Institute Insights: August 2019

Contents:

Displaced persons collect relief supplies in Ituri province, north-east DRC. Interethnic violence has ravaged the Ituri Province since December 2017. UNICEF/Madjiangar

From the Director

The 2019 State of Food Security and Nutrition in the World (SOFI) report was released July 15. This year’s report found that the number of hungry people in the world rose in 2018, for the fourth year in a row, to more than 820 million people.  

Why the reversal? The report lists conflict, climate change, and a global economic slowdown as the primary causes. 

Climate change is arguably the most daunting of these. Humanity has little experience—even on a small scale—in managing the shifts in an entire economy, environmental policies, social systems, and other spheres of life that are urgently needed to slow and then stop climate change. Until recently, many people lacked even basic awareness of the scope and immediacy of the threat. 

As Bread for the World Institute has said in the past, an immediate full-scale global effort on climate change is needed. The SOFI is clear: climate change is driving hunger. Much more needs to be done to help people adapt and build resilience in the face of the dramatic changes underway. Two key areas of action are faster response to natural disasters, especially when crops are wiped out as in Mozambique earlier this year, and expanded climate-smart approaches in agriculture, food security, and nutrition programs. The international community at every level needs to get serious, urgently, about reducing greenhouse gas emissions. The U.N. Climate Summit in September is crucial: it is increasingly clear that to avoid the worst impacts of climate change, greenhouse gas levels must peak by next year, 2020, and then decline rapidly. 

Much more is known about how to manage the global economy to reduce hunger; practical strategies can enable national governments and the global economic system to prevent economic shocks and setbacks from leading to widespread hunger. It is not always possible to predict and avert complex economic problems themselves, but social protection programs, combined with advance preparations to strengthen community resilience and enable families to “bounce back,” make it entirely possible to prevent mass hunger, malnutrition, and disease.

Conflict-affected areas are home to the majority of today’s hungry people. It is not difficult to understand how this could be. The most recent statistics indicate that a record number of people—nearly 71 million—have been forced to flee their homes, largely due to violence. Most rely on agriculture or associated work, such as supplying seeds or tools for purchase, to feed their families. When they are forced to leave their land, they have no way of supporting themselves. The statistics on displaced people underline the larger truth: conflict destroys human life and the resources necessary to it.  

The United States has long been a generous donor to humanitarian relief efforts, and the combined efforts of international donors, national governments, aid workers, local civil society organizations, and community volunteers have saved millions of lives in emergencies created by conflict and natural disaster. Not only is the current level of financial support insufficient despite these efforts, however, but responding to an unending series of emergencies is simply not a sustainable long-term plan. To end hunger, malnutrition, and other human ills, it is absolutely essential to prevent conflict and create and sustain the conditions for a lasting peace. 

News headlines reinforce this argument day after day, year after year. At this writing, for example, the withdrawal of ground forces of the United Arab Emirates from Yemen offers hope that combatants are at last coming to the realization that there is no military solution to the conflict there. Young children and other civilians who have died—uncounted as yet but believed to number at least in the hundreds of thousands—are the “collateral damage” of the failure to find nonviolent solutions much sooner. Meanwhile, in the Democratic Republic of the Congo (DRC), so-called “low-level” conflict, including attacks on healthcare facilities and aid workers, is hindering efforts to contain an outbreak of the Ebola virus. Already a year old, the outbreak is now the second-worst on record. In an alarming development, cases have been detected in the city of Goma, population 2 million.

Bread for the World Institute’s 2017 Hunger Report, Fragile Environments, Resilient Communities, argues that the main drivers of hunger, including climate change and conflict, can be understood as forms of fragility. A comprehensive approach to finding solutions for fragility is essential to ending hunger. 

This issue of Institute Insights looks at how work on governance has enabled Kenya to make faster progress on nutrition, provides an update on Rohingya refugees in Bangladesh, and, turning to the United States, discusses some of the connections among nutrition, mass incarceration, and structural racism.

Asma Lateef is director of Bread for the World Institute

Asma Lateef is director of Bread for the World Institute.

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Photo by Todd Post / Bread for the World

Nutrition in Kenya Gets a Boost from … “Governance”

By Jordan Teague

Kenya has made rapid progress on two severe forms of child malnutrition—stunting and wasting. Not only that, but in 2015, the Global Nutrition Report named Kenya the only country worldwide that was on track to achieve all five of the World Health Assembly targets on maternal and child nutrition. Kenya is still on track to achieve all targets but one—reducing  anemia among women of childbearing age by 50 percent.

In April 2019, a team from Bread for the World Institute traveled to Kenya to explore the question of how the context in Kenya, particularly governance, can inform other efforts to speed up progress on nutrition.

The Institute on Governance defines governance as “determining who has power, who makes decisions, how other players make their voice heard, and how account is rendered.” Another definition is “the exercise of power or authority by political leaders for the well-being of their country’s citizens or subjects.” Bread for the World Institute defined governance in the 2017 Hunger Report as “the norms by which a government operates, measured in terms such as transparency, accountability, rule of law, and strength of institutions.” The report emphasized a key ingredient in good governance: the need for government to be able and willing to provide services and fulfill the other expectations that people have of their government. 

What, then, does good governance for nutrition look like? As just mentioned, it is essential for the government to show commitment to improving nutrition. This can be accomplished through putting in place national nutrition policies—plans that bring together multiple sectors to respond in a coordinated way to the causes of malnutrition. Other ways of showing commitment include enacting legislation that creates and supports an enabling environment for nutrition; approving sufficient funding for nutrition services, especially for the most vulnerable people; and allowing space for other stakeholders to advocate and carry out programs—particularly local civil society. 

Kenya has an established set of policies on nutrition at the national level. The National Food and Nutrition Security Policy (FNSP), launched in 2011, committed the government of Kenya to reducing hunger and malnutrition. In 2017, the government released the National Food and Nutrition Security Policy Implementation Framework, which provided details on strategies that would achieve the FNSP. The FNSP also led to the creation of the National Nutrition Action Plan (NNAP), now entering its second phase, and the Kenya Health Strategic Plan. The NNAP provides practical guidance on implementing Kenya’s commitment to nutrition and includes cost estimates for achieving various objectives.

Nutrition has been included in other national policies and plans. Kenya’s constitution, which went into effect in 2010, has the most progressive bill of rights of any country in Africa. It includes the right to be free from hunger, the right to have adequate food of acceptable quality, and other provisions that are important to good nutrition. In 2018, Kenyan President Uhuru Kenyatta announced that his second term would have the Big 4 goals of manufacturing, affordable housing, affordable healthcare, and food security.

While Kenya’s policy environment is sound, policies mean very little if there is no funding provided to implement them. The Ministry of Health has a nutrition budget line item of 250 million Kenyan shillings. Nearly all (245 million shillings) is allocated to treating acute malnutrition, which clearly saves children’s lives. It is encouraging that the Ministry of Health tracks nutrition spending and is thus in a position to make informed decisions about priorities as funding is available.

Parliament has also been active on nutrition. In 2012, the Kenyan Parliament passed the Breast Milk Substitutes Regulation and Control Bill, which committed the country to adopting the World Health Organization’s recommendations for appropriate rules to govern the marketing of breast milk substitutes. Also in 2012, Parliament passed legislation that required micronutrient fortification of wheat flour, maize flour, and vegetable fats and oils. In 2017, Parliament required employers to adopt breastfeeding-friendly workplace policies through the passage of the Breastfeeding Mothers Bill

The National Nutrition Action Plan also included the creation of a national nutrition technical forum. This forum, established in 2012, is a multi-stakeholder platform that allows various stakeholders to coordinate nutrition plans, monitor the NNAP’s progress, and share best practices for nutrition in Kenya. In recent years, Kenya’s “devolution” process has transferred a great deal of government power and responsibility to state and local levels of government.  This led to the establishment of county-level nutrition working groups, which can energize local advocates by supporting efforts to launch programs that communities themselves view as most important. To date, almost half the counties have nutrition action plans that are being implemented by county nutrition working groups. Other counties are working to establish line items in their budgets to invest in nutrition.

Kenya’s efforts to establish the government policies, structures, and budgets to support nutrition are part of the reason for the country’s success in accelerating progress in this critical aspect of human life and development.

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

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A Rohingya boy carries an older relative up a muddy path at the Kutupalong extension site, built on land allocated by the Bangladesh Government. UNHCR/Paula Bronstein

Update: Rohingya Refugees in Bangladesh

By Abby Attia

In 2017, the government of Myanmar (formerly Burma) launched a campaign of ethnic cleansing against the Rohingya, a minority Muslim group. More than 670,000 people fled to neighboring Bangladesh, joining at least 200,000 other Rohingya who had fled earlier rounds of violence. Still others are displaced within Myanmar or living as refugees in other host countries, including Pakistan, Malaysia, Saudi Arabia, and others. U.N. investigators and others have argued that the Myanmar military’s actions rise to the level of genocide

A robust global humanitarian response and the hospitality shown by many members of host communities saved many lives. A study of the impact of food assistance programs, conducted in October 2018 and recently published by the Bangladesh Institute of Development Studies, the International Food Policy Research Institute, and other partners, reported mixed results. Virtually all the refugees who arrived in 2017 are receiving food assistance, but malnutrition is still at very high levels. 

More than 1.1 million Rohingya now live in the remote district of Cox’s Bazar, outnumbering the local population despite the extremely high population density of Bangladesh as a whole. The study found that the average Rohingya refugee lives on less than one-third of the global poverty threshold—between 63 cents and 73 cents per day. Food assistance is approximately 80 percent of the income of most households, leaving little for necessities such as fuel, clothing, and soap. 

Nearly every household receives food parcels, vouchers to buy food, or a combination. So far, however, food aid has not succeeded in reducing the high rates of malnutrition among children. Of those between the ages of 6 months (the age when breast milk can no longer supply all needed nutrients) and 5 years, 32 percent are chronically malnourished and 13 percent suffer from acute malnutrition. Pregnant women, of whom 29 percent are underweight, are at risk of serious complications during childbirth, and their newborns are at risk of low birthweight (less than 5.5 pounds). Lack of clean water and sanitation facilities are exacerbating malnutrition. The study found that a high percentage—between 34 percent and 41 percent—of children ages 6 months to 5 years recently had diarrhea, part of a dangerous cycle of malnutrition, weakened immune systems, and illness. 

Although households spend most of their income on food, 57 percent reported that they run out of food before the next round of food aid distributions. Continued humanitarian assistance is critical, but by itself, it is not enough to enable people to rebuild their lives. 

It is unclear if or when refugees will be able to return to Myanmar. What they have witnessed and heard from other survivors, along with outside investigators’ documentation of a wide range of crimes against humanity committed in Myanmar, has understandably caused very high levels of fear and anxiety. Violence against Rohingya people who remain in Myanmar continues, and the national government has taken actions that marginalize, even threaten to erase, the group. For example, they were not counted during the last national census, and they have been denied the right to vote. Myanmar has more than 100 ethnic groups, but the Rohingya are often not listed as such.

Meanwhile, the government of Bangladesh has expressed concerns about its ability to serve as host over the longer term. Bangladesh itself is a low-income country, with more than 160 million people living in an area the size of Wisconsin. One-third of the land floods every year, and climate change has brought more severe flooding. Despite this, Bangladesh is nearly self-sufficient in rice production. Although most families have meager resources at their disposal, the country has also made impressive progress on infant mortality, stunting, and other human development indicators. 

In the longer term, Bangladesh needs support from the global community to create the conditions for refugees to earn income without displacing Bangladeshi workers. Rohingya refugees are 27 percent of the population of the Cox’s Bazar district, while they are nearly 3 percent of the population of the broader Chittagong region. Chittagong is Bangladesh’s poorest region, with an average household income of $5 a day, so officials are particularly concerned about local jobs. 

Migration issues are controversial all over the world, but there are strategies that can enable migrants and host communities to live together and build an economy that creates jobs for both groups. The report mentions, for example, Jordan’s employment program for Syrian refugees, which aims to use loans and trade concessions from the World Bank and the European Union to support job creation for both Syrians and Jordanians. 

Just as humanitarian aid has played a crucial role in saving the lives of people forced by violence to leave their countries and their means of earning a living, development assistance is essential as the situation evolves. Bangladesh allowed more than one million people fleeing for their lives to cross its borders at a time when wealthier nations are rejecting much smaller groups of refugees. Now, Bangladeshis and Rohingyas need a comprehensive approach to development that looks in creative ways at how refugees can serve as assets in their new communities rather than languish as economic burdens. 

Abby Attia is a Crook Fellow with Bread for the World Institute.

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This is Kadija Clifton and her children. Photo courtesy of Kadija Clifton.

One in Four and One of a Kind

By Todd Post

Kadija Clifton, 26, is a vegan who is vigilant about providing her two young children with the best food she can on her limited income. She and the children participate in the Supplemental Nutrition Assistance Program (SNAP), which allows her to shop for healthier foods than she could otherwise offer them. SNAP helps the family during a time of adjustment.

Clifton’s younger child has had more difficulty with the healthy vegan approach than her older child. He craves some of the junk food pervasive in his neighborhood in Washington, DC. Clifton has a theory about why one child will eat a wider variety of healthy foods than the other: she was able to breastfeed her first child. 

She was unable to breastfeed her younger child because she was incarcerated for the first two years of his life. Nor was she able to eat the healthy diet she needed during pregnancy—she found out she was pregnant shortly after she went to prison. The improved nutrition available to most low-income pregnant women through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was not available to her. Neither were any of WIC’s additional services, such as prenatal care and counseling.

I met Clifton through her role as a senior advisor for the podcast series One in Four, whose title refers to the fact that one in four Americans has a criminal record. One episode, while it mentions Clifton’s incarceration experiences, focuses on coming home to her children, how she has begun to turn her life around, and her struggles as a person with a criminal record.  As Michelle Alexander, author of The New Jim Crow: Mass Incarceration in the Age of Colorblindness, says, “The system of mass incarceration is based on the prison label, not the prison time.” The seriousness of a person’s offense and the length of the sentence are not considered relevant. The status “formerly incarcerated” is all that matters. 

I was drawn to Clifton’s story for a couple of reasons. Mass incarceration is a direct cause of the high U.S. levels of hunger and food insecurity compared to other wealthy countries. Bread for the World Institute’s Marlysa Gamblin has written extensively about this, for Institute Insights and elsewhere. While men still make up the vast majority of incarcerated people in the United States, in recent decades, women are being incarcerated at more than double the rate of men. Children are the collateral damage since 80 percent of women jailed each year are mothers.

Even beyond the higher risk of hunger for Clifton’s children because their mother was incarcerated, I was particularly troubled because her son was so young at the time. As Bread for the World Institute and other anti-hunger advocates emphasize, the 1,000 days between pregnancy and a child’s second birthday are the most important time in human development. Good nutrition matters more than during any later time in life, with lifelong impacts on health, educational attainment, and other outcomes. Medical research has shown definitively that the most nutritious food for infants is breastmilk.

Clifton’s son was removed from the prison soon after his birth. There was no possibility that she would be allowed to breastfeed. It is hard to overestimate the trauma of swift separation from one’s newborn. Being pregnant while incarcerated involves further constraints. One of these is lack of access to a nutritious diet, as mentioned earlier. Other constraints are physical and may include being handcuffed during medical exams, with a correctional officer in the room at all times; being shackled while in labor; or giving birth in a prison cell and/or without qualified medical support.

Racism is an integral part of the U.S. criminal justice system. It has a structure, policies, and attitudes that have so far proven stubbornly resistant to change. For details, please see Gamblin’s work on mass incarceration as a hunger issue. This means that women who are incarcerated are disproportionately women of color, as are incarcerated women who are pregnant or new mothers.  

There is far less information than there should be on pregnancy and birth outcomes among incarcerated women because a scant amount of data is collected. Racism may be a cause of this as well. As Institute Insights has recently discussed, women of color, particularly African American women, have much higher rates of maternal mortality than whites. Surely the difficult environment of prisons and jails can only be worsening those disparities.

I noted that One in Four is focused on reentry, and I want to be sure to include Clifton’s life post-incarceration. She has been reunited with her children and is working through the emotional issues that entails for all of them. In June, she graduated from Georgetown University’s Pivot Program, run by the university’s business school. It is designed to help people make a successful transition back to the working world after they are released, focusing on leadership and other skills needed to start their own businesses.

Cloud 9 Eats, the business Clifton intends to launch, is a response to the lack of healthy foods in the various food deserts of Washington, DC. Moreover, she wants to provide work for formerly incarcerated people. Many workers in the food industry have criminal records, a fact that may not be widely known to the public. It is one of the few industries that offers people a real shot at a second chance. More power to Kadija Clifton and all purveyors of food justice in marginalized communities.

Todd Post is senior researcher, writer, and editor with Bread for the World Institute.

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Illustration by Doug Puller / Bread for the World

Observing Black August: The Roots of Hunger in Enslavement and Mass Incarceration

By Marlysa D. Gamblin

Ending hunger and malnutrition sounds like a daunting goal, even for a wealthy country such as the United States. It is most equitable and effective to prioritize individuals and groups with the highest rates of hunger. 

People of color come from a wide range of diverse communities, all of whom are at higher risk of hunger than white communities. Bread for the World Institute fact sheets published in 2018 contain more specific information on hunger in the African American, Indigenous, and Latino communities. In some states, the hunger rate of people of color is six times that of whites. 

Every year, Black August is a time to acknowledge that a major cause of hunger and poverty in the United States, particularly in communities of color, is mass incarceration. This August is also the Quad-Centennial, commemorating 400 years since the first people from Africa were forcibly shipped to North America as slaves. 

The enslavement of African people and their descendants established structural racism in what later became the United States. African Americans were generally considered property, while Indigenous people were considered savages. The law offered virtually no protections to either group. 

The disproportionate incarceration of African Americans has been documented as occurring as early as 1790, when freed African Americans were incarcerated at higher rates than whites. In Pennsylvania, for example, freed African Americans were just 2.3 percent of the state’s population, but almost 15 percent of the statewide prison population—seven times the rate of their representation in the community. 

While legal enslavement ended in 1863 with the passage of the Emancipation Proclamation, racism was still pervasive in U.S. criminal justice, economic, social, religious, and other systems. Many U.S. states introduced so-called Black Codes—a set of laws that forbade African American former slaves to meet in large numbers or be out in public after “curfew.” The Black Codes continued to enslave African Americans through incarceration. Following the Black Codes, a Convict-Lease System allowed prisons to rent out inmates to work on plantations and other sites. The result was that many local governments had a significant incentive—access to cheap inmate labor—to continue arresting and imprisoning African Americans for “crimes.” The Convict-Lease System was formally terminated in 1965, but prisons continue to furnish cheap labor on a “free market” basis. 

Mass incarceration is a continuation of the tactic of achieving racist aims using literal captivity. It is an element of structural racism that drives hunger in this country, and it must be dismantled if hunger is to end. When a parent is incarcerated, almost 70 percent of households reported having difficulty meeting basic needs such as food. And, while data is sparse, studies such as one conducted by the National Institutes of Health found that 91 percent of people returning from jail or prison reported being food insecure. Because African Americans are far more likely to be incarcerated than whites convicted of the same offense, many African American communities have lost large numbers of parents and workers.

Bread for the World Institute invites you to observe Black August with us—to lament this history of racism in our country, learn about the impacts on hunger among African Americans of a criminal “justice” system that perpetrates injustices, and consider how best to counter the effects of mass incarceration and the wider system of racism. During this Quad-Centennial year, the United States has a special opportunity to examine, acknowledge, and respond to enslavement and its impacts on the country today.

Marlysa D. Gamblin is domestic advisor for policy and programs, specific populations, at Bread for the World Institute. 

 

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