Community Gardens

Nutrition and Garden Program (Posting Date 11.9.08)
Part of the education Partners in Hope (PIH) provides their patients involves nutrition. The idea is a simple one: the more healthy patients will survive longer on HIV treatment. Upon intake to PIH, patients are evaluated for the need for HIV treatment with anti-retrovirals (ARVs). But prior to starting ARVs, all patients undergo two counseling sessions: a course on ARVs, and a course on Healthy Living. Included in the Healthy Living course is a session on nutrition and gardening. This session is a hands-on demonstration that teaches patients about the fundamentals of nutrition. The session is conducted at PIH’s own Community Garden, in front of the clinic building. The nutrition session uses the example of the Malawian house as a model or analogy to nutrition. For example, the “bricks of the house” are the equivalent to protein gained from eating meat, and “vitamins” are equivalent to the mortar that holds bricks together. Since most Malawians do not read, or at least don’t read well, a diagram of the house and the 6 nutrition groups (the 6th being water) is used to communicate the teaching points. This diagram is hand-drawn, and is displayed inside the demonstration house (see picture in photo album titled “Nutrition Program”).
After hearing about the fundamentals of nutrition, patients then learn about farming for sustainability by touring PIH’s community garden, complete with house, outhouse, and kitchen (all are separate brick units). Majority of Malawians (over 80%) live in rural areas and are subsistence farmers; consequently, most of the 88% of unemployed Malawians are, in fact, working every day to survive. The main crops include maize, pumpkins, and some fruit, like watermelon. Unfortunately, these crops are seasonal, and are only planted after the rainy season, which starts in another 2-4 weeks. Malawian farmers will cultivate these crops, and only these crops, and will live off these crops for the remainder of the year. They do not plan any crops that provide a continuous, staggered harvest, or anything that reintroduces nutrients to the grossly overused, nutrient-poor soil, and use only synthetic fertilizers. So depending on the harvest of maize, pumpkin, and the occasional fruit, it is either feast or famine…literally. Given this non-sustainable pattern of farming, the PIH program attempts to train patients to plant staggered harvests, to use their soil and resources wisely, and to grow plants that have multiple uses. Teach a man to farm, and he farms forever.
The idea of multiple uses for one plant is key to improving the ability of Malawians to become self-sustaining. This is a culture that recycles everything. Except for plastic bags like the ones from our grocery stores, almost everything has multiple uses or lives. From tires to logs to plastic water bottles, Malawians are very resourceful and use what they’ve got on hand. Using this practice already engrained in the daily practices, PIH is trying to expand this concept to farming by introducing the concept of Plant Guilds. Plant Guilds are groups of plants that, when planted together, have multiple, symbiotic uses. For example, in one area near the house, one can plant a tall fruit tree (ie: mango tree) that provides shade for the house and surrounding plants, and fruit for the household. The tree’s deep roots help draw water and nutrients from the lower layers of soil, and the trunk of the tree provides a stand for fruit-producing vines, like tomato plants. Next to the tree and tomato plant would be various plants that produce pretty flowers for decoration but also fruit or edible leaves or roots. And legumes are then planted to provide ground cover and help reintroduce valuable nutrients like nitrogen into the ground. The flowers provide areas for bees and other insects to help pollinate plants, and a small pond (usually made out of a small, plastic jug or bucket) sits in the middle of this guild and provides a home to frogs that control plant-eating insects. Again, multiple uses for one object—in this case, plants. I wonder what US farmers are doing. Do they use plant guilds? Are they planting staggered crops and finding multiple uses for the same plant? What about at home, in our own gardens? Are we thinking sustainability, or are we too short-sighted and plant only for the season?
After this session, we went out to a local “urban” village (? shanty town, ? slum) to see a successful farm. About 5 minutes north of PIH, on the way to the heart of Lilongwe, we turned off the main road and onto a dirt road with numerous, steep potholes. We traveled slowly through the village, through the market teeming with people selling goats, chickens, fruit, and phone cards (people may not have money for food and housing here, but they all have a cell phone). Traveling through this village, the biggest issue regarding health and nutrition was this: the idea of a nutritious garden was great, but whereinthehell are patients going to plant a garden in this urban village? There are simply too many houses placed close together to provide any space for individual gardens; perhaps a community garden would work, but you need a very large one to provide nutritious food for all the people of these villages.
We passed a rock quarry, a home-based care center (? equivalent to nursing homes), and many Malawian children who all ran after the jeep, shouting “Azungu!” (white person). After a few turns, and traveling down a narrow road, we eventually reached a house with two men playing a board game. This was the home of the PIH patient, and his successful garden. We met the patient, and he allowed us to tour his small garden. It did, in fact, use the principles of Plant Guilds, using trees, legumes, and ponds, although most of the garden was prepared for the upcoming crop of maize that would be planted in a few weeks. I don’t know how successful his garden is, but the folks at PIH are very proud of his attempt to practice these principles. And I don’t know if any of the patients located in the surrounding rural villages are planting a garden based on the PIH training, or do they simply do what’s been done year-in and year-out.
So the quest for adequate nutrition for HIV+ patients is ongoing. You can see that nutrition for the poor is a huge issue, regardless of whether you live in the developed world, or a resource-poor country. And although fast food has not really made it to Lilongwe, it has to other areas of sub-Saharan Africa, including South Africa, which means that it will come to Malawi soon. And with the arrival of the “western diet” comes all of the ill effects—worsening hypertension, obesity, high cholesterol, and diabetes. Malawi currently does not have the infrastructure to provide rudimentary care to its people; it fails miserably to provide maternal and perinatal care, and is trying desperately to scale up its HIV programs. So how can Malawi possibly care for diabetes, hypertension, high cholesterol, and obesity?
On a positive note, the trip to the village ended on a high note. Upon getting out of the truck, we were greeted by dozens of local children who were very friendly, and wanted to interact with the Azungus. They greeted us with smiles, shy waves, curious stares, and a smattering of “hello’s” and “good morning’s” in English; I replied with what little Chichewa I know. As a side note, I’m not sure why the kids weren’t in school—they may have been on break for lunch, or something—but in Malawi, school is free for all kids, with school sometimes consisting of a blackboard outside underneath the shade of a tree. Anyway, the kids followed us around, keeping their distance, but after we finished our tour, I went up to many of them, saying hello, and giving them Hi-Fives and hand shakes. And then I took out my camera…and the kids went crazy!!! They all wanted their pictures taken, and I was happy to oblige. Gathering them all together was a challenge, as they all wanted to be in front. I was finally able to get most of the kids to stand still for a minute so I could take a few pictures, and they all got great joy out of seeing themselves on the camera screen afterwards. As did I.