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Soil-bag gardens to reduce chronic malnutrition and micro-nutrient deficiency

The idea is to teach teenage and young mothers aged 15-25 years to start and maintain a soil-bag garden of vegetables. This will avail them with nutritious food during pregnancy and for their young children and this will help in combating the problem of chronic malnutrition and micro-nutrient deficiency.

Photo of Reach Out, Mbuya Parish HIV/AIDS Initiative
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Updated on 01.12.2014
Proposed Questions for Interviews with young mothers aged 15-25 years.

  • Interviewer will ask the mother age, marital status, level of education and number of children below 5 years living with her at home. This is to obtain some demographic information about the interviewee.
  • Do you know the advantages of eating vegetables? Where did you get this information from? Please mention some advantages you know?
  • What food do you prepare for yourself and your child on a normal day? How many meals do you feed the child a day? How many times do you eat a day?
  • How often do you feed your child and yourself on vegetables and fruits? Where do you get them from?
  • Are there any challenges you face in feeding your child with fruits and vegetables?
  • We are would like to teach women to grow their own vegetables in a soil bag, would you be willing to participate in such a project? (Interviewer will briefly describe the soil-bag garden project) What do you expect to benefit from such a venture?
 
Key Informant interview Held on 28.11.2014
The key informants for this study are the Mother to mother mentors. The facility assigns a trained female mentor to every pregnant mother that comes for Antenatal Care. These mentors follow up with the mother throughout the pregnancy and after birth with regular home visits until the child is fully immunised. They have access to the mother’s health files so that they know the health situation of the mother.

 

How often do you see cases of underweight or anemic pregnant women?
M2M 1: Anemic and pregnant… there are some cases. But not many. You know every pregnant woman is given iron and folic acid supplements and this helps them.
M2M2: Underweight and pregnant… I have not yet seen a case. Anemic mothers, if you compare the cases we see to the Ministry of Health Target, they are many. I see about seven cases a month.
M2M 3: You can’t say those iron supplements help them. Most women come for the first ANC late! Like at the end of the second trimester because she feels healthy. So the cases we see here may not represent the full problem.
How often do you see cases of underweight or anemic children? What ages are they?
M2M 1: I see some cases of underweight and anemic children. They are mostly between 6 months and three years. The ones between 0 to 6 months are rarely underweight because we tell the mothers to only breast feed them… they are not even supposed to give them water.
M2M 2: It’s when they start weaning the babies that we see problems coming in.
M2M 3: Some children become underweight because they fall sick. Especially the with HIV.
 
And cases of underweight or anemic lactating mothers?
M2M 1: The underweight mothers are mostly clients (HIV Positive mothers: Reach Out is an HIV initiative and a Health center III)
M2M 2: We put new mothers that cannot feed themselves on food support, because they have need to eat well to get breast milk. So you see for mothers who cannot breast feed, we give them powdered milk and the baby is ok. The ones that can breast feed cannot be put on food support, and when they begin weaning they get malnourished.
M2M 3: But I hope you know that all cases we put on food support are HIV clients. Not all new mothers who cannot afford food are eligible for food support.
 
Are the women educated on how to eat during pregnancy and breast feeding?
M2M 1: Yes, we tell them when they come for ANC, on home visits and clinic days. You see that chart (she points at a large chart on the wall) we tell them that to stay healthy you should eat a balanced diet which has foods like that.
M2M 2: Its part of the ANC education. For weaning a child, we tell them to mash pawpaw or potatoes and mix with some milk for the baby, passion fruit juice freshly made and not bought from the supermarket, water melon, some eggplant and mashed pumpkin… we tell them a lot of things.
M2M 3: One of the duties of a mother to mother educator is to educate about eating properly.
 
So if they know, why are there cases of malnourished, underweight and anemic children and mothers?
M2M 1: The say they do not have men to support them and they have no jobs. That is what many of the say. That their husbands leave them and they end up doing odd jobs like washing other people’s clothes to earn what to eat. And this is not enough.
M2M 2: The children also get sick and do not eat well, so they become underweight and anemic. Some leave the babies with housemaids when they go to work. And you know a maid cannot care for your child the way a mother will do it. They may not give the baby food on time.
M2M 3: By the way some women just do not care about feeding the baby well. You can tell a person everything but it’s up to them to put it into practice. We see this mostly in the young girls whose boyfriends left them to care for an unwanted child by themselves. Those girls do not care. But their biggest problem is they are poor.

Do you think teaching them how to grow vegetables in soil bags will help these ladies?
M2M 1: If it gives them a source of income, then it will help. Also it will reduce the cases of anemic children and women. Medicine cannot replace food. So even if we treat them here, and they still do not eat healthy, the problem is not solved. It will help them.
M2M2: Yes it will help. But the problem will be getting them to put in the effort. Town people are biased the minute you mention farming. Maybe you show them someone who has done it in town. Otherwise these ladies are stubborn.
M2M3: You try it out and see. Have you done interviews with some mothers about your project? (Interviewer answered “Not yet”) Now you go and ask them if they are willing. The idea is good though. It will give them no excuse to get some of these diet related illnesses.
 
Updated On 24.11.2014

With the collaboration of Send A Cow, Uganda http://www.sendacow.org/uganda, an agricultural NGO that is teaching the children at Kampiringisa Rehabilitation center a variety of gardening skills, we set up an exposure visit on Friday 21st October, 2014, to interview the children on how to set up a good soil bag garden and get insight on the yield and challenges one would expect from it. Because of the nature of the facility we are not allowed to use pictures of the children on public media but we took pictures of their soil-bag gardens.

How to set up a Soil bag garden

One needs two nylon sacks or polythene bags. One bag is not strong enough to hold the weight of the soil. Then mix soil with manure in a 2:1 ratio i.e. two basins of soil with one of manure. Pour one basin of the mix in the sack. Place an open cylindrical tin in the middle of the sack and pack it with stones. Then with the tin still in the sack, pour more soil mix in the sack, around the tin. Repeat this process until the sack is full. Punch holes around the sack making sure they are not too close together. Prop the bag against the wall or tie it to support stands to keep it upright. Your sack is now ready to plant vegetables.
 The stones in the sack ensure that water is circulated evenly throughout the soil. The holes in the sides are outlets where one can grow more of the vegetables.

The yield

The children explained that they always get a good harvest from the bags. Last season they sold the excess cabbage, carrots and egg plants from the bags because they could not eat it all. They cautioned that one must adhere to the 2:1 ratio of soil and manure because the vegetables might grow too big before they are ready.  
Alice, a 17 years old girl, explained that a soil bag garden is better than a ground garden because it requires little effort for starting and maintenance yet yields a lot. She says she has grown a wide range of vegetables on her sack like cabbage, egg plants, carrots, pumpkin leaves, sukumawiki, tomatoes and Irish potatoes.  She has saved enough to support herself when she leaves the rehabilitation center.

Challenges
The children explained that there seem to be no challenges with the gardens in the rural areas. The bag is off the ground and so pests rarely attack the plants and since they are fast growing vegetables, they do not get diseases before harvest. They anticipated that since our project will be in slums, we might need to protect the bags from destructive children, home animals like goats and chicken.

About Kampirimgisa Rehabilitation Center
Kampiringisa National Rehabilitation Centre is Uganda’s only juvenile detention centre (prison for children). It is located in the Mpigi District on the outskirts of the capital city, Kampala. The center run by the Ugandan Ministry of Gender, Labour and Social Development is mandated to detain young males and females in conflict with the law from the ages of 12 to 18, however it also houses many children under 12 street children who have not been convicted of any crime but merely rounded up and dumped from the streets of Kampala. Some parents bring their “stubborn” children to the center for a short time. The children we interviewed were helpful. They explained the process in great detail and answered all questions asked, breaking off to make jokes and tell personal experiences.

Sumitted On 17.11.2014

According to FANTA-2 (Food And Nutrition technical Assistance II project) 2010, most common forms of malnutrition in Uganda were chronic malnutrition and micronutrient deficiencies,  in particular, deficiencies in iron (prevalence of 73% among under-fives and 49% among women of reproductive age) and vitamin A (20% among under-fives) Chronic malnutrition is persistent lack of access to necessary vitamins and minerals in early childhood, leading to health problems later in life even if the patient later receives adequate nutrition. The consequences of Vitamin A deficiency include growth failure, depressed immunity, blindness, aneamia and depressed cognitive function.
 
This is unfortunate given that Uganda is a land of plenty; anything grows once planted due to the good climate and fertile soil. Green vegetables like pumpkin leaves, ‘doodo’ and sukumawiki are seen as weeds yet they grow everywhere even in the urban areas. These are foods rich in iron and Vitamin A.
In urban areas, especially slums, there is no land to grow one’s own food. The cost of living in the urban setting in Uganda is very high and many young people are unemployed. Many young mothers face the dilemma of ensuring that their child has at least one meal a day.  They therefore opt for cheap fried snacks like cassava, pancakes, chapattis, doughnuts and buns. These foods lack the nutritional content to boost immunity and the mother and child regularly fall sick, incurring heavy medical expenses. The long-term economic impact of this is estimated at USD 310 million annually due to lost productivity and health services to the sick.

THE SOLUTION
Soil- bag gardens, also known as vertical gardens, provide an easy and economical way to grow nutritious vegetables on the veranda or small backyard of slum homes. Most initiatives with soil-bag gardens have been done in Kenya slums, and since they have been successful in ensuring food security for many child-headed households there, we would like to use this approach in Uganda.

Soil-bag gardens require so little ground area and labour that a pregnant woman living in a slum can do it. By the end of her term, she will not only have fed well during the pregnancy but also have nutritious food for the baby when she starts weaning it.
There’s a variety of food that can be grown and these include: pumpkin, Irish potatoes, sukumawiki, cabbage, carrots, tomatoes and onions. All these are foods that are rich in Vitamin A and iron. In fact, these could become a source of income for the mothers when well-maintained to get a good harvest.
 

Who will benefit from this idea and where are they located?

The target population is young mothers aged 15-25years and children 0-5 years in the slum areas of Kinawataka, Acholi quarters and Giza-Giza, These are also the catchment areas for Reach Out Mbuya. The young pregnant mothers will be able to feed well and have healthy babies.

How could you test this idea in a quick and low-cost way right now?

We would get 20 young mothers who are already clients of Reach Out on the PMTCT (Prevention of Mother To Child Transmission) program and educate them on how to grow vegetables in soil-sacks and feed during pregnancy and lactation period. The soil-sacks and pumpkin seeds which can be cheaply got from the nearby Nakawa market since the traders throw them away as waste after selling the pumpkins. Home visits will be done over a period of six weeks to assess how the mother’s feeding has changed and the requirements to grow a better soil sack garden. This small sample will provide information on how the project tools should be improved to make it more effective.

What kind of help would you need to make your idea real?

We need the Local Council chairperson for the slum areas, nutritionists, volunteers, a monitoring and evaluation team to assess the progress of the campaign and input from the OpenIDEO team.

Is this an idea that you or your organization would like to take forward?

  • Yes. I am ready and interested in testing this idea and making it real in my community.

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Spam
Photo of Bettina Fliegel
Team

Great initiative team! Looking forward to hearing what you find out from the young women in the slums. Do they take up the project? Do they understand the value of eating these vegetables? How do you explain to them what the benefits are of doing this gardening and eating vegetables? I am amazed that apparently the soil is Uganda is so fertile but so few people eat vegetables and the incidence of Iron deficiency in children is so high, as is malnutrition in general. How can you combat whatever the culture is there about not accessing vegetables? Is it common for families to have small garden plots in rural areas? I have not read much on that in this challenge, rather many references to the same issues of food insecurity, and malnutrition. Perhaps teaching how to garden in school would help?
Have you seen IYEN 's idea on 2 Legumes? They have been interviewing mothers about feeding practices. They appear to feed small children primarily posho, potatoes, and when they can afford it rice. The mothers are concerned about their ability to afford legumes regularly. Growing these vit rich vegetables is so important!
https://openideo.com/challenge/zero-to-five/ideas/solve-two-legumes-one-cereal-meal-for-smart-children

Spam
Photo of Joseph Kalibbala
Team

+Bettina Fliegel Thanks for points raised. Actually we haven't interviewed any women from the slums yet, but its one of our next objectives. we too can't wait to communicate the outcomes.
About explaining to them, we shall do that using models, and describing to them in detail what is required, step by step in order to start the project using the local language of the area. After that we shall them follow them up to get feedback of how they are progressing, any challenges or success stories they have.

In rural areas, individuals usually are able to practice farming on large pieces of land, which is scarce in town or urban areas. That is why we want to introduce this idea of Sand bags in urban areas.

Spam
Photo of Bettina Fliegel
Team

Hi Joseph. Can you also add a simple educational component to your conversations with the young women in regards to how the different vegetables promote health? Basic information can be very empowering and can perhaps nudge them towards maintaining this project as a form of self care and care for their fetus and their small children. There are 6 vegetables on your list. Perhaps a picture of them, drawing or photos, which can be incorporated into a poster and information on what vits are found in each one, and what aspects of health they promote - what that translates to in practical terms, things that they will understand and become invested in.
ex) Carrots - Vit A - Promotes good vision and prevents a form of blindness, contributes to a child's normal growth, and without enough Vit A they may not grow as big as they can, Boosts immunity which means that it will help keep the baby from getting sick a lot. In this way every time the young woman works on the garden and feeds her child a vegetable she can do so with an understanding of how she is providing for his/her growth, development and health needs. I think parents really enjoy having this knowledge and it motivates them.
What do you think?

Spam
Photo of Joseph Kalibbala
Team

Bettina, thanks again, we will surely work on said points to improve the idea, to benefit the end user.

Spam
Photo of Bettina Fliegel
Team

Maybe you can test the idea out and see if they respond positively?

Spam
Photo of Bettina Fliegel
Team

Hi all.
Have a look at this TED talk for inspiration. It highlights work that was initiated by one teacher in the poorest Congressional district in the USA, in the Bronx, NY. It addresses the issues of childhood obesity, food poverty, loss of jobs, and economic insecurity in this community.
I wonder if there are learnings here that can be applied to your project.
http://www.ted.com/talks/stephen_ritz_a_teacher_growing_green_in_the_south_bronx?language=en
https://www.youtube.com/watch?v=VgGL6mz3dBY

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