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Uganda and Food Security: Thoughts from a Personal Experience

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

Crisis in Nepal: What about nutrition?

By Sheela Sinharoy

As the tragedy of the earthquake in Nepal continues to unfold, we see images of disaster response teams at work. How does assistance reach those who need it, especially in terms of meeting the food security and nutrition needs of the affected population?

In general, humanitarian response is led by the United Nations (UN) Office for the Coordination of Humanitarian Affairs (OCHA). OCHA uses a cluster approach; in Nepal, the nutrition cluster is jointly led by the Ministry of Health and Population (MoHP) and UNICEF. Other UN agencies (e.g., World Food Programme), bilateral organizations (e.g., United States Agency for International Development or USAID), and non-governmental organizations (e.g., CARE) are all members of the cluster. In many countries, the cluster has regular meetings so that coordination and communication mechanisms are already in place before a disaster strikes.

Each cluster follows the guidance in The Sphere Handbook, which outlines minimum standards in the areas of water supply, sanitation and hygiene promotion; food security and nutrition; shelter, settlement and non-food items; and health. This handbook represents the contributions of many humanitarian agencies and is meant to have universal application to any humanitarian response. It particularly emphasizes affected populations’ right to dignity, protection, and assistance and promotes their active participation as a way to ensure the appropriateness and quality of the response.

The food security and nutrition section of the handbook includes standards for the protection of safe and optimal infant and young child feeding, management of acute malnutrition and micronutrient deficiencies, and food security. It states that food rations should meet the following nutrition requirements: 2,100 kcals per person per day, 10% of total energy provided by protein, 17% of total energy provided by fat, and adequate micronutrient intake. If the affected population has access to some food, then the ration should aim to fill the gap between what people can access and the nutrition requirements. There are many other considerations outlined in the handbook, including the cultural acceptability of the food ration and the ability of the affected population to store and prepare the foods.

According to the May 1, 2015 Nepal situation report issued by OCHA, more than 3 million people require food assistance. In line with The Sphere Handbook, the nutrition cluster has decided to standardize food assistance to include 400g rice, 60g lentils, 25g oil, and 7.5g iodized salt per person per day. Some of the food comes from in-country supplies, and some is brought in from other countries in the region. WFP, as lead of the logistics cluster in Nepal, manages this and has dispatched trucks and, in some cases, helicopters to carry food and other supplies to priority areas.

Disasters such as the earthquake in Nepal require an immediate expert response. OCHA and the nutrition cluster, by following The Sphere Handbook, are working to protect the nutrition of the affected populations in the most effective way possible.

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Food Security in Puerto Rico: Vulnerable Food Supply

By Mayra S. Crespo Bellido

In 1942, Dr. Lydia J. Roberts was asked by Dr. M. L. Wilson of the US Food and Nutrition Board to visit Puerto Rico under the pretenses that “there was a problem in [the island], which ordinarily imported much of its food.” After all, the island only produced 65% of the food the habitants needed, 35% was being imported at the time. Dr. Roberts was assigned to study the food and nutrition situation in order to report back to Washington, DC. Out of her collaboration with the University of Puerto Rico as a visiting professor, a clear picture of the living situation for the islanders during the 1940s was portrayed in her book Patterns of Living in Puerto Rican Families. This classic one-of-a-kind report depicts explicitly the poor health conditions and severe food insecurity in most households, mostly due to lack of educational and monetary resources. During this period infectious diseases were ranked #1 among the most common causes of mortality for all ages.

In the 21st century, a changing landscape of health problems troubles Puerto Rico. Following nutrition transition patterns of developing countries, the leading causes of death of our time are all from complications of chronic conditions associated with the increasing prevalence of obesity in the island. In 2013, 35% of Puerto Ricans living in the island benefited from the Nutrition Assistance Program, and the majority of the population benefits from other programs such as WIC and Child Nutrition Programs. Nonetheless, Puerto Rico deals with serious food security issues as the island produces only 17.65% of the food it consumes, importing 82% from over 10 different countries.

According to the Food and Agriculture Organization (FAO), food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food which meets their dietary needs and food preferences for an active and healthy life. The four dimensions of food security as defined by the FAO are: food availability, food access, proper utilization and stability. A recent study established that food security is not distributed equally as people living in rural areas of the island are disproportionately affected unemployment rate, greater proportion of habitants below the poverty level and lower education levels all of which may create barriers to food access and proper utilization. However for the Puerto Rican population it becomes a little more complicated than that.

Dr. Myrna Comas, Puerto Rico Secretary of Agriculture, has made it her lifework to bring awareness of the vulnerability of the food chain supply in Puerto Rico. As stated by Dr. Comas, the high dependence on imported foodstuff, constant decreases in local agricultural production, the fact that there is only one functioning seaport that receives all merchandise imported, the great distances food has to travel to get to the island, and a lack of policy to ensure food security are some of the many reasons the food chain supply to the island is susceptible to external influences. Some identified risk factors that could interfere with the supply of food are: global climate change, food and water contamination, reduction of terrains devoted to agriculture in the island, accidents, and free trade agreements, among others.

Under the direction of Dr. Comas, the Puerto Rico Department of Agriculture has systematically addressed these issues for the past couple of years. Part of this plan to counterattack the risk of having a food crisis includes an educational campaign to bring awareness to the matter of food security, and initiatives to conserve agricultural lands and to promote local agricultural production of staple foods. There is evidently a long way to go until this matter is resolved. Hopefully with increased knowledge and understanding of the repercussions of letting this problem remain unaddressed will encourage the proper authorities to create local and international food policy that avoids an impending food crisis in the island.

References
Rosario-Mejías, M, Dávila-Román, A. (2012). Distribución geográfica de la seguridad alimentaria en Puerto Rico, 2005-2009. CIDE Digital 3(1-2), 109-118.

http://academic.uprm.edu/mcomas/HTMLobj-159/tesis.pdf

http://www.elnuevodia.com/expuestopuertoricoaunacrisisalimentaria-1717099.html

http://puertorico.media.indypgh.org/uploads/2012/01/bolet_n__13_enero_2012.pdf

http://jp.pr.gov/Portal_JP/Portals/0/Publicaciones/PublicacionesHistoricasOnline/Compendio%20de%20Estadisticas%20Sociales%20-%201988-2.pdf

http://www.fao.org/focus/e/obesity/obes2.htm

https://www.cfda.gov/index?s=program&mode=form&tab=core&id=3050f5bc0ed98a93fcc273237e0dd0cd