By Amber Furrer, MS

The term “food security” at a basic level was defined by the World Food Summit of 1996 as “when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life” (FAO 1996). This is obviously a key element in success and well-being of any people, though its realization will look a little bit different in America, where we do still have food insecure, compared to other parts of the world.

There are many facets to the problem: poor infrastructure and organization, poverty, limited education, social injustice and gender inequality, conflict, and lack of natural resources. Solutions also cannot generally be broadly applied because each country experiences these issues differently. Despite the successes of the Green Revolution in agriculture and food research implementation and nutrition interventions since the 1960’s, around 850 million people (or about 15% of the world’s population) remain malnourished. For children specifically, this jumps to 20%. The enormity of the problem can leave a person wondering what possible difference one person or one organization could make.

On May 8, I traveled to Uganda on 3-week assignment with a United States-based NGO whose mission is to serve the vulnerable in developing countries with development and relief efforts. Uganda, like the surrounding countries, is given a “low human development” score in the 2014 Human Development Report by the United Nations. In 2006, 38% of Ugandan children experienced chronic malnutrition, or stunting. Vitamin A and iron deficiency remain critical problems in population health, especially for mother and children (FAO 2010)

The broad focus of my assignment was nutrition education and recipe development for a small-holder farmer cooperative. In general, farmers are an important target for nutrition education because they are able to impact the local food supply and most farmers are women of reproductive age.
Preparing for my trip, I wasn’t sure what kind of impact I would have. A semi-tropical climate allows Ugandans to grow and consume a variety of foods, and on paper I thought their diet seemed pretty adequate. But of course things on paper are always a bit different than what you find in reality.

I spent two days with each group of farmers, the first day communicating (through a translator) the basic, important concepts of nutrition and the second explaining and demonstrating foods and preparation methods that could improve the diet quality of people in their district. I shared the kind of information that we take for granted: the role of carbohydrates, protein, fat, vitamins, and minerals in our bodies and the importance of consuming a balanced diet including a variety of foods in addition to other simple but important tidbits like “don’t feed tea and coffee to your children.” When it came to recipe demonstrations, I explained things that most people in the US could look up on a computer whenever they wanted, but for these women and men was not accessible.

Along the way, I began to recognize that consumption patterns, while related to economic factors, often have more to do with cultural practices and preferences and societal barriers. A visitor to Uganda immediately notices the huge amount of carbohydrate sources consumed at every meal. There are several, including Irish potatoes, (white) sweet potatoes, cassava, green banana, rice, corn and millet-based pastes, and wheat-based chapatti. Ugandans also grow a variety of beans, ground and tree nuts, vegetables, and fruits, so it is not that nutritious foods are totally absent, but are consumed in skewed proportions.

Fruit is considered child’s food, and vegetables (including beans) are consumed in very small amounts. Meat, dairy, and eggs are not widely affordable, and insects and fish have an undesirable “poor food” stigma attached. Influences and perceptions of a Western diet have made white bread and other packaged foods sought-after commodities, rather than the native whole grain millet, avocadoes, mangos, and other naturally nutritious foods that Americans are ironically trending towards.

In lacking a strong education system and broad computer access, Ugandan people live in an information desert. Despite the agricultural potential for variety, many dishes are made and consumed the same way day after day with the same ingredients because knowledge on nutrition and food preparation is lacking. There are countries with enough conflict and natural resource struggles that educating on the benefits of vegetable and dairy/animal protein consumption might be a moot point, but in Uganda these things are more achievable. Timing seems critical: these farmers were at a point where they requested this training, and that makes the potential impact far greater.

Easily-modified agricultural factors can have broad influence on the diet. For example, simple introduction of orange-fleshed, rather than white-fleshed, sweet potatoes can vastly improve vitamin A intake. Increasing use of fertilizers or crop rotation practices can ensure that minerals which foods like peanuts should theoretically contain are actually present.
Gender-related issues can also impact diet quality. Women are responsible for feeding themselves and their children, but the money, even money they earned, is not always in their hands. Men may have a nice meal at a restaurant while women eat cassava and potatoes at home. In addition, the common practice of multiple wives and the perception of children as a status symbol often make families quite large.

Overall, while economic, agricultural, and societal factors do play a role in food security, in countries such as Uganda I think nutrition education has strong potential to directly provide needed knowledge and indirectly change practices and prejudices that impede diet quality. My personal experience fully supports UNICEF recommendations for future nutrition education programs, including starting young, investing in women and girls, and collaborating across ministries to support integrated approaches to improving the diet (Unicef 2014). These integrated approaches address other strong nutrition influencers such as food safety and hygiene and health and disease, in addition to agricultural production.

FAO. 1996. “Declaration on World Food Security.” World Food Summit, Rome: FAO.
FAO. 2010. “Uganda.” United Nations. http://www.fao.org/ag/AGN/nutrition/uga_en.stm
Unicef. 2014. “Multi-Sectoral Approaches to Nutrition: The Case for Investment by Educational Programmes.” http://www.unicef.org/eapro/Brief_Education_Nutrition.pdf