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M.A PUBLIC HEALTH RESEARCH SHOWCASE

Topic

PUBLIC HEALTH ADVOCACY AND FAMINE IN ZIMBABWE 2000-4

Tirivanhu Juru

tirivanhujuru@hotmail.com

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BRIEF OBSERVATION ON ZIMBABWE'S FOOD SECURITY AND VULNERABILITY.

¾ Agriculture is the backbone of the economy of the 11.3 million population.

¾ 1980 onwards -Zimbabwe had a food surplus and the UN's World Food Programme (WFP) had a procurement office in the capital Harare.

¾ 2000 - The Land Reform process;- Ill-planned, and sometimes spontaneous

¾ 2001 - Agriculture industry in crises and food security compromised

¾ 2003 - Infant mortality had risen by 15% as compared other Southern African States - Prices rose by 619.5% (IRIN: 2004)

- Zimbabwe accounted for two-thirds of UN World Food Programme's (WFP) $311 million Southern African regional appeal

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PUBLIC HEALTH DIMENSIONAL IMPLICATIONS OF THE FOOD FAMINE.

¾ Diseases.

- eg HIV/AIDS is worsened by extended periods of food insecurity & weakens households resiliency.

¾ Child Malnutrition.

- eg 25,600 children identified to be underweight in Zimbabwe's Harare's 25 municipal clinics.

¾ Social and psychological

- Family breakdowns as household heads migrate to distant cities in search of paid labour and increases the already precariously exploding urban populations.

¾ Politics and Governance.

- 2002 ; Law and order compromised as food unavailability breed national discontent

¾ Economy/ Lifestyles

- The economy affected as food shortages compromised the much needed production

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THE FAMINE MODEL/THEORY FOR EFFECTIVE INTERVENTION

1. The Malthusian Model of famine;

Population growth > Production

• Starvation

• Death

¾ A Thomas Malthus 19th century demographic approach within the human population framework

¾ Number of people doubles every 25 years (unless checked), thus growing at a geometric rate (1, 2, 4, 8, 16, 32, etc), while food production increases at just an arithmetic rate (1, 2, 3, 4, 5, 6, etc), a population will always outstrip food supply (Ross; 2000). Thus population growth always

outpaces production and starvation will result in famine deaths.

¾ The theory/ model has merits but fails as it do not envisage the modern food technology advances

¾ Unfortunately some famine interventions still follow this logic.

Source: Lautze et.al; 2003, p. 106

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2. Amartya Sen's starvation model of famine;

• Loss of entitlements

• Starvation

• Death

¾ Amartya Sen added economic ideas of famine starvation leading to deaths.

¾ ''Starvation is the characteristics of some people not having enough to eat. It is not the characteristics of there not being enough to eat'' (Sen; 1991; p. 1).

¾ Even in the worst famine food is always available and what always lacks are the economics oriented ''entitlement rights''.

¾ Although the economic oriented view of famine do not fully cover the multi-faced famines in Zimbabwe or elsewhere, it however goes a long way in explaining the intractable and close link relationship between the deep seated poverty and hunger in most Zimbabwean famines.

Source; Sen; 1981

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3. De Waal's Health model of famine;

Drought + Social disruption + Economic crises

• Health crises Food crises

• Death Destitution

¾ Alex de Waal's research on the Darfur (Sudan) region during the 1984-5 drought and subsequent famine

¾ Deaths in a famine are a resultant of diseases than outright starvation.

¾ This ''health model of crisis'' picks the lethal relationship between malnutrition and diseases, especially malaria, measles, acute respiratory infections and diarrhoeal diseases that with malnutrition, are usually the leading cause of mortality in famine disasters (Toole & Waldman 1997).

¾ Explained also is the role of democratic institutions and famine and why market fail to address food shortages in famines and weak purchasing power and transportation costs easily leading to spatial segmentation or

informational asymmetric that leads to vulnerabilities, speculation and hoarding.

¾ This is precise in the Zimbabwe case. Besides the 2002 drought, social/political disruptions and the economic crises has contributed to the country's food insecurity.

¾ Unfortunately very few famine intervening agencies apply this New Public Health Agenda related model in the famine mitigation work

Source; De Waal; 1989

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WHAT SHOULD BE DONE?

PUBLIC HEALTH ADVOCACY

1. Pre-disaster Public Health Advocacy

¾ The rationale is that famine is a slow-onset disaster (Twigg:2004).

¾ Effective use of Early Warning Systems (EWS); EWS- ''system of data collection to monitor

people's access to food, in order to provide a timely notice when a food crises threatens and, thus, to elicit appropriate response'' Davies et.l (1991)

* Need to harmonise the 2 EWSs in Zimbabwe which always produced conflicting food deficit estimates

1. Save the Children Fund SCF follows the household food economy approach 2. Govt (backed by USAID) follows the maize equivalent approach

¾ Enlisting the political will;- * Govt are reluctant to call for outside help

¾ Institutional capacity building;-

* Public education & communication; eg Schools Emergency Educational Programme by SCF

* Partnership & Agencies' network to avoid the ''paradox of power'' crises in emergencies.

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2. Disaster and Post-disaster (Rehabilitation) Public Health Advocacy

¾ Emphasis on linking relief with development, i.e ''developmental relief'' (Red Cross; 1996) to make communities more resilient to future emergencies. (ICRC)

¾ Guiding framework for public health rehabilitation means information for advocacy centres on;

* Restoration

* Structural reforms e.g. restructuring/dismantling bureaucracy and red tape inhibiting quick response

* Institutional (capacity) building e.g reorienting the Department for Civil Protection DCP in Zimbabwe

¾ Emphasis on public health assessments for post disaster needs

* Famines have strong budgetary implications & Govt thrusts economists to makes vital decisions based on cost and sound financial arguments ignoring the famine severity on human malnutrition and psychological trauma.

* Therefore assessments should be all inclusive to cover on - Psycho social assessments,

- Lay health beliefs/ Disaster myths - Problems of dependency syndrome.

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¾Economic livelihood coping strategies, rebuilding & adaptation assistance

* Food-for-work projects in Zimbabwe- This is carrying work projects and receiving food as payment.

This is part of the ''developmental relief'' strategy in Zimbabwe run by various relief Agencies.

* Cash-for-work projects in Zimbabwe- This is crucial and has twin advantages of physical rehabilitation and financial income enhancement

‰ Cash based response is now a favoured approach than the commonly used food handout strategy E.g in 1991 the International Fund for Agricultural Development's work in Ethiopia observed that;- ''It costs US$800 to carry a ton of food to the Ethiopian highlands to fed a family for a year, while, with half as much, the same family could improve its own production capacity and feed itself for twenty years (Alamgir& Arora; 1991, p.12).

¾ Planning the ''Exit Strategies'' (Twigg: 2004)

* There is need to end abrupt withdrawals by intervening agencies to ensure a sense of continuity in the rehabilitation periods.

¾ Disasters as ''windows of opportunity''

e.g stimulating community empowerment and participation and ''developmental relief''

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ENDNOTES

Integrated Regional Information Network IRIN (2003) ''Zimbabwe; Economic gloom deepens despair'' (19 August 2004) Nairobi. United Nations Office for the Co-ordination of Humanitarian Affairs http://www.irinnews.org/report.asp?ReportID=42757&SelectRegion=Southern_Africa&SelectRegi on=SOUTHERN_AFRICA (19/08/04).

Ross, E. (2000) ''Poverty politics and population in capitalist development''. Corner House Briefing No.

20, July 2000. http://www.thecornerhouse.org.uk/briefing/20malth.html (27/07/2004)

Lautze, S et.al. (2003) Risk and vulnerability in Ethiopia; learning from the past, Responding to the Present, Preparing for the future. Tufts University, USAID/ Ethiopia, June.

Sen, A (1981) Poverty and Famines; An Essay on Entitlement and Deprivation. Oxford. Oxford University Press

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Toole, M & Waldman, R (1997). ''Refugees and displaced persons; War, hunger and public health''.

Journal of the American Medical Association. 270; 600-606.

De Waal, A (1989), ''Famine and mortality; A case study of Darfur, Sudan 1984-5''. Population Studies;

43; 5-8

Twigg, J (2004) ''Disaster risk reduction: Mitigation and preparedness in development and emergency programming''. Good Practice Review: 9: March 2004. London. Humanitarian Practice Network (ODI).

ICRC, (1996) ''Annex V : Key factors for developmental relief''. International Review of the Red Cross no 310, p.55- 130

http://www.icrc.org/web/eng/siteeng0.nsf/iwpList151/8B78BA0E6ECD4313C1256B660059AD89 Alamgir, M & Arora, P (1991) Providing food security for all. London. Intermediate Technology

Publications for the International Fund for Agricultural Development (IFAD)

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