The post is subtitled: AKA an emotional rant about the importance of education!
It is becoming increasingly apparent through my interviews and discussions groups with the villagers here that nutritional ‘knowledge’, at least in a medicalised (and Western) sense of the word, is desperately lacking. Little is known about the components of a healthy diet. I have not heard any mention of ‘protein’, and when I have asked about the constituents of a healthy diet, I have been informed that the common diet consisting chiefly of toh (pronounced as rhymes with ‘slow’ - a staple made of maize flour and water) and (haricot) leaves is quite adequate. Dietary diversity in Burkina Faso has been estimated as the second lowest worldwide, based on a count of seven food groups - given the general consensus I have found through just brief interactions, this figure seems hardly surprising.
Whilst the villagers we encounter daily do not appear to be ‘chronically hungry’ (lacking in food quantity, defined by energy intake), it is highly probable that ‘hidden’ hunger (lacking in food quality) is profound here. According to the UN (2014), 2billion people globally suffer from hidden hunger, a deficiency in vitamins and nutrients, and subsequent malnourishment. Micronutrient deficiencies are hugely prevalent across West Africa. In Burkina, rates of anaemia are reported to be as high as 88%, and child stunting 35%. Almost all of the children we see around Soumosso have contracted, bloated stomachs, a common symptom of Kwashiorkor, the protein deficiency disease.
I was further appalled to discover that it is widely believed that the nutritional demands of everyone within the household are the same: everyone – men and children, teenagers and breastfeeding women - should eat the same things, as well as the same sized portions. This resonates with the findings of other West African nutritional studies, e.g. Huybregts et al. (2009) who reported that the additional nutritional burden of pregnancy is not accounted for in Burkinabe dietary practices, with no differences in food intake, food choice and nutritional intake between pregnant and non-pregnant women.
Women are a group of integral importance. As in many cultures around the world, they are the prime decision makers regarding household food consumption, and are involved in both food collection and preparation. In my own research, I am discovering the crucial role of women in wild food consumption. They are the key bearers of knowledge on a plethora of wild foods – they know which wild leaves are edible, which medicinal plants can be used to treat malaria, the seasonality of specific fruits, the list goes on… Meanwhile, they are also, especially at reproductive age, highly vulnerable to nutritional deficiencies such as anaemia. This, I believe, grants the horrific lack of nutritional understanding here all the more urgency.
Whilst I feel obliged by academia to stay focused on my own research, I cannot help but become exasperated by this sheer absence of medical knowledge. Worldwide, there are success stories of health interventions structured around the provision of health education. The SELEVER intervention, a women’s poultry program to improve income and nutrition funded by the Bill & Melinda Gates Foundation, is one such Burkina-based example, although its impacts remain to be seen. In its drive to achieve the 2025 Global Nutrition Targets, the UN stresses the importance of integrating the education sector into development policies and programmes, as well as others beyond merely the health sector.
But such examples of policies and programmes are too few and far between. We need more and we need them to reach those who most need it. Women, as the predominant food providers, are key. Education provision need not be expensive, and the information needed is not complicated. But without it, my fear is that the villagers we have come to know and grow fond of these last few weeks will continue to suffer the same nutritional ailments as their previous generations.
But there is another side to the coin. As I finish my research here, I am able to reflect on the insights I now have into ‘indigenous’ knowledge around food consumption. What is intriguing is that as well as alarming divides between these local knowledge systems and medical knowledge, there are overlaps - and even things we in Western society might be able to learn from…
I have been astounded by the medicinal knowledge that some villagers hold in using plants to treat common maladies, such as malaria, colds and morning sickness. Faced with the rising threat of antibiotic resistance and superbugs in the UK and worldwide, the ability to turn to such knowledge is surely something we must aspire towards. Not rushing to the GP (or heaven forbid A&E, but don't even get me started on this topic!) for drugs at the first symptoms of a common cold, but utilising other (natural) remedial sources.
Seasonality is another issue that as a country with the ability to import gross quantities of fruit and vegetables, we are growing ignorant of. Whilst in both societies, there is awareness of their vitamin-related benefits, our knowledge and consumption of seasonal, locally-available produce is comparatively poor. We Brits consume kiwis, bananas, mangoes year-round in a bid to reach our precious ‘five-a-day’. Here, people of all ages collect and consume the wild fruit of the season, safe in the knowledge that when it runs out, another tree will come to bear fruit. Seasonality is a pertinent (indeed life-threatening) nutritional issue here in Burkina. Whilst overlaps between our knowledge systems do exist, there is much that we in the UK should relearn.
Our ignorance of certain nutrition and health knowledge in the West has grown, and we must be sure that others do not suffer the same fate. Some villagers have raised with me their acute awareness – and their concern – that local knowledge is being lost. Overreliance on manufactured pharmaceuticals and settlement growth, amongst other forms of modernisation, threaten their everyday practices of food consumption.
To return then to my original argument: adequate nutritional and health education is of the utmost importance to the improvement and maintenance of community wellbeing. But the solution is not as simple as just imposing Western nutritional norms and knowledge onto remote communities. Indeed, there are many horror stories of where ignorant attempts to do so have done severe damage. By engaging with and trying to understand communities such as that of Soumosso, I sincerely hope that as researchers, we can bridge the (unhealthy) divides between indigenous and Western medical knowledge, whilst being sensitive to and addressing local contexts and needs, to ensure the conservation of valuable indigenous knowledge. In doing so, nutritional and health concepts that may currently seem alien can be made a normality and reality, and conditions of malnourishment ameliorated.
 Rather confusingly also called Charlotte, we are affectionately known by the villagers as ‘grande’ and ‘petite’ Charlotte.
 Gelli et al. (2017) ‘Improving diets and nutrition through an integrated poultry value chain and nutrition intervention (SELEVER) in Burkina Faso: study protocol for a randomised trial’. Trials, 18:412 DOI 10.1186/s13063-017-2156-4
 Huybregts et al. (2009) ‘Dietary behaviour, food and nutrient intake of pregnant women in a rural community in Burkina Faso’. Blackwell Publishing Ltd, Maternal and Child Nutrition, 5. pp.211-222
 Gelli et al. (2017). As previous.