Behind the Numbers: The PRB blog on population, health, and the environment

by Jason Bremner, program director, Population, Health, and Environment Program 

Sitting on a chartered bus in Rwanda, surrounded by members of the East Africa Population, Health, and Environment (PHE) network, I’m excited to finally put into practice our work from the last several days at the “Meeting of the East Africa PHE Network.”  With me in the bus are a collection of practitioners, researchers, and policy-makers from Ethiopia, Kenya, Rwanda, Tanzania, and Uganda.  We’ve spent the week discussing communication strategies for raising awareness about East African issues related to population, health, and environmental change, and shared experiences of projects that are integrating different interventions to address these interlinked challenges.  We are now on our way to visit projects that are coming up with creative solutions for meeting the complex and multiple needs of rural Rwanda. 

Leaving Kigali, the capital of Rwanda, we head south winding our way through the endless hills and valleys of this land appropriately coined “the land of a thousand hills”.  These thousand hills are actually part of the population, health, environment story of Rwanda.  Rwanda, a country about the size of Massachusetts, has a population of approximately 10 million people, and is the most densely populated country in Africa.  The majority of Rwandans depend on agriculture for their livelihood, and less than a fifth of the population lives in cities.  As we look out at the hillsides we see the intense use of all types of land for agriculture.  Lowlands and river floodplains are packed with plots of rice and other crops, and steep hillsides are contoured with terraces and planted with bananas, coffee, cassava, and eucalyptus trees.  In fact, as we drive the two hours to Huye (formerly called Butare), the second largest city in Rwanda, we see little land not being used for some use or another. 

What this means for households, however, is less apparent, and cannot be summed up in a single, simple to understand indicator.  Households that depend on small plots of land for their livelihood face a whole host of risks to their health and well-being.  First, due to limited land availability, many households only produce just what they need for subsistence or even less, which means they face the risk of malnutrition if droughts, pests, or poor health of a family member reduce crop yields.  Those households with sufficient education and skills might prevent against this danger if they supplement their livelihood with work in non-farm employment, but others will simply remain vulnerable.  Second, if there is no available land for new households, families will have to either divide their already small plots among their children as they become adults, or children will have to make touch choices regarding their future.  The options for these young adults will be to stay and eke out a livelihood from a small inherited piece of land, migrate to a city and compete for a limited number of jobs, or migrate to a rural area looking for available land.  In Rwanda, available land tends to be poorly suited for agriculture or at the edges of protected areas.  Also not apparent from looking out over these hills is the fact that despite great strides in meeting people’s desire for family planning, the population in Rwanda is still growing by approximately 2.5 percent annually.

Our first stop on the trip is to the SPREAD project (Sustaining Partnerships to Enhance Rural Enterprise and Agribusiness Development), an alliance between USAID, Texas A&M University, and public and private institutions.  SPREAD targets rural Rwandan agricultural cooperatives and enterprises involved in high value commodity chains and provides them with appropriate technical assistance and access to credit and health related services to increase incomes and improve livelihoods.  What makes this project interesting to our the PHE network members is that the project focuses on improving the livelihoods of rural farmers but also recognizes the role that improved access to health services plays in these development efforts.  The project aims to complement their agricultural extension agents’ work on improving coffee production with health education related to hygiene, HIV/AIDS, and family planning.  In fact, when I listen to the extension agents talk to us about their work, I realize that they communicate about PHE relationships and the interlinked challenges that households face more easily than I often do.  We have an excellent visit that stimulates a great number of questions both for the SPREAD staff and extension agents as well as discussion among the group itself.

(Read part 2 of this post)

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