Time to think about the precautionary principle

In Rwanda, poverty and malnutrition remain prevalent in rural areas even when this is the same area producing the food for the entire country. What is even more problematic is that much of the food produced is nutrient deficient. For example, feed for dairy cows can produce milk low in protein. Analysis of fish purchased in the market has shown that healthy looking filets can be nutrient-deficient. Thus, humans consuming food from both locally grown plants and animals are potentially, also, nutrient-deficient even when appearing healthy. In Rwanda this is particularly important for women because it is known that the genetics of women’s eggs prior to conception can be impacted by diet. Thus there is the potential that children are at risk prior to starting life. The precautionary principle says that good nutrition, starting with healthy plants and animals, builds opportunities that cannot be regained once children are born. Additionally, it lowers costs by reducing the need for corrective action by the medical system in later years. For example, young children often get sore throats and fevers. Good nutrition reduces risks and increase rapid recovery. But, again, the precautionary principle needs to be exercised. These symptoms can be from a “strep” (streptococcal) infection that can be cured with simple antibiotics. Left untreated, the infection can result in severe damage to heart valves and other major health problems. These cardiac problems have led to very costly surgery and perpetual health costs throughout life. Some in Rwanda have pushed for building capacity to perform these complex procedures when much of this could have been avoided with a simple test for a few Rwandan Francs. It is not just the quantity of the food available, but also the quality. The tradition of luncheon buffets piled high is of questionable value if the nutritional value is compromised. The journey starts with a healthy, well managed, soil producing healthy plants for humans and animals. Soil testing and providing appropriate nutrients in the quantities needed for the crops creates quality food for humans, particularly young children who need that foundation for both physical and mental capabilities when starting life’s journey. Agriculture and Health are inexorably bound together. The potential pandemics such as bird flu and, now, Ebola have international health agencies more than concerned. Animals and other disease vectors know no political boundaries. As we see with the current problems with maize, it touches all starting with the plants and the soil. Rwanda’s agriculture and health campuses are jointly part of interdisciplinary work now being consolidated under the One Health Programme. But the precautionary principle points to care that needs to be exercised at home. For Rwanda with the stretched and limited financial resources, it starts at the farm level. Two private ventures, one in health, the CFW Health Stores, and one in agriculture, the One Acre Foundation points to business models that are similar to those found elsewhere. They employ local citizens and professionals, provide supplemental training and centralised support services that can bring critical resources to bear on local needs. And, they point to the ability of the private sector to intervene at critical points where the current, under-resourced, public sector cannot adequately respond, particularly in the traditional, theory-based, models. The major issues to overcome lie not with the physical infrastructure such as buildings but lack of hands-on training of both faculty and students and field supported personnel able to identify problems, make field supported decisions, and respond timely and appropriately. The key is a field-experienced graduate, skilled in evidence-based practices in both areas of health and agriculture. For Rwanda and globally, practical experience trumps traditional classroom delivered theory. The precautionary principle recognises that agriculture is, perhaps, the most complex enterprise in which a person can be engaged. Small actions can have significant impact where the connection is not seen or often not clearly understood. Nutrition is a complex set of interactions with often-delayed consequences. Additionally, there are few lands that have not been impacted by human use and few communities that have not had their tenure practices changed over time. As with Pandora’s Box, the change agents have been released. Much that was known has either been lost or discarded. Today, the areas of human and agricultural health require more than restoring past practices or blindly trusting the new ones. Nutrition is important in recovery from illnesses, often as important as conventional drugs. While hospitals can provide information on proper diets, the practice in Rwanda of families and friends providing meals does not guarantee that these recommendations can be followed, especially among poor families. Lack of meeting proper nutrition can lead to failure to recover, recurrent problems and expenses that can be avoided by changing practices. The same issue appears, as mentioned above, when pregnant or lactating mothers and young children lack proper nutrition for both physical and cognitive development. Governments in developed countries have programmes to supplement diets of low-income families, a practice that needs careful consideration in Rwanda. The tie between a healthy soil leading to healthy citizens able to contribute productively is a critical consideration for Rwanda. The cost of prevention demands consideration of the precautionary principle that ties health and agriculture together in Rwanda and globally. The writer is a futurist focusing internationally on both policy and practice on issues of sustainability, renewable resources and post secondary education.