Question

Indeed, without immediate help, many people in America face a startling dilemma hunger. Which is the best way to punctuate the sentence?

Answer 1

I believe that it is right the way it is.  I mean look closely at it.  All the commas are in the right place and there is a period at the end of the sentence. 

Answer 2

indeed, without immediate help, many people in America face a startling dilemma: hunger.

Commas are placed in a sentence in order to separate two clauses that have "but" or "and" in between. We prefer semicolons when we have to separate two independent clauses that don't have any conjunction, and we use a colon when we want to introduce an enumeration, or when we will introduce an explanation of the precedent clause. In this case, we are introducing an explanation because we are showing that the dilemma is hunger, so a colon is employed.