military transport and other supplies were dedicated to military use, and unavailable for use by the refugees. By mid May 1942, the monsoon rains became heavy in the Manipur hills, further inhibiting civilian movement. The number of refugees who successfully reached India totalled at least 500,000; tens of thousands died along the way. In later months, 70 to 80% of these refugees were afflicted with diseases such as dysentery, smallpox, malaria, or cholera, with 30% "desperately so". The influx of refugees created several conditions that may have contributed to the famine. Their arrival created an increased demand for food, clothing and medical aid, further straining the resources of the province. The poor hygienic conditions of their forced journey sparked official fears of a public health risk due to epidemics caused by social disruption. Finally, their distraught state after their struggles bred foreboding, uncertainty, and panic amongst the populace of Bengal; this aggravated panic buying and hoarding that may have contributed to the onset of the famine. By April 1942, Japanese warships and aircraft had sunk approximately 100,000 tons of merchant shipping in the Bay of Bengal. According to
General Archibald Wavell, Commander-in-Chief of the army in India, both the
War Office in London and the commander of the British
Eastern Fleet acknowledged that the fleet was powerless to mount serious opposition to Japanese naval attacks on
Ceylon, southern or eastern India, or on shipping in the Bay of Bengal. For decades, rail transport had been integral to successful efforts by the Raj to forestall famine in India. However, Japanese raids put additional strain on railways, which also endured flooding in the Brahmaputra, a malaria epidemic, and the
Quit India movement targeting road and rail communication. Throughout this period, transportation of civil supplies was compromised by the railways' increased military obligations, and the dismantling of tracks carried out in areas of eastern Bengal in 1942 to hamper a potential Japanese invasion. The
fall of Rangoon in March 1942 cut off the import of Burmese rice into India and Ceylon. Due in part to increases in local populations, prices for rice were already 69% higher in September 1941 than in August 1939. The loss of Burmese imports led to further increased demand on the rice-producing regions. This, according to the Famine Commission, was in a market in which the "progress of the war made sellers who could afford to wait reluctant to sell". The loss of rice imports from Burma, which many districts in Bengal were dependent on, provoked an aggressive scramble for rice across India, which sparked a dramatic and unprecedented surge in
demand-pull price inflation in Bengal and other rice producing regions of India. Across India and particularly in Bengal, this caused a "derangement" of the rice markets. Particularly in Bengal, the price effect of the loss of Burmese rice was vastly disproportionate to the relatively modest size of the loss in terms of total consumption. Despite this, Bengal continued to export rice to Ceylon for months afterwards, even as the beginning of a food crisis began to become apparent. All this, together with transport problems created by the government's
"boat denial" policy, were the direct causes of inter-provincial trade barriers on the movement of food grains, and contributed to a series of failed government policies that further exacerbated the food crisis.
1942–1945: Military build-up, inflation, and displacement , July 1943. Calcutta became a hub for hundreds of thousands of Allied troops. The fall of Burma brought Bengal close to the war front; its impact fell more strongly on Bengal than elsewhere in India. Major urban areas, especially Calcutta, drew increasing numbers of workers into military industries and troops from many nations. Unskilled labourers from Bengal and nearby provinces were employed by military contractors, particularly for the construction of American and British airfields. Hundreds of thousands of American, British, Indian, and Chinese troops arrived in the province, straining domestic supplies and leading to scarcities across wide ranges of daily necessities. The general inflationary pressures of a war-time economy caused prices to rise rapidly across the entire spectrum of goods and services. The rise in prices was "not disturbing" until 1941, when it became more alarming. Then in early 1943, the rate of inflation for foodgrains in particular took an
unprecedented upward turn. Nearly the full output of India's cloth, wool, leather and silk industries were sold to the military. In the system that the British Government used to procure goods through the Government of India, industries were left in private ownership rather than facing outright requisitioning of their productive capacity. Firms were required to sell goods to the military on credit and at fixed, low prices. However, firms were left free to charge any price they desired in their domestic market for whatever they had left over. In the case of the textiles industries that supplied cloth for the uniforms of the British military, for example, they charged a very high price in domestic markets. By the end of 1942, cloth prices had more than tripled from their pre-war levels; they had more than quadrupled by mid-1943. Much of the goods left over for civilian use were purchased by speculators. As a result, "civilian consumption of cotton goods fell by more than 23% from the peace time level by 1943/44". The hardships that were felt by the rural population through a severe "
cloth famine" were alleviated when military forces began distributing relief supplies between October 1942 and April 1943. The method of credit financing was tailored to UK wartime needs. Britain agreed to pay for defence expenditures above the amount that India had paid in peacetime (adjusted for inflation). However, their purchases were made entirely on credit accumulated in the Bank of England and not redeemable until after the war. At the same time, the Bank of India was permitted to treat those credits as assets against which it could print currency up to two and a half times more than the total debt incurred. India's money printing presses then began running overtime, printing the currency that paid for all these massive expenditures. The tremendous rise in nominal money supply coupled with a scarcity of consumption goods spurred
monetary inflation, reaching its peak in 1944–45. The accompanying rise in incomes and purchasing power fell disproportionately into the hands of industries in Calcutta (in particular, munitions industries). Military build-up caused massive displacement of Bengalis from their homes. Farmland purchased for airstrip and camp construction is "estimated to have driven between 30,000 and 36,000 families (about 150,000 to 180,000 persons) off their land", according to the historian Paul Greenough. They were paid for the land, but they had lost their employment. The urgent need for housing for the immense influx of workers and soldiers from 1942 onward created further problems. Military barracks were scattered around Calcutta. The Famine Commission report of 1945 stated that the owners had been paid for these homes, but "there is little doubt that the members of many of these families became famine victims in 1943".
March 1942: Denial policies Anticipating a Japanese invasion of British India via the eastern border of Bengal, the British military launched a pre-emptive, two-pronged
scorched-earth initiative in eastern and coastal Bengal. Its goal was to deny the expected invaders access to food supplies, transport and other resources. First, a "denial of rice" policy was carried out in three southern districts along the coast of the Bay of Bengal –
Bakarganj (or Barisal),
Midnapore and
Khulna – that were expected to have surpluses of rice.
John Herbert, the governor of Bengal, issued an urgent directive in late March 1942 immediately requiring stocks of
paddy (unmilled rice) deemed surplus, and other food items, to be removed or destroyed in these districts. Official figures for the amounts impounded were relatively small and would have contributed only modestly to local scarcities. However, evidence that fraudulent, corrupt and coercive practices by the purchasing agents removed far more rice than officially recorded, not only from designated districts, but also in unauthorised areas, suggests a greater impact. In addition to destroying surplus rice, British authorities denied requests from Indian officials to import wheat. Far more damaging were the policy's disturbing impact on regional market relationships and contribution to a sense of public alarm. Disruption of deeply intertwined relationships of trust and trade credit created an immediate freeze in informal lending. This credit freeze greatly restricted the flow of rice into trade. The second prong, a "boat denial" policy, was designed to deny Bengali transport to any invading Japanese army. It applied to districts readily accessible via the Bay of Bengal and the larger rivers that flow into it. Implemented on 1 May after an initial registration period, the policy authorised the Army to confiscate, relocate or destroy any boats large enough to carry more than ten people, and allowed them to requisition other means of transport such as bicycles, bullock carts, and elephants. Under this policy, the Army confiscated approximately 45,000 rural boats, severely disrupting river-borne movement of labour, supplies and food, and compromising the livelihoods of boatmen and fishermen. Leonard G. Pinnell, a British civil servant who headed the Bengal government's Department of Civil Supplies, told the Famine Commission that the policy "completely broke the economy of the fishing class". Transport was generally unavailable to carry seed and equipment to distant fields or rice to the market hubs. Artisans and other groups who relied on boat transport to carry goods to market were offered no recompense; neither were rice growers nor the network of migratory labourers. The large-scale removal or destruction of rural boats caused a near-complete breakdown of the existing transport and administration infrastructure and market system for movement of rice paddy. No steps were taken to provide for the maintenance or repair of the confiscated boats, and many fishermen were unable to return to their trade. The Army took no steps to distribute food rations to make up for the interruption of supplies. According to Human Geographer Senjuti Mallik, data suggests that the British harvested 29 million tons of wheat from 1943-1944 and that they chose to save the wheat in case British civilians needed it instead of redirecting the surplus to Bengal. and they had important political ramifications. The
Indian National Congress, among other groups, staged protests denouncing the denial policies for placing draconian burdens on Bengali peasants; these were part of a nationalist sentiment and outpouring that later peaked in the
"Quit India" movement. The policies' wider impact – the extent to which they compounded or even caused the famine to occur one year later – has been the subject of much
discussion.
Provincial trade barriers Many
Indian provinces and
princely states imposed inter-provincial trade barriers from mid-1942, preventing trade in domestic rice. Anxiety and soaring rice prices, triggered by the fall of Burma, were one underlying reason for the trade barriers. Trade imbalances brought on by price controls were another. The power to restrict inter-provincial trade was given to provincial governments in November 1941 under the
Defence of India Act, 1939. Provincial governments began setting up trade barriers that prevented the flow of foodgrains (especially rice) and other goods between provinces. These barriers reflected a desire to see that local populations were well fed, thus forestalling local emergencies. In January 1942,
Punjab banned exports of wheat; this increased the perception of
food insecurity and led the enclave of wheat-eaters in Greater Calcutta to increase their demand for rice precisely when an impending rice shortage was feared. The
Central Provinces prohibited the export of foodgrains outside the province two months later.
Madras banned rice exports in June, followed by export bans in Bengal and its neighbouring provinces of
Bihar and
Orissa that July. The
Famine Inquiry Commission of 1945 characterised this "critical and potentially most dangerous stage" as a key policy failure. As one
deponent to the Commission put it: "Every province, every district, every [administrative division] in the east of India had become a food republic unto itself. The trade machinery for the distribution of food [between provinces] throughout the east of India was slowly strangled, and by the spring of 1943 was dead." Bengal was unable to import domestic rice; this policy helped transform
market failures and food shortage into famine and widespread death.
Mid-1942: Prioritised distribution The loss of Burma reinforced the strategic importance of Calcutta as the hub of
heavy industry and the main supplier of armaments and textiles for the entire Asian theatre. To support its wartime mobilisation, the British Indian Government categorised the population into socioeconomic groups of "priority" and "non-priority" classes, according to their relative importance to the war effort. Members of the "priority" classes were largely composed of
bhadraloks, who were upper-class or
bourgeois middle-class, socially mobile, educated, urban, and sympathetic to Western values and modernisation. Protecting their interests was a major concern of both private and public relief efforts. This placed the rural poor in direct competition for scarce basic supplies with workers in public agencies, war-related industries, and in some cases even politically well-connected middle-class agriculturalists. As food prices rose and the signs of famine became apparent from July 1942, the Bengal Chamber of Commerce (composed mainly of British-owned firms) devised a Foodstuffs Scheme to provide preferential distribution of goods and services to workers in high-priority war industries, to prevent them from leaving their positions. The scheme was approved by Government of Bengal. Rice was directed away from the starving rural districts to workers in industries considered vital to the military effort – particularly in the area around Greater Calcutta. Workers in prioritised sectorsprivate and government wartime industries, military and civilian construction, paper and textile mills, engineering firms, the
Indian Railways, coal mining, and government workers of various levels – were given significant advantages and benefits. Essential workers received subsidised food, and were frequently paid in part in weekly allotments of rice sufficient to feed their immediate families, further protecting them from inflation. Essential workers also benefited from ration cards, a network of "cheap shops" which provided essential supplies at discounted rates, and direct, preferential allocation of supplies such as water, medical care, and antimalarial supplies. They also received subsidised food, free transportation, access to superior housing, regular wages and even "mobile cinema units catering to recreational needs". By December of that year, the total number of individuals covered (workers and their families) was approximately a million. Medical care was directed to the priority groupsparticularly the military. Public and private medical staff at all levels were transferred to military duty, while medical supplies were monopolised. Rural labourers and civilians not members of these groups received severely reduced access to food and medical care, generally available only to those who migrated to selected population centres. Otherwise, according to
medical historian Sanjoy Bhattacharya, "vast areas of rural eastern India were denied any lasting state-sponsored distributive schemes". For this reason, the policy of prioritised distribution is sometimes discussed as one
cause of the famine.
Civil unrest The war escalated resentment and fear of the Raj among rural agriculturalists and business and industrial leaders in Greater Calcutta. The unfavourable military situation of the Allies after the fall of Burma led the US and China to urge the UK to enlist India's full cooperation in the war by negotiating a peaceful transfer of political power to an elected Indian body; this goal was also supported by the
Labour Party in Britain.
Winston Churchill, the
British prime minister, responded to the new pressure through the
Cripps' mission, broaching the post-war possibility of an autonomous political status for India in exchange for its full military support, but negotiations collapsed in early April 1942. On 8 August 1942, the Indian National Congress launched the Quit India movement as a nationwide display of nonviolent resistance. The British authorities reacted by imprisoning the Congress leaders. Without its leadership, the movement changed its character and took to sabotaging factories, bridges, telegraph and railway lines, and other government property, thereby threatening the British Raj's war enterprise. The British acted forcefully to suppress the movement, taking around 66,000 in custody (of whom just over 19,000 were still convicted under civil law or detained under the Defence of India Act in early 1944). More than 2,500 Indians were shot when police fired upon protesters, many of whom were killed. In Bengal, the movement was strongest in the
Tamluk and
Contai subdivisions of Midnapore district, where rural discontent was well-established and deep. In Tamluk, by April 1942 the government had destroyed some 18,000 boats in pursuit of its denial policy, while war-related inflation further alienated the rural population, who became eager volunteers when local Congress recruiters proposed open rebellion. The violence during the "Quit India" movement was internationally condemned, and hardened some sectors of British opinion against India; The historians
Christopher Bayly and Tim Harper believe it reduced the
British War Cabinet's willingness to provide famine aid at a time when supplies were also needed for the war effort. In several ways the political and social disorder and distrust that were the effects and after-effects of rebellion and civil unrest placed political, logistical, and infrastructural constraints on the Government of India that contributed to later famine-driven woes.
1942–1943: Price chaos Throughout April 1942, British and Indian refugees fled Burma, many through Bengal, as the cessation of Burmese imports continued to drive up rice prices. In June, the Bengal government established price controls for rice, and on 1 July fixed prices at a level considerably lower than the prevailing market price. The principal result of the fixed low price was to make sellers reluctant to sell; stocks disappeared, either on to the black market or into storage. The government then let it be known that the price control law would not be enforced except in the most egregious cases of war profiteering. This easing of restrictions plus the ban on exports created about four months of relative price stability. In mid-October, though, south-west Bengal was struck by a series of
natural disasters that destabilised prices again, causing another rushed scramble for rice, greatly to the benefit of the Calcutta black market. Between December 1942 and March 1943 the government made several attempts to "break the Calcutta market" by bringing in rice supplies from various districts around the province; however, these attempts to drive down prices by increasing supply were unsuccessful. On 11 March 1943, the provincial government rescinded its price controls, resulting in dramatic rises in the price of rice, due in part to soaring levels of speculation. The period of inflation between March and May 1943 was especially intense; May was the month of the first reports of death by starvation in Bengal. The government attempted to re-establish public confidence by insisting that the crisis was being caused almost solely by speculation and hoarding, but their propaganda failed to dispel the widespread belief that there was a shortage of rice. The provincial government never formally declared a state of famine, even though its
Famine Code would have mandated a sizable increase in aid. In the early stages of the famine, the rationale for this was that the provincial government was expecting aid from the Government of India. It felt then its duty lay in maintaining confidence through propaganda that asserted that there was no shortage. After it became clear that aid from central government was not forthcoming, the provincial government felt they simply did not have the amount of food supplies that a declaration of famine would require them to distribute, while distributing more money might make inflation worse. When inter-provincial trade barriers were abolished on 18 May, prices temporarily fell in Calcutta, but soared in the neighbouring provinces of Bihar and Orissa when traders rushed to purchase stocks. The provincial government's attempts to locate and seize any hoarded stocks failed to find significant hoarding. In Bengal, prices were soon five to six times higher than they had been before April 1942. Free trade was abandoned in July 1943, and price controls were reinstated in August. Despite this, there were unofficial reports of rice being sold in late 1943 at roughly eight to ten times the prices of late 1942. Purchasing agents were sent out by the government to obtain rice, but their attempts largely failed. Prices remained high, and the black market was not brought under control.
October 1942: Natural disasters Bengal was affected by a series of natural disasters late in 1942. The winter rice crop was afflicted by a severe outbreak of fungal
brown spot disease, while, on 16–17 October a
cyclone and three
storm surges ravaged croplands, destroyed houses and killing thousands, at the same time dispersing high levels of
fungal spores across the region and increasing the spread of the crop disease. The fungus reduced the crop yield even more than the cyclone. After describing the horrific conditions he had witnessed, the
mycologist S. Y.Padmanabhan wrote that the outbreak was similar in impact to the
potato blight that caused the Irish
Great Famine: "Though administrative failures were immediately responsible for this human suffering, the principal cause of the short crop production of 1942 was the [plant] epidemic ... nothing as devastating ... has been recorded in plant pathological literature". The Bengal cyclone came through the
Bay of Bengal, landing on the coastal areas of Midnapore and 24 Parganas. It killed 14,500 people and 190,000 cattle, whilst rice paddy stocks in the hands of cultivators, consumers, and dealers were destroyed. It also created local atmospheric conditions that contributed to an increased incidence of malaria. The three storm surges which followed the cyclone destroyed the seawalls of Midnapore and flooded large areas of Contai and
Tamluk. Waves swept an area of , floods affected , and wind and torrential rain damaged . For nearly 2.5 million Bengalis, the accumulative damage of the cyclone and storm surges to homes, crops and livelihoods was catastrophic: The cyclone, floods, plant disease, and warm, humid weather reinforced each other and combined to have a substantial impact on the
aman rice crop of 1942. Their impact was felt in other aspects as well, as in some districts the cyclone was responsible for an increased incidence of malaria, with deadly effect.
October 1942: Unreliable crop forecasts At about the same time, official forecasts of crop yields predicted a significant shortfall. However, crop statistics of the time were scant and unreliable. Administrators and statisticians had known for decades that India's agricultural production statistics were completely inadequate and "not merely guesses, but frequently demonstrably absurd guesses". There was little or no internal bureaucracy for creating and maintaining such reports, and the low-ranking police officers or village officials charged with gathering local statistics were often poorly supplied with maps and other necessary information, poorly educated, and poorly motivated to be accurate. The Bengal Government thus did not act on these predictions, doubting their accuracy and observing that forecasts had predicted a shortfall several times in previous years, while no significant problems had occurred.
Air raids on Calcutta The Famine Inquiry Commission's 1945 report singled out the first Japanese air raids on Calcutta in December 1942 as a causation. The attacks, largely unchallenged by Allied defences, continued throughout the week, triggering an exodus of thousands from the city. As evacuees travelled to the countryside, food-grain dealers closed their shops. To ensure that workers in the prioritised industries in Calcutta would be fed, the authorities seized rice stocks from wholesale dealers, breaking any trust the rice traders had in the government. "From that moment", the 1945 report stated, "the ordinary trade machinery could not be relied upon to feed Calcutta. The [food security] crisis had begun".
1942–1943: Shortfall and carryover Whether the famine resulted from crop shortfall or failure of land distribution has been much debated. According to
Amartya Sen: "The ... [rice paddy] supply for 1943 was only about 5% lower than the average of the preceding five years. It was, in fact, 13% higher than in 1941, and there was, of course, no famine in 1941." The Famine Inquiry Commission report concluded that the overall deficit in rice in Bengal in 1943, taking into account an estimate of the amount of carryover of rice from the previous harvest, was about three weeks' supply. In any circumstances, this was a significant shortfall requiring a considerable amount of food relief, but not a deficit large enough to create widespread deaths by starvation. According to this view, the famine "was not a crisis of food availability, but of the [unequal] distribution of food and income". There has been very considerable debate about the amount of carryover available for use at the onset of the famine. Several contemporary experts cite evidence of a much larger shortfall. Commission member Wallace Aykroyd argued in 1974 that there had been a 25% shortfall in the harvest of the winter of 1942, while , responsible to the Government of Bengal from August 1942 to April 1943 for managing food supplies, estimated the crop loss at 20%, with disease accounting for more of the loss than the cyclone; other government sources privately admitted the shortfall was 2 million tons. The economist George Blyn argues that with the cyclone and floods of October and the loss of imports from Burma, the 1942 Bengal rice harvest had been reduced by one-third.
1942–1944: Refusal of imports Beginning as early as December 1942, high-ranking government officials and military officers (including John Herbert, the Governor of Bengal;
Viceroy Linlithgow;
Leo Amery the Secretary of State for India; General
Claude Auchinleck, Commander-in-Chief of British forces in India, and Admiral
Louis Mountbatten, Supreme Commander of South-East Asia) began requesting food imports for India through government and military channels, but for months these requests were either rejected or reduced to a fraction of the original amount by Churchill's War Cabinet. The colony was also not permitted to spend its own sterling reserves, or even use its own ships, to import food. Although Viceroy Linlithgow appealed for imports from mid-December 1942, he did so on the understanding that the military would be given preference over civilians. The Secretary of State for India, Leo Amery, was on one side of a cycle of requests for food aid and subsequent refusals from the British War Cabinet that continued through 1943 and into 1944. Amery did not mention worsening conditions in the countryside, stressing that Calcutta's industries must be fed or its workers would return to the countryside. Rather than meeting this request, the UK promised a relatively small amount of wheat that was specifically intended for western India (that is, not for Bengal) in exchange for an increase in rice exports from Bengal to Ceylon. The tone of Linlithgow's warnings to Amery grew increasingly serious over the first half of 1943, as did Amery's requests to the War Cabinet; on 4August 1943 's'' graphic photographs of starving famine victims in Calcutta focussed the world's attention on the severity of the crisis -->Amery noted the spread of famine, and specifically stressed the effect upon Calcutta and the potential effect on the morale of European troops. The cabinet again offered only a relatively small amount, explicitly referring to it as a token shipment. The explanation generally offered for the refusals included insufficient shipping, particularly in light of Allied plans to
invade Normandy. The Cabinet also refused offers of food shipments from several different nations. When such shipments did begin to increase modestly in late 1943, the transport and storage facilities were understaffed and inadequate. When Viscount Archibald Wavell replaced Linlithgow as Viceroy in the latter half of 1943, he too began a series of exasperated demands to the War Cabinet for very large quantities of grain. His requests were again repeatedly denied, causing him to decry the current crisis as "one of the greatest disasters that has befallen any people under British rule, and [the] damage to our reputation both among Indians and foreigners in India is incalculable". Churchill wrote to
Franklin D. Roosevelt at the end of April 1944 asking for aid from the United States in shipping wheat in from Australia, but Roosevelt replied apologetically on 1 June that he was "unable on military grounds to consent to the diversion of shipping". Experts' disagreement over political issues can be found in differing explanations of the War Cabinet's refusal to allocate funds to import grain.
Lizzie Collingham holds the massive global dislocations of supplies caused by World War II virtually guaranteed that hunger would occur somewhere in the world, yet Churchill's animosity and perhaps racism toward Indians decided the exact location where famine would fall. Similarly, Madhusree Mukerjee makes a stark accusation: "The War Cabinet's shipping assignments made in August 1943, shortly after Amery had pleaded for famine relief, show Australian wheat flour travelling to Ceylon, the Middle East, and Southern Africa – everywhere in the Indian Ocean but to India. Those assignments show a will to punish." In contrast, Mark Tauger strikes a more supportive stance: "In the Indian Ocean alone from January 1942 to May 1943, the Axis powers sank 230 British and Allied merchant ships totalling 873,000 tons, in other words, a substantial boat every other day. British hesitation to allocate shipping concerned not only potential diversion of shipping from other war-related needs but also the prospect of losing the shipping to attacks without actually [bringing help to] India at all." Peter Bowbrick elaborates further on the British government's delay in shipping food, stating that Linlithgow's request for food shipments in December 1942 was half-hearted and that it was made on the assumption that Bengal already had a food surplus but that it was being hoarded, which is why it was ignored by the British metropolitan government. Further delays after April 1943 stemmed from the refusal to divert ships away from the preparations for
Operation Overlord, whose failure would have been disastrous for the world and whose success was as a result prioritised above aid to India. == Famine, disease, and the death toll ==