Lying outside her hut on a tattered mat, 20-year-old Maria struggled with her breathing as she tried to explain why she and her five orphaned nieces and nephews in her charge had not eaten.
Maria (whose name is changed to protect the family’s privacy) was dying from Aids-related diseases, as well as from severe malnutrition.
“I had to sell my plot of land to survive,” she said through her gasps for breaths. Tears rolled down her hollow cheeks. “I haven’t taken my tablets [for tuberculosis] for five days, because I’m too hungry. The pills make me feel sicker, if I take them without food.”
Maria dropped out of school when she was 15 years old to look after her own parents, who were ill for a long time before they died. Her own husband deserted her when she fell sick, and the children living with her were offspring of her three sisters, all of whom died of Aids. Her eldest niece, at 14 years, already had a baby of her own.
A month after the interview, Maria died. The children had to leave their home as someone claimed it was theirs. A neighbour, who used to visit Maria and who is also living with the virus, gave Maria’s destitute orphaned nieces and nephews temporary shelter.
The family lives in Nicoadala, in the northern province of Zambezia, which was once known as the breadbasket of Mozambique, as it has the potential to feed the whole country.
But a combination of factors — the effect of 16 years of civil war which ended in 1992, widespread poverty and unpredictable weather patterns — have kept most families at subsistence level, and little able to withstand the HIV/Aids epidemic that is growing fast in the country, although its full impact is yet to be felt.
In 2003, Mozambique’s HIV/Aids prevalence rate was 13,6% and last year it shot up to 14,9%. The United Nations Food and Agriculture Organisation (FAO) predict that between 1985 and 2020, Mozambique will lose more than 20% of its agricultural labour force to HIV/Aids.
Most policy-makers recognise that HIV/Aids is not just a health issue, but developing adequate policies to mitigate the devastating impact it is having, especially on subsistence farmers — who make up 77% of the population in Mozambique — remains a huge challenge.
What is clear is the anecdotal stories are tragically dramatic.
“The story of that family [Maria and her family of orphans] and others gives us an idea of the situation,” said Bertine Niesten, project officer for the FAO.
“We must remember the vice-versa effect of HIV/Aids whereby HIV/Aids can increase the risk of food and nutrition insecurity, and in turn food insecurity can increase vulnerability to the impact of HIV/Aids as children are forced to drop out of school and young people, especially girls, turn to risky behaviour in order to survive,” she said.
“It is a challenge still to ensure local organisations integrate HIV/Aids into projects in the agricultural sector,” Niesten said. “And it is also difficult to identify families because of the stigma attached to HIV/Aids.”
Since 1999, government policies — including in the agriculture sector — focused more on HIV/Aids prevention. In 2002, polices started to address the mitigation of HIV/Aids, especially in the rural areas.
And since the beginning of last year, funds became available for limited treatment with life-prolonging anti-retroviral drugs (ARVs) in the public health system and care for the sick.
Impact on subsistence farming
Most of the research into the impact HIV/Aids has on subsistence farming is qualitative and anecdotal. A case study carried out in Chokwe, in the southern province of Gaza on farmers’ knowledge of seed, supported by the FAO and published January last year, concluded that the long-term impact of HIV/Aids is not addressed sufficiently.
The paper argues that HIV/Aids, along with other factors, could erode into the knowledge on seed and seed management — critical to household food security.
However, a report to be presented at an international conference in South Africa on HIV/Aids and food and nutrition security this month is calling for a rethink of current views. It suggests that certain shifts in agriculture in the Southern African region are not always due to HIV/Aids but are more likely due to change in agriculture policy.
Policy-makers in Mozambique agree that more focus needs to be paid to mitigating the epidemic’s impact on food security. The government is now implementing different initiatives in all of the country’s 11 provinces, but the numbers of subsistence farmers reached are limited compared with the scale of the epidemic. More than 1,5-million people are living with HIV/Aids.
Albertina Alage, the head of department of rural extension and focal point for HIV/Aids in the ministry of agriculture, said: “We have advanced a lot, but we have problems. Sometimes finances for our plans are not timely, or do not come at all.”
Alage explained that since 1999, rural extension workers have been educating the communities about both new agricultural practices and HIV/Aids prevention.
“We have a problem in that we have few women rural extension workers. So, we instead appoint a woman in the community to also assist in the sessions. We also do not have enough communication material in local languages,” she said.
In 2002, programmes focused on trying to reduce the impact. Alage gave an example of demonstrating communities’ agro-processing machinery, which will assist families affected by the epidemic, giving them time to both farm effectively and look after the sick.
“They can then form associations and apply for loans but the machinery,” she said.
Prolonging agricultural workers’ lives
The FAO supports the provincial government in the central province of Sofala implementing a project prolonging the lives of agricultural extension workers. The HIV prevalence rates in Sofala is more than 30%, and extension workers have been especially at risk of HIV infection, being a highly mobile group. They are posted in areas without their families for long periods at a time.
The FAO, at the request of the provincial government, supports extensions workers who are taking ARVs with transport money so that they can make the often long journey to the provincial capital to receive treatment and collect their drugs.
“The provincial agricultural directorate is very organised. It was their request as they were concerned at the numbers of extension workers they were losing to HIV/Aids,” Niesten explained.
The FAO also supports about 840 orphaned pupils aged 12 to 17 years in the central provinces of Manica and Sofala with life skills and practical farming tips, which are given on demonstration plots.
The pupils learn how to prevent diseases, use fertilisers and irrigation, and at the same time, they learn life skills. The idea, explained Valentina Prosperi, a UN fellow for the FAO, “is that the pupils then teach their parents and the community”.
Another area that is crucial to food security in the long term is the right to inheritance. The UN Children’s Fund and the FAO are supporting the government to give more legal protection to children orphaned by Aids.
The UN World Food Programme (WFP) also supports a number of programmes directed at improving the food security of subsistence farmers living with HIV/Aids. For example, the WFP provides corn soya blend, fortified with micronutrients, to more than 4Â 000 people, including pregnant women, who are on ARVs. People living with HIV/Aids need 10% to 30% higher energy requirements than a person who is HIV-negative.
The WFP also provides 20Â 000 people affected by the epidemic and 50Â 000 orphaned children with a monthly food ration.
The deputy country director of the WFP, Karin Manente, explained that “sustainability is a concern. That is why our support is for a limited time frame. For example, we give food to ARV patients for the first six months, to help them through the most difficult period to get back on their feet. We want to assist people to prolong their lives; this also helps children stay in school.”
Like Mozambique, most of the 13-member Southern African Development Community countries face similar problems. Southern Africa holds 2% of the world’s population; but it has 70% of the world’s people who are living with HIV and Aids, according to ActionAid, an international charity, based in South Africa. — IPS