Hunger and Malnutrition in Cote d'Ivoire
April, 2002
A friend asked me about hunger for a program she was doing at church. I thought others of you might be interested in my experience of hunger in Cote d'Ivoire...
People in Cote d'Ivoire don't generally die from a lack of food. We're very fortunate here that is the case. We're far enough below the Sahara Desert that our land is fertile. Especially in the south where I am, we can grow most things without fertilizer and there are plenty of fruits and vegetables available.
The problem in Cote d'Ivoire is nutrition. Kids and older people are much more likely to die or be sick from malnutrition than from hunger itself. The diet here is based on igname (a root vegetable sort of like a huge dry flavorless potato), rice, and plantain bananas. Fruit is readily available too. But there is very little protein in the diet. Protein is available but expensive and people don't understand enough about nutrition to make protein a priority. There are also very few green vegetables. I think green vegetables would grow here, but again, it's a question of knowledge. I see cucumbers and lettuce at our weekly open air market, but not very often and never in large quantities. I have never seen spinach, broccoli, or kale here.
Another difference is cultural. It's kind of the inverse of what we do in the US. How many times have I seen friends make sure their kids eat well-balanced meals while they themselves grab a diet coke and a couple cookies (you know who you are)? Here, the head male in the family will take what he wants to eat, then the other adult males, then the head female, then other adult females. The kids get what's left. That's usually a lot of rice or igname, a little tomato sauce, and literally the meat (fish or chicken) that the adults have picked over, if any at all. The thinking is that the adults need to have strength to work in the fields, and the kids don't need as much strength or energy.
At my host family during training, the ten year old boy would eat my chicken after I was done eating it. He could pick the bones absolutely clean. Other volunteers have mentioned that during training they would purposely leave extra meat uneaten on the bones so the kids would get more.
Finally, deforestation is changing the climate, which is effecting the rainy season and the crop yields. The north is nearly stripped of trees, and the west is rapidly following. It's a tough situation - this country is poor, and the Western countries pay good money for the lumber. People choose the short term income rather than the long term good of the country. We are already seeing shorter rainy seasons, which reduces the crop yield, which brings the farmers less money...so they are more inclined to sell their trees for the extra cash...and the cycle begins.
Isn't the problem complex? This year's cocoa and coffee corps were very poor, and most people blame it on a lack of rain from deforestation. (I'm way out of my league here in terms of scientific knowledge...) So you have people who earn most of their money at the end of coffee/cocoa season and this year their income was low. Now they can afford even less variety in their diets and even less protein.
Add to that the compounding factor of the 10 - 12% HIV infection rate - where good nutrition and clean water are so important since preventing secondary infections is key - and you can see the problem of food and nutrition getting bigger and more complex.
I'll tell you a little about what I see with my two neighbor families that I am very close to. Both men are employed by the government in middle income jobs. The Kodja family has one child at home, a 5 year old. I see him eating a small serving of meat at least once a day, with a huge portion of starch (igname, rice, or plantains). The sauce they eat on their starch usually has tomatoes, eggplant, and onion in it. Other than that, I never see him eat vegetables. I see him eat fruit on occasion, and I have never seen him drink milk. I see the adults eat fruit every so often too, more than once a week.
When I say the portion of starch is huge, I mean huge! An adult serving might be two cups or more. A child's serving is more like a cup or 1 1/2 cups.
The N'Guessan family has four children, girls 14 and 10, boys 5 and 1. I only see them eat meat or fish about three times a week. The kids in this family do eat more fruit, perhaps one serving per day. Their sauces have the same ingredients - tomatoes, eggplant, and onion - as the Kodjas. I have seen the five year old with a packet of dry milk one time, eating it by licking his finger and dipping it in the packet!
The baby is still being breast fed. They have been supplementing with water, pasta, and igname since he was about four months old. They feed him the pasta and igname without sauce, so I think he never gets any vegetables at all.
If you are thinking that perhaps the kids get milk on their cereal at breakfast, think again! Breakfast here is the same as lunch and dinner. No cereal or toast, no pop tarts or granola bars.
So what's the answer? It's not easy, is it? Giving people the knowledge about nutrition is not enough. You must also convince them that the cultural attitudes need changing too - that kids need to eat high quality foods, including protein and calcium, even though they are not going out to the fields all day. People need to be convinced that in order to grow up healthy and learn well, kids need good nutrition. That would be a start. And planning for the long term, especially with the deforestation issue, is key. But that's a very hard lesson to teach and learn. We in the developed world still don't have that one down yet.
I have considered teaching a nutrition class for teenagers and young mothers, as a start. Anyone else with ideas, please send them on!!