Anatomy Of A Hunger Strike: Why Is It Done And What Does It Do To The Human Body?

Anatomy Of A Hunger Strike: Why Is It Done And What Does It Do To The Human Body?

By Kristyna Foltynova May 21, 2021

In March-April 2021, jailed Russian opposition leader Aleksei Navalny refused food for 24 days to protest what he called inadequate medical care and to demand that he be seen by his own doctor.

In 2019, another opposition activist, Lyubov Sobol, went on a hunger strike for 32 days to protest the exclusion of her and other activists from running in local elections in Moscow.

And in 2018, prominent Ukrainian film director Oleh Sentsov didn't eat for 145 days, calling for the release of Ukrainian political prisoners held in Russia.

Why do protesters put their lives in danger and use hunger strikes as a form of protest? What happens to the human body when it doesn't have enough nutrients for such a long period of time? And what sparked the first major hunger strike believed to have been held in Russia?

What Is A Hunger Strike?

A hunger strike is a method of protest during which food is refused. It is mostly used by those who have no other form of protest available -- usually prisoners. Such an action is often aimed at protesting prison conditions, achieving a policy change, or bringing attention to a certain case or cause.

By refusing food (or food and fluids, in the case of what's called a dry hunger strike), protesters put their lives in danger, risking permanent damage to their health and, eventually, death.

What Does A Hunger Strike Do To The Human Body?

Long-term refusal of food affects most organs and systems in the human body. Such behavior causes muscle weakness, vulnerability to infections, psychological problems, and, eventually, organ failure.

It is estimated that if a protester is healthy before going on a hunger strike, and continues to receive fluids, he or she is at risk of dying from malnutrition after six to eight weeks.

However, a protester can die much sooner -- after three weeks if they're seriously ill. If refusing fluids, too, death can come after one week. While the loss of muscle mass may be significant, a person usually dies because of an infection or organ failure.

Systems In The Human Body
That May Be Affected

(During a hunger strike)

While people can survive up to several weeks without food under certain conditions, physical and mental impairment can begin within two to three days. Due to a lack of carbohydrates, the body switches to its fat and protein reserves and starts using them as its main source of energy.

This leads to fat and muscle loss as well as changes in the body's processes. Levels of electrolytes also drop significantly, which can lead to impairment of various bodily functions.

After two weeks, a person can experience dizziness, weakness, loss of coordination, and a low heart rate. Within the next week, he or she may suffer from vision loss or other neurological problems.

After one month or after losing more than 18 percent body weight, there may be permanent damage to the body. The person may experience difficulty swallowing, vertigo, hearing and vision loss, and possible organ failure.

After 45 days, there is a high risk of death, mostly due to infection or cardiovascular collapse.

Hunger Strike Symptoms By Day
(Compared to the length of some hunger strikes occurring in Russia)

Even after a protester decides to end a hunger strike, there is the potential risk of "refeeding syndrome." This syndrome occurs as a result of shifts in fluids and electrolytes, meaning that giving too much food or fluids too quickly may be dangerous and potentially fatal. It may include liver dysfunction, heart arrhythmia, and pulmonary, neurological, or other symptoms.

Therefore, the U.K.'s National Institute for Health and Care Excellence suggests that trained health-care professionals make sure that nutrients are cautiously and gradually introduced to anyone who has refused food for five days or more.

Refeeding Syndrome Signs
(Examples of symptoms)

How Do Officials React To Hunger Strikes?

A hunger strike is a special type of protest in which participants are prepared to harm themselves to achieve a goal. Hunger strikers often rely on the moral force of their protest, as some may be determined to even die for their cause. This type of action might also bring a certain amount of publicity to their case and help them succeed.

There are several reasons why authorities usually don't want a hunger striker to die. For example, it is generally expected that a responsible society will not allow a preventable death, so authorities might face consequences from the public or censure by foreign institutions. In addition, they may fear that, if they let a protester die, he or she could become a martyr for that cause.

That is why officials sometimes forcibly feed hunger strikers -- or threaten to do so. Force-feeding is done against someone's will, usually by inserting a plastic tube through the hunger striker's nose into the stomach. While the goal might be to keep the protester alive, force-feeding is considered to be cruel, inhumane, and degrading treatment. It is also extremely painful and can cause serious bleeding or other complications.

A Modern History Of Hunger Strikes

It is believed that one of the first major hunger strikes in modern history occurred at the end of the 19th century in Russia.

According to a study written by Kevin Grant, a professor of history at Hamilton College in New York, one of these hunger strikes was recorded in 1878, when political prisoners held in the Peter and Paul Fortress in St. Petersburg refused food to protest against inhumane prison conditions.

In the following years, there were also several hunger strikes by female political prisoners in Siberia, which were "remarkable given the relatively small number of female political prisoners sent" there. One of these strikes started in solidarity with a prisoner, Yelizaveta Kovalskaya, who had been violently transferred after she had allegedly insulted a visiting official. The episode, which resulted in several deaths (some of the prisoners ended their hunger strikes to eat poison) became known as the "Kara tragedy" and the prison was closed soon after.

Yelizaveta Kovalskaya

Yelizaveta Kovalskaya

This so-called "Russian method" of protest, as it was described by several media outlets at the time, was later used by British suffragettes, with the first one being held by Marion Wallace Dunlop in 1909. Due to fears that she might die in prison and thus give the movement more sympathy among the public, she was released after 91 hours. Other suffragettes followed her example. Many were released from prison, but others were forcibly fed.

The next decades would witness many other hunger strikers around the world. India's Mahatma Gandhi staged several hunger strikes to protest British rule, the longest said to have been 21 days. Bobby Sands, a member of the Irish Republican Army (IRA), starved himself to death in 1981 after 66 days on hunger strike while demanding to be treated as a political prisoner, not as a criminal.

Soviet dissident Anatoly Marchenko went on several hunger strikes and died in prison in 1986, most likely from complications of a hunger strike. Indian activist Irom Sharmila ended her hunger strike in 2016 after refusing food for 16 years -- arguably the longest such fast in the world. The government had force-fed her through a nasal drip for more than 10 years.

Notable Hunger Strikes

Examples Of Recent Hunger Strikes In Russia

Maria Alyokhina, a jailed member of the Russian performance-art punk band Pussy Riot, started a hunger strike because she was not allowed to attend her own parole hearing. She later said that, in an attempt to turn other prisoners against her, prison officials locked inmates in their rooms and restricted their movement. She ended her protest 11 days later after these restrictions were lifted.

Another member of the group, Nadezhda Tolokonnikova, started a hunger strike in September 2013 to protest against prison conditions. She was forced to end the fast after nine days due to her health. She was later moved to a different prison.

Ukrainian military pilot Nadia Savchenko said she was captured by Russia-backed separatists in eastern Ukraine and smuggled into Russia in 2014. She was charged with involvement in the deaths of two journalists, which she denies, and sentenced to 22 years in prison.

She launched several hunger strikes, including one that was 83 days long. On April 6, 2016, she started a "dry" hunger strike, refusing both food and fluids. She was eventually swapped for two Russian prisoners in May 2016 after serving two years of her sentence.

Ukrainian filmmaker Oleh Sentsov, arrested in Crimea in 2014 after Russia's forcible annexation, started a hunger strike on May 14, 2018. He demanded the release of all Ukrainian political prisoners being held in Russia. Under the threat of force-feeding, he agreed to take oral nutritional supplements about two months later, according to his lawyer.

Facing permanent damage to his health and the prospect of being force-fed, he ended the hunger strike on October 6, 2018. He served five years of a 20-year sentence before being released in a prisoner swap between Kyiv and Russia-backed separatists.

Russian opposition activist Lyubov Sobol launched a hunger strike in July 2019 after she was barred from running in an election for Moscow's city legislature. She ended her monthlong protest due to concerns over the health of one of her aides who had joined the hunger strike in solidarity.

Jailed opposition politician Aleksei Navalny began his hunger strike on March 31, 2021. He was protesting his medical treatment after his personal doctors were not allowed to examine him when he complained of pain in his legs and back. He ended the hunger strike 24 days later after his doctors warned him that he was at risk of suffering cardiac arrest.