Dr Unni Karunakara, international president of Médecins Sans Frontières, has said of Somalia that "We may have to live with the reality that we may never be able to reach the communities most in need of help" and that "....glossing over the man-made causes of hunger and starvation in the region and the great difficulties in addressing them will not help resolve the crisis".
There's a truth there, although not quite in the way Dr Karunakara intended it no doubt.
Our whole aid industry is one of those man made causes of hunger and starvation. It may fill bellies today, but it ensures that tomorrow there will be even more bellies needing filling.
What have we got to show for decades of foreign aid, charity, famine relief, the whole caboodle?
Every year or two we get the 'worse disaster in recent years'. It's regular as clockwork, every couple years the problem is back and is worse than ever. These regions are always hovering on the bring of catastrophe.
We've just made it bigger, that's all, and bigger isn't better when there were never enough resources or infrastructure to begin with.
It has been said before that we'd be better off giving the third world condoms instead of food - there's a truth in there. True, they can't eat them, but if the population ceased to grow at least the food that there is would have to feed less mouths.
Of course, the most likely net result would be local marketplaces having stalls piled high with Durex featherlite and ribbed ticklers rather than making any meaningful impact on population control.
Big families are an ingrained cultural trait, until that changes then the problems only get worse.
We've the vicious circle of big families, and Western aid ensuring that more people survive to reach childbearing age, who in turn have big families.
That cannot carry on indefinitely, something has to give. The West cannot reach, nor support, an ever growing number of people.
Even if we do reach them all then what about tomorrow? The underlying causes have in no way been fixed, all we do is delay the inevitable and make sure that it will be worse when it does finally happen.
It is a bottomless pit and it always will be. More food + more medicine = more people = even more food + even more medicine = well, you get the picture.
Were a nation that otherwise supported itself to fall victim to a drought or famine and require short term, one off assistance, then there may well be good argument for rendering that help.
When they are falling victim to those disasters every year or two and requiring massive assistance each time, indeed requiring aid every year just to function, then it is a clear signal that our assistance is for naught.
Our continual aid and charity solves nothing, it just continues to perpetuate - and to make worse - the whole set of underlying problems which these nations face.
As unpleasant a truth as it may be, there is a finite limit to how many people a given region can support. We may be able to push past that limit for a while, but we cannot do so forever, and we cannot keep pushing further and further past that limit without disastrous consequences.
Populations cannot grow indefinitely, and we cannot continue to feed ever growing populations in multiple countries - sooner or later there are just too many people and the whole system collapses under the weight of mouths clamouring to be fed.
The consequences of our assistance, which has allowed these problems to assume such gigantic proportions, will be suffering for the people of the third world on an unprecedented scale.
Dr Unni Karunakara, international president of Médecins Sans Frontières, has said of Somalia that "We may have to live with the reality that we may never be able to reach the communities most in need of help" and that "....glossing over the man-made causes of hunger and starvation in the region and the great difficulties in addressing them will not help resolve the crisis".
