Feeding the Sick through Biointensive Farming
by Medie Jesena Parrott photos by Emmanuel Manirarora
Imagine this: You’re a mother of five children and are still breastfeeding your youngest baby when your husband gets injured while working on your farm. The local hospital doesn’t have surgeons, so he has to go to the referral hospital three hours away. You are subsistence farmers and do not have any cash for bus fare, let alone hospital fees. You grow your own food on your small plot of land and trade crops for firewood, rice, clothes, and other essentials for your family, and what little money you earned from selling woven mats has already gone to buy school uniforms for your oldest three kids. Even with the new baby, you, like the majority of Rwandan women, spent more time farming than your husband did. Neither one of you will be farming anytime soon, and you cannot afford to pay someone to take care of your crops. You borrow bus fare money for your family of seven, and you leave your house and farm behind.
You could not bring much food with you, so when you arrive at the hospital, your children are crying of hunger. You are also very hungry and are worried that you may not have enough breast milk for your baby. Your husband has to have surgery on his leg, and they tell you that he will be in the hospital for over one month. You cannot leave him because the hospital does not have enough nurses to care for all the patients, so the families have to feed, bathe, and take them to the toilet, as well as buy medicines and pay for tests. You initially rely on the kindness of other patients’ families, who share some of their food with you and the children, but there are days, several of them, when your family eats hardly anything. This is nothing new—you went hungry at home, too, especially in the dry season. But being so far away and not being able to glean leaves from neighbors’ bean, squash, and moringa plants has made you feel weak and desperate.
Then you hear about a program at the hospital that feeds patients and their families, and think: it’s too good to be true. You put your name on the list, and they give you a generous amount of wholegrain sosoma porridge (soy, sorghum, and maize) with milk the next morning. For lunch you get a heaping plate of healthy vegetables with ground peanuts, an avocado, an egg, and ubugali (cassava porridge), and you feel as if you’ve been saved, and your children will be all right after all. Every day you receive a slightly different but equally healthy meal that tastes surprisingly good, especially considering it’s free! You find out that the same smiling people who provide you with food also teach families how to cook balanced meals from food that they grow themselves, even with very little water and no pesticides. Other beneficiaries who live in town have been given small livestock, and you receive a bag of moringa seeds with instructions on how to grow your own once you return to your village. A few times a week, you go down to the kitchen and help out with cooking, and they explain what kinds of foods are best eaten together and what you should eat while you are breastfeeding. Sometimes, when other mothers watch your kids, you even join with the morning stretching and exercise. A month goes by, your husband is discharged, and you head back home with your children, ready to apply all you have learned from the kind folks at the hospital.
This scenario is often repeated with slight variations at the Centre Hospitalier Universitaire du Butare (CHUB) where Kuzamura Ubuzima (KU) does most of its work in the Southern Province of Rwanda. The organization has expanded services to the maternity ward of a nearby district hospital and has been asked to replicate its program in two other nearby hospitals, including one that serves a large population of refugees from the Democratic Republic of the Congo.
I was teaching nurses and nursing students at CHUB and the University of Rwanda while living with my husband in Butare from 2015-2017, but I had been in Rwanda since 2013. A pediatrician colleague and I observed that some patients mysteriously deteriorated, and some passed away, regardless of proper therapy. We discovered that Rwandan hospitals did not have the resources to provide food, so families were expected to feed the patients. Those who did not have family, or who were very poor, often did not survive. Moved by this discovery, we met with hospital administrators, a prominent nutrition professor, and an environmental activist to create Farming for Child Health that started feeding 30 children and breastfeeding mothers in May 2015. After a few months, we partnered with a German organization that was providing restaurant food to patients in the surgery ward, and we renamed the Rwandan non-profit organization Kuzamura Ubuzima, or Growing Health, which is a 501(c)(3) organization in the US.
The large referral hospital, where KU started in 2015 and where it continues to provide services, has allotted over 10 acres of farmland, including more than one acre of banana plants and several avocado trees, for this project. Having adapted some biointensive methods to its climate and terrain, KU grows organic crops that are cooked by staff onsite with the help of able-bodied family members. They serve two highly nutritious meals per day to patients and their families; conduct teaching sessions about sustainable agriculture, healthy and hygienic food preparation, and balanced meals; and demonstrate stress management exercises, including yoga and qi gong. After four years, KU has not only expanded programming to include 125 patients at two hospitals, but has hired agriculture and health trainers, with the goal of having a more sustainable impact on the lives of the patients and families that we serve. The organization helps them survive the difficult period of hospitalization, but also wants them and their families to thrive after they return home, hopefully disrupting the self-perpetuating cycle of poverty and illness.
In a tiny country as densely populated as Rwanda (the third most populous in Africa), where farm plots have been shrinking exponentially with every generation, subsistence farming using traditional methods has failed to provide adequate nutrition to families, and 35% of Rwandan children are stunted from chronic malnutrition. Biointensive farming was implemented by KU starting in 2015, working from my much marked-up and dog-eared “How to Grow More Vegetables“ book signed by John Jeavons. It took some effort to calculate measurements from English to metric and to match up seasons of the year, but the principles of enriching and not exhausting the soil, conserving through composting and seed-saving, and following nature’s own example through companion planting and crop-rotation made sense to adapt to local soil and crops. Most Rwandan farmers do use animal waste as fertilizer, but kitchen and garden waste are typically buried or burned. We broke a strong taboo and attracted attention with our mixed plantings on a large scale at our 10-acre hospital farm, so much so that our agronomist feared being cited for it. We continue to teach about keyhole kitchen gardens, which originated in Rwanda, as a way to employ biointensive practices.
There is intense pressure in many parts of Africa to use pesticides and GMO seeds, and KU takes a non-GMO stance on our farm in solidarity with our biggest seed donor, Baker Creek Heirloom Seeds, which has been donating seeds to our project annually since 2015. We trial new varieties and save the seeds of crops that are well adapted to the soil and climate of Rwanda and, in doing so, promote both crop and diet diversity.
Main image: Agronomist Athanasie Uwitonze and farmworkers prepare the soil for planting.
Row, left image: KU beneficiaries enjoying lunch
Row, center image: Emmanuel Manirarora, agricultural trainer, holds a purple cabbage (unusual in Rwanda).
Row, right image: Laurette Mushimiyamana, program coordinator and KU’s first employee, holds an infant.
Kuzamura Ubuzima is looking for community partners and individuals in Mendocino County to help with its efforts. For more information, please visit kuzamuraubuzima.rw.
Medie Jesena Parrott co-founded Kuzamura Ubuzima while teaching nursing in Rwanda, before moving to Ukiah with her husband. She now works as a pediatric nurse practitioner at the AHUV Rural Health Clinic. Contact BruinPNP@gmail.com for additional information.