The Human Cost of DOGE’s War on U.S.A.I.D.

Millions of deaths?

It’s millions of deaths.

Earlier, I asked you to be a psychiatrist. Now I’m asking you to be a political analyst—and both things are asking a lot. Who will be held accountable by either the law or, more likely, history in this episode? And let’s hope it’s a limited episode. How will the amount of destruction and death be accounted? And what effect do you think it’ll have on the lives of those responsible for executing this?

I think the reason why Elon Musk, the same month he’s been made a trillionaire, is screaming online and aloud at congressmen and others, and responding to things that I put online, is because he believes he’s going to be held accountable by history.

Trump routinely asks publicly—and, reportedly, privately—about whether he’s going to hell or not. And the anger that is directed at those who suggest there has been public man-made death, the anger comes from the cognitive dissonance between what they want to think they are—world dominators, people who will be remembered in history as having done good—they can’t countenance the image that is suggested by this, which is that they are monsters.

Atul, you were in South Sudan not long ago. Tell me, why were you there in the first place, and what were you trying to find out?

The United States has been instrumental in supporting its very establishment as a country. It’s the youngest country in the world. It has still unresolved political issues and conflicts that have left people very vulnerable, and providing aid against suffering has been a key thing that the United States did. The subcounties I visited, where these primary-health-care centers were, did not have intact government services otherwise.

Who did you talk to?

I met with, first of all, a woman named Angelina David, who is the clinical manager in Panyijiar for the International Rescue Committee clinics. She was overseeing the clinics that were shut down and could tell me exactly what happened. It was a complete shutdown, and a scramble, because there were medicines and other things on the shelves they didn’t want looted, so they had to get out to these places—and they’re very far away. You have to travel, in some cases, seven or eight hours in order to get to the extent of what’s there.

I then went and visited some of those facilities, and I connected, with her help, to the subcounty chiefs—they’re called the payam administrators—who keep their own records of deaths. So one of the things I found was that their own records showed that they are measuring an over-all tenfold increase in child and adult deaths.

Wait. A tenfold increase?

Yes.

And how much of that increase can be put at the feet of DOGE and the cutting of American aid?

I can’t exactly parse it out, but a huge amount of it. You know, it went from forty-two deaths in those seven subcounties for children, for example, over two years, 2src23 to 2src24, and those deaths rose to two hundred and fourteen, that they recorded.

I also met with villagers and learned of dozens of cases of direct effects. I’ll give you an example. One was a woman I met in a community called Machar, and her name was Nyajiek Gai Guol. Her niece was staying with her, a two-year-old girl, who developed the symptoms of pneumonia. The clinic that would have been there to take the girl to was no longer there. In order to travel, she had to go three hours, walking and by canoe.

The girl arrived alive. They attempted to do resuscitation. She had already gone into organ failure, and died. Completely avoidable. And I found numerous cases like these.

I have to say, not only must this make you beyond furious—the people there, their attitude toward the United States must be transformed, no?

It’s heartbreaking and devastating to see the people we’ve abandoned. They, first and foremost, are furious at their own government. These are people with leaders who have been at war with one another on and off for a couple of decades. Part of our role there has been to be a steady force of support against suffering. America is loved there, and that has not faded.

How is that possible?

Because we’ve generally been there, and there is belief that we have not yet completely abandoned them, that we may yet come back. They know Trump has done it. When I left, however—this was the first time I’d seen this—there was someone from China Aid. China has rebranded their agency in providing coöperation and assistance. And there was an official coming to visit to offer their capabilities.

Let’s say that, in the best scenario, the system is reconstructed. What will that require? And, if the best scenario comes about, what do you think, ultimately, the death toll will be?

You know, my parents came from India, and India was a place of starvation and recurrent droughts, and, with support that lasted a quarter century, emerged after the Green Revolution and food aid as a place that was a food exporter and a breadbasket to the world. And, if we’re not committed to this fundamental proposition, then nothing happens. If we are committed, as we were—as the vast majority of Americans were, for six decades—then incredible things happen. If we believed in it today, we could stop this from being in the millions. The only reason I predict that it gets to seven figures is because we’re so deeply divided over everything right now, as a country. We’ll halt worsening the damage, but it’ll take joint effort to actually stop it and regain our momentum. ♦