Nutrition in Commercial Farms Finding the right plaster for the wound

by Leslie Adams (Provincial Nutritionist in the Ministry of Health in Mashonaland Central, Zimbabwe).

Children living in Large Scale Commercial Farms in Zimbabwe, most of which are owned by white farmers, have higher rates of undernutrition than children living in communal areas. This is in spite of the fact that communal lands are generally in the poorer agricultural regions. We know about these higher rates of undernutrition because the National Health Information System records growth monitoring data at static and mobile health facilities in both communal and commercial areas. In 1995 commercial areas recorded between 1/4 and 1/3 more children below the 3rd percentile weight-for-age than in communal areas. How should we address this problem? This has been a pressing question for some years. In the past the intervention of choice has been to unofficially extend the government and donor sponsored Child Supplementary Feeding Programme (CSFP) to farms.

The Child Supplementary Feeding Programme

The CSFP is a village based supplementary feeding programme that provides on-site feeding for all under five children in targeted villages. Children receive one meal of porridge made up of maize, groundnuts and oil every day. This provides approximately 550 kcals per capita. Mothers are responsible for preparing the meal which is eaten communally. The programme is initiated in response to the effects of drought on crop production, with areas targeted on the basis of information on harvests compiled by AGRITEX (a branch of the Ministry of Agriculture). AGRITEX assesses agricultural production based upon rainfall and crop estimate data. Zones with the greatest shortfall in crop- production are classified as 'Red Zones' and have traditionally been immediately included in the CSFP. Areas of marginal harvests (yellow zones) are screened using Mid Upper Arm Circumference measurements (MUAC), and those where more than 15% of children aged 1-5 years have a MUAC of less than 13.5 cms are included in the programme. Screening is done by Village Community Workers (VCWs). In areas such as the Zambezi valley the programme has been perennial since the drought of 1992.

Extending the CSFP to Commercial Farms

The reason why the CSFP is automatically extended to farms is that the govemment has become conditioned to never look a gift horse in the mouth' and because a lasting solution is far more difficult than supplying food. Decision-making health workers feel guilty if they withhold this 'gift' from the farm workers without a clear directive from above. Is this right though? Is it right to supply food in farms during drought periods, when the problem is still there in times of good harvest? Are we not putting the wrong plaster on the wound? And might not this plaster prevent the wound from ever healing?

Another issue comes up with the way farms are targeted. At the moment food is only given out to those farms with the highest rates of malnutrition (our MUAC screening data showed one third of the commercial farms in one district had more than 15% of children malnourished). Such farms are likely to be those where least development has taken place and where the farmer has consistently refused to improve living and working conditions for his labourers.

It is therefore easy to envisage a situation where targeting the CSFP to those commercial farms which have high rates of undernutrition is likely to discourage those farmers who have taken certain initiatives which may have reduced levels of undernutrition, like feeding in pre-schools, and to lead them to withdraw such assistance and ask the govemment to feed the children. The government would effectively be subsidising the commercial farmers.

A further problem with including farms in the CSFP is that it may detract from the provision of assistance to the communal areas. Over the years the CSFP has been unable to cater for its intended beneficiaries due to logistical problems and the scale of the programme. If some of the food received by the MoH for the CSFP was diverted to commercial farms where labourers get a basic wage, then communal areas (where households may have no access to other food or income, if the programme is properly targeted and really needed) may be even more under-supplied.

Factors underlying autritional problems in Mashonaland Central Province:

Mashonaland Central province lies to the North of the capital, Harare, and has a population of around 1 million, 1/3 of whom live in commercial farms. Over 95% of commercial farm land lies in the province good agricultural region (region II); 3/4 of communal land holdings lie in the province's poor agricultural regions (over 50% in region IV and 20% in region III).

For the province overall, the level of under-nutrition stands at 9.3% less than 2 Standard Deviations Weight- for-Age (Jan-Dec. 1996). In November 1996 we conducted a farm survey and found 22.6% of children were undernourished (less than 2 Standard Deviations Weight for Age) as opposed to 9.9% for the province as a whole. The level of underweight in the province has continuously declined since 1991, which can perhaps be partly attributed to the CSFP.

In commercial farm areas of Mashonaland Central Province under-nutrition is a permanent feature. It is consistently high in good years as well as lean years and consistently higher than in communal areas. Given this fact, what should the solution be? In order to come up with a solution we conducted research to ascertain the root cause of the problem.

Participatory Rapid Appraisal research conducted in June 1996 showed three fundamental problems in commercial farms:

• Absolute poverty: In commercial farms most farm workers earn the minimum wage which in 1995 stood at USD 33 per month. This salary is supposed to cater for the worker and his nuclear family. PANGS estimated that the poverty datum line in 1995 for a family of 6 stood at USD 178 a month.
• Living conditions for farm workers and their families are, for the most part, sub-standard, with a minority having access to clean water, sanitation and good housing. Diarrhoeal disease is widely prevalent.
• Poor organisation, communication and co-operation. In commercial farms people are thrown together from a variety of backgrounds. There are no traditional systems of leadership to bind people together and allow mutual benefit from collaboration. Linked to this is poor communication with the owner because the structures and channels are not there. Thus grievances fester and development is limited.

These three points represent the underlying constraints to improving nutritional status. So, how should we get round them?

Solutions to the problem:

The Farm Health Scheme started operating in Mashonaland Central in the mid 1980s. The programme has grown to become multi-disciplinary and now includes education (child and adult literacy), income generation, and mobilising for organisation as well as health care initiatives.
Studies by organisations working in commercial areas have shown that farm workers are unempowered. They are poorly organised and have poor channels of communication with the farm owner. They have job insecurity, with most on seasonal contracts or daily piecework. There is little understanding between the farmer and his workers, with an educational and cultural void distancing the two groups.

The Farm Worker Programme is supported by Save the Children Fund. SCF's main input is in social mobilisation, particularly Farm Development Committees, which aim to encourage workers to organise themselves properly, and to bring the farmer into the discussion forum. This initiative is crucial to the Farm Worker Programme in general. At the moment workers do not have a voice.

Most of the problems on commercial farms, including nutrition, can be addressed through improving communication and understanding. Farm owners have shown that if they are given compelling information which emphasises the benefits of a costly intervention (as well as the benefits which would accrue to their workers) then they are likely to take on board this information and provide better facilities for their workers. Explaining that VIP latrines can help productivity by reducing time off work due to diarrhoeal disease will justify to their bank manager the need to build latrines. If there is a need for farm owners to assist with food provision in pre-school then first they have to know how many of their workers' children are undernourished (this information is not routinely communicated to them). They also have to be aware of why children need frequent feeding, and that without food at pre-school, children will not benefit from the teaching, they will run away, they will distract their working mothers, and perhaps come to harm.

In June 1996, a team from the provincial government underwent training under FAO's Communication for Development in Southern Africa project. The training involved participatory research in communication strategy design and sought to ascertain why people were not participating in development activities. The goal of the programme is to increase participation through effective communication. Through this programme, which trains development workers to formulate an appropriate communication strategy, we hope to see a noticeable difference between those farms where the intervention is taking place and the non intervention farms.

Our communication strategy addresses 3 problems which were prioritised by the farm workers.

• Lack of sufficient food for the family
• Poor child care
• Poor organisation and co-operation among workers

We are producing discussion tools in the form of serial picture codes, games, flash cards, posters and leaflets which will guide the Farm Health Scheme teams in creating awareness through discussion. The discussions will enable the workers to come up with their own solutions, which, because they are self- generated, will effectively address the problems in the long-term.

Conclusions

I have often been asked by govemment and NGO staff as well as farmers to extend the CSFP to commercial farms. I would argue that supplying CSFP rations is merely easing people's consciences at the same time as making the problem worse for the future. In a few months time we will have produced materials which will facilitate discussions enabling every farm community to address the problem (if it recognises the problem) with a community-derived long-term solution. Outside of drought there is double the rate of under nutrition in commercial farms as in communal areas. We should start by highlighting the problem and sorting it out in non-drought years.

See also: PostScript by Jeremy Shoham