Dialogue - Issue 04: Volume V: Severe Food Crisis as HIV Affected Households Fail to Meet Minimum Calorie

Regional Trends 

In 2001 the Food and Agriculture Organization (FAO) of the United Nations predicted that the HIV epidemic would have far reaching effects on food security, household composition and community structures among small-scale farmers (FAO, 2001). Evidence of the predicted extensive hunger was found in all three of the regions In Namibia. Close to 90% of the households do not grow enough staple food to meet daily calorie needs. None of these households have other sources of income - whether livestock, crops, or cash - that make up for the shortfall in basic food production. Over 70% of the households produce half, or less than half, of the food they need to survive. This is clearly a famine, though it does not look like a famine. Whole communities are not affected. There are no mass movements of refugees in search of food. This starvation takes place in seemingly normal communities. The hungry are interspersed with unaffected households. To the outside observer there is no sign of hunger. 

Using the basic household survey tool of the NHIES 2003/04, a total of 144 HIV affected households were surveyed in three regions of Northern Namibia (Kavango, Oshana and Oshikoto) during November 2004. Data was collected on household demographics, income and expenses. According to the FAO, Namibians derive 53% of their calorie needs from grains. In the areas of the study, pearl millet (omahangu) is the staple grain. Using the calorie requirements of adult males and females, as well as the calorie value of cooked omahangu porridge, it was possible to calculate the amount of threshed omahangu an average household from the sample needed to meet the FAO estimate of calorie needs. This came to 1705 kilograms of omahangu a day for the average household. The survey found that 86% of households did not produce the amount needed to meet roughly half of their calorie requirements via omahangu production neither other crops, nor livestock filled the shortfall. Two thirds of the sample owned livestock, however the majority had numbers too small to allow for regular off-take and thus were unable to supplement to the diet. The only conclusion is that the majority of households surveyed are hungry for parts of every year. 

A similar study carried out in 2003 in the Ohangwena Region found that almost 60% of HIV affected households studied had at least one day in the previous month where they did not have food (FAO, 2003). This study points to a loss of labour and knowledge of farming practices which in turn led to smaller fields being planted and lower crop yields. In 2000 an analysis of the epidemic on livestock production also pointed to the loss of both labour and knowledge as factors, which contribute to decreases in livestock numbers. Livestock assets are likely to be the first to be sold once a household�s medical expenses increase due to illness brought about by AIDS. Cultural practices also play a role, as widows do not always inherit livestock or croplands after a husband dies. 

The HIV epidemic has dynamic impacts throughout the communal farming community. While national results show an overall decline in HIV prevalence, specific sites associated with the regions surveyed indicate a mixed pattern. Some sites are in decline, others on the rise and still others showing little change. These fluctuations could be the result of mortality, actual change in behaviour, failure to change behaviour, migration, or issues in the Sentinel Survey itself. Unfortunately, the Sentinel Survey does not measure behaviour. It is not clear if basic demographic information of women attending antenatal clinics is collected. This data would complement the Sentinel Survey, and enhance our understanding of the epidemic.