Face-to-face with malnutrition in sugarcane growing communities of Busoga

By Francis Lwanga

Having read an article ‘sugarcane-growing causing food insecurity-study’ in The New Vision of 2014, I developed interest in getting a deeper understanding of how serious the food insecurity and malnutrition challenges are in this region.

In the same year, we designed a research protocol to assess the food security and nutritional status of children residing in Nabitambala parish, Busede sub-county, Jinja district. This sub-county has history of longstanding involvement in sugarcane growing. We investigated a total of 382 households. Within these households, lived a total of 646 children whose nutritional status we assessed.

We found that a half of the households we assessed had severe food insecurity and only 12% were food secure. Approximately 2 out of every ten children had acute malnutrition, a third (215 children) had stunted growth and more than a quarter (167 children) was underweight. An estimated 8%, 10% and 15% of the children were found to be severely wasted, underweight and stunted respectively. Going by the World Health Organization grading of the problem of malnutrition, the level of stunted growth and underweight seen in our research was considered high while the level of wasting had reached a critical level.

Indeed during our day to day research activities, it was common for us to find severely malnourished children with impoverished parents who could not even afford to transport their sick children to the nutrition unit in Nalufenya. Our vehicle on many occasions acted as ambulance to transport such cases. At Nalufenya, we got to learn that majority of the malnourished came from predominantly sugarcane growing communities.

 It was surprising to note that although households appeared food insecure with visible signs of hunger especially among women and children, many of the women we saw had on average five to seven biological children who were closely spaced. The men looked to be redundant probably because once mature, sugarcane does not need to be weeded yet it is the only business available in these communities. It is probably this business of not being occupied that creates time for getting the babies. We realised that malnutrition was more common in households with many children compared to those with few.

But is sugarcane growing the cause of this unfortunate yet avoidable state of affair? Going by the Food and Agricultural Organization (FAO) definition of food security, one may say no. The FAO says that food security exists when ‘all people, at all times, have physical and economic access to sufficient, safe and nutritious food…’ From this definition we can be able to say that an individual can access food by growing it or through buying using cash. We can therefore say that engagement in cash crop production may not fully explain the food insecurity which has culminated into the poor nutrition status of children in this region. Such communities are expected to generate enough income from sale of the cash crop which could be used to increase their purchasing power for foodstuffs. It is surprising that the money generated from the cash crop is not transformed into food.

We however, do not know whether these people are paid peanuts for their produce to the extent that they cannot afford to buy food. But if it is true that they are paid peanuts, why is it that they continue to grow the sugarcane year in year out? Is there a tendency for men to take all the money paid to them and at the end do not support their children and wives? If so why are these men different from the men in urban areas who also do not have gardens but support their wives and children in rented rooms?

It should be understood that our research was conducted among sugarcane out growers. In many of the households, sugarcane was grown up to the door steps living a very limited space (if any) for food crop production. What puzzles me however, is that as we blame sugarcane production for causation of malnutrition in this region, Bushenyi, the so called Uganda’s food basket has also been covered in a blanked of malnutrition. In face of this dilemma, what could be the way forward for this problem which is threatening lives of the innocent children in these communities?

We should understand that solving the problem of malnutrition in food crop growing communities is much easier and cheaper than doing so among cash crop producers. It is therefore important that measures are put in place to ensure that families spare some land for food production. It also appears that men have more powers over land ownership than females yet it is the females who struggle to look for food. In this aspect, women need to be empowered to enable them make decision in regards to allocating land for food crop production.

As a short term remedy, we should map the sugarcane growing communities and label them as communities which are at risk of malnutrition. By doing so community based management of malnutrition can be intensified in these communities thereby bringing services nearer to individuals who are not able to move to health facilities. There is also need to increase family planning uptake among couples of these communities as a way of mitigating the problem of malnutrition.

The writer is a public health specialist with interest in public health nutrition programming