In East Africa, a humanitarian disaster is fast unfolding. The worst drought in 60 years means that crops have failed and livestock have perished. Poverty, climate change, and rising grain prices are combining to endanger a population already vulnerable to malnutrition and hunger-related diseases. More than 10 million people are affected across areas of Somalia, Ethiopia, Kenya, and Uganda. Multitudes are on the move, leaving their homes and walking hundreds of miles to seek food and medicine in temporary feeding stations. Just last month, Islamic militants broke up camps at the Somali-Kenyan border, forcing tens of thousands to flee back into starvation. News reports describe mothers having to choose between buying medicine for their weakest child and nourishment for the others. They live in a situation in which everyday decisions are truly vital. Who is at fault for this awful situation? What are its likely consequences? One way to answer those questions is to reflect on past famines for which the historical records are robust enough to draw useful parallels with the present. Too many analyses today focus on the conditions in the camps and the parched land. Those issues are important, and the world needs to know about them if aid is to be raised to feed the dying. They are, however, only one part of the story.