Article
25 of the Universal Declaration of Human Rights proclaimed the right to
adequate food as an indispensable element of the right of everyone. Article 6
(2) of the Convention on the Rights of the Child proclaimed that States Parties
shall ensure to the maximum extent possible the survival and development of the
Child. The Convention included specific
provisions for the protection of children in areas of armed conflict.
The
constitution of Uganda (1995) requires that “The state shall take appropriate
steps to encourage people to grow and store adequate food; establish national
food reserves; and encourage and promote proper nutrition through mass
education and other appropriate means in order to build a healthy state”. And
the Uganda Children’s Statute of 1996 gives children under the age of 18 the
right to adequate diet.
In
spite of these laudable instruments at the international and national levels
very little practical enforcement has been taken to improve the nutritional
status of Uganda’s children.
To
understand this sad fact one needs to examine Uganda’s incorporation into the
global economy as a subordinate member dependent on the production of raw
materials including foodstuffs for export to earn foreign exchange to import
consumer and intermediate goods for development.
Prior
to Uganda’s colonization at the start of the 20th century,
communities produced goods according to their local comparative advantage and
exchanged surplus through barter in local and regional markets. Consequently parents
and their children ate adequate and balanced diets (carbohydrates, proteins,
minerals, vitamins and fats) for a healthy and active life except during occasional
periods of food shortages caused by natural or man-made developments such as
drought or conflict.
The
colonization of Africa including Uganda was designed to secure raw materials
for European manufacturing enterprises and food stuffs to feed their exploding
populations. Consequently Uganda’s fertile land and economically active labor
were diverted to the production of cotton, coffee, tea and tobacco and
foodstuffs for export in exchange for imported goods that largely served the
interests of local elite and expatriate personnel.
By
the 1930s signs of under-nutrition in the form of Kwashiakor (a protein
deficiency disease generally associated with under-nutrition and vitamin
deficiency especially among children) had become evident. Although efforts were
made to improve the nutritional security through the development of fisheries
to provide an affordable source of protein to low income families and training of
mothers in hygiene and preparation of balanced diets, the situation improved
little before independence in 1962 and has deteriorated since the 1960s.
Between 1959 and 1994 stunted growth among children had increased from 30
percent to 44 percent. In 2008 under-five child under-nutrition stands at 40
percent.
Studies
by international and national organizations have demonstrated that Uganda’s diets
are dominated by cassava, maize and plantains with inadequate or no dietary
supplements – hence high levels of under-nutrition and neurological
disabilities.
When
the National Resistance Movement (NRM) government came to power in 1986, it was
very determined to reverse under-nutrition among Uganda’s children (0-18 years)
and mothers. It advocated a policy of balancing production of food for domestic
consumption and for export. It also stressed the production of nutritious crops
such as millet, sorghum and lentils that had been neglected in favor of
agricultural exports.
However,
the implementation of the program soon ran into difficulties. The government,
under pressure to obtain financial and technical assistance, entered into
structural adjustment agreements (Washington Consensus) with the World Bank and
the International Monetary Fund (IMF) with stringent conditions.
The
government agreed to increase exports of agricultural commodities including
food stuffs to earn the badly needed foreign currency to retire external debt
and raise surplus for domestic use. Consequently, more land and labor went into the production of
traditional commodities of coffee, cotton, tobacco and tea as well as non-traditional
exports of fish (wild and farmed fish), beans, sesame, fruits and vegetables
and flowers. Additionally, government
policy of commercializing agriculture through production for cash rather than
for domestic consumption has resulted in many families selling virtually all
their food and keeping very little especially of nutritional value for their
families.
The
government also agreed to balance the budget resulting in severe reductions in
expenditures on social services that have adversely affected children.
Consequently,
30 percent of Ugandans go to bed hungry, over 33 percent are mentally sick in
part because they eat food dominated by non-nutritious cassava, maize and
plantains without adequate dietary supplements, 40 percent of children under five
are under-nourished, 12 percent of infants are born underweight because their
mothers are under-nourished and up to 80 percent of children are dropping out
of primary education in large part because they are hungry.
Infants
born underweight develop permanent disabilities and face the prospect of early
death. And children who are under-nourished suffer mental and physical
under-development which undermines their performance in school and productivity
at work.
This
disturbing situation calls for the implementation of structural adjustment with
a human face through a combination of measures to ensure the survival and full
development of Uganda’s children.
It
has been recognized that when a mother is under-nourished, illiterate and
produces children in rapid succession, that mother will produce underweight
children, will not have the knowledge and skills as well as time, energy and
resources to take good care of her children respectively. Therefore the
improvement of women’s nutrition, provision of education and training and establishment
of facilities for child spacing should be developed and implemented as an
integral part of child survival and development.
Mothers
should be encouraged to breast feed for at least six months. Studies have shown
that mother’s milk has unmatched health and nutritional properties. Consequently
infant formula or bottle-feeding which unfortunately is seen by many as the
‘modern’ way should be discouraged as much as possible. Weaning foods are also
important. In some communities, there is a false belief that weaning food
should be soft on the digestive system. Consequently, the food consists of overcooked
bananas and vegetables that ultimately contribute to under-nutrition.
Although
commendable work has been done to control communicable diseases such as
diphtheria, whooping cough, tetanus, measles, polio and tuberculosis, many children
in Uganda are still dying from them. Therefore more needs to be done so that
all children are immunized.
Poor
hygiene and sanitation contribute significantly to child morbidity (sickness)
and mortality (death). More efforts are called for to ensure universal access
to safe drinking water and clean sanitation especially the provision of
latrines and the washing of hands before touching food. Mothers’ Unions in
collaboration with health officials and NGOs should step up their vital role in
these areas especially in urban areas where congestion and associated health
problems are getting out of hand.
Poor
hygiene and sanitation are reflected in high levels of diarrhea. Mothers and
other child care providers need to be conversant with oral rehydration therapy
(ORT) which replaces lost fluids in the body. Diarrhea does not kill outright:
it is dehydration which diarrhea brings about that kills.
One
of the components of human development is education. In Uganda many children
are dropping out of school early or are performing poorly in part because they
do not eat lunch. There are many families that cannot afford to provide lunch
for their children. In these circumstances, authorities at national and local
levels with international support such as from the World Food Program and other
interested non-state actors should work with parents and local organizations including
churches and civil societies to provide school lunches. There is overwhelming
evidence from developed and developing countries that school lunches keep
children especially girls at school and improve their performance.
Since
the 1970s, Uganda has suffered political instability, internal wars, endemic
and epidemic diseases such as AIDS which have brought untold suffering to the
children. It is important that Ugandan authorities and their development
partners take extra steps to protect children from undue suffering. Where there
is a will, there is always a way!
Not
least, benchmarks should be established to monitor and measure periodically the
impact of these programs so that corrective measures can be taken as and when
necessary to ensure that Uganda’s children are properly prepared for the twenty
first century and can compete as students and as workers in a globalized
world. Part of the foreign exchange earnings
should be allocated to these worthy endeavors.