Institute Insights: June 2019

Contents:

David Kpan harvests cocoa near Wehplay, Liberia, with five of his children. Photo by Laura Elizabeth Pohl

From the Director

As we approach summer, hungry and malnourished people in many countries are entering their most difficult time of year. July and August are the peak of the “hunger season,” sometimes known by the more innocuous-sounding term “lean season.” This is when most of the food grown last season has been consumed, while the next crop is not yet ready to harvest. It is a fact of life for many smallholder farmers, but it is made far worse when conflict and/or climate change affect agriculture.

In this issue of Institute Insights, we take a closer look at how natural disaster (e.g., in Mozambique) and conflict (e.g., in South Sudan) affect hunger and malnutrition. We also discuss the debate around proposed changes in U.S. nutrition guidelines, and we consider how mass incarceration affects a particularly vulnerable group—the children of people in prison.

Over the past couple of years, we have been especially concerned about near-famine conditions, which have sometimes crossed the line into famine, in several conflict-affected countries, including Yemen, South Sudan, and northeastern Nigeria. Wider areas, particularly the Horn of Africa and the Sahel, a region on the outskirts of the Sahara Desert, are also suffering from drought and conflict. The hunger season will worsen conditions for people who are already in crisis.

When I look at the most recent updates on Yemen, South Sudan, and northeastern Nigeria, they read almost like those of a year ago. Despite a few signs of hope, the absolute numbers of people who are at risk are shocking, and so are the personal stories of individual babies or mothers, fathers or families.

In Yemen, fighting continues. At the end of March 2019, the World Food Program said that 70 percent of the population needs food assistance and that half of these, about 10 million people, are "one step away from famine." This group includes 2 million children suffering from acute malnutrition.

A peace agreement has been signed in South Sudan. Fighting continues despite the peace agreement, but there are fewer reported instances of armed conflict. Some communities are believed to be already suffering from famine, while many more are nearing famine conditions (in humanitarian parlance, they are in “emergency” status), and they could well become famine regions as the hunger season arrives.

In northeastern Nigeria, violent conflicts between farmers and herders continue, and bands of Boko Haram fighters also pose a threat. According to the International Organization on Migration, at least 1.8 million people remain displaced and unable to resume the work they used to do to support themselves, mainly farming and herding. Some communities are in the near-famine “emergency” category; it is believed that there are others in similar situations in areas that remain inaccessible to aid workers. Screenings of nearly 4,500 children who arrived from inaccessible areas revealed acute malnutrition and severe acute malnutrition rates of 30.7 percent and 15.8 percent, respectively.

The Sustainable Development Goals call on the global community to leave no one behind so that we can end hunger and malnutrition. Yet people trapped in these and other conflict areas are undoubtedly being left behind. In order to end hunger by 2030, much more must be done to prevent and resolve conflict, anticipate and mitigate cyclical hunger seasons, build resilience in the most vulnerable communities, and strengthen the capacity of local actors to manage crises.

Asma Lateef is director of Bread for the World Institute

Asma Lateef is director of Bread for the World Institute.

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The plates below are examples of a planetary health diet. This is a flexitarian diet, which is largely plant-based but can optionally include modest amounts of fish, meat and dairy foods.

U.S. Dietary Guidelines: Moving Forward from Where We Are

By Karyn Bigelow

Institute Insights has reported frequently on the existential threat of climate change, a threat that makes it imperative to quickly and dramatically reduce global greenhouse gas emissions. But what are some steps we can take to make this happen?

One of the five largest contributors to climate change in the United States is the food that we consume (or waste). The agriculture sector alone is the source of 9 percent of annual U.S. greenhouse gas emissions.

One solution is for large numbers of people to adopt a diet that is better for both human health and the planet, a planetary health diet as it is often called.

The upcoming publication of the U.S. dietary guidelines for 2020-2025 offers an opportunity to shape public attitudes and consumption toward a more earth-friendly diet. The U.S. Departments of Health and Human Services (HHS) and Agriculture (USDA) will release the newest version of the nutrition standards in 2020. From their first edition in 1980, the guidelines have been an important influence on our national food consumption. One key reason is that in addition to being part of the “farm bill,” the guidelines are used as the nutritional standards in federal nutrition programs such as school meals.

One weakness of previous editions of the guidelines has been that they promoted a universal diet—a one-size-fits-all approach that does not take into consideration, for example, the different nutritional needs of various age groups or people with specific non-communicable diseases. The new version will for the first time include specific guidelines for maternal/child nutrition (pregnant women and children up to age 2).

Most strikingly, given the grim scenarios of climate change, the guidelines have never even mentioned sustainability or reducing the impact of climate change. The guidelines issued in 2020 offer an opportunity to make a second important improvement by including sustainability.

In January 2019, the EAT Lancet Commission released a report that explains and illustrates a planetary health diet. Bread for the World Institute joins many other nutrition and food security advocates in recognizing and responding to the pioneering contributions of The Lancet, a respected U.K. medical journal, to maternal/child nutrition. Its series in 2008 helped many policymakers and healthcare professionals recognize how fundamental early childhood nutrition is to healthy human life—and, perhaps even more importantly, understand that straightforward, cost-effective actions can lead to dramatic improvements in nutrition.

The EAT Lancet Commission report looks at human diets on a global scale. Researchers take into consideration equity and nutritional needs for different regions of the world. According to the report, the typical North American diet includes too much of the following: dairy products, eggs, grains, meat, and starches. Meanwhile, most of these foods are typically less accessible and under-consumed among people in lower- and middle-income countries. The EAT Lancet report calls for people in the United States to eat more plant-based foods and far fewer animal products, fats, oils, and starches.

The upcoming U.S. nutrition guidelines could make an important difference in efforts to reduce greenhouse gases by beginning to promote a planetary health diet with less reliance on animal products. Switching to a mostly plant-based diet could reduce food-produced greenhouse gases by up to 70 percent by 2050. Not only will this help the planet by slowing climate change, a healthier diet will also save millions of lives in this country. We know that heart disease is a major health problem—in fact, it causes one in four deaths in the United States. Another example: in 2015, nearly 80,000 people died from illnesses linked to diabetes as an underlying condition.

The 2020 dietary guidelines will influence U.S. food policies for years to come, particularly through the next farm bill, which is scheduled to be reauthorized in 2023. Action steps such as eating less meat and dairy and more fruits and vegetables will contribute to the effort to limit global warming to a maximum of 1.5 degrees Celsius, as climate scientists now believe is essential.

In a 2017 Institute resource on climate change, one question was “Are there any signs of hope?” One answer was that some critically important sources of hope are human resilience, ingenuity, creativity, and adaptability. Human decision-making will determine all the outcomes. As more Americans become aware that climate change is a serious, imminent threat, offering them concrete ways to be part of the solution, such as by adopting a more sustainable way of eating, could empower people to make greater contributions to the effort rather than feeling trapped in pessimism and inertia.   

Karyn Bigelow is a research associate with Bread for the World Institute.

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Nate Gordon is a member of the HELP program for male returning citizens in Cincinnati, OH. HELP was featured in Bread for the World Institute’s 2014 Hunger Report, Ending Hunger in America. Gordon is shown here with his daughter. Photo by Joseph Molieri f

Another Group of Separated Children Faces Hunger and Poverty

By Michele Learner

Adults realize that children are the most vulnerable people in the community—dependent on others for their very survival. The United States has millions of devoted parents, grandparents, and foster parents doing the best they can to raise children to be healthy, happy, kind, and productive. Yet as a nation, we seem to give a lot more lip service to the importance of meeting children’s needs than actual attention and resources. It is a sad commentary that the demographic group most likely to live in poverty in our country is children younger than 3.

Over the past year, people all over the country have expressed their horror over the U.S. government policy of deliberately separating children seeking asylum at the U.S. southern border from their parents. Public protest ultimately put a stop to this, at least as an overt practice. The public was further outraged to discover that there was no organized system of tracking children who had been separated, raising grave doubts as to whether the administration had intended to reunite these families—ever.

In addition to those who are part of families seeking asylum in the United States, yet another significant group of children – 2.7 million strong – have also been separated from their parents, and as a result, suffer from extremely high rates of hunger and poverty. These are children whose parents are currently incarcerated. Moreover, researchers reported in 2015 that an even larger number of children—more than 5 million, or 7 percent of all U.S. children—have had an incarcerated parent at some point in their lives. This data reflects the fact that the United States has one of the world’s highest rates of incarceration (second only to the Seychelles, an island nation with a small population). In late 2015, the U.S. incarceration rate was 698 per 100,000 people, while Canada’s rate was 106 per 100,000 people.

Bread for the World Institute’s 2018 briefing paper, Mass Incarceration: A Major Cause of Hunger, describes the devastating impacts of skyrocketing incarceration rates targeted at communities of color. For example, one study found that almost 70 percent of households reported having difficulty meeting basic needs, such as food and housing, when a family member was incarcerated. On a national level, researchers found that the overall U.S. poverty rate would have dropped by 20 percent between 1980 and 2004 if not for mass incarceration. Please see the paper for more on mass incarceration and its effects.

Mass incarceration is a product of policy choices. It was not, and is not, a response to increasing crime rates. Because public policies created mass incarceration, it is the responsibility of our elected leaders to take corrective action—including by respecting the rights and meeting the needs of the children harmed by it.

This is not a responsibility that officials have taken seriously. The neglect begins with startling gaps in information about who the children of incarcerated people are and what happens to them. One researcher says, for example: “Although the number of children and youth placed in foster care as a result of their parent’s incarceration is not clearly identified through current data collection systems, estimates suggest that tens of thousands of young people in foster care may have incarcerated parents.”

Another specialist goes into greater detail, explaining that there is a lack of information not only on “the number of foster children whose mother is incarcerated,” but the “effect of having an incarcerated mother on the number or type of placements children experience while they are in care, their length of stay, or their permanency outcomes (e.g. reunification versus adoption).” It is difficult, more likely impossible, to fully respond to children’s needs without some of this basic information.

Data from 2010 hints at the scope of the problem. About 45 percent of people sentenced to imprisonment were living with their minor children. This source reported that 88 percent of incarcerated fathers rely on the children's mother to care for them, but only 37 percent of incarcerated mothers rely on the father for primary care. Among mothers, 45 percent rely on the children's grandparents, 23 percent on other friends and relatives, and 11 percent on foster care. Yet grandparents and other relatives often struggle to support the children financially. Among children living with a grandmother, the reported poverty rate is 25 percent, and 33 percent lack health insurance. Moreover, in this study, two-thirds of those serving as caregivers for children with incarcerated mothers reported that they could not afford to meet all the child’s necessary expenses. 

A significant share of U.S. poverty is linked to mass incarceration. Pervasive racism in the criminal justice system drains communities of color of their parents and income earners. Children whose parents are in prison are at risk of suffering from any of a broad range of material, emotional, and social deprivations. Researchers find that the collateral damage related to incarceration may exacerbate social inequality through its negative impact on disadvantaged children and families. Mass incarceration is undoubtedly moving the country further from its goal of ending hunger and food insecurity.

Michele Learner is associate editor with Bread for the World Institute.

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Macomia district, in Cabo Delgado, Mozambique, has been hard-hit by Cyclone Kenneth, which made landfall on April 25. Photo by OCHA/Saviano Abreu

Prioritizing Nutrition for the Most Vulnerable After Natural Disasters

By Jordan Teague

Does it seem to you as though there’s never a break in the bad news about the world’s natural disasters? We hear about hurricane after earthquake after cyclone. Moreover, this list will only grow more quickly in the future, because climate change is creating the conditions for stronger and more frequent storms. This means that it will be more important than ever not only to save lives during natural disasters, but to have recovery strategies prepared in advance.

Southern Africa, particularly Mozambique, was hit by two major cyclones in March 2019. According to the U.S. Agency for International Development (USAID), Cyclone Idai is the worst natural disaster in southern Africa in recent memory. It was quickly followed by Cyclone Kenneth. The enormous amount of work in the immediate aftermath included search and rescue as well as providing hundreds of thousands of displaced people with food, water, health care, and shelter.

As in any emergency, providing people with food must include, as an urgent priority, providing the right nutrition for children under 2 and pregnant women. Rapidly developing brains cannot be put on “pause” while nations recover. As Bread for the World Institute has said before, the window between pregnancy and the second birthday, the “1,000 Days,” is the best opportunity to ensure that people get the nutrients critical to their growth and development. But the flip side is that during this time, even short episodes of malnutrition can have devastating lifelong consequences for a person’s health and development.

The immediate needs were overwhelming but only the beginning; the two cyclones also caused serious long-term problems. Catastrophic flooding swept away the livelihoods of entire communities. In Mozambique, 80 percent of the workforce is in the agricultural sector. Cyclone Idai destroyed more than 700,000 hectares (1.7 million acres) of crops, 13 percent of Mozambique’s total farmland, just before harvest time. Farmers lost an entire season’s worth of work, and families lost their sole source of income. Even more importantly, these crops were needed to nourish children.

Mozambique was struggling with child malnutrition well before Cyclone Idai. Data showed that in 2011, more than 6 percent of all children under 5 were acutely malnourished – up 2 percentage points from 2008. This is classified as “medium” severity. About 43 percent of children were stunted, which indicates that they were survivors of early childhood malnutrition. That is a far higher rate than the global average.

Achieving the goal of ending malnutrition means that each person has sufficient nutritious food, a diverse diet, services such as nutrition education, micronutrient supplements as needed, and early identification and treatment of malnutrition.

As a result of the cyclones, Save the Children, a U.S. nonprofit organization working in Mozambique, expects to see a near doubling of the country’s rate of acute malnutrition among young children. Families simply do not have food, especially nutritious food, to feed their children. This is where humanitarian assistance comes in! The U.S. government has contributed to the humanitarian relief effort alongside other donors, providing more than $70 million to date to areas hit by the cyclones.

But Mozambique and other countries in the region will be trying to recover for quite some time.  Families working to rebuild their lives and livelihoods will need support to do so. Farmers will need seeds, other farm inputs, and tools so they can plant new crops. People—particularly young children and pregnant women—will need a variety of nutritious foods to sustain them until the new crops are ready. To prevent an increase in acute malnutrition from leading to rates of stunting even higher than before Cyclone Idai, the government of Mozambique, its global partners, nutrition and agriculture specialists, and communities themselves must focus their attention on nutrition for pregnant women and young children.

Jordan Teague is a senior international policy advisor at Bread for the World Institute.

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A child is screened for malnutrition at a UNICEF-supported health center in Aweil, South Sudan. Photo by UNICEF South Sudan/Sebastian Rich

South Sudan: Another Famine on the Horizon

By Michele Learner

The United Nations Children’s Fund (UNICEF), the Food and Agriculture Organization (FAO), and the World Food Program (WFP), sometimes known collectively as the “U.N. food agencies,” reported on February 22, 2019, that without effective humanitarian assistance at the right time, South Sudan risks sliding into famine in 2019. As mentioned earlier in this issue, combatants in the country’s five-year-old civil war signed a peace treaty in late 2018, but fighting continues, albeit with fewer reported violent incidents. The civil war has already claimed the lives of 400,000 people and forced 4 million others to flee their homes.

The U.N. food agencies report that about 30,000 people are currently living in famine conditions in eastern and central regions of South Sudan. This number could jump to 260,000 people if sufficient food assistance does not reach them in time. Humanitarian officials were alarmed to find, in January 2019, that 6.17 million people were in the formally defined hunger phases Crisis, Emergency, or Famine (the IPC Phases 3, 4, or 5). This data helped inform the projection that nearly 7 million people could face acute food insecurity at the height of the lean season, May to July in South Sudan.

Agriculture specialists estimate that local production in 2019 will meet only 52 percent of the country’s cereal needs, compared with 61 percent last year. Before the war, the average farming household harvested enough food for seven months. The latest data show that 57 percent of the population has been able to harvest crops, but only enough for one to four months.
As Bread for the World Institute often mentions, conflict is one of the main causes of hunger. Low-income nations at peace have made significant progress against hunger, which means that an increasing percentage of people experiencing hunger live in conflict zones. It’s not hard to see how war causes hunger and disease. Not only does it destroy human life—one family tragedy after another—but it also destroys crops, farm equipment, and farm animals.

People who survive but are displaced from their land have no way to produce food. Transportation routes may be too dangerous to allow people to search for food. Markets may have little food for sale, or they may stock some staple grains or other reserves, but at prices that few can afford. Armed combatants may simply take what they want from markets and private homes. The rains may be late or inadequate or simply absent, or there may be floods. 

In the 1980s, when people in wealthier countries responded to horrifying TV images of famine in Ethiopia and elsewhere, the international community began to pool research and knowledge in an effort to determine how these tragedies could be predicted and, therefore, prevented. The result was the launch in 1985 of the Famine Early Warning Systems Network, usually known as FEWSNET. Predicting significant hunger crises has become much more of a science.

Unfortunately, the “preventing” half of the effort has been less successful. Actions, when they come, are often too little, too late. Frequently, one or several warring factions are to blame. Humanitarian officials have repeatedly called for all parties to the conflict to allow humanitarian access to people in need. Another problem has been a shortage of resources. Donor countries and organizations do contribute financial resources, but humanitarian appeals routinely fall far short of the amount needed to save lives.

Although full of daunting realities, FEWSNET reports also have heartening aspects. The reports’ careful compilation and interpretation of the most relevant data shows that the knowledge exists as to what signs to look for, and how much time is left to respond once those signs are spotted. But if the political will to do what is necessary to avert the worst-case scenarios is simply not strong enough, it becomes far less important to have this advance warning. The resulting assistance and impact for people trapped in hunger emergencies is then so much less than FEWSNET and other predictive tools have made possible.

FEWSNET uses an approach called scenario development, which guards against errors by including accurate analysis of the current situation, assumptions about the future, assessment of potential changes that would alter the scenario, and analysis of the likely responses of various actors. It begins with steps such as identifying assumptions (if the end forecast is faulty, relief officials can at least go back to see which assumptions were unwarranted) and ends with steps such as assessing the likelihood of specific events and how they would affect the projection.

In addition to factors that are directly related to agriculture and food production, such as rainfall, longer-term weather predictions (generally done by satellite), and harvest amounts, FEWSNET tracks livestock health, staple food and commodity prices, seasonal labor demand, levels of conflict, government and international aid, pest infestations, vegetation patterns, conditions as compared to the previous year and to a five-year average, to what degree transportation and trade have been disrupted and on which routes, and more. It is the identification and measurement of many relevant factors, some of which are not at all obvious, that makes FEWSNET remarkably accurate.

Michele Learner is associate editor with Bread for the World Institute.

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Tools
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