Poverty, Food Insecurity, HIV/AIDS, and Gender in Lilongwe, Malawi

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2016 Perilous Connections: Poverty, Food Insecurity, HIV/AIDS, and Gender in Lilongwe, Malawi

Mambo, Tatenda T

Mambo, T. T. (2016). Perilous Connections: Poverty, Food Insecurity, HIV/AIDS, and Gender in Lilongwe, Malawi (Unpublished doctoral thesis). University of Calgary, Calgary, AB. doi:10.11575/PRISM/27305 http://hdl.handle.net/11023/3372 doctoral thesis

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Perilous Connections: Poverty, Food Insecurity, HIV/AIDS, and Gender in Lilongwe, Malawi

Tatenda T. Mambo

A THESIS

SUBMITTED TO THE FACULTY OF GRADUATE STUDIES

IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE

DEGREE OF DOCTOR OF PHILOSOPHY

GRADUATE PROGRAM IN GEOGRAPHY

CALGARY, ALBERTA

SEPTEMBER, 2016

Although food security has largely been a rural issue, it is increasingly an urban concern,

particularly in slums and informal settlements of southern Africa. In Malawi, high urbanization

rates are leading to new configurations of the urban landscape, characterized by the growth of

slums. Slums highlight the increasing prominence of poverty within cities, exhibited by deplorable

living conditions. Much of this poverty stems from absence of economic growth relative to the rate

of urban growth. Given that cities are cash dependent, slum residents often cut back on food

expenditures, which are viewed as variable compared to more fixed costs such as rent, fuel, and

education. Food security is further complicated by the HIV/AIDS epidemic, which largely affects

the most economically active segments of the population (15–45 years), resulting in the erosion of

social and human capital, and removal of social safety nets. Good nutrition, imperative for people

infected with HIV/AIDS, slows progression of the disease, makes medication more effective, and

maintains immune strength to fight opportunistic infections. The burdens created at the intersection

of HIV/AIDS and food security disproportionately affect women because they are physiologically

more susceptible to infection and furthermore, they are the primary care givers, producers and acquirers of food within households. The status and resources available to women are therefore central to addressing the problems outlined above. Drawing on a pragmatist perspective emphasizing context, this study holistically explores the causal dynamics and linkages between poverty, food insecurity, HIV/AIDS and gender in Kauma and Mgona, two slums in Lilongwe,

Malawi. While food insecurity was high in both study sites, geography accounted for the differences, affording Kauma residents a wider range of livelihood activities. Contrary to the literature, migration to the city for many women limited their ability to contribute to their household, financially or by acquiring food, and as such decreased self-determination. Gender

ii dynamics within households and the resources available to women in the urban environment, determined women’s contributions to household food and nutritional status. Only by holistically studying food insecurity and the interrelated complexities of poverty, HIV/AIDS and gender, can we begin to find comprehensive solutions.

iii

Acknowledgements

I would like to start off by thanking my supervisor Dr. Miriam Grant for her guidance, support and mentorship throughout my degree program. Thank you to my co-supervisor Dr.

Dianne Draper, you have ever been encouraging and supportive which always helped to calm my nerves. Thank you to the rest of my supervisory committee, Dr. Amal Madibo and Dr. Chu-Ling

Tam. Your input throughout my degree program made me a better researcher.

A very special thank you to the International Development Research Center (IDRC) whose generous funding made this research project possible. Thank you to Dr. Alexander Kalimbira and

Dr. David Mkwambisi from Bunda Agricultural College who supported and guided me while I was in Malawi collecting data for this project. Thank you to Dr. Michael Mambo, dad your presence, support and connections in Malawi were instrumental in getting this project done. Thank you to James who helped me scope out research sites and helped me make a good first impression with village heads. Thank you to everyone who participated in this research project. Thank you for allowing me into your lives and sharing your stories with me.

Thank you to everyone in the UofC geography department who has helped me along this journey. Paulina, Catharine, Linda, Brenda thank you steering me in the right direction, keeping me abreast of milestones and deadlines, and always helping me when I showed up unannounced and unprepared.

Thank you to the office mates I have had along the way. I learned a lot from all of you.

Sarah, Sam, Evans, Chris and Rita. Our discussions ever challenged me to be a better researcher and academic.

iv To my friends and family, thank you for loving and accepting me as I am. Without you I could not have gone through this grueling process, you are the support system that helped me make it through.

Finally, I would like to thank Typhenn. Thank you for dealing with me and my neurosis through this process. I’m grateful for your unconditional support, encouragement and positive energy through this journey. You stood beside me through it all and I made it to the other side, thank you.

v Table of Contents

Abstract ...... ii Acknowledgements ...... iv Table of Contents ...... vi List of Tables ...... ix List of Figures and Illustrations ...... x List of Symbols, Abbreviations and Nomenclature ...... xiii

CHAPTER ONE: INTRODUCTION ...... 1 1.1 Introduction ...... 1 1.2 Purpose of the Study ...... 4 1.3 Organization of the Dissertation ...... 6

CHAPTER TWO: THE NUTS AND BOLTS: RESEARCH DESIGN AND EXPERIENCES IN THE FIELD ...... 8 2.1 Philosophical Perspective ...... 8 2.1.1 Pragmatism ...... 8 2.1.1.1 Tenants of Pragmatism ...... 9 2.1.1.2 Critics of Pragmatism and its Limitations ...... 12 2.2 Research Questions ...... 14 2.3 Strategies of Inquiry ...... 15 2.4 Methods and Analysis ...... 17 2.5 Research Validity and Validation Strategies ...... 23 2.6 Getting the Hands Dirty: Steps on the Ground to Collect the Data...... 24

CHAPTER THREE: LITERATURE REVIEW ...... 37 3.1 Poverty and Underdevelopment ...... 37 3.1.1 Development and Poverty Measures ...... 43 3.1.2 Poverty and Development in Africa Today ...... 44 3.2 Urbanization ...... 49 3.2.2 Reasons for Urbanization in Africa ...... 52 3.2.3 Urbanization and Slums ...... 54 3.2.4 Urbanization and Gender ...... 56 3.3 Food Security ...... 57 3.3.2 Food Security and Urbanization ...... 60 3.3.3 Food Security and Gender ...... 70 3.4 HIV/AIDS ...... 73 3.4.1 Gender and HIV/AIDS ...... 77 3.4.2 HIV/AIDS and Urbanization ...... 80 3.4.3 HIV/AIDS and Food Security ...... 81 3.5 Conclusion: Research Opportunity ...... 84

CHAPTER FOUR: GEOGRAPHY OF MALAWI AND INTRODUCTION TO STUDY SITES ...... 87 4.1 Geography of Malawi ...... 87 4.2 Malawi and Food Security ...... 92

vi 4.3 Malawi and HIV/AIDS ...... 100 4.4 Malawi and Urbanization ...... 102 4.5 Introduction of research sites: Kauma and Mgona ...... 109 4.5.1 Kauma ...... 109 4.5.2 Mgona ...... 113 4.6 Description of Research Participants ...... 115 4.7 Employment and Income ...... 120 4.8 Housing Situation ...... 126 4.9 Migration Patterns ...... 130

CHAPTER FIVE: FOOD SECURITY, GENDER AND HIV/AIDS ...... 134 5.1 Food Security ...... 134 5.1.1 What it means to be food secure ...... 135 5.1.2 Annual/Seasonal Variability of Food Security ...... 136 5.1.2.1 Annual perspective ...... 137 5.1.2.2 Daily Perspective: Meal Consumption on a Daily Basis ...... 141 5.1.3 Cost and Sources of Food ...... 145 5.1.4 Determinants and Challenges to Food Security ...... 152 5.2 Gender: Women’s Importance to Food Security ...... 154 5.3 HIV/AIDS, food security and gender ...... 159 5.3.1 HIV/AIDS and Impact on Households ...... 159 5.3.2 Perspectives on the Causes and Drivers of the Disease ...... 165

CHAPTER SIX: ANALYSIS ...... 171 6.1 Food Security ...... 173 6.1.1 Comparing Food Insecurity in Kauma and Mgona ...... 179 6.2 Food Security and Gender ...... 182 6.3 Food Security and HIV/AIDS ...... 187 6.3.1 Some Notes on Gender and HIV/AIDS ...... 192 6.4 Conclusion ...... 194

CHAPTER SEVEN: CONCLUSION ...... 195 7.1 What are the levels of food insecurity? ...... 195 7.2 What are the coping strategies of women and food insecure households? ...... 198 7.3 How is HIV/AIDS affecting the food security of households? ...... 199 7.4 What social and economic interventions can be employed to combat food insecurity? ...... 200 7.5 What policy gaps exist and how can policy be used to address food insecurity? ..204 7.6 Impact of Research Design on the study ...... 207 7.7 Research Contributions ...... 208

REFERENCES ...... 213

APPENDIX 1: SURVEY QUESTIONNAIRE AND INTERVIEW QUESTIONS ...... 249

APPENDIX 2: DEMOGRAPHICS FOR QUOTED RESEARCH PARTICIPANTS ....261

vii

viii List of Tables

Table 2.1: Research Methods and Sampling...... 19

Table 3.1: Household Food Insecurity Prevalence in Poor Communities (% of households) ...... 62

Table 3.2: Source Used by Household to obtain Food (%) ...... 64

Table 4.1: Malawi Agricultural Reforms and Programs 1970-2013 (adapted from Harrigan 2008) ...... 94

Table 4.2: National and Urban Trends in Malawi ...... 104

Table 4.3: Population and urbanization in Malawi’s Major Cities ...... 106

Table 4.4: Number of participants and percentage in each income bracket in Kauma and Mgona ...... 125

ix List of Figures and Illustrations

Figure 1:1: The links between food insecurity, gender and HIV/AIDS within the slum environment ...... 6

Figure 3:1 GDP per capita by region in US$ (Data Source : World Bank 2014a) ...... 47

Figure 3:2 Trends in urbanization and national GDP per capita for high, mid-high, mid-low and low income country groups from 1960–2015...... 52

Figure 3:3 Undernourished trends: progress made in almost all regions, but at very different rates ...... 59

Figure 3:4 Links between Urbanization, Food Insecurity, HIV/AIDS and Gender ...... 85

Figure 4:1: Map of Malawi Administrative Districts (Data Source Hijmans et al. 2004; Software ESRI 2011) ...... 88

Figure 4:2: Malawi Real Growth in GDP 2002-2013 (Data Source: World Bank 2014b) ...... 90

Figure 4:3: Malawi Annual Maize Production and Dietary supply adequacy 1992-2014 (Source: FAOSTAT (2015)) ...... 100

Figure 4:4: Map of Kauma (Sortware ESRI 2011; Basemap source ESRI 2015) ...... 111

Figure 4:5: Mwesambala village on edge of area 52 (Photo credit: Tatenda Mambo) ...... 112

Figure 4:6: Map of Mgona (Software ESRI 2011; Basemap source ESRI 2015) ...... 114

Figure 4:7: Percent of participants in each age group for Kauma and Mgona ...... 116

Figure 4:8: Percent of married participants and heads of household for Kauma and Mgona .... 117

Figure 4:9: Number of residents per household in Kauma and Mgona ...... 118

Figure 4:10: Overall education levels of participants in Kauma and Mgona ...... 120

Figure 4:11: Employment activities for participants in Kauma and Mgona ...... 122

Figure 4:12: Total percent and valid percent of participants for each individual income bracket. Total Percent = Number participants per answer category / total number participants for each site. Valid percent = number of participants per answer category / total number participants who answered ...... 124

Figure 4:13: Total percent (Number participants per answer category / total number participants for each site) and valid percent (number of participants per answer category / total number participants who answered) of participants for each household income brackets ...... 126

x Figure 4:14: Examples of house in Kauma for a. CCDC village and B Kanyangw’a Nchokere (Photo credit: Tatenda Mambo) ...... 127

Figure 4:15: Housing material for participants in Kauma and Mgona ...... 128

Figure 4:16: Rent paid by participants in Kauma and Mgona ...... 129

Figure 4:17: Time (in years) spent living in current house for participants in Kauma and Mgona ...... 131

Figure 4:18: Annual rural return for participants in Kauma and Mgona ...... 132

Figure 4:19: Days spent in rural areas for participants of Kauma and Mgona ...... 132

Figure 5:1: Food situation in the last 12 months for participants in Kauma and Mgona ...... 137

Figure 5:2: Factors affecting participant’s ability to obtain food, ranked by participants of Kauma and Mgona ...... 138

Figure 5:3: Occurrence rate of not eating enough food because of insufficient money ...... 139

Figure 5:4: Frequency of being hungry but not eating because not able to afford enough food 140

Figure 5:5: Frequency of meal skipping because of insufficient food...... 141

Figure 5:6: Frequency of meal consumption in Kauma and Mgona ...... 144

Figure 5:7: Monthly household money spent on food as a percentage of income ...... 146

Figure 5:8: Average spent on daily foodstuffs by participants in Kauma and Mgona ...... 147

Figure 5:9: Ranking of Staple food sources by participants of Mgona and Kauma ...... 148

Figure 5:10: Sources of non-staple foods ranked by participants in Kauma and Mgona ...... 149

Figure 6:1: Interactions of food insecurity, gender and HIV/AIDS within the slum environment ...... 172

Figure 6:2: Causes of food insecurity within the slum environment (adapted from Crush, Grant & Frayne 2007) ...... 174

Figure 6:3: Geographic differences in Kauma and Mgona and how they affect food insecurity 182

Figure 6:4: Gender dynamics and food security ...... 184

Figure 6:5: Food security and HIV/AIDS (adapted from Crush, Grant & Frayne 2007) ...... 188

xi Figure 7:1: Global distribution of annual income spent on food and percent under 5 years stunting prevalence (Data Sources: (% income spent on food USDA/Economic Research Service 2014; % stunting children < 5 years WHO 1995-2014) ...... 197

xii List of Symbols, Abbreviations and Nomenclature

Symbol Definition AFSUN African Food Security Urban Network ART Antiretrovirals CCOD Centre for Community Organization and Development FAO Food and Agriculture Organization of the United Nations FISP Farm Input Subsidy Program GDP Gross Domestic Product GNI Gross National Income GNP Gross National Product HDI Human Development Index IMF International Monetary Fund MSAF Malawi Social Action Fund MTC Mother-to-Child transmission (of HIV) UA Urban agriculture UN United Nations UNDP United Nations Development Programme WFP World Food Program WTO World Trade Organization bonya Fish chambo Fish similar to bream futali potatoes mixed with groundnut flour ganyu piece work/casual labor a thick porridge made from cassava which has a smoother and kondowole stickier consistency than nsima mcheni Fish a thick porridge with a dough like consistency made from ground nsima maize maize meal where the bran of the seed is removed taking with it minerals, vitamins and fiber, further processed to give it a smoother ufa woyera texture and whiter color usipa Fish

wokomani maize flour purchased in small quantities

xiii

Chapter One: Introduction

1.1 Introduction

For many in the developed world, the notion of Africa evokes images of poverty, disease

and hunger. The sad fact is that despite efforts and some progress over the last few decades,

famines are still a reality Africa. The challenges of hunger and malnutrition still persist on the

continent, with an undernourishment rate of 21.2% (24.8% for sub-Saharan Africa) (FAO 2014).

In 2015-2016, 27 million in Southern Africa are expected to face hunger (Orr 2015). With the growing concern of climate change, access to food continues to be a pressing issue within the sub- continent. For example, Malawi experienced a famine in 2002 that affected upwards of 30,000 people (Hajdu et al. 2009), and again in 2005, drought led to a government response of over

US$200 million (Syroka & Nucifora 2010). Zimbabwe over the last 15 years has experienced drastic falls in agricultural production due to drought, economic and political instability, and inadequate farming methods, making the country reliant on food aid (Clark 2015). It is expected that 1.5 million Zimbabweans will require food aid in the 2015-2016 season (Orr 2015).

Ironically those in the developed world – particularly the USA (Nord, Jemison & Bichel

1999) – are increasingly falling sick and dying from diseases that are a result of too much food.

Obesity and diabetes are increasingly more common in the developed world due to high calorie diets rich in refined carbohydrates, saturated fats and sugars. In Los Angeles, California, it is estimated that one in three children in low-income neighbourhoods suffers from type 2 diabetes

(Algert, Agrawal & Lewis 2006). While Americans die from too many calories, Africans die from too few calories. Although there has been progress in some aspects, the challenges of food security

are still very immediate on the continent and are getting worse in the urban areas of the sub- continent (Maxwell 1999; Ruel & Garrett 1999; Andersson 2011).

Although food security has largely been a rural issue, it is increasingly an urban concern worthy of more attention, particularly in the slums and informal settlements of southern Africa.

The African Food Security Urban Network (AFSUN) survey of 11 southern African cities in eight countries found that 75% of poor urban households were food insecure (Frayne et al. 2010). With a 3.6% annual urbanization rate for Africa (UN-HABITAT 2014), city populations are growing faster than they can be accommodated, particularly in light of stagnant economic growth in countries such as Malawi and Zimbabwe. Moreover, the majority of urban growth is being realised in the informal sector, resulting in the growth and creation of slums where poverty concerns are shifting from the rural areas to the city (Frayne 2010). Given that cities in sub-Saharan Africa are expected to have over 400 million residents by 2020, and Africa is expected to reach its urbanization tipping point by 2030 (UN-HABITAT 2013b), food insecurity will be a huge problem to solve. Furthermore, given that urban populations are dependent on rural food production, climate change will only pose greater challenges as drought is expected to become more common in Southern Africa (Gregory, Ingram & Brklacich 2005; Mann & Kump 2008).

New migrants to the city find themselves in situations devoid of basic services, resulting in health concerns over sanitation and potable water that can lead to gastro-intestinal infection (Ruel

& Garrett 1999). Migrants also find that employment opportunities are few and far between, largely relegating them to casual labor and petty trading, resulting in low-incomes (Crush, Grant

& Frayne 2007). Unfortunately, the stark reality of the city is that everything comes with a price tag unlike the rural environment, where many necessities and resources can be accessed without a

fee. Due to the cash-intensive nature of the city, residents are forced into a juggling act between

competing budgetary demands in search of items on which they can cut back in order to stay afloat

(Crush, Grant & Frayne 2007). Unfortunately, food is typically on the chopping block, being

viewed as a variable expense in light of other expenses such as rent and school fees, which then

results in food insecurity (Crush, Grant & Frayne 2007).

The HIV/AIDS epidemic is another concern in sub-Saharan Africa that is having far- reaching societal effects, leaving nothing untouched. Southern Africa, which has been particularly hard hit, has seen everything from economic to societal institutions affected, including food security. HIV/AIDS on the whole is destructive because of the high prevalence rates in many countries and the reorganization of affected society’s demographic structure. HIV/AIDS is decimating the 15-49 year demographic group that largely makes up the breadwinners within society and on which all other demographic groups depend on for their livelihood (Barnett &

Whiteside 2006). Loss of this demographic group through illness and premature mortality reduces labour for household survival and livelihood activities; these include food production and procurement, education, providing household needs such as shelter, and preparing/mentoring the next generation to take over (Sheung-Tak Cheng & Siankam 2009). When the breadwinners are eliminated, this leads to skipped generation and child-headed households that struggle to survive

(Chitiyo & Chitiyo 2009). For such households, getting access to adequate amounts of food is an everyday challenge, given their limited ability to earn a living.

Central to understanding how food insecurity is affected by the slum environment and

HIV/AIDS within the household, is the need to take into account the status of women and their access to resources. The problems of food insecurity and HIV/AIDS disproportionately affect

women for a variety of reasons that range from cultural norms to physiology (Topouzis 1999).

Understanding the plight of women is important because women are seen as the primary acquirers and custodians of food within households. Women oversee a household’s food needs at the most basic level and are intimately aware of the realities of hunger as it relates to children. Researchers such as Gwagwa (1998) and de Bon et al. (2010) have found that improving women’s access to resources has a greater effect on reducing food insecurity when compared to men. With regards to

HIV/AIDS, because of cultural norms and a lack of power within gender dynamics, women are often forced into situations that make them prone to HIV/AIDS infection because they are not able to advocate for their own health interests (Barnett & Whiteside 2006). Furthermore, when

HIV/AIDS enters a household, the burden of care typically falls to women who are then taken away from other livelihood activities, in turn affecting food security. Given that women typically do not occupy the most privileged positions in southern African societies, considering gender relations provides great insight into understanding food security at the household level within the slum environment, and with respect to HIV/AIDS.

1.2 Purpose of the Study

In order to achieve a comprehensive understanding of the challenges that slum residents face with regard to food security, other factors such as HIV/AIDS, gender, poverty and the realities of the slum environment must be considered (Figure 1:1). Failure to do so results in a fragmented picture of what slum residents actually deal with, and creates a poor foundation on which to develop solutions and policy changes. In an effort to address the concern of food insecurity within the urban context of southern Africa, this study investigates food insecurity in two informal settlements of Lilongwe, Malawi. The purpose of this study is to use a holistic approach to

understand the challenges of urban food security faced by residents of Mgona and Kauma, taking into account the interrelated impacts of poverty, HIV/AIDS and gender within the backdrop of the slum environment. Specifically, this study proposes to answer the following research questions:

• What are the causal dynamics and linkages between poverty, food insecurity,

HIV/AIDS and gender within the urban environment?

. What are the levels of food insecurity?

. What are the coping strategies of women and food insecure

households?

. How is HIV/AIDS affecting the food security of households?

. What social and economic interventions can be employed to combat

urban food insecurity?

. What policy gaps exist and how can policy be used to address food

insecurity?

Figure 1:1: The links between food insecurity, gender and HIV/AIDS within the slum environment

1.3 Organization of the Dissertation

Chapter 2 outlines my research design, explaining my philosophical perspectives, strategies of inquiry, methods and analysis. Informed by pragmatism, this study employs a case study approach using mixed methodology. Both qualitative and quantitative data were collected from participants and key informants; these data were then analyzed using exploratory data analysis and content analysis. This chapter concludes with a narrative of the data collection process and various challenges that came up in the field. 6

Chapter 3 reviews the literature on the research themes of poverty, urbanization,

HIV/AIDS and gender within the African context. This review provides a comprehensive overview of each theme, outlines the major debates, and illustrates how, when combined, they lay a foundation for this study.

Chapter 4 provides background on Malawi, its history, political trends and economic issues, and contextualizes the themes of food security, HIV/AIDS, and urbanization. This chapter also describes the two study sites, Kauma and Mgona, and presents background and demographic information that provides context for the readers.

Chapters 5 reports the data provided by participants in Kauma and Mgona on the topics of food security, HIV/AIDS and gender. Both quantitative and qualitative data are reported, with food security issues explored using a mix of both approaches, while HIV/AIDS and gender are reported using mainly qualitatively data that were collected through semi-structured interviews.

Chapter 6 uses a holistic approach to show how food security, HIV/AIDS and gender interact in co-dependent relationships within the larger context of the urban slum environment and with respect to participants’ experiences. Furthermore, differences between Kauma and Mgona are explained largely in geographic terms.

Chapter 7 concludes by summarizing the answers to my research questions, offering potential solutions and policy recommendations, and highlighting the contributions that this research and possible areas for future research.

Chapter Two: The Nuts and Bolts: Research Design and Experiences in the Field

The design of this research project was influenced by a number of factors that include

research goals, previous studies, and practicality. As such, this study employed a mixed method

approach, collecting data on known parameters, while providing opportunity to learn/gain new

insights. The following chapter outlines the research design of this study, addressing philosophical

perspectives, strategy of inquiry, methods, and analysis. The chapter concludes with a narrative of the data collection process and experiences in the field.

2.1 Philosophical Perspective

I used a pragmatic philosophical perspective to frame and design this study. Pragmatism is particularly relevant because the focus is on context, and the validity of ideas is based on the

results they yield (Barnes 2008). With this philosophical perspective, it is the people who

contextualize and define the nature of the problem, making it an internal issue rather than a

problem defined and valued from the outside. In this section, I discuss the basic tenants and origins

of pragmatism and then relate it to my study.

2.1.1 Pragmatism

Pragmatism has been called a philosophy of hope, seeking to make the world a better

place; an open way of thinking to allow people to attain their dreams (Wood & Smith 2008). For

classical pragmatists like Dewey, pragmatism is a means by which philosophers can step out of

their ‘ivory towers’ and onto the street to address the concerns of the common ‘man’ (Menand

2001). What makes pragmatism distinct is the manner by which ideas are validated. Under pragmatism, an idea’s legitimacy is entirely determined by the results it yields. Pragmatism seeks to make a connection between theory and practice, between thought and action (De Waal 2005). 8

As stated by Wood and Smith (2008 p.1527), pragmatism “is a philosophy of engagement whose very method is about exploring the possibility that there may be other, more useful ways to know, and (inter)act with, the world…pragmatism promotes an open-mindedness to ideas whose usefulness is ultimately determined through practical application.” Pragmatism – a truly American philosophy – is grounded in anti-foundationalism, pluralism and radical contingency among other things (Hepple 2008). Despite its utility, pragmatism in many circles has found itself marginalized, mythologized and over simplified.

Pragmatism was born out of the horrors of the American civil war in the 19th century

(Menand 2001). The founders of pragmatism, who included Charles Sanders Peirce, John Dewey,

William James and Oliver Wendell Holmes, were at a loss, trying to understand how something like the civil war took place and how the popular European philosophies of the time did not allow a frame of thinking that would avoid it (Menand 2001). Self-titled The Meta Physical Club, they sought to re-imagine or justify new notions of democracy, culture and ideas that would be a new way of engaging with the world to solve problems (Menand 2001; Barnes 2008). At the heart of their quest was the goal to make their philosophy relevant to peoples' everyday affairs, creating an avenue through which actual problems could be solved (Menand 2001; De Waal 2005). Barnes

(2008 p. 1544) quotes Dewey saying “philosophy recovers itself when it ceases to be a device for dealing with problems of philosophers and becomes a method, cultivated by philosophers, for dealing with problems of men.”

2.1.1.1 Tenants of Pragmatism

As Barnes (2008) notes, there are five important beliefs central to pragmatism that are shared by both classical and neo scholars of the field, with some variation. These five aspects are 9

1) the rejection of foundational truths, 2) belief that knowledge is socially created, 3) belief in radical contingency, 4) an openness to ideas from different perspectives, and 5) always seeking better solutions through experimentation and a belief in pluralism.

Pragmatism completely rejects the notion of a priori or self-evident truths, a notion consistent between the classical and neo pragmatists. Pragmatism holds that no ideas are self- evidently true and all are open to scrutiny or revision. Pragmatists believe that foundational truths work only to impede the quest for what truly works in addressing practical concerns. Once ideas cease to have utility they should be left behind. As Barnes (2008 p. 1544) notes, “Ideas didn’t exist in perfect form but emerged contingently and experimentally in response to particular need and practices…in a given time and place.”

As alluded to above, the utility of ideas are tied to a particular location. Under pragmatism, knowledge is socially constructed, which means that beliefs arise as a response to certain conditions within a particular context. Context provides a basis for norms, notions of what matter, and a structural backdrop for understanding and interpreting events. It is context that provides a basis for ‘local epistemology’ – “a dynamic complex of beliefs, norms, goals, and practices” (Longino 2002 p. 187). This is not to negate individuality, but it is the context that sets up notions of what problems are and how societies seek to achieve their goals. This framework provides pragmatism its ontological footing – relating to or based upon being or existence. The world is seen in light of how societies understand their contexts and what they want to achieve in them (Jones 2008). This notion of truth being socially constructed does not relegate truth to something free floating. The test, as with all aspects of pragmatism, is whether the ideas held actually serve society’s need (Wood & Smith 2008).

Pragmatism also functions on the basis of radical contingency or reflective intelligence, meaning ideas are never able to reach a stage of perfection or completeness (Barnes 2008). As conditions change and the utility of ideas erodes, these ideas can be improved upon or even thrown out. Depending on the desired goals, minds can be changed. There should ever be a willingness to revisit or refashion ideas as more knowledge is acquired and other ideas show the possibility of greater utility (De Waal 2005). For Dewey, ideas are pliable and adaptable to changing circumstances. Dewey argues that notions of perceived (complete) knowledge only give people the ability to guess about the future and never know (Barnes 2008); these guesses at times are right and other times wrong. Therefore, a spirit to always be willing to revisit ideas is to be maintained.

Particularly for the classical pragmatists, this new way of thinking brought with it an openness to multiple opinions. This openness was to be achieved through democracy and free speech, with the aim of welcoming as many opinions as possible to the table and allowing for as many possible ideas with which to experiment. Experimentation, as noted by Dewey, is the way by which people could improve on the ideas that were currently held, always allowing the possibility for better solutions and lessen the propensity for conflict (Barnes 2008). The notion of openness and welcoming everyone to the table differed with neo-pragmatists such as Rorty, who argued that bringing everyone to the table is not a necessity (Barnes 2008). The classical pragmatists sought this process to be an open public process in the endeavor of improving society.

Rorty, on the other hand, saw this as a private process aimed at making the individual better, not the society (Barnes 2008). Rorty’s position seemed to open room for critics who stressed that pragmatism leads to an 'any and everything goes' mentality.

Lastly, pragmatism encourages a spirit of pluralism. Pragmatism rejects notions of ideas having a final coherence. No one idea can provide an answer to everything or every situation.

Barnes (2008) notes that James and Dewey were particularly critical of Hegel’s notion of a final reconciliation of difference, otherness and contradiction. James (1995) argued that rather than trying to reconcile difference, otherness and contradiction, they should be juxtaposed. At heart, the reconciliation Hegel sought was intended to make the world look less messy and more straightforward. The early pragmatists lived in a world where things were not ordered but were messy. Despite the appeal for a simplification of truth and an ordering of things to make them appear neat, this version of the world did not exist then and it does not exist now (Barnes 2008).

2.1.1.2 Critics of Pragmatism and its Limitations

Pragmatism has had its share of criticism that almost saw the philosophy fall completely out of use. The greatest criticism levied against pragmatism is that it is characterized by an

'anything and everything goes' belief (Wood & Smith 2008). Given that pragmatism enhances a willingness to entertain all ideas regardless of origin, such criticism may seem warranted.

However, when ideas are understood and applied within a particular context that allows people to address actual problems, the possibility for an 'anything and everything goes' mentality quickly fades. Anything and everything may be welcome to the table in an attempt to seek solutions; however, anything and everything cannot be an answer to real problems found in contextualized situations. Simply put, any and everything cannot be truth, it is only that which proves useful or able to solve problems that is true (Hepple 2008).

Given that pragmatism came from the US, the Europeans saw it as a resemblance of

American capitalism, where things were valued based on their quantifiable worth (De Waal 2005).

Pragmatism's focus on results was equated to the value of art only being judged by what price it

could fetch at an auction. De Waal (2005 p.3) captures Bertrand Russell’s argument – an early

critic of pragmatism – saying “What does not generate material benefit is meaningless”. James

bore the brunt of the criticism because he referred to the cash value of ideas (De Waal 2005).

An important consideration is Rorty’s (1982) notion of excluding some from the

conversation, which creates the possibility that self-imposed censorship allows unfruitful views or

goals to be pursued. Taken to the extreme, this self-imposed exclusion can easily be a breeding

ground for radical ideologies. The only insurance against the ills of societies is to bring the entire

society together to engage in the conversation.

In the absence of a pragmatism methodology, there is potential for a slippery slope to

pluralism. In every situation, a particular set of methodology needs to be developed in order to address the particular problems in the locale. This looseness towards methodology can very easily result in a poor exhaustion of the conversation and experimentation stage that is meant to be a precursor to the methodology. If the epistemologies developed are truly not a reflection of the context (not local epistemologies), then there is potential that poor grounded pluralism may result.

2.1.1.3 A pragmatism approach to understanding food security in Lilongwe

Pragmatism is a breath of fresh air in its approach and quest for solutions. In my research, pragmatism provides a basis from which to see and understand the concerns of food security and

HIV/AIDS through the local context. Pragmatism provides an open way of thinking that allows contextually relevant ideas regarding research design, accommodating the realization that prescriptions of concerns can be as varied as the contexts that exist. Given how long food security

has been a concern in Malawi, it is important that researchers are not bound in their thinking to

ideas that have been utilized in the past and lack a track record of consistent results.

Pragmatism forms the basis for addressing my research questions in a manner that looks

at context and understanding the case through a local lens, instead of some international standard

that denotes how things should be regardless of location. Given the less than desirable results of the development agenda since the 1960’s, it is time that programs aimed at improving people’s

living standards (development) be concerned with finding solutions for the particular context and

abandon a ‘one size fits all’ approach.

2.2 Research Questions

As chapter 3 outlines, urban food security has received much attention is recent years,

providing important baseline data regarding the extent of urban food insecurity in sub-Saharan

Africa. While the AFSUN baseline survey provided important contributions to urban food security

in many sub-Saharan cities, it did not cover Lilongwe. Furthermore, of the many other studies

conducted on urban food security in Malawi, the vast majority have been conducted in Blantyre

(Mvula & Chiweza 2013; Dodson, Chiweza & Riley 2012; Riley & Dodson 2014) and a few others in Zomba (Javdani 2012). Taking a holistic approach, I sought to address food insecurity in

Lilongwe taking into account the influencing factors of poverty, HIV/AIDS and gender, this research is thus seminal with respect to Lilongwe. My study utilizes both qualitative and quantitative methods, making it possible to gather data within defined know-parameters, while also providing room to learn new information about the situation and gain a more complete picture.

In this study, I aim to answer the following research questions:

• What are the causal dynamics and linkages between poverty, food insecurity, HIV/AIDS

and gender within the urban environment?

. What are the levels of food insecurity?

. What are the coping strategies of women and food insecure households?

. How is HIV/AIDS affecting the food security of households?

. What social and economic interventions can be employed to combat urban

food insecurity?

. What policy gaps exist and how can policy be used to address food

insecurity?

2.3 Strategies of Inquiry

Of the multiple strategies of inquiry available for qualitative data, I employed a case study approach. “Case study research is a qualitative approach in which the investigator explores a bounded system (a case) or multiple bounded systems (cases) over time, through detailed, in-depth data collection involving multiple sources of information… and reports a case description and case-based themes” (Creswell 2007 p. 73). The first uses of the case study approach appeared in ethnography, where the aim was to get an understanding of an entire culture. Today the approach has evolved somewhat to where researchers seek to attain an understanding of an issue explored through one or more cases (Hammersley 2009). It is argued that case studies should aim to capture the uniqueness of cases rather than use them as a basis for wider generalization; emphasis here is 15

placed on understanding the case, where quantification of data is not a priority (Hammersley

2009). The case study approach has a long history and is common among a wide range of disciplines, which includes law, medicine and psychology (Creswell 2007; Hammersley 2009).

Case studies comprise three different types depending on the size and intent of the study, namely the single instrument case study, the collective of multiple case study and the intrinsic case study (Creswell 2007). When using the single instrument case study approach, the researcher focuses on one topic and chooses a bounded case to demonstrate the topic (Stake 1995). With the collective case study, again one topic is selected but multiple cases are chosen to illustrate the issue; Creswell (2007) notes that this can be done by looking at multiple programs in multiple cases or looking at multiple programs in a single case. Finally, with the intrinsic case study, the focus is on the case itself because it is unusual or unique in some way. This approach is similar to narrative research, except the aim is still to provide a detailed description of a case taking into account its context (Creswell 2007). Case study research draws data from multiple sources and this process tends to be in-depth and extensive. Authors such as Yin (2003) suggest that six types of data be collected: documents, archival records, interviews, direct observations, participant- observations, and physical artifacts (Yin 2009).

The case study approach brings with it various advantages and disadvantages. Case studies work well because they provide in-depth understanding of issues; the attention placed on context ensures that the findings are situated in reality, working within the circumstances the case exists in. Furthermore, the in-depth understanding is a result of the multiple data collection sources that validate the findings. The approach is also flexible because of the multiple data sources and approaches, and the research gives a human face to the findings. A major drawback associated 16

with case studies is that the results tend to be un-generalizable because of the focus on context

(Creswell 2007); however, this is not a big concern for qualitative researchers, particularly when the aim is to understand the uniqueness of a case (Hammersley 2009). It is argued that the case

study approach has a tendency to lack rigor because it is not a method of doing research but a

choice of what to study (Stake 1995); however, other researchers choose to see case studies as a methodology, or comprehensive research strategy (Creswell 2007).

The case study strategy is particularly effective for this study because the particular issues of food security and HIV/AIDS within the context of urban slum environments best aligns with the exploration of cases within a bounded system. The selected research sites fit these criteria well:

they are distinct slum environments within the city with themes/cases in common. Thus, I designed

this study using the collective case study approach and conducted two case studies in two low-

income slum neighborhoods in Lilongwe.

2.4 Methods and Analysis

I employed mixed methods to collect data for this project, including a survey of food types and sources consumed by the residents, key informant interviews with local authorities, use of food diaries by the participants, semi-structured in-depth interviews with households, and use of secondary data which included news stories, audio, print and television (Table 2.1). I used the concurrent nested strategy for this study, whereby both quantitative and qualitative data were collected simultaneously. Although similar to the concurrent triangulation strategy treats both methods with equal priority (which may not be true practically), the concurrent nested strategy imbeds either method into the other method; this generally guides the research process with the

aim of collecting data at different levels, asking a different question, and/or allowing the researcher

to gain a wider perspective of the research topic (Creswell 2003).

The concurrent nested approach was preferable for this study because is allowed me

collect data for the various research questions based on the method that would suit it best. In

addition, the concurrent nested strategy it allowed all the data to be collected at once, as opposed

to the sequential strategies that required data to be collected a different times in multiple stages.

Concurrent mixed method strategies are advantageous as the multiple types of data at once, they

provide different types of data, and allow the researcher to gain different perspectives from the data collected (Creswell 2003). Limitations of this strategy include the need to transform data in order to integrate it during analysis, the researcher needs expertise in both methods to study phenomena, and the researcher may be unclear on how to resolved discrepancies that arise from the different methods (Creswell 2003).

I used quantitative methods to largely answer questions regarding food security, while qualitative methods were used to answer questions regarding gender, HIV/AIDS and food security, particularly the dynamic relationships between these themes. The multiple and varied nature of these methods align with the case study approach aimed at getting a clear understanding of a case within a particular context. All data was collected in accordance of University of Calgary ethics protocol.

Table 2.1: Research Methods and Sampling Method Instrument Target Data Analysis Kauma Mgona Participants Participants Surveys Written Demographic Exploratory 41 50 information, data analysis assessment of food security, poverty Food Diaries Written Day-to-day Content 5 5 food analysis, consumption exploratory data analysis Semi- Oral/speaking, Qualitative Content 41 50 structured recorder description of analysis interviews dynamics of HIV/AIDS, food security poverty and gender Observations encounters, Broader Reflexive indirect picture of analysis, experiences, happenings triangulation conversations pictures. Analysis of Publications, Peer reviewed Reflexive secondary Government and official analysis, data releases, TV, information in triangulation radio, understanding Newspapers, the case

My field season took place from May to September, 2012. I surveyed 41 participants in

Kauma and 50 in Mgona to collect data on the types of food participants ate throughout the year.

These participants were selected through a combination of random and purposive sampling. These

surveys helped me to understand how varied participant's diets were and the implications this had

for nutrition. I also sought to determine the sources of the foods participants ate throughout the year; this data provided a baseline understanding of where their food comes from and allowed me

to determine what avenues could be pursued to increase access to food. The survey was comprised of both open-ended and closed questions, allowing me to gather data on defined parameters and learn about situations outside what was already known. Though the surveys were written, in the case of poor literacy, I provided assistance with the help of a field assistant fluent in Chichewa.

(To see the survey instrument and interview questions see appendix 1).

Upon gathering the data from the surveys, I coded all responses in a spreadsheet. I used exploratory data analysis using SPSS software (IBM 2013 version 22) in order to discover the underlying structure of the data. I used taxonomy, measures of central tendency, and measures of dispersion to tease out the underlying structure of the data. The advantage of using exploratory data analysis is that it allows the researcher to organize data without making assumptions about the data, and reveals the underlying structure of the data (Kitchin & Tate 2000). I then aggregated the data into tables to allow for easy comparison.

I conducted informal interviews with informal food vendors in Mgona and Kauma to acquire data on food sources. These interviews helped contextualize the origins of food available and provided insight into informal channels of food distribution.

I used semi-structured interviews in households to collect data on challenges and coping strategies regarding food, how HIV/AIDS affects/disrupts food security, and how gender affects food security. According to Bernard (2006), semi-structured interviews are effective when a researcher will only have one opportunity to interview a respondent. The semi-structured interview technique allows for the freewheeling quality of the unstructured interview yet it is somewhat structured as there are certain points that have to be covered in a chronological order (Bernard

2006). It can be a very effective technique as it ensures that the required areas of research are

covered yet at the same time, there is the flexibility that allows for new leads to be followed. I also

used semi-structured interviews to gather information from 10 key informants; these included city

officials, NGO representatives, government officers, chiefs, and village heads. Interviewing city

officials was important as these areas fell under their jurisdictions and they were involved in

running public works programmes in one of the study cites. The approach to these interviews was different given the power dynamics between myself and the key informants.

Rigidity and flexibility were important when conducting interviews with household participants and key informants. Some portions of the interviews were rigid because I was looking for answers to some specific questions in order to answer my research questions. In being flexible,

I at times let the interviews go in unexpected directions, allowing participants to lead parts of the

interview; in doing so, the rich, subtle detail they shared greatly enhanced the stories they were telling and therefore the quality of the interview. I used probing to encourage participants to share and tell their story, giving them an open floor to speak.

I used content analysis to analyze the qualitative data acquired from the semi-structured interviews. As defined by Ole Holsti (1969), content analysis is "any technique for making inferences by objectively and systematically identifying specified characteristics of messages"

(Holsti 1969 p. 14). The use of this method allows the researcher to identify the properties of the data (Neuendorf 2005). The categorizations that result provide a meaningful reading of the content being examined. All qualitative data was coded and analyzed using Nvivo (Nvivo 2012 version

10).

In addition to the survey and semi-structured interviews, I asked some participants to keep a food diary for 2 weeks. The food diary gave me a day-to-day snapshot of the challenges households face with food security. I asked participants to document what food they were eating, how often they ate, how they prepared their food, and the quantity of the food. I was particularly interested in how households cope with difficult situations and how these situations are reflected in their day-to-day food consumption. To fittingly capture the challenges of food security, I was in the field during the cold dry months when food is typically in short supply and more expensive.

This timing effectively captured the day-to-day challenges during the most difficult time of the year for food insecure populations. I collected diaries from 5 participants from each slum selected through purposive sampling, with an aim to have different types of households represented. The number of participants was much smaller compared to the other methods because this technique required the participants to keep a higher level of consistent participation, and fewer participants were willing or able to maintain food diaries. In addition to interviews and food diaries, I utilized many secondary data sources including publications from the African Food Security Urban

Network survey, which used a number of indicators effective in understanding some of the contexts around food security in southern African countries.

With regard to the sampling of participants, female headed households were underrepresented especially when compared to similar research done by Riley and Dodson (2014) in Blantyre. A possible explanation for this underrepresentation is the time of day that the sampling occurred: the female heads of these households may have been away from their homes working at the time of visitation. Also missing from the research participants were child headed households, which I was hoping to come across. Possible ways to have better representation of these groups 22

would have been sampling later into the evening, however, this was a challenge since my research

assistants were female and there were concerns for their safety being in the study sites into the evening and transportation for them to get home.

2.5 Research Validity and Validation Strategies

Validity in qualitative research is particularly important, as the data generated should go beyond telling convincing stories and demonstrate rigor so that conclusions can be accepted more definitively (Kitchin & Tate 2000). For this study, internal validity – concerned with the integrity of the conclusions – was maintained by referencing the data collected to support conclusions made about the study. More importantly, I made sure not to speak to findings or ideas to which there was not sufficient data to support. In situations where there were insufficient data to support an idea, such ideas were presented as possible explanations, highlighting that they are educated guesses. External validity – concerned with the generalizability of a study – was maintained by ensuring that it conformed to the standards of the strategy of inquiry. According to Creswell

(2007), data collection for a case study should include at least 20-60 participants for the results to be generalizable. Given that a minimum of 47 participants were sampled in each study site, the results are generalizable for the study sites, maintaining external validity.

Validation strategies for this study included triangulation, negative case analysis, and peer

review. As a researcher in training, peer review was a constant occurrence through the various

stages of the research, which included proposal development, grant application, thesis writing and thesis defense, whereby my supervisory and examination committees scrutinized my work.

Negative case analysis – the reworking of hypotheses in light of disconfirming evidence

(Creswell 2007) – was employed when unexpected findings were found, for example in the case

of loss of self-determination for some women who moved to the city. This strategy was particularly important as it made my research more honest. I acknowledged instances where the hypotheses I had before conducting my research either abandoned, questioned or proved incorrect in light of the data I corrected.

Triangulation – the process of using data generated from and through multiple sources, methods and theories to provide corroborating evidence to support an idea put forth (Creswell,

2007) – was also used as a validation strategy for this study. Triangulation was built into the research methods as data on different themes were collected both qualitatively and at different scales. In addition, while in the field informal triangulation took place through interactions and conversations with informal participants from outside the study sites, and key informants that acted to validate data from the study sites. Furthermore, published research on similar topics within the country and region were referenced and corroborated thus validating the findings of this study.

2.6 Getting the Hands Dirty: Steps on the Ground to Collect the Data.

I arrived in Lilongwe on May 22, 2012, to commence data collection for this project. The data collection period lasted a total of 5.5 months, which mostly coincided with winter in Malawi.

The presence of green mangos at the market in October was a sign that winter was coming to an end. My initial task after arriving in Lilongwe was to attain approval for my research from the

National Health Sciences Research Committee (NHSRC). Months prior to my departure from

Calgary, I had been in contact with researchers at the Center for Agricultural Research and

Development at Bunda College (located 30km from Lilongwe city center) – my affiliate institution

– to inquire as to whether I would need additional research approvals. Time and again they simply

did not answer my question. Two weeks before leaving Calgary, researchers at Bunda Collage

informed me I would need NHSRC approval, however, there was confusion since my research did

not technically fit into the NHSRC guidelines. Dr. Kalimbira – my affiliation contact at Bunda

College – was instrumental in getting the ball rolling, which allowed me to submit the application

once I arrived in Lilongwe. As a result of this required approval, I did not start conducting formal

data collection until my third week in Lilongwe.

Dr. Kalimbira and his associates at Bunda College were instrumental during my initial weeks in Malawi. The Centre for Agricultural Research and Development most generously provided me with an office from which to work. I met other researchers at Bunda College who

were doing research on urban agriculture. They provided recommendations for potential research

sites, as well as potential research assistants. Dr. Kalimbira also put me in touch with one of the

librarians at Bunda College who was very helpful in providing me access to literature I could not

find from Calgary. Bunda College was also a place to meet with other researchers and practitioners

independent of the College. I met a number of NGO representatives at Bunda College while

attending a guest lecture from the Minister of Agriculture and Food Security, Professor Peter

Mwanza, M.P, who is an alumnus of the college.

While waiting for approval from NHSRC, I used my time to get a better understanding of

the city and to scope out potential field sites. My first visits were to the neighborhoods of Dubai

and Baghdad. I had read about these slum neighborhoods in the literature and as such, I thought

they would be a good place to start as it would put a picture to what I had read. Following these

visits, I went to Kauma, Chinsapo, Mtandire and Kawale upon the recommendation of two

researchers at Bunda College. These visits to different slum neighborhoods were eye-opening as 25

they enabled me to see a range of areas and conditions, allowing me to make an informed decision

with regards to my research sites.

My time waiting for approval was also used to find research assistants. Following the

recommendation of a professor at Bunda College, I started out with two research assistants. Before

commencing data collection with these research assistants, I went through some training with them

to ensure that the survey instrument was translated accurately and they were clear about the expectations I had of them. The major last step of the training was to conduct a pilot study. Over a series of two days, we went to Area 25 C in the northern part of Lilongwe to collect some trial data. Area 25C exhibited a number of similar characteristics I was looking for in my research sites which included informal housing, high densities, low income residents and poor infrastructure.

Over the two-day period we conducted 25 interviews. The performance of the research assistants was rather mixed during the trials. The male research assistant did not perform very well. He habitually arrived late, did not follow instructions, expressed a lack of engagement, and showed poor writing skills. After looking through the data he collected, it was clear we could not work together. I replaced him with a female research assistant who proved to be more engaged. His

replacement had a lot of experience as a research assistant and performed well during her training.

On June 25, 2012, I received approval from NHSRC for the study and I was able to start

collecting data. Prior to the approval, I had made a number of preliminary site visits to Kauma,

where I met with the chief who was quite receptive to the project. He appointed one of his aides –

Lebiam – to assist us in any way that we required. The services of the aide were quite useful

initially. Lebiam provided me with important background information on Kauma, access to other

gate keepers in the area and access to participants. Given that we had approval from the chief, it 26

gave us legitimacy as we collected data. My initial visits to Kauma were spent with Lebiam, who

gave me multiple tours of Kauma (due to its large size), which helped me get familiar and

comfortable working in the area. During the tours, Lebiam discussed the history and progressive

growth of Kauma. One of my visits to Kauma was spent in the market talking to vendors about

what they were selling, peoples’ buying patterns, the origins of their goods, and how successful

their activities were. On the last day of touring Kauma we visited with members of the Kauma

home base care group, which is a support/care group for HIV/AIDS infected residents of Kauma.

The home based care group was instrumental in providing knowledge and insight into the

challenges of food security and HIV/AIDS. They expressed interest in participating in the research

and later on members of the group were interviewed.

In many ways Lebiam’s presence was instrumental in getting us access to informants,

information and other leads, however, at times his presence presented difficulties. Initially he wanted to select participants for us and keep track of the people we had interviewed. At times his presence made potential female participants uncomfortable. After the first day of formal data collection, I informed him that we would not need his assistance finding participants, and that we were not going to collect names or track people we had interviewed so they could remain anonymous and feel comfortable to freely answer our questions. He seemed surprised but agreed to let us do our work. Lebiam was actually a very good contact to have because he was Kamua’s representative member in Lilongwe Urban Poor Peoples Network (LUPPEN). LUPPEN is an NGO that advocates for the needs of slum communities in Lilongwe. Time and again I was able to make important contacts through Lebiam.

At the start of formal data collection in Kauma, I had two female research assistants, Kitty

and Maureen. Given their prior experience, we set a target of 8 interviews per day, which would

mean about 7 days to interview 50 participants. Though we did reach the target on the first day, it was demanding. The following day Kitty did not show up and later explained that she was ill. I proceeded with Maureen and Kitty never rejoined us. Overall this did not turn out too badly since there would be more consistency in the data collected; furthermore, Maureen and I developed a good working relationship that facilitated the data collection. Maureen had a gift for interacting with the participants in a way that made them feel comfortable and at ease. She was always conscious of fully translating the participant’s responses to ensure I understood what they were saying, which enabled me to ask insightful follow-up questions. On average, Maureen and I conducted 5 interviews per day. The data collecting period for Kauma lasted 11 days. These data were collected over a 5.5 week period. We collected data in 8 of the 12 villages of Kauma. The final 6 interviews were conducted with members of the home-based care group. They graciously allowed us to conduct the interviews in their building, which provided confidentiality and a good place to work from. The confidentially was important because we noticed that there was some stigma levied against members of the home-based care group. On the last day of the tours around

Kauma, Lebiam would not come with me to meet with members of the home-based care group.

He never really explained why he was not coming along but said he would meet up with me after

I was done with them.

At the end of data collection in Kauma, Maureen began the process of translating and transcribing the interviews. This long and painstaking process took her seven weeks to complete.

This process involved a lot of back and forth between us as I reviewed the transcribed interviews 28

to ensure everything was translated accurately. During this time, Lebiam and I collected GPS

points along the entire boundary of Kauma and its 12 individual villages in order to create a map

of the area (Figure 3.4). This process took a while, and Lebiam was the right person to do it with

as he knew the boundaries well.

My last data collection exercise in Kauma was to conduct an interview with the chief. He

was gracious enough to grant us the time and provide us with lunch. I did make subsequent visits

to Kauma, but those were mostly to report on some of the data and to show Lebiam and the chief

the map of Kauma we had been able to generate from the GPS points. On the whole, data collection in Kauma went quite well. I would largely credit this success to the initial visits I made to Kauma before data collection. The first meeting with the chief of Kauma went very well and he was happy that we asked for his permission before working in his territory. The assistance provided by Lebiam and the tours of the area helped me get familiar and comfortable working in the area.

A few weeks before data collection was done in Kauma, I had begun considering where I

would collect data for the second case study. I had three places under consideration, Chinsapo,

Kalawa and Mgona. I decided to go with Mgona because it was quite unique from other slums due

to its location, origin and development, and its density. Through Lebiam’s contacts at LUPPEN, I

was able get in touch with Gertrude, the LUPPEN representative for Mgona. Given the success I

had in Kauma, I thought it would be good to follow the same approach with Mgona as I had done

in Kauma. Getrude managed to arrange a meeting for me to meet with the chief. The chief was

happy to let us collect data on the condition that his household would be the first place we would

begin our data collection. Prior to data collection, the chief’s nephew gave me a tour of Mgona

and educated me on the history and growth of the area. I then spent an additional day with Pempo

– a potentially new research assistant – going through the market talking to vendors.

While still collecting data in Kauma, I approached the city of Malawi with the aim of conducting an interview with a city official on slums and the growth of the city. I thought it would be the best timing to conduct an interview with the city before conducting the second case study, so that I would be able to get insight into some of my initial observations from Kauma. My assumption was that with insight on how the city sees slums and their approaches toward them, I would be able to consider what was occurring in Mgona from the city’s perspective. After a lot of back and forth I was able to meet with Mr. Hilary Kamela. He was most gracious with his time and we spent almost two hours talking. He was very upfront and frank about the city’s stance toward slums. He definitely spoke like a technocrat and not a politician. He invited me to meet with him again so that he could share some data and reports with me. He provided me with other leads to follow, which allowed me access to information on slums and the activities of various

NGOs within Lilongwe.

Following leads from Mr. Kamela, I was able to meet with people from the Centre for

Community Organization and Development (CCOD), which had been conducting research in some of the slums in Malawi. CCOD had just completed an Enumeration Report on Mtandire – one of the largest slums in Lilongwe – and had previously done one on Chinsapo. They were able to provide me with additional data, however, my discussions with them did not prove to be too fruitful. They expressed concern that I was possibly getting skewed data because I was an outsider and therefore the respondents would be more likely to over exaggerate how poor they were in the hopes of receiving assistance. They did not, however, offer any suggestions as to how I could avoid 30

this potential problem. Their concerns were worthy of consideration, but it left me with no new

concrete steps to move forward. Yes, I am a foreigner and an outsider; that is something I cannot

change. The only real option based on their comments would be for me to abandon the research

and only have locals do the work.

Prior to the start of data collection in Mgona, Maureen was still transcribing interviews

from Kauma and informed me that she would not be interested in assisting me with data collection

in Mgona. She said it was time-consuming work and that transcribing had become very tedious.

In an effort to increase her morale to ensure she continued to do good work, I provided her

additional money to complete the transcribing; she was happy with this arrangement. In the meantime, I had to find a new research assistant. Through my previous research assistant Kitty, I met Pempo who had done some work as a research assistant. Pempo seemed like she would be a good fit, so I put her through some training and I took her along for the tour of Mgona and the

Market.

On the morning of September 6th, Pempo and I commenced data collection in Mgona. Our

first stop was the chief’s household, but no one was available. The chief of Mgona did not provide

us with an aide, but I was happy to work without one. Pempo and I collected data in all four areas

of Mgona. The nature of data collection in Mgona was very different compared to Kauma. Pempo

and I conducted more group interviews in Mgona compared to Kauma because of the higher

density. We tended to find potential participants clustered together. In some situations, we would

conduct individual interviews with some of them and in other cases we would interview them as a

group; it would always depend on the situation. It was also difficult to get privacy. If we were

conducting an individual interview, neighbors, friends or even passer-bys would sit down to hear 31

what we were talking about. Similar situations did happen in Kauma, but with less frequency. The group interviews had their pros and cons. Group interviews generated more discussion during the semi-structured interviews where it was good to hear different ideas debated by the participants.

A downside is that the propensity for honesty or openness may have been reduced when it came to more sensitive or personal aspects of the interview.

During the second week of data collection in Mgona, I suffered a motorcycle accident, which forced me to cease data collection activities for 3 weeks. The accident was not too serious but I opted to stop using the motorcycle to get around the slums. Once data collection resumed things moved along quite smoothly.

As with the participants in Kauma, people in Mgona were quite open to participating. We did get a number of questions from people asking if we were from an NGO doing a project to give people assistance. This made it clear to us the necessity to ensure that people understood there would be no compensation for participating in the research. The final interview Pempo and I conducted in Mgona was with the Chief and his two village heads. The interview started very well but suddenly took an awkward turn: one of the village heads disrupted the interview as he was not clear how useful our work was to the area given that there was no financial benefit. After explaining again that we were students on a mission to learn and conduct research, he noted that his participation in the interview was a waste of his time. In short order he excused himself from the interview. It was unfortunate to lose him. Given that he was the youngest amongst the leaders, he would have provided a different perspective. Once the interviews were completed, I set out to collect GPS points to create a map of Mgona and its four sections (Figure 3.6). This process took

2 days. As with Kauma, I provided the chief with a copy of the map generated from the data

collection process.

With the second case study completed I followed up with two leads for interviews with

Mr. Benard Mphepo, a project coordinator for the NGO Training Support for Partners (TSP), and

Ms. Chimwemwe from the Ministry of Agriculture and Food Security. TSP is a capacity building

NGO whose mission is to provide process oriented capacity building to help facilitate socio-

economic development in Malawi. TSP focuses its efforts on pragmatic services relating to training, research and development. I had a desire to meet with a TSP representative because they have done work in both Kauma and Mgona with regards to sanitation and access to potable water.

My key informant interview with Mr. Mphepo gave me further insight into the issues of life in the

slums and provision of services from the supply side.

The final key informant interview I conducted in Malawi was with Ms. Chimwemwe

Chilenga from the Ministry of Agriculture and Food Security. Though I was grateful that Ms.

Chilenga made time to meet with me, the interview did not go very well. We were constantly

interrupted and she left for extended periods of time. Furthermore, she did not provide me with

clear answers to some of my questions. She seemed rather frazzled and unable to focus. She was

very busy, which would explain her lack of engagement during the interview.

Overall, I had a very successful field season. By the end of the data collection period, I had conducted 91 interviews with participants and 10 key informant interviews. I would credit this success to the contacts I have in Malawi, who were able to give me a lot of background information and gave me access to their own contacts. My father – who lives in Malawi – was a great help in

getting acclimated to Malawi. There are a number of resources I did not need to figure out thanks

to his presence and assistance. My contacts at Bundu College were also invaluable, as their advice

and expertise gave me important points to consider. On the whole, I was happy with the research

assistants I used. Their personalities and skill sets were well suited to the type of data collection I

was doing. Things did not always move smoothly with the research assistants, but in the end I got

what the research needed.

While in Lilongwe I stayed in Area 25C which had a mix of lower and middle income housing. The outskirts of area 25C looked a lot like some of the poor housing seen in Kauma and

Mgona. My positionality while conducting this research varied dependent on the level of contact

I had with people. After informing my research participants I was from Zimbabwe, most remarked they initially thought I was from the USA. I was able to learn about Malawi culture and customs

from my father, which made it easier to interact and connect with people. Being a Zimbabwean

and having the ability to have simple conversations in Chichewa meant that potential participants

did not view me as a complete outsider. Some research participants asked me about Zimbabwe

and how the issues we were discussing compared. I was able to make a good connection with Chief

Nkumbu, who had spent several years living in Zimbabwe. We actually exchanged a few words in

Shona. My positionality as a male also varied depending on the situation. During situations when

topics surrounding sexuality and sexual relations were discussed with female participants, I relied

more on my research assistants to lead interviews and come up with their own follow up questions

based on our prior discussions about the goals of the research. There were a number of occasions

where I excused myself from the interview and allowed research assistants to take over.

With regard to reflexivity and how my presence affected the behavior of research

assistants, I found a more pronounced impact with female research participants. On a number of

occasions I asked female research participants if I could take pictures of them, their home or their

livelihood activities and they were reluctant to give me permission citing concern that their

husbands would not be pleased that I had captured their image. This was an occurrence both in

Kauma and Mgona. This highlights the importance of using female research assistants which I

believe made the female participants more receptive initially to interact with us. Even if I spoke

Chichewa fluently, trying to embark on this research without a female presence would have made

them female participants initially uncomfortable.

I did not come across modeling of behavior from male participants attempting to show

how forward thinking they were with regard to gender as Riley and Dodson (2016) found in their

study (thought I cannot be sure of this). Male participants who reported being open-minded about gender were actually demonstrating particular behavior prior to requesting an interview with them.

Kudzai a 41 year old man in Kauma (refer to appendix 2 for more demographic details) was actually washing his families clothes when we arrived at his house to ask for an interview. He continued washing clothes during the interview while his wife had gone to fetch water.

Additionally, we arrived at Thembiso’s (male, kauma see appendix 2 for demographic details) home in Kauma while he was caring for his sick wife in the house. While there may have been some performing or acting among men attempting to show their openness to gender, there was not much I managed to pick up on. The fact that I was from Zimbabwe and not white could have made them think that they did not have to perform or act for me as I could have understood their position and knew the cultural context better. 35

If possible I would have liked to talk to more people from the Ministry of Agriculture and

Food Security, but that did not work out. On many occasions, I tried to locate a child headed household but was unable to find any. I often got leads about where I could find one, but those leads never materialized. My experience in Malawi would have been more enhanced had I been able to speak Chichewa, as this would have removed a barrier with my participants. I had also hoped to spend some time living in the slums, but most people I approached with this idea advised against it for fears to my health or for my safety. I understand where the concern came from, but I feel that if I am going to document people’s experiences, I should do my best to live them. Despite this limitation, I believe I gained a good idea of life in Kauma and Mgona.

Chapter Three: Literature Review

In this chapter I review the literature on the themes that make up this study – poverty, urbanization, HIV/AIDS and gender – within the context of food insecurity. In order to address the concerns of food security in urban sub-Saharan Africa, or to propose any potential interventions, food security must be placed within the context of these interactive themes. The aim of this chapter is to provide a comprehensive understanding of each theme, the major debates, and to illustrate how, when combined, they lay a foundation for this study.

3.1 Poverty and Underdevelopment

The root cause of many problems in Africa, ranging from poor infant health to lack of basic sanitation, can be traced to poverty. The terms poverty and underdevelopment are often used in tandem; however, it is important that these terms be distinguished. What differentiates poverty from underdevelopment is scale. The term poverty is typically used to address the household and individual level, whereas underdevelopment refers to the societal level (Allen & Thomas 2000).

Both terms are connected to and evoke the image of ‘doing without necessities,’ deprivation and/or deficiencies. Though poverty and underdevelopment can been measured in absolute terms, such as living on less than US$1 per day, or falling below 0.55 on the Human Development Index, poverty is also relative in nature. What is considered ‘poor’ will vary greatly depending on the location and context. For example, the presence of rolling electricity blackouts can be viewed as underdevelopment in one locale, whereas even having electricity in a different locale is a sign of development. As such, it is important to keep in mind the relative nature of these concepts.

Poverty as a concept can be viewed in a few different ways. According to the World Bank

(2000), “poverty is pronounced deprivation in well-being.” The logical question that follows this

definition is, what is well-being and what is the reference point for deprivation (Haughton &

Khandker 2009)? Another important question would be: who gets to define these concepts? The

most common view of poverty is seen as an individual’s inability to attain commodities or exercise

command over resources to meet their needs (Haughton & Khandker 2009). Here, the commodities

people are able to acquire are compared with some pre-determined threshold, which then

determines whether or not they are poor. Another view of poverty is whether households are able

to acquire specific goods or services (Haughton & Khandker 2009). For example, households can

be considered food, health or sanitation poor. This type of consumption can typically be measured

directly and then compared to predetermined thresholds. The most complex and multidimensional

view of poverty/well-being questions how effectively people are able to function within society.

Sen’s (1999) view is that well-being is determined by the capabilities that individuals within

society are able to exercise in order to meet their needs, which include health, education, political

freedoms, protection from risks and even information. This multidimensional view of well-being

is not subject to simple approaches such as increasing incomes, but requires fundamental societal changes in order to improve well-being.

The notion of development takes a much broader scale than poverty, and can simply be defined as ‘good change’ (Chambers 1997); it evokes an image of moving towards something better (progress). Development implies a stage of arrival (developed) vs. a state of trying to arrive

(developing). As such, some societies are considered developed and the rest un/underdeveloped.

The idea of development comes from modernization theory (Rostow 1990), where rational thought, science and technology were viewed as the vehicles through which development

(improvements to society) would be achieved (Peet & Hartwick 2009). Development captures

humanity’s imagination because of its appeal to make things better, free humans from the vestiges of nature and allows humanity to better itself and create societies that reflect this enhancement.

The latter half of the twentieth century is said to have been the era of development. The development era was ushered in by Harry S. Truman’s 1949 inauguration speech where he stated:

“We must embark on a bold new program for making the benefits of our scientific advances and industrial progress available for the improvement and growth of underdeveloped areas. The old imperialism – exploitation for foreign profit – has no place in our plans. What we envisage is a program of development based on the concepts of democratic fair dealing” (Truman, 1949, quoted in Esteva 1992, p.6).

The importance of Trumans’s speech as argued by Esteva (1992) is that development was seen as a process by which to break out of underdevelopment. Truman’s speech was not pivotal in that it introduced a new concept, but that it defined the vast majority of the world as ‘underdeveloped’ and claimed that the United States had the prescription; this then led to US and western hegemony

(Esteva 1992; Allen & Thomas 2000). As many countries in Africa, Asia and Latin America became independent, development was their main priority.

Though improvement/betterment may be its aim, many argue (Shiva 1988; Rahnema &

Bawtree 1997) that development does not improve the capabilities of those who are being developed. Much of this criticism stems from how development is viewed from divergent perspectives. Returning to and scrutinizing the term ‘good change’ provides a starting point to see where perspectives differ. Who gets to define what ‘good’ is? Depending on the interests held and the current status quo, what is considered good will differ, and that which is good for some will not be good for others (Bodley 2014). ‘Change’ implies disruption of some form. Change can lead to drastically negative results for some groups, threatening livelihoods. In the end, inherent in the term ‘good change’ is the reality that there will be winners and losers (Allen & Thomas 2000; 39

Bodley 2014). The question with regard to development is whether the proposed change benefits the greater good (though once again there are fierce arguments about what is in the interest of the

greater good).

Post-Development scholars (Rahnema 1997; Sachs 1992; Esteva 1992; Escobar 2000)

argue that development is merely a process of westernization and its failure has nothing to do with

the strategies employed, but instead is the wrong answer to a different question. At the heart of

development is a desire to improve people’s lives or their standard of living; the true challenge is

how to do this in a manner that brings everyone along for the ride (or at least a large part of society).

Since capitalism has been the system by which most countries organize their economies, economic

growth has been the standard by which development is measured. For many, economic growth

equates to development, and for this reason, many do not benefit because of the disproportionate

way the rewards of capitalism are shared – the majority of the profits go to the few (entrepreneurs

and investors) while the remainder goes to the many (workers) (Illich 1997; Latouche 1997).

History shows that economic growth and development don’t always come together (Allen &

Thomas 2000). Economic growth always tends to benefit those who are already rich or who control

the factors of production. As Peet (2009) argues, development is not simply about increasing

wealth, it’s a question of how the wealth is distributed and what outcomes it allows members of

society to achieve.

One area in which development has fallen short is on the status of women. For the most

part, women in sub-Saharan Africa are poorer than men, have lower literacy rates, have less access

to resources to pull themselves out of poverty and typically have a lower degree of self-

determination due to cultural norms (Kevane 2014; Hovorka 2005). Von Bülow (1992) referencing

her work in Kenya, argues that the social status of women in sub-Saharan Africa today is a reflection of the colonization process that employed a divide and conquer approach, giving men greater control and dominance over women as women’s livelihood activities were monetized, putting them into the productive sphere where they came to be governed by men (Von Bülow

1992).

Development and its spread to the global south has created disparaging circumstances for women. At the heart of the problem is how ‘development’ deals with the productive and reproductive spheres. While the development project expressed through capitalism was meant to lead to emancipation of human kind, it instead further burdened women with more work, much for which they were not–and still are not -compensated (Beneria and Sen, 1997; Visvanathan,

1997). What is seen as ‘women’s work’ is completely ignored under the modernization strategies of development because it is hidden in the private space of the domestic sphere (Mapetla &

Schlyter 1998). As a result, all the work which is vital for the reproduction of society and which supplies labor to the productive sphere is unpaid and unappreciated. At the same time, successful reproduction of society necessitates that women participate in the productive sphere as well.

Reorganization of modern society has meant that women end up having dual roles where they participate both in the reproduction of society (domestic sphere) and the productive sector (public sphere) but are only compensated for one (Mapetla & Schlyter 1998). Moser (1993) in addition argues that women have a third role besides reproductive work and productive work, which is community management. Women’s community management role is an extension of their reproductive role where they manage resources related to water, healthcare and education. Unlike

the men’s role of community politics where they are compensated directly through wages or indirectly through status, women are not compensated for this third role.

Influenced by feminism, development strategies changed to better address the concerns of women by calling for a reorganization of society, bringing to light imbedded biases and oppression against women (Visvanathan 1997; Tinker 1997). These changes in development practice were expressed through policy changes, resulting from particular gender focused development theories

(Peet and Hartwick, 2009). Multiple development theories that were influenced by feminism were generated within a relatively short period of time, each influenced by different epistemologies such as socialism, political ecology, postmodernism and radical feminism (Peet & Hartwick 2009).

These theories include women in development (WID), women and development (WAD), gender and development (GAD), women environment and development, and postmodernism and development. While all of these development theories were important and advocated for the needs of women practically and theoretically, gender and development was particularly important in academic research as it sought to understand women’s positions in society based on gender –“the social relationship between men and women, in which women have been systematically subordinated” (Moser 1993 p.3) or “a set of shared and evolving discursive habits that prescribe and proscribe behaviour of persons in their social roles as men and women…” (Kevane 2014 p.14)

– rather than sex –“their biological differences from men” (Moser 1993 p.3).

Functionally, women are the heart of societies in their roles as caretakers, providers and nurturers; the success of any society is predicated on ‘women’s work’ that is fundamental to the survival and reproduction of society (Berik, van der & Seguino 2009). As a result, the status of women within societies is a strong determinant for what future generations will look like. Taking

this into consideration, it is important that development strategies address the concerns of women

and afford them better status.

3.1.1 Development and Poverty Measures

The manner in which development is measured has tended to follow the

economic/monetary approach. Arguably, the most popular measure of development is a country’s

Gross National Product (GNP) – the measure of the total domestic and foreign income claimed by

residents of a country in one year – and Gross National Product per capita – a measure of the

average income of each member of the population (Allen & Thomas 2000 p. 11). “Developed”

countries typically have a per capita Gross National Income (GNI) of US$20,000 or higher while

“developing” countries are below this threshold. However, because GNP per capita is an average calculation, it is not effective at indicating where poverty exists; averaging hides poverty making

it difficult to know where it begins and ends, in effect disguising the relationship between rich and

poor. Moreover, GNP per capita underestimates collective and subsistence goods, and

overestimates commercialized goods (Allen & Thomas 2000).

Measures of poverty at the individual scale are also based on monetary thresholds, but

better reflect the balance of poverty within a society than development measures. One common

measure of extreme poverty is the number of people living on less than US$1 per day (based on

1985 purchasing power parity), which illuminates the proportion of a population that is poor

(Chen, Datt & Ravallion 1994). This ratio between poor and non-poor people illuminates the

variability that is present within societies; whereas average calculations blanket an entire locale as

being poor, threshold measures show that even in societies concentrated with poor people, there

are also some who are rich.

In 1994, the United Nations Development Programme (UNDP) adopted the concept of

Human Security, which echoes the multidimensional nature of poverty put forward by Sen (1985) and eventually led to the development of the Human Development Index (HDI, where very high human development values range from 1-0.8, high development is 0.79-0.7, medium development is 0.69-0.55 and low development is 0.54-0). The HDI importantly aims to determine human welfare by using parameters that go beyond economic measures, since non-economic parameters have been acknowledged to greatly determine well-being (UNDP 1994). Such dimensions include health, food, literacy and freedom. Human security further brings this to light by focusing on thresholds for individuals vs. averages at the country/regional level, placing focus on those below the determined threshold levels for well-being (King & Murray 2001). Other alternative measures of poverty that came from human security include the Gender Development Index (measure gender gaps accounting for disparities between women and men in dimensions of health, knowledge and living standards), the Gender Inequality Index (measures gender inequality in three aspects of human development –reproductive health, empowerment, and economic status) and the

Multidimensional Poverty Index (an index that identifies deprivation across the same dimension of the HDI showing people who are multi-dimensionally poor) (UNDP 2015).

3.1.2 Poverty and Development in Africa Today

Since independence, how far has sub-Saharan Africa come with regard to development?

An overview of historical to present Gross Domestic Product (GDP: measure of the total final

output of goods and services produced by an economy (Allen & Thomas 2000 p.11)) values

(though data collected before the 1980’s is minimal or non-existent for some regions) show

unfavorable results, especially when compared to other regions of the world for the same time period. Data from the Africa Development Bank (2012a) shows that GDP growth since 2000 has been relatively robust, with growth rates of 5.6 % for sub-Saharan Africa and 4.5% for North

Africa. Though these growth numbers are impressive, they have had modest impacts in reducing

poverty. Since the independence era of the 1960’s, Africa still remains the poorest continent, and sub-Saharan Africa has seen modest increases in GDP per capita from 1960 to 2012 (Figure 3.1).

With regard to the HDI, 36 of the 44 countries listed in the low development category (below 0.55) are African (UNDP 2015); the remaining sub-Saharan Africa countries are listed in the medium development category with no countries in the high and very high categories. Botswana, with a score of 0.698, is the highest ranked sub-Saharan Africa country on the HDI in the medium development (0.699 – 0.56) category, placing it on par with countries such as Egypt, Palestine,

Indonesia and Paraguay (UNDP 2015).

The available GNP data from the 1960’s suggests that political self-determination and economic growth went hand in hand; between 1960 and 1973, many countries outpaced economic growth figures seen in the first half of the century (Collier & Gunning 1999). During this time,

Africa’s growth was as high as that seen in Asia. Growth staggered, however, in the mid-seventies, and economic growth declined, governments became burdened with debt, and dictatorships spread through the continent. In an effort to become industrialized like their former colonizers, newly independent countries followed a ‘mal-development model’ that was not controlled by the former colonies, furthermore, the model was not adjusted or tailored to local conditions (George 1988

p.14). This industrialization project was ever dependent on outside cash, indicating its

unsustainability. Former colonies were soon burdened with so much debt that financing it became

impossible (George 1988). To address these debt problems, many countries were forced to embark

on Structural Adjustment Programs in the 1980’s and 1990’s, that saw much of the gains from the

1960’s reversed, as poverty rates not seen before independence appeared (Wa Muiu 2008; Collier

& Gunning 1999; Peet & Hartwick 2009). From the 1980’s, GDP per capita declined 1% per annum; so prevalent were these declines that by 2000, 32 African countries were poorer than in

1980 (Collier & Gunning 1999). Overall, sub-Saharan Africa has and continues to lag behind all other regions of the world (Figure 3.1); despite a few shining stars (South Africa, Botswana,

Namibia), the vast majority are struggling.

GDP Per Capita by Region (US$) 12000

10000

8000

6000

4000

2000

0 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2014

East Asia & Pacific South Asia Sub-Saharan Africa

Latin America & Caribbean Middle East & North Africa

Figure 3:1 GDP per capita by region in US$ (Data Source : World Bank 2014a) Africa continues to face many challenges as it seeks to develop, including high

indebtedness, corruption, inability to pursue beneficial trade interests –under the WTO, and poor or nonexistent infrastructure. For many African countries, their total GNP is far less than their total foreign debt. Much of the payments they are able to make goes directly to debt servicing and does not touch the principle (Moyo 2009). In essence, many African countries find themselves in a debt cycle where they are continually forced to borrow in order to repay loans (Moyo 2009). Debt for many countries is simply a short-term Band-Aid solution (Peet & Hartwick 2009).

Ideally, the goal is for African countries to engage in international trade, which will grow their economies, increase GNI per capita, improve their balance of payments, and eventually help reduce poverty. However, Africa’s performance on the trade front has been very dismal until quite

recently. In the 1970’s, Africa accounted for only 2% of global trade. Three decades later, only

modest increases have been realized. Between 1976 and 2006, Africa’s share of global trade fell

from 2.9% to 0.9% (AfDB 2010) but increased to 3.4% in 2008. Today, Africa’s share of global

trade remains under 4% (UN Economic Development in Africa Report (2013)).

Another factor that has made development difficult in sub-Saharan Africa is corruption.

Given the levels of underdevelopment, a political career is the most viable route to wealth and

power. In the west, people enter politics largely because they have financial resources, whereas in

Africa, people go into politics to get rich. The impact that corruption has on African development

cannot be ignored. Examples such as Mobutu Seseseko, who at the time of death had personal

wealth of US$8 billion while his country had a national debt of US$12 billion, highlights the extent to which corruption can cripple a country (Abrokwaa 1999). All the while, the west gives silent

approval as they hold much of this stolen wealth in their banks. As Moyo (2009) notes, for development to take place, African leaders first need to be vested in the development of their countries. Unfortunately, the large amounts of aid fosters more corruption as leaders are no longer accountable to their people but instead are most interested in making a case for poverty, allowing them access to more aid (Moyo 2009).

Historic events, western influence, and poor leadership have steered Africa into its current state of development seen today. In addition, sub-Saharan Africa continues to struggle with a host of problems, including low GDP, poor global trade performance, massive debt, and corruption that compounds the issues of underdevelopment and poverty. It is within this context that the problems

of urbanization and HIV/AIDS exist and affect food security in the sub-continent. Urbanization is

one area where underdevelopment and poverty is clearly exhibited.

3.2 Urbanization

Across the world, there are high rates of urbanization, particularly in Asia and Africa. 2011

saw a major threshold reached where more than 50% of the world’s population lives in cities

compared to a century ago when about 20% lived in cities (UN-HABITAT 2013a). It is expected

that by 2050, about 66% of the world’s population will live in cities (UN DESA 2014a), and, as

the world population increases, it is projected that 93% of this growth will be realised in the cities

of the developing world, i.e. Africa and Asia (UN-HABITAT 2013a). In the 1950’s, the developed world had more urban residents with about 54% (442 million); today, however, about 70% of the

world’s urban residents reside in the developing world (UN-HABITAT 2013a). Between 2010 and

2015, it was estimated that on average 200,000 people per day would be added to cities.

Regionally, North America, and Latin America and the Caribbean are the most urbanized, with

respectively about 82% of their populations living in cities compared to Europe at 73%, Asia at

48% and Africa at 40% (UN DESA 2014a). In raw numbers, Asia is adding the most urban

residents per week with 880,000, followed by Africa with 230,000 and lastly Latin America and

the Caribbean with 150,000 (UN-HABITAT 2013b). By continent, Africa has the highest urbanization rate at 3.55% with Asia not far behind at 2.5% (UN DESA 2014b). Africa is expected to reach its urban tipping point after 2030 while Asia is expected to reach its tipping point around the 2020’s (UN-HABITAT 2013b).

Since the mid 2000’s, sub-Saharan Africa has been the fastest urbanizing continent in the world. Compared to the 1950’s when the sub-continent’s urban population was estimated at 16.1%, by 2000 the urban population had increased to 34.5% and today it stands at 40.9% (UN DESA

2014b). The urban landscape in sub-Saharan Africa is quite unlike most regions of the globe.

Africa today remains the poorest continent and is slated to remain so for many years as its ratio of

the global poor is increasing (Günther & Harttgen 2012): in 1980, one of every ten poor people

globally lived in Africa; by 2000 the ratio had increased to one in three and projections suggest

this ratio will increase to one in two with more poor people living in cities (Cohen 2004b).

Urbanization rates have been over 3.5% annually for countries such as Ethiopia, Kenya, and

Malawi (UN DESA 2014b). Today, Botswana, South Africa and Zambia have over 40% of their populations living in cities (UN DESA 2014b). Despite the levels of poverty on the continent, the urban population is increasing through natural increase, reclassification (the transformation of rural areas into urban areas) and rural-urban migration (Fox 2014). Urbanization rates in sub-

Saharan Africa are so high because most of the population still lives in rural areas. For example,

countries such as Malawi, Uganda and Mozambique have more than 70% of their populations

living in rural areas (UN DESA 2014b). It is projected that 70% of future population increase in

sub-Saharan Africa will take place in urban centers. The sub-continent’s population is expected to

increase to 1.4 billion in 2030 from 639 million in 2000 (UN DESA 2014b).

From a global perspective, urbanization is typically associated with progress,

modernization and an increased standard of living. Social indicators such as literacy, health,

women’s status and social mobility are typically highest in cities. Women’s participation in the

labour market is also typically highest in cities, which are seen as vehicles of economic growth and social advancement (Cohen 2006; UN-HABITAT 2013b). This positive association with urbanization has generally been the case in Europe and North America; Africa, on the other hand, is experiencing high rates of urbanization in the absence of economic development (Kessides 2007;

UN-HABITAT 2013b). In developing countries,

“The proliferation of risks ()… challenge the conventional notion of ‘Cities as the Home of Prosperity’ i.e. where… successful, flourishing or thriving conditions’ prevail… Ill-balanced development notions and polices have meant that,… cities all too often have become places of deprivation, inequality and exclusion” (UN- HABITAT 2013b p.4)

In high and middle-income countries, GDP per capita is ever higher than urbanization (Figure 3.2); in low-income countries, however, urbanization has out-stripped GDP per capita since the 1960’s.

A comparison between similar sized cities in Europe and Africa shows drastically more services available in the European cities (Kessides 2007; UN-HABITAT 2013b). Cohen (2006 p.9) observes:

“The vast majority of African cities are economically marginalized in the new global economy and most […] are growing despite poor macroeconomic performance and without significant direct foreign investment.”

Since Cohens remarks, some African cities have shown improvements in basic infrastructure and communications networks, however, poverty and inequality remains the heart of the problem (UN-

HABITAT 2013a). Given the rate of population increase, city authorities do not have the financial resources to provide infrastructure and services to all city dwellers. As a result, many African governments have policies in place that try to discourage rural-urban migration in an effort to slow the growth of cities (UN-HABITAT 2013b).

Figure 3:2 Trends in urbanization and national GDP per capita for high, mid-high, mid- low and low income country groups from 1960–2015. Series have been indexed to 0.1 in 1960 and the y value shows the percentage change with respect to the base year (Data Source: urbanization UN DESA 2014a; GDP per capita World Bank 2014a) 3.2.2 Reasons for Urbanization in Africa

Historically, urbanization in Africa started toward the end of the colonial period and accelerated during the independence era due to demographic, political and economic factors (Fox

2012). After WW2, mortality rates declined globally –and in Africa- due to advances in medicine, while at the same time, Africa’s birthrate remained high due to cultural preference for large families, resulting in unprecedented population increase (Clapham 2006; Fox 2012). During the 52

independence era, many countries experienced a surge in rural-urban migration as employment opportunities grew with the Africanization and expansion of the civil service, and investment in urban public works; furthermore, the removal of residence restrictions on Africans in urban areas allowed more people to make cities their home (Stren & Halfani 2001; Fox 2012).

During the 1980s and 1990s, Africa experienced drastic falls in economic growth in part

thanks to structural adjustment, which lead to many economies shrinking, resulting in the urban

poor experiencing reduced living standards (Potts 1995). Despite this poor economic performance, urban growth remained high even as real wages dropped drastically, eroding the rural-urban wage

gap and investment in urban infrastructure halted (Potts 1995; Becker & Morrison 1995). Fox

(2012) argues that these high urbanization rates were maintained due to access imports and aid

(particularly food) and continued declines in the mortality rate. Potts (1995; 2005) on the other hand argues that while some countries did experience urban growth during this period, some countries such as Zambia provide evidence of urban contraction with urban residents returning to the rural areas.

Though migration was considered the most common reason for urban population growth, natural increase is now the leading cause of population growth in cities at 60%, while

reclassification accounts for another 20% (UN-HABITAT 2013b). Another factor that increases

city populations is international immigration, though this is seldom considered. With regard to

rural-urban migration, economic incentives most commonly motivate people to move to cities: wages in cities usually tend to be higher than rural areas. Moreover, a move to an urban area can be a household survival strategy designed to reduce risk. As such, the decision is made at the

household level rather than the individual level, spreading risk between different livelihood options

for the household (De Brauw, Mueller & Lee 2014). Cities also draw people in because rural-urban

migrants are expected to see a higher standard of living, and cities tend to afford residents access

to services and opportunities that rural environments cannot provide. Particularly within the

African context, the breakdown of livelihoods in rural areas due to the effects of HIV/AIDS has

also caused people to migrate (Lockwood, Mtika & Mmanga 2005; Devereux 2002b; de Waal &

Whiteside 2003). The drastic reduction of labor due to mortality has seen agricultural productivity

drop, forcing people to look for quick return endeavours to make a living (Crush, Grant & Frayne

2007).

3.2.3 Urbanization and Slums

Migrants who come to the city find themselves in a situation where expectations do not

measure up to reality. Instead of being places of opportunity and prosperity, African cities all too

often are places of deprivation, inequality and exclusion – all symptoms of economic and social crises (UN-HABITAT 2013b; World Bank 2000). It’s not that African cities do not provide

economic and social opportunities, but that firstly there are not enough to go around and secondly, not all residents have equal access to opportunities and resources, which leads to the creation of

slums.

The word ‘slum’ is used to convey various forms of inadequate urban living arrangements

that manifest in many different configurations. Simply put, a slum is a densely populated area

characterized by substandard housing, squalor, and poor access to public and social services (UN-

HABITAT 2003). The housing in question can take the form of simple temporary structures

without basic services (water, sanitation, electricity), or permanent structures with limited or

deteriorated infrastructure (UN-HABITAT 2003). There is no agreement on how slums should be

defined because of the various forms they take globally. However, based on institutions involved

in slum issues, some attributes are reported in the UN issue, The Challenge of Slums (2003 p. 11):

• Lack of basic services, substandard housing or illegal and inadequate building structures

• Overcrowding and high density

• Unhealthy living conditions and hazardous location due to lack of basic services

• Insecure tenure (irregular or informal settlements)

• Poverty and social exclusion

• Minimum settlement size

The living conditions within these slum environments are a far cry from the expectation of an urban existence. The overcrowding, lack of sanitation, and basic services result in higher risk factors, especially regarding health outcomes (Schlein & Kruger 2006). The prevalence of water-

borne diarrheal diseases and gastrointestinal infections in urban sub-Saharan Africa is quite

widespread for reasons that include contaminated water and food, overcrowding, limited access to

water, and poor food and household hygiene (Bradley et al. 1992; Ruel & Garrett 1999). It is

estimated that the urban poor are growing faster than urban dwellers in general. Fox (2014) notes that urban poverty is rising even as rural poverty has begun to decline. The UN approximates that in 2012, 61% of the urban dwellers in sub-Saharan Africa lived in slums compared to 30% in Asia and the Pacific, and 23.5% in Latin America. (UN-HABITAT 2013b). It is expected that urban poverty and slum proliferation will remain a common feature of urbanization in Africa given the inadequacies of urban institutional capacities. Considering that most urban growth is expected to

take place in secondary and smaller cities where urban governance capabilities are lacking, the

slum proliferation is likely to replicate itself (UN-HABITAT 2014).

3.2.4 Urbanization and Gender

With regard to women’s status in the city, certain assumptions are associated with cities as

being places of wealth generation, improved standards of living, and greater access to social and

public services (De Brauw, Mueller & Lee 2014; Cohen 2006; Tacoli 2012). Taken for granted

within these assumptions is that urban women are afforded greater social, economic and political

freedoms; the realities are quite different especially in the developing world where urbanization is largely associated with poverty. Poverty within the urban environment presents gendered

dimensions as it disproportionately burdens household members responsible for unpaid work such

as cooking, cleaning, and care duties as they are forced to juggle paid and unpaid work or lose decision making power because they are not earning a cash income (Tacoli 2012). This juggling act and discussion of power dimension also brings to question the issue of time poverty (Tacoli

2012). As the State of Women in Cities 2012/3 (2013c) reports, considerable evidence shows that many barriers in the urban environment impede women’s empowerment. While women are integral to the success and running of cities, they are typically the last to benefit as many of their offerings are undervalued and unappreciated. Such evidence is seen in gender gaps that are prevalent in the tenure rights, decent work and pay, personal security and safety, and access to and accumulation of assets (UN-HABITAT 2014). It is a moral right and practical imperative that women’s participation in urban society be allowed to reach its full potential if cities are to realise growth and stability (UN-HABITAT 2014).

Outlined in the State of Women in Cities 2012/13 (2013c) are four main reasons why gender should be considered in relation to the prosperity of cities. First, future cities of the developing world will be marked by feminised urban sex ratios particularly in the > 60 and >80 age groups.

As urban centres swell, there is likely to be a high propensity for female-headed households because of the freedoms and independence from patriarchy that earning one’s own money can bring about. Second, because poor households are disproportionally affected in not gaining access to water, accommodation, food, and sanitation, women face greater challenges because of the unpaid work they do within the domestic sphere (care giving, child care, washing, cleaning etc.)

(Tacoli 2012). Third, women’s participation in the labor market is associated with urbanization and has great potential to shape future urban configurations through declining birth rates, increased education and raising aspirations (Chant 2007). Another major consideration is that wealth in the hands of women tends to result in better living standards and outcomes for families and communities. Fourth, there is a lot of evidence to show that urban women are disadvantaged compared to men when trying to access health care, housing and employment. This is particularly the case within slums. If women and cities are to realise their full potential, barriers that impede women need to be addressed.

3.3 Food Security

Despite developments in modernization and better distribution capacities, the dangers of hunger and malnutrition are still present the world over. In 1999, it was estimated that 35,000 people each day died from starvation (Koc 1999). Ten years later, the situation was still horrific, with 25,000 people dying from hunger every day and more than 2 billion people worldwide

suffering from micronutrient malnutrition (FAO 2002). The latest numbers from the FAO (2014)

approximates that globally, about 842 million people suffer malnutrition – down from 1 billion in

(2010). It is estimated that malnutrition rates have dropped 17% since 1990-1992 (FAO, 2013).

The vast majority of the chronically hungry are found in developing countries where there is

considerable regional variation.

The largest numbers of undernourished people are found in Asia (552 million), followed

by Africa (226 million); however, Africa proportionally has the highest prevalence rate at 23.8%

(down from 32.7% in 1990-92) while Asia’s prevalence rate is 13.5% (FAO 2014). The drop in undernourishment in sub-Saharan Africa is a result of improved communications technologies, which has helped overcome traditional infrastructure constraints and promote market integration

(FAO 2014). Additionally, the recent increases in food prices have renewed private investor interest in agriculture, which has been accompanied with public investment (see Figure 3.3) (FAO

2014).

“Food security is achieved, if adequate food (quantity, quality, safety, socio-cultural acceptability) is available and accessible for and satisfactorily utilized by all individuals at all times to live a healthy and happy life” (Gross et al. 2000 p.4). While traditionally, food security has been seen as an issue relegated to rural populations of the developing world (Crush et al. 2011;

Cohen & Garrett 2010), over the past two decades, researchers have been documenting the paradox of malnutrition and obesity occurring at the same time in various geographic locations (Stuckler

& Nestle 2012; Caballero 2005). This occurrence of over- and undernutrition within communities and even households has been referred to by researchers as “dual burden” households (Doak et al.

2005; Garrett & Ruel 2003). Ashe and Sonnino (2013) refer to this change in academic understanding of food security as the new food (in)security era which is characterized by food

insecurity increasingly being seen as an urban issue determined not by availability but instead access to food, and food insecurity becoming more concerned with both the quality and quantity of food. Important food security components include availability, accessibility, and utilization.

Figure 3:3 Undernourished trends: progress made in almost all regions, but at very different rates (FAO & IFAD 2014 p.11)

Sub-Saharan Africa finds itself in a rather precarious situation with regards to food security. Countries such as Zimbabwe that used to be the breadbasket of southern Africa find themselves in a situation where they are no longer able to produce adequate amounts of food to feed their own populations. In fact, since the early 2000’s, after the land redistribution program,

Zimbabwe has become dependent on food aid (Rosen & Shapouri 2008). In 2016, it is expected that southern African countries such as Zimbabwe, Zambia, Malawi and South Africa will be

dependent on food aid due to El Niño which has caused drought across the region (FAO 2016b).

Today, sub-Saharan Africa’s per capita production of basic crops has actually fallen and is no higher now that it was in the 1960’s (Rosen & Shapouri 2008). The situation is only expected to worsen with the projected problems associated with climate change, resulting in persistent and prolonged drought conditions (Gregory, Ingram & Brklacich 2005). Across southern Africa many countries have already experienced more persistent and frequent droughts (Connolly-Boutin &

Smit 2015).

3.3.2 Food Security and Urbanization

Food security within the urban environment has become more precarious in sub-Saharan

Africa since the 1990’s as urbanization rates accelerated, creating poverty concerns in urban areas

(Crush, Grant & Frayne 2007; Cohen & Garrett 2010). It is estimated that annually sub-Saharan

Africa’s urban population increases by 10 million, 7 million of which occurs in the informal sector or slums (UN-HABITAT 2010). The slums created make for poor environments characterized by overcrowding, poor hygiene and a lack of basic services, all of which have negative effects on food security. Slum environments are also characterized by poverty and unemployment.

Since the late 1990’s, interest in urban food security among academics has grown. Early work by authors such as Ruel (1999; 1998), Garrent (1998; 1999), Cohen and Popkin (1997) highlighted the growing challenges of food insecurity within the sub-Saharan African context as more people moved to cities, causing a shift in poverty caused by the issues highlighted in section

3.2 above, where access to food became largely dependent on access to cash, rather making the most productive use of land resources. Research on urban food security was further built on by

other researchers, and AFSUN (African Food Security Network) has been instrumental in

spearheading efforts to provide baseline data on the state of food insecurity in southern Africa,

making it possible to do standardized studies across the region that are easily comparable. The

2008 AFSUN baseline study was a huge undertaking, where surveys were conducted in 11 cities

from 9 different countries, sampling a total of 6,327 households and 28,772 individuals (Crush &

Frayne 2014). Based on the findings from this survey, urban food insecurity in southern Africa is

high with 57% of the households severely food insecure and 19% of household moderately food insecure (see Table 3.1).

Though there is rising concern over food insecurity among the urban poor in developing countries, a similar concern regarding urban food insecurity among policy makers has been slow to emerge (Cohen & Garrett 2010; Crush & Frayne 2014; Crush & Frayne 2011a). While

academics have highlighted the concerns of urban food security, large agencies such as the Food

and Agricultural Organization (FAO), World Bank, and the World Food Program (WFP) that have

highlighted increasing concerns about global food security have largely directed their focus on

rural based solutions. The latest report from the FAO is entitled “The State of Food and Agriculture

Social protection and agriculture: breaking the cycle of rural poverty” (FAO 2016c).

Crush and Frayne (2011a) note that the majority of the solutions to food security in sub-

Saharan Africa are focused on increasing small-holder farmer production and the plight of the rural poor, and argue that the focus on increasing production is rather limited. Referencing Amartya

Sen’s (1981) seminal work – who argues that the problem of food security is not one of production but rather one of access – Crush and Frayne (2011a) indicate that supermarkets in many African cities are bursting with food, while at their doorstep poor people are unable to feed themselves.

“The donor emphasis on increasing production as a response to hunger is limited, since a

substantial part of the problem is that poor people cannot afford to purchase the food they need”

(Bryant 1988 p.11).

Table 3.1: Household Food Insecurity Prevalence in Poor Communities (% of households)

Food Mildly food Moderately Severely food City secure insecure food insecure insecure Windhoek, Namibia 18 5 14 63 Gaborone, Botswana 12 6 19 63 Maseru, Lesotho 5 6 25 65 Maputo, Mozambique 5 9 32 54 Manzini, Swaziland 6 3 13 79 Blantyre, Malawi 34 14 30 21 Lusaka, Zambia 4 3 24 69 Harare, Zimbabwe 2 3 24 72 Cape Town, South Africa 15 5 12 68 Msunduzi, South Africa 7 6 27 60 Johannesburg, South Africa 44 14 15 27

Total 17 7 19 57 Data source: (Frayne, Crush & McLachlan 2014)

The largely singular focus on food security as a rural production issue has meant that urban

food insecurity has not received much need attention in the form of policy-based solutions. Food security in the urban environment is clearly related to money, and access to money is dependent

on a host of other parameters (macro-economic conditions, education, gender, human capital etc.)

(Yamada 1996). Proposing and developing solutions for the urban environment is therefore complicated, which may explain why there is more focus on rural food insecurity. As Bryant

(1988) makes clear, the central key to finding a solution lies in giving the poor purchasing power,

but given the cash-intensive nature of cities, obtaining purchasing power is difficult, increasing the

need to consider other factors that influence food security challenges in the city.

For the urban poor in developing countries, food is typically the single largest item on

which households spend their money. Many of the urban poor in southern Africa and other parts

of the globe spend upwards of 60% of their income on food alone (Tevera & Simelane 2014;

Masvaure 2015; Ivanic & Martin 2008; Ruel & Garrett 1999). As a result, the cash-intensive nature

of cities results in households cutting back on food wherever possible in order to meet their other

basic needs, exacerbating food insecurity (Crush, Grant & Frayne 2007; Cohen & Garrett 2010).

Given these households spend so much on food, they are more vulnerable to food price fluctuations

(Ivanic & Martin 2008), which are very disruptive and a source of social strife, exemplified by

food riots in north Africa prior to the Arab spring (Bargawi 2014; Rosenberg 2011; Cohen &

Garrett 2010).

Urban residents in sub-Saharan Africa have a number of options from where they can

obtain food. These sources include supermarkets, small shops, restaurants, informal markets, street

food, urban agriculture, food remittances and food aid. The reliance on either one of these sources

depends on location. Data from the AFSUN 2008 baseline survey shows that supermarkets, small

shops, and informal food markets –79%, 68%, and 70% respectively– are the more utilized food

sources across the 11 cities surveyed (Frayne et al. 2010). However, when looking at the data for

each of the cities, a different picture emerges for cities such as Lusaka, Maputo and Harare where no more than 30% of participants utilized supermarkets and 98% utilized informal markets (see table 2.1) (Crush & Fayne 2010).

Table 3.2: Source Used by Household to obtain Food (%)

Data Source: (Crush & Fayne 2010)

An alternative to buying food in the urban environment is to grow it; however, one of the

biggest challenges with this strategy for the urban poor is land availability and legal access to it. 64

For many, access to land for food production is limited or non-existent because is it financially

prohibitive (Crush, Grant & Frayne 2007; Ruel & Garrett 1999; Hovorka 2006a). Furthermore,

poor urban residents are also likely to invest less in food production due to insecure land tenure,

potentially resulting in loss of their efforts (Lorenz 2015). Urban agriculture (UA) –the raising of

plants and animals within and around cities (FAO 2016a)- has seen increased activities particularly in poor regions of the world. There remains much debate among academics as to the utility of the practice with regard to food security, nonetheless, it is a coping strategy being utilized by the urban poor as it potentially helps in several ways. As Poulsen et al (2015) outline, UA may provide household with access to highly nutritious and varied foods (especially perishable foods), reduce household expenditures allowing other needs to be met, and provide a stable food supply in situations of variable wages and food prices. Urban residents can also benefit from UA as a livelihood strategy, allowing them to sell surplus food and address other cash intensive needs.

From a gender perspective, UA can benefit women as they typically face challenges attaining employment in the urban environment, allowing them to contribute to their households and undertake child caring duties at the same time (Poulsen et al. 2015; Hovorka 2006a).

Though UA has received much attention in recent years for its actual and potentially positive outcomes, researchers such as Crush et.al (2011) argue that for the urban poor, UA does

not provide significant benefits with regards to reducing food insecurity. Based on their 11 city

survey across the Southern African Development Community (Frayne et al. 2010), the urban poor

mostly relied on supermarkets and the informal sector to access food as 22% of households relied

on UA for their own consumption (Crush & Frayne 2011b; Frayne et al. 2010). However, there

was varying data for each of the cities (see table 3.2). The urban poor are typically not able to

participate in UA because they lack resources. When they are able to participate, their yields are typically low because they cannot afford inputs (Poulsen et al. 2015; Cohen & Garrett 2010). Crush et al’s (2011a) arguments on UA are echoed by Hampwaye (2008), who says the benefits that the urban poor receive from UA have been exaggerated and that the extent of the impact is low.

On the other hand, researchers such as Mkwambisi et al. (2011) argue that UA undertaken by low-income female-headed households in Malawi provides them an insurance against income losses and provides employment. They argue that low-income participants are “receiving significant income from livestock programs” (Mkwambisi, Fraser & Dougill 2011 p.1).

Tawodzera’s (2014) study in Harare, Zimbabwe, found that UA played a significant role with many households –particularly food secure households– allowing them to grow some of their own food. Of all the households in Tawodzera’s study, 66% cultivated field crops while 43.5% cultivated garden crops (Tawodzera 2014). Furthermore, Smart et al’s (2015) study in the

Copperbelt province in Zambia reports that UA has had a significantly positive effect, substantially contributing to food security in the region. Though the debate on UA will continue and probably remain unresolved, the context in which it is practiced will have a large effect on its utility (Poulsen et al. 2015), highlighting the need to avoid seeking overall/generalizable findings or statements

(Riley & Dodson 2014). While UA may not be a panacea to urban food security, it nonetheless will be part of the mix in addressing it.

Another factor that determines urban food security is the existence of formal and informal safety nets. Safety nets are important because they can reduce people’s vulnerability to shocks and challenges. On the whole, poor urban residents tend to benefit more from informal safety nets based on kinship ties rather than formal safety nets which are not existent in all locations and in

many cases are unable to reach all in need (Crush & Fayne 2010). Theoretically, urban dwellers should have better access to formal safety nets compared to rural populations because (i) they are more densely populated hence easier to reach than rural populations, and (ii) urban populations have greater access to the authorities and as such can more easily petition them for services (Ruel

& Garrett 1999). While social programs can be effective in addressing food security challenges, such programs face difficulty being financially sustainable, targeting the right people, and being a band aid solution that never deals with the core problem (Cohen & Garrett 2010). Limited data exists on the effectiveness of formal safety nets through programs and activities such as community food kitchens, food aid, and school feeding programs. Tevera and Simelane’s (2014) study in Manzini, Swaziland found that only 16% of households in their study were able to utilize community kitchens. Their study found that even fewer households (0.6%) obtained access to food aid for which Swaziland receives large amounts annually, reflecting a rural bias in the distribution of food aid (Tevera & Simelane 2014). Data from the AFSUN baseline survey shows that food aid and community kitchens were not a significant food source (see table 3.2) (Crush & Fayne 2010).

Formal assistance programs in urban areas tend to be more targeted; for example this includes food assistance for orphans and their care givers who have suffered the effects of HIV/AIDS, nutritional assistance programs for HIV/AIDS patients taking drugs, and school lunch programs that do not specifically target food insecure households, but ensure that children have access to a balanced meal (Tevera & Simelane 2014).

The nature and extent of informal safety nets for urban residents is also important, giving residents alternative avenues to pursue during difficult times. Informal networks are based on social capital. Strong informal networks lead to reciprocity, social trust, communication, amplifies

reputations, reduces incentives for opportunism and creates a template for future collaborations

(Ruel et al, 1999). In urban environments, informal safety nets may be diminished because of a

looser sense of community, and urban violence can reduce trust in communities where there are

no kin ties, especially for new arrivals (Cohen & Garrett 2010; Ruel & Garrett 1999). Nonetheless,

there is evidence from the literature that informal safety nets play a significant role in the form of

food remittances from rural areas, shared meals with neighbours and friends, and borrowing food

(Tawodzera 2014; Andersson 2011; Frayne et al. 2010). By far the most important informal safety

net strategy is food remittances. Based on data from the 2008 AFSUN baseline survey, dependence

on food remittances varied widely among the 11 cities, from a high of 72% in Windhoek, Namibia

to a low of 14% in Cape Town, South Africa (Crush & Frayne 2014). Other cities with high

dependence on food remittances include Gaberone at 70%, Manzinia at 53%, and Maseru at 49%

(Crush & Frayne 2014).

As populations switch to an urban lifestyle, a transition takes place with regard to food and

nutrition as women and household members are pulled away from household activities and join

the work force. The result is an increased intake of both processed and pre-cooked food

(particularly street food). Processed and street foods are advantageous to city dwellers as they save

time and are cheaper per capita in the short term for small families when taking into consideration

time, fuel costs for cooking and food transportation (Ruel & Garrett 1999; Rane 2011). Street foods also provide income opportunities for entrepreneurs in cities where unemployment tends to be high. Street food consumption varies widely across countries and cities. In Nigeria poor urban residents spend half of their food budget on street food, while in Accra, Ghana they spend 40% on

street food (Cohen & Garrett 2010). Street foods also provide the advantage of avoiding waste of

leftovers where there is no refrigeration (Ruel & Garrett 1999).

For all the advantages of street food, it raises some nutritional concerns since it tends to be

high in fat, sugar and has higher levels of contamination (Ruel & Garrett 1999; Crush & Fayne

2010). An FAO study (1990) found that even though the pathogens found in street food were

similar to foods prepared indoors, the microbial loads were higher. People who patronize street

food venders are likely to report suffering from food borne diseases such as diarrhea, cholera, typhoid, and food poisoning (Drechsel et al. 2008; Gulyani & Bassett 2007; Rane 2011).

Contamination is particularly a threat in urban slums where a lack of basic access to potable water, sanitation and disposal of waste services (Cohen 2004a), easily lead to food and water contamination. Other factors that lead to food contamination include improper food handling, chemical and microbial contaminants, improper storage temperature and reheating of food, and poor personal hygiene (Rane 2011). Street food is believed to be responsible for the high prevalence of diarrheal and gastrointestinal infection.

The transition to diets high in refined sugar and fats is not only a phenomenon found in street food but a reflection of the urban environment. In the 1960’s studies showed a direct linear relationship between an increase in GNP and consumption of refined sugars and fat in developed countries (Perisee, Sizaret & Francois 1969). For developing countries today, the high consumption of refined sugars, carbohydrates, and fat is not necessarily associated with an increase in GNP but with urbanization (Drewnowski & Popkin 1997; Caballero 2002). These changes to urban diets present nutritional and health concerns for the future as non-communicable chronic diseases that include obesity, cardiovascular disease and diabetes are becoming more common in

developing countries, challenging the notion that these diseases are only associated with affluence

(FAO/WHO 2003; Popkin 2015; Popkin, Adair & Ng 2012). Health concerns such as obesity and

diabetes have become more pressing in the developing world, exacerbated by changes in lifestyle

activities as urban jobs typically entail less physical activity (Popkin & Doak 1998; Popkin, Adair

& Ng 2012).

3.3.3 Food Security and Gender

Given that acquiring food is not simply determined by the presence/availability of food,

other societal dimensions –e.g. age and class– influence the discussion of food security. Gender

relations is one such dimension that plays a critical role in determining and understanding food

security. The FAO (2016c) reports that women having greater control over household spending

results in increased expenditures on items such as food and nutrition, health, and education. Studies

by Gwagwa (1998) and De Bon (2010) have shown that women’s access to resources is a greater

determinant of a household’s food and nutritional status than men’s resources. Unfortunately,

women typically occupy less privileged positions in society (Kevane 2014; UN-HABITAT 2014;

Hovorka 2006a), curtailing their ability to positively influence household food security (Dodson,

Chiweza & Riley 2012).

Women’s lesser status in society is the result of both institutionalized marginalization and cultural norms that see them (women) excluded from male-dominated occupations, limits their self-determination, restricts their command over community and household resources, saddles them with burdens of reproductive labor, all the while privileging the needs of men and boys over those of women and girls (Dodson, Chiweza & Riley 2012; Visvanathan et al. 1997; Hovorka

2006a). Taken together, these discriminatory practices towards women restricts their earning

capacity and livelihood options, limiting the positive impact they can have on household food

security, especially given that much of the activities around production, acquisition and

preparation of food in sub-Saharan Africa falls within the domain of women’s work (Mapetla &

Schlyter 1998). In rural and urban areas the vast majority of subsistence agriculture is undertaken by women (Ngwira, Bota & Loevinsohn 2001; Hovorka 2006a), while men typically participate

in labour activities for a cash income (Barnett & Whiteside 2006; Dodson, Chiweza & Riley 2012).

In cities, women’s day-to-day activities typically center on acquiring and preparing food for their

households (Gwagwa 1998; Riley & Dodson 2014). In fact, this gender expectation is so ingrained

in parts of Zambia that men will not admit to food preparation even when there are no women in

their households (Schlyter 1998).

Within the context of sub-Saharan Africa and the developing world, gender has drastic

implications on urban food security given that many households in cities are headed by women or

women are the primary breadwinners (UN-HABITAT 2013c). As highlighted in section 3.2.3, as

the urban population grows, more households are headed by women, and there have been studies

showing links between poverty and female headed households (Goebel, Dodson & Hill 2010; UN-

HABITAT 2013c). However, the implied association between female-headed households and food

security have been challenged by other studies (Mallick & Rafi 2010; Dodson, Chiweza & Riley

2012). Dodson et al (2012) notes that women’s lower status and income earning does not

necessarily translate to more food insecurity given that food is typically a higher priority and more

of their money is spent on food. However, such households are more likely to experience shocks

when prices rise or earning ability is affected (Dodson, Chiweza & Riley 2012).

Gender relations within the household have a large impact on food and nutritional status.

Ideally, men and women would work together taking on different livelihood roles and income generating opportunities to spread risk and enhance food security (Dodson, Chiweza & Riley

2012); however, household members can engage in activities that erode trust and partnership, negatively affecting food security. Gwagwa’s (1998) study in Durban, South Africa, found that income retention (hoarding of income) is a typical practice among men. This retained income is then spent on items or activities that only benefit the hoarder; due to this, increases in men’s incomes tend to benefit only themselves compared to women, whose increases in income benefit the entire household.

While there has been debate about UA and its impact of household food security, studies have shown that UA can be used by women as a means to support families on a daily basis, reduce the impact of poverty, and as a means of social and economic empowerment (Hovorka 2006a;

Hovorka 2006b; Hovorka 2005). Considering the marginalized status of women, UA is an activity they can often exploit because it is typically peripheral and ignored, raising concerns about formalizing it, as this could see women lose their access and control over the practice (Hovorka

2006a). At the same time, UA affords women to ability to juggle multiple roles as urban farmers

–subsistence, production, environmental management- and care-giving roles such as caring for children (Crush, Hovorka & Tevera 2010).

The reduced status of women in society directly affects household food security, as such, a discussion of food security without gender produces an incomplete picture and limits the utility of any understanding gained.

3.4 HIV/AIDS

Globally, the HIV/AIDS epidemic has been stabilizing with fewer new infections occurring on a yearly basis between 2008 and 2014, thanks to sustained and strategic implementation of scientific knowledge, political commitment and civil society engagement (UNAIDS 2016a). This has lead UNAIDS and its partners to adopt new targets for the eradication of HIV/AIDS, which include the 90-90-90 treatment target for 2020. The goal for this objective is for 90% of all people living with HIV to know their status, 90% of all people with diagnosed HIV infection receive sustained antiretroviral therapy, and for 90% of all people receiving antiretroviral therapy to have viral suppression (UNAIDS 2014a). In addition to these new targets, supplementary efforts are being made to accelerate prevention of new infections and the elimination of stigma and discrimination (UNAIDS 2014a). These ambitious targets are expected to be achieved through a new sustainable development agenda, investment in science, innovative solutions, national and local leadership, and strong political commitment (UNAIDS 2016a; UNAIDS 2016b).

Epidemiological data from 2014 shows that the rate of new HIV infections fell by 42%, from 3.5 million at their peak in 1996 to 2 million in 2014 (UNAIDS 2009; UNAIDS 2014b). The epidemic still disproportionately affects sub-Saharan Africa, where 68% of all the infections occur

(UNAIDS 2013; UNAIDS 2014b). The only regions where HIV/AIDS prevalence is increasing are Eastern Europe, Central Asia, and Asia and the Pacific (UNAIDS 2013; UNAIDS 2009).

Between 2011 and 2014, the Middle East and North Africa have seen steady numbers regarding new infections (UNAIDS 2014b). In 2012, there were 1.6 million AIDS related deaths globally;

2014 saw 1.2 million deaths, down from 2.3 million in 2005 (UNAIDS 2013; UNAIDS 2014b).

One of the reasons for the falling mortality rates is the increased access HIV/AIDS patients

have to Antiretrovirals (ART’s) (Beard, Feeley & Rosen 2009; UNAIDS 2013). Access to ART’s

increased to 47% in 2014 compared to 7% in 2003 (UNAIDS 2009; UNAIDS 2014b), mostly in eastern and southern Africa, which have the highest prevalence and poverty rates. The 2013

UNAIDS report estimates that 5.5 million deaths were avoided in low-income countries because

of improved access to ART’s. In 2014 alone, 900,000 (1.2 million globally) deaths in sub-Saharan

Africa were avoided (UNAIDS 2014b). Beard et al (2009) highlight the improvements in patients’

physical, emotional and mental health as they are better able to perform daily functions. There has

also been increased access to drugs that prevent mother-to-child transmission (MCT) of HIV.

Access to these drugs rose from 10% in 2004 to 88% in southern and east Africa, and to 42% in west and central Africa in 2014 (UNAIDS 2009; UNAIDS 2014b). As a result, the number of

children dying from AIDS-related causes fell from 320,000 in 2005 to 150,000 deaths in 2014

(UNAIDS 2013; UNAIDS 2014b).

Though the sub-Saharan Africa numbers are stabilizing, they are unfortunately stabilizing

at high levels (UNAIDS 2009). The improved access to drugs has increased HIV/AIDS prevalence,

as more people are living longer due to the fall in AIDS-related deaths in multiple countries

(UNAIDS 2009). This trend is highlighted by the fact that sub-Saharan Africa has 68% of all new

infections among adults, 91% of all new infections among children, and 71% of the world’s AIDS

related deaths (UNAIDS 2013). These statistics are in stark contrast to the fact that sub-Saharan

Africa only has 10% of the world’s population (Barnett & Whiteside 2006). Stabilization of the

epidemic at these levels means that HIV/AIDS will continue to be a major problem for years to

come.

HIV/AIDS has only acted to create new problems or accentuate existing ones in sub-

Saharan Africa. Increased premature mortality due to HIV/AIDS has resulted in an increasing dependency ratio (Crush, Grant & Frayne 2007; Topouzis 1999). HIV/AIDS largely affects the

15-49 years demographic group, which is the productive backbone of all societies (Couderc &

Ventelou 2005). In Zimbabwe, life expectancy fell to 34 years in 2003 compared to 52 years in

1990 (Barnett & Whiteside 2006). For countries such as Botswana, Malawi, Mozambique and

Zambia, life expectancy in the early 2000’s fell below 40 years (Barnett & Whiteside 2006), however, in these countries it has now increased to at least 55 years (UN DESA 2015). The elimination of the 15-49 age group creates dependent demographic groups such as children and old people who are taking on roles traditionally not theirs (Sheung-Tak Cheng & Siankam 2009), thus creating child-headed and skipped generation households (Baker & Mutchler 2010). In the process, as elderly people bury their adult children, they are losing their safety nets (Barnett &

Whiteside 2006).

Within sub-Saharan Africa, the difficulty in fighting the epidemic is a reflection of the poverty and underdevelopment present even before the arrival of the disease. Since HIV/AIDS is primarily a health concern, fighting it requires a healthcare system with suitable infrastructure to distribute treatment and information (Haacker 2002). However, the health infrastructure in Africa is poor and in some cases, for example in Zimbabwe, it is crumbling rather than expanding

(Chikanda 2007). Health budgets that were unable to meet their nations’ healthcare needs before

HIV/AIDS became a critical issue. HIV/AIDS has only further compounded the problem by filling hospitals with patients they are unable to treat (Chikanda 2007). Poverty forces people to migrate, putting them at higher risk of getting infected, as migrants tend to have higher infection rates

(Crush, Grant & Frayne 2007; UNAIDS 2016a). Furthermore, poverty pushes people into

commercial sex work, which increases risk of infection and promotes spread of the disease (Barnett

& Whiteside 2006; UNAIDS 2016b). The systemic structures of poverty make people prone to

engage in risky behaviour in an effort to make a living. Many studies have cited an attitude toward

death being the same regardless of whether it comes from HIV/AIDS, cholera, or starvation

(Cornish & Campbell 2009). For those caught in poverty’s jaw, the long-term threat of HIV/AIDS

is overlooked in light of more immediate short term concerns.

The major difference between HIV/AIDS and other challenges such as drought or

corruption, is that HIV/AIDS leads to permanent changes and reorganization of society (Topouzis

1999; Barnett & Whiteside 2006). Households, communities and societies cannot really recover

from the erosion of social and human capital resulting from HIV/AIDS related mortality (Mtika

2001a). With drought, it will eventually rain again. With HIV/AIDS though, the shock waves and

disturbances affect future generations. What education outcomes can be expected from a

generation where there is high absenteeism by students because they have to participate in

household chores due to family illness or mortality (Chitiyo & Chitiyo 2009)? On the flip side,

how can students learn when there is high absenteeism from teachers due to illness, or worse still,

no teachers because of premature mortality (Chitiyo & Chitiyo 2009)?

A clear way by which HIV/AIDS is reorganizing society is through the loss of social capital that insulates households from challenges and is necessary to give them an opportunity to get back on their feet. In many African societies, reciprocity is an important characteristic that holds communities together (Mtika 2001a). As documented by Mtika (2001a), the initial stage of challenges brought on by HIV/AIDS increases solidarity within communities. This solidarity leads

to social immunity, where the community comes together to help those affected, keeping community ties strong. However, Mtika (2001) documents that in time, social immunity begins to decline for two reasons. First, affected households have little chance to return to the normalcy that prevailed before the onset of the epidemic; as a result, their continual need for assistance puts too much pressure on the community. At the same time, the affected household is not able to give help to others, which acts to weaken social immunity. Second, the high prevalence rate of HIV/AIDS leaves almost no one untouched by the disease. This being the case, community members in time are forced to focus on their own immediate needs. Mtika (2001) documents how help to extended families begins to disappear as households focus on needs closer to home.

The above erosion of social capital results in the loss of extended family, which plays important traditional roles in raising children (Baker & Mutchler 2010). Limited resources in new configurations of households mean that children are less likely to receive adequate support, gain opportunities to stop the cycle of poverty, and prevent risk factors for contracting HIV/AIDS that may see them go the way of the lost generation (Barnett & Whiteside 2006), particularly female children (Türmen 2003).

3.4.1 Gender and HIV/AIDS

HIV/AIDS disproportionately affects women more than men. From 2004 to 2008,

HIV/AIDS prevalence among women rose from 57% to 60% (UNAIDS 2009). Young women and girls are also (particularly!) at higher risk of infection. In Kenya, this risk is three times greater for girls within the 15-19 years age group and five times higher in the 20-24 years age group (UNAIDS

2009). Gouws et al.’s (2008) study finds that for most countries in southern Africa, infection rates for young women aged 15-24 were on average three times higher compared to men of the same

age. HIV/AIDS prevalence rates also peak between 30 -34 for women but in the late 30’s – 40’s for men (UNAIDS 2009).

Women are at a higher risk of infection for a number of different reasons that include physiological, cultural and socio-economic factors. Physiologically, women are two to four times more at risk than men for contracting HIV during unprotected vaginal intercourse (Topouzis 1999;

UNAIDS 2009). Male-to-female transmission of HIV is more efficient because semen has a higher concentration of the virus than women’s secretions, and women have greater surface area (mucosa) where they are exposed to their partner’s secretions (UNAIDS 1998). Their physiology puts women in a rather precarious situation given the importance of fertility in African culture – the ability to bear children is part of the women’s identity and worth to the family into which they are married (Gwagwa 1998).

Socio-culturally, women again are at higher risk of infection mostly because of their lack of self-ownership, which “refers to whether a person owns her or his body and has control over her or his actions” (Kevane 2014 p.17). Women are not always able to decide with whom and when they have sex. The concept of marital rape has no cultural basis in southern Africa. A study in Lesotho found that 47% of men and 40% of women believed that a woman could not deny their husband or boyfriend sex (Andersson et al. 2007). Studies also found that women in monogamous relationships are not more protected from infection for two reasons: women are unable to negotiate abstinence or contraception, and women cannot stop their spouses/boyfriends from having other sexual partners (Barnett & Whiteside 2006; Topouzis 1999). The 2009 UN report on HIV/AIDS notes that it is culturally accepted that men have multiple partners (UNAIDS 2009). Colvin (2000)

argues that 60-80% of African women infected with HIV were in monogamous relationships where they were not able to negotiate safe sex or stop their husband’s sexual escapades.

The bride price is another means through which women have limited self-ownership. This bride price transfers the rights of a woman from her father to her husband as compensation for her lost labour (Kaler 2006). This tradition evokes a notion of the wife belonging to her husband because of the financial sacrifice/investment made. Culturally, she then becomes part of her husband’s family and so are any offspring from the marriage (Kaler 2006; Topouzis 1999).

Therefore, if the wife ever decides to leave her husband, she does so without her children, who are part of his family. This unfortunately becomes a barrier to women leaving, even in the face of a cheating husband who could infect her with HIV (Topouzis 1999).

The use of unsterilized instruments during male and female circumcision is another risk factor for the spread of HIV. Circumcision itself, however, has very different outcomes with regard to transmission of the disease during intercourse. For women, circumcision increases the risk of

transmission through increased exposure of sensitive tissue that comes into contact with semen

(Hrdy 1987). For men the opposite is true, as removal of the foreskin reduces the surface area of

sensitive tissue that comes in contact with women’s secretions (Bailey, Plummer & Moses 2001).

Epidemiological data shows that circumcised men have lower HIV prevalence rates compared to

uncircumcised men (UNAIDS 2009). In Kenya for example, uncircumcised men are three times

more likely to be infected compared with circumcised men (UNAIDS 2009). For this reason, researchers have argued that circumcision is one of the best strategies to fight the disease given the low appeal for condom use (Watkins 2011). Countries such as Botswana, Kenya and Namibia

are scaling up their circumcision programs (UNAIDS 2009). Botswana aimed to have 80% of males between 0-49 years circumcised by 2013 (UNAIDS 2009).

Another important set of factors to consider with regards to women’s risk of infection are socio-economic factors. A correlation exists between women’s education, employment opportunities, access to information, social inequalities and their risk of contracting HIV/AIDS

(Türmen 2003). Women’s poor status in sub-Saharan Africa results in them having limited ability to make decisions for themselves. Poverty and the inability to pursue adequate livelihood strategies can leave women with no other option but to provide sexual services as a coping strategy either for income, favours or in-kind gifts (Crush, Grant & Frayne 2007; Topouzis 1999). Performing sexual services as a livelihood strategy is a reflection of women’s poor socio-economic standing and a last resort in many cases. The long-term threat of premature mortality from HIV/AIDS is ignored in light of day-to-day survival needs (Topouzis 1999; Crush, Grant & Frayne 2007).

Topouzis (1999) quotes a government official in Kenya saying the following “When there is drought, you can have a girl for a loaf of bread” (Topouzis 1999 p.17).

The importance of women`s socio-economic status is further brought to light when one considers the inability of households to cope after the death of a male breadwinner. Given the importance of women`s access to resources and the welfare outcomes of households (Topouzis

1999; de Bon, Parrot & Moustier 2010; Gwagwa 1998), the ability for women to inherit and maintain access to resources is paramount.

3.4.2 HIV/AIDS and Urbanization

The links between urbanization and HIV/AIDS are well established in the literature. On the whole, urban environments have higher infection rates compared to rural areas (Crush, Grant

& Frayne 2007). Migration to urban areas facilitates the spread of the disease to rural areas because

migrants spend time in either locale depending on the time of year. There also tends to be a higher infection rate among migrants compared to other segments of the population (Crush, Grant &

Frayne 2007) who typically migrate to urban environments. However, when urban dwellers fall sick, they typically return to their rural homes to be cared for (Mtika 2001b). This return not only takes the disease into the rural areas, but puts more pressure on human resources by the addition

of a mouth to feed with no increase in labour. Furthermore, the need to care for the infected

individual in either the rural or urban environment takes resources away from income generating

or productive activities (Grant & Parpart 2010).

3.4.3 HIV/AIDS and Food Security

The effects that HIV/AIDS has on food security are realized through a reduction in labour

quality and quantity, a reduction in income, and increases in expenditures (for medicine and

transport to clinics for example) (Topouzis 1999). However, there is a more fundamental

relationship between HIV/AIDS and food security: i.e. nutrition. Once an individual is infected

with HIV, attacks to the immune system by the virus requires that good nutrition is maintained to

slow wasting of the body and progression of the disease (Ivers et al. 2009). To maintain health,

increased intakes of up to 50% more protein and 16% more carbohydrates are required (WHO

2005). Ironically, at the same time, the body is less able to absorb nutrients (Ivers et al. 2009).

Nutrition is also important if the infected person is taking medication because it makes the treatment more effective (Mamlin et al. 2009). As such, many recommend that treatment be accompanied with nutritional assistance (Ivers et al. 2009; Mamlin et al. 2009). In the absence of medication, the infected individual will in time experience more severe symptoms that will prevent

them from participating in income-generating or productive activities. Such symptoms include

diarrhea, weakness, vomiting and opportunistic conditions such as tuberculosis (Ivers et al. 2009).

Access to nutrition varies between rural and urban environments; in general, the nutritional status in rural areas is determined by agricultural production, whereas money determines access to

nutrition in urban areas.

As mentioned earlier, HIV/AIDS is changing the demographic structure of societies such

that the physically productive portion of the demographic profile is being eliminated. With regards

to agriculture, this change happens in two ways. First, infected individuals are unable or only

sparingly able to participate in food production activities (Barnett & Whiteside 2006), thereby increasing the workload for the rest of the household while they remain a mouth to feed. Second,

care for the infected person will lead to labour being pulled away from food production (Grant &

Parpart 2010; Mtika 2001b). Labour is therefore split between caring for the sick in addition to

other livelihood duties. Care for the sick diverts attention away from food production, increasing

the risk for food insecurity (Grant & Parpart 2010; Mtika 2001b).

Because of the reduced labour available for food production, households are forced to find

alternative means of providing enough food. Households begin to employ strategies that cut labour

demands, such as growing crops that are less labour intensive (Crush, Grant & Frayne 2007; Cohen

& Garrett 2010). In rural areas, many communities when faced with such situations tend to switch

from cultivation of maize to cassava, which is less nutritious (Barnett & Whiteside 2006). While

this strategy addresses the labour concerns, it results in the production of food that is less nutritious

and has lower caloric value (Ngwira, Bota & Loevinsohn 2001). The need to save labour can also

result in households neglecting other farming activities important to good yields. Such activities

include mulching, weeding and ploughing (Mtika 2001b), and failure to do these activities can also increase the risk for food insecurity through poor harvests.

A household attacked by HIV/AIDS will likely have more than just one individual affected

(Topouzis 1999). The terminal nature of the disease, especially if untreated, will see a switch in perspective to more short-term concerns. As a result, activities like farming that give long-term pay outs are likely to be abandoned for activities that give a quicker return, such as hustling or illegal activity (Ngwira, Bota & Loevinsohn 2001; Mtika 2001b; Cohen & Garrett 2010). As such, people are more prone to migrate to cities or other countries in search of opportunities that give a quicker return. The switching of activities and early mortality and morbidity results in poor transfer of agricultural skills and knowledge to the next generation (Topouzis 1999; Mtika 2001b). This early departure puts the next generation in jeopardy as they have not the skills or know-how to successfully transition into heads of the next generation (Barnett & Whiteside 2006; de Waal &

Whiteside 2003), which in turn propagates food insecurity to the next generation because they are unable to make use of the assets and resources left behind.

In the urban environment, once a household member begins to suffer from HIV/AIDS, this will lead to absenteeism that will result in reductions or disappearance of income (Bollinger &

Stover 1999). The lost income will therefore result in more pressure on other household members to provide. Because of the need to care for the sick, this can lead to other household members being pulled away from income generating or livelihood activities (Grant & Parpart 2010; Crush,

Grant & Frayne 2007; de Waal & Whiteside 2003). The loss of income makes a huge impact on food security because urban residents tend to spend the majority of their income on food. For urban residents, the ability to earn an income is a determinant of food security.

For both urban and rural households, the effects of HIV/AIDS go well beyond affecting the individual’s health and affect the entire household’s income situation and children’s education.

Due to pressures placed on the household, children are likely to be pulled out of school, not only to care for the sick, but because money is no longer available to cover their tuition costs (Grant &

Parpart 2010; Barnett & Whiteside 2006). In such scenarios, girl children will be pulled out of school before boys (Grant & Parpart 2010; Topouzis 1999). Pulling children out of school will have long-term negative effects such as continuing the cycle of poverty into the next generation.

3.5 Conclusion: Research Opportunity

As previously noted, many of the problems found in sub-Saharan Africa are intertwined, and one problem is based on or largely influenced by another precursor problem. The problem of urban food security in Lilongwe is no exception, and as such, it is important that food security concerns in Lilongwe be studied within the context of the multiple influencing factors that apply: namely HIV/AIDS, poverty, gender and urbanization (Figure 3.3)

While the effects of food insecurity are clear in the rural environment, more research is needed on the dynamics of food security within the urban context. Urban food security is rooted in poverty and the lack of amenities or infrastructure, which translates primarily to an issue of access. These problems are compounded by the effects of the HIV/AIDS epidemic, which indirectly impedes people’s access to food by disrupting livelihoods, crippling communities, and making it difficult for people to get by (Figure 3.4). Moreover, central to understating these disruptions is the need to consider gender because of the disproportionate effects experienced by the sexes: once there is HIV infection (regardless of the sex), women are particularly affected because of the burden of care and the need to provide food for the household (Figure 3.4).

Figure 3:4 Links between Urbanization, Food Insecurity, HIV/AIDS and Gender (Source: adapted from Crush et al. (2007 p.42))

Urban food security research has received more attention in recent years with some of the studies highlighted above. While the studies undertaken by the AFSUN group are important, there remain numerous cities where further research needs to be undertaken, especially given the variance found among different cities in the regional survey by AFSUN. While studies on urban food security have been conducted in Malawi, none have been conducted in Lilongwe with a particular focus on

slums, gender and HIV/AIDS creating an opportunity to do pertinent research aimed at addressing a pressing issue expected to be even more challenging in the future.

Chapter Four: Geography of Malawi and Introduction to study sites

4.1 Geography of Malawi

In the summer of 2012, I travelled to Lilongwe, Malawi, to collect data for my research.

Malawi is a small narrow, landlocked country located in south-eastern Africa, bordered by

Mozambique, Tanzania and Zambia (Figure 4.1), Malawi’s total area is 118,484 km2, slightly smaller than the combined area of New Brunswick and Nova Scotia, and about the size of

Pennsylvania. Malawi is shaped by the Rift Valley in east Africa and is largely dominated by Lake

Malawi, which makes up one third of the country’s area. Lake Malawi is over 750 km long and up to 80 km wide in some sections. The northern part of Malawi is mountainous on the western edge, which leads eastward to the Nyika plateau and sloping forested areas. The central region is mostly agricultural and is where the capital city Lilongwe is located. The southern region of the country is mostly low-lying and densely populated. Mount Mulanje stands out in the southern region, reaching a peak of 3000 meters. Malawi has a tropical climate that experiences three seasons: a cool, dry season from April to August, a warm dry season from September to November, and a rainy season from December to April. My field work mostly coincided with the cool dry and warm dry seasons (May to November).

Socially, Malawi is comprised of many different ethnic groups, which include the Nyanga,

Tumbuka, Yao, Lomwe and Chewa. Most of these ethnic groups are typically found in specific parts of the country with the exception of the Chewa, who are widespread. The country is mainly made up of Christians, accounting for 75% of the population, while Muslims account for 20%

(Commonwealth 2014). The remaining 5% is comprised of African religious beliefs, Hindus, Jews,

Rastafarians and Atheists (Commonwealth 2014).

Figure 4:1: Map of Malawi Administrative Districts (Data Source Hijmans et al. 2004; Software ESRI 2011) 88

English is widely spoken throughout the country thanks to a primary enrollment rate of

97%. Malawi has a population of over 15 million and a life expectancy of 55 years

(Commonwealth 2014). Life expectancy has increased in recent years in large part due to reduced mortality from HIV/AIDS. Other diseases that are common in Malawi include malaria, dysentery, bilharzias, measles and tuberculosis. The infant mortality rate in 2014 was 45 per 1000 live births compared to Zambia, Mozambique, and Tanzania at 45, 59 and 36 per 1000 live births respectively

(World Bank 2014c).

Malawi remains one of the poorest countries in the world with a gross national income per capita of US$320 and a human development index of 0.445; it ranks 173 out of 187 countries on the HDI (UNDP 2015). Malawi’s economy is largely based on agricultural commodities, which include tobacco, cotton, sugar and tea; this dependence resulted in negative or minimal economic growth in some years due to low global prices. Malawi went through structural reforms in the late

80’s and 90’s in an effort to bring economic stability. In the late 2000’s, under President Bingu wa

Mutharika, Malawi experienced dramatic increases in economic growth (Figure 4:2). Economic decline between 2009 and 2012 was a result of a number of factors, including the 2008 global financial crisis that resulted in reductions of official development assistance, foreign direct investment, and remittances. Furthermore, fluctuating international prices (tea, coffee, tobacco) resulted in poor terms of trade (AfDB 2012b). Malawi also experienced economic decline due to drought from 2009 to 2011, resulting in poor harvests that affected the export sector. In addition,

Malawi has seen reduced donor budget support since 2011 due to policy non-compliance under the IMF Enhanced Credit Facility and the ‘Cashgate’ scandal (AfDB 2013; The Economist 2014;

Africa Research Bulletin 2014). 89

Malawi Real Growth in GDP 2002-2013 10 9 8 7 6 5 4 3 GDP growth (annual %) (annual GDP growth 2 1 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Figure 4:2: Malawi Real Growth in GDP 2002-2013 (Data Source: World Bank 2014b) Malawi acquired its independence from Britain in 1964 when Dr. Hastings Kamuzu

Banda led the Malawi Congress Party (MCP) electoral victory (Pachai 1973; Wills 1985). After

eliminating political rivals in the early years of his presidency, Malawi became a one party state

in 1971 when Banda was sworn in as life president (Pachai 1973).

Life in Banda’s Malawi saw its ups and downs economically. Overall, the 1970’s were

successful as Banda implemented macroeconomic policies based on import substitution in order

to unshackle its dependence on Britain (Wills 1985). A lot of investment was pumped into

manufacturing, infrastructure and agriculture. Most of these activities were done through

government organizations and parastatals that included the Agricultural Development and

Marketing Corporation, the Capital Development Corporation, and the Malawi Development

Corporation (Harrigan 2008). The 1980’s, however, brought an economic downturn to Malawi,

mainly due to rising oil prices in the early 80’s and a drop in global commodity prices. Malawi 90

also suffered greatly from the civil war in Mozambique, which blocked Malawi’s trade routes

(most of their import and exports went through the Beira port in Mozambique) (Wills 1985).

Malawi also faced added pressure to assist refugees from Mozambique (Harrigan 2008). By the late 1980’s the economy was in dire straits and needed assistance; this forced the country to turn to the International Monetary Fund (IMF) and the World Bank, leading to a series of Structural

Adjustment Programs (Harrigan 2003).

The involvement of the IMF and World Bank, coupled with the donor community, led to calls for political reforms that would make way for multi-party democracy. For decades, Banda had been able to quell local calls for democracy mostly through intimidation and fear (Wills 1985).

Once the donor community started to cut funding in order to force Banda’s hand, he had no choice but to concede (Chilowa 1998). A referendum on multi-party democracy won with 64% of the vote, allowing changes to be made to the constitution and paving the way for multi-party elections.

In 1994, Malawi held its first truly democratic elections, which were won by Bakili Muluzi

(Harrigan 2003).

The Muluzi presidency was marred with a number of scandals that ranged from corruption, misappropriation of funds, and mismanagement of the country’s strategic grain reserve

(Harrigan 2008; GRAIN 2010). Before the end of his second term, Muluzi attempted to amend the constitution to allow him a third term. Under widespread protest and resistance he failed. He handpicked his successor, Bingu wa Mutharika, who won the 2004 election campaign. Overall,

Mutharika is considered to have had a successful presidency. During his first term in office much of the country’s resources were steered towards agricultural growth, especially for smallholder farmers through the Farm Input Subsidy Program (Chisanga 2007). Under his watch, the number 91

of people living under the poverty line dropped 11 percentage points (UN-HABITAT et al. 2012).

During Mutharika’s second term, there were bursts of protest and outrage over increasing food and

fuel prices. Mutharika suddenly died two years before the completion of his second term and was

succeeded by Vice-president Joyce Banda. But Joyce Banda, Malawi’s first female president, was

unable to win the 2014 presidential elections and was succeeded by Bingu wa Mutharika’s younger

brother Peter Mutharika.

The multi-party democracy era in Malawi is best described by Malawians as ‘political gymnastics.’ With the exception of Muluzi, every president that came to power formed their own political party or changed parties, though transition of power between presidents always took place smoothly for the most part. Malawi today is drastically different from the one party era, but it remains one of the poorest countries in Africa.

4.2 Malawi and Food Security

Food insecurity in Malawi has been a persistent theme for decades. Going as far back as the

1949/50 growing season, Malawi has experienced drought almost once every decade. In 1949/50,

Malawi saw a famine that led to many deaths and widespread malnutrition (no estimates given)

(Vaughan 1985). In 1979/80, Malawi saw another drought and again in 1991/92, when the country experienced a famine that affected the entire region, resulting in major drops in agricultural production and thousands of deaths (Hajdu et al. 2009). Yet again, famine struck between 2002

and 2005. During this period, maize production fell by 30%, causing maize prices to increase by

more than 300 % (Devereux 2002b; Devereux 2002a). Unlike the previous famines, the 2002-2005

famine was caused not only by climatic factors – drought and floods – but also by socio-cultural

and macro-economic factors (Hajdu et al. 2009). Palamuleni et al (2003) argue that at the 92

household level, HIV/AIDS became the single largest contributor to food insecurity –as referred

to by Mtika (2001) in section 3.4.3. GRAIN (2010) (a small international non-profit organization) argues that the 2002-2005 famine was a “human-made disaster” because the country’s strategic grain reserve was sold off due to pressure from the donor community. Following this famine, the

Malawi government under Bingu wa Mutharika embarked on a subsidy program that many researchers and donors eventually hailed as the ‘Malawi Miracle’ (Sachs 2012), and is proclaimed as a blueprint to create a new green revolution in Africa (Javdani 2012).

A persistent theme of Malawi’s agricultural sector and another cause of the 2002-2005 famine are the various changes and U-turns of policy over the past three decades (see

Table 4.1). Prior to the 1970’s, the Malawi agricultural sector was biased toward estates that produced cash crops, such as burley tobacco, tea and sugar. This bias came at the expense of smallholder farmers who were expected to produce surpluses of staple crops such as maize (Kydd

& Christiansen 1982). This policy proved to be unsustainable as trade fell by more than 35%, the country saw a drought in 1979/80, and the civil war in Mozambique disrupted trade routes

(Harrigan 2003). Harrigan (2003) states:

“The strategy had intensified the concentration of the country’s export base in tobacco, making the country highly vulnerable to exogenous shocks, created a highly import dependent estate sector, and marginalized smallholders leading to food and foreign exchange shortages” (p.849).

The economic problems of the late 1970’s saw Malawi turn to the IMF –lead to Malawi embarking on Structural adjustment see George (1988) section 3.1.2. Central to the relationship between the IMF and the Malawi government are differing notions of food independence (self- sufficiency) and what role, if any, government should play. Dealings between Malawi and the IMF resulted in four distinct phases. 93

The period from 1981 to 1987 was characterized by traditional IMF neo-liberal market-

oriented and state minimalist policies, as shown in

Table 4.1. These policies were implemented through the vehicle of structural and sectoral adjustment loans (Harrigan 2003).

Table 4.1: Malawi Agricultural Reforms and Programs 1970-2013 (adapted from Harrigan 2008) Period Program/Activity Affected/Beneficiaries Results/Consequences 1970-1980’s State Control over Benefited estate and well Continual of Colonial agriculture inputs, off farmers, marginalised policies subsidised 20-60% the poor 1981-1987 Structural Adjustment, Small holder farmers Increased cash crop state minimalist increase in cash crop exports, reduced policies, removal of production displacing supply of maize, 50% subsidies and market maize, reduced increase in maize cost manipulation to profitability of maize. encourage cash crop Subsistence farmers production heavily affected 1987-1994 ADMARC increases 1.3 million given seeds Economic smallholder maize and fertilisers. 1992 stratification, maize prices and reintroduces drought affects 5-7 production down subsidies. USAID million relative to tobacco funds transition from maize to tobacco 1997-2005 Return of market 2002 famine results in Increase in cash crop oriented state largest maize production production among minimalist policies: drop in decades, millions smallholder farmers at removal of subsidies, affected the expense of maize, sale of strategic grain the poor and reserve, incentives for subsistence farmers cash crop production negatively affected. 2005-2013 Farm Input Subsidy Smallholder and National level food Program. Subsidies subsistence farmers security achieved, reintroduced for seed increase maize maize surpluses and fertilizer production. exported. Program cost high and impedes other important economic development programs

Specifically, the Malawi Agricultural Development and Marketing Corporation (ADMARC)

sought to increase smallholder farmers’ exportable production of cash crops – i.e. tobacco, cotton

and groundnuts – by increasing their prices. To better encourage production of export crops, maize

prices were kept the same in order to make them relatively less lucrative. To aid in cutting the

government’s budget deficit, fertilizer subsidies were removed.

Despite a short honeymoon period, the general consensus is that these policies were

“inappropriate and poorly sequenced” (Chilowa 1998; Harrigan 2001; Harrigan 2003, p. 849).

While export cash crop production increased, maize production fell and its profitability was drastically reduced with the removal of fertilizer subsidies. Export cash crops had displaced the production of maize, reducing the per-capita production of the staple crop. By 1987, a food crisis had developed, especially among subsistence farmers who were overlooked by the IMF’s pricing policies. Missing were non-price reform policies (Chilowa 1998). As a result, maize prices increased by 50% consecutively between 1985-1986 and 1986-1987 (the increase in poverty referred to in section 3.1.2 after structural adjustment) (Harrigan 2003).

Herein came the differing opinions between the Malawi government and the IMF. For the

Malawi government, the displacement of maize production by cash crops was causing food insecurity. The IMF, on the other hand, argued that food security could be achieved by using foreign exchange earnings from cash crops to import food (Chilowa 1998). The Malawi government differed with this viewpoint because they equated food security with self-sufficiency.

The failures of Structural and Sectoral reforms saw a reversal of IMF policies that ushered in a second phase of policy reforms from 1987 to 1994 (see

Table 4.1). By the late 1980s, the Post-Washington consensus1 moved away from the

neoliberal, market friendly approach and placed sustainable, egalitarian democratic development

at the heart of the agenda acknowledged that agrarian sectors within low-income countries had

certain constraints that price market-based reforms were unable to tackle (Lele 1990; Harrigan

2003); as such, these constraints could be overcome through the interaction of the public sector

and the market paving the way toward development. President Banda, facing mounting criticism,

went on to implement policies that were in clear defiance of IMF neo-liberal market oriented and

state minimalism. In mid-1987, Banda increased ADMARC’s smallholder prices for maize by

36% and re-introduced fertilizer subsidies at 22%, higher than the pre-reform period (Harrigan

2003). The focus now was to improve crop productivity among resource-poor farmers and to

release land for cash crops without jeopardizing food production (Chilowa 1998).

The second phase of Malawi’s involvement with the IMF saw an improvement in maize

production, growth of the agricultural sector (with the exception of estate agriculture), and growth

of real GDP (Harrigan 2001). In 1991 alone, smallholder agriculture grew by 15.8% (Harrigan

2001). At this point, the IMF began to see input subsidies as a good use of government money,

until development constraints were addressed to allow the country to use foreign exchange

earnings to purchase food shortfalls. Unfortunately, the recovery was short-lived due to the

following: the 1992/94 drought, an increased influx of refugees from Mozambique, and a

1 “While the Washington consensus made economic growth the main goal of development, the new consensus moves away from the neo-liberal, market-friendly approach and places sustainable, egalitarian and democratic development at the heart of the agenda. It includes a more poverty-focused approach that protects and supports the poor and prioritizes social spending on education and health” (WHO 2016 p.1) 96

suspension of humanitarian aid due to President Banda’s suppression of democracy (Chilowa

1998; Harrigan 2003).

The departure of President Banda (age 96) in 1994 saw the return of humanitarian aid and

coincided with the end of the drought. Agricultural productivity among smallholder farmers began

to increase by 43% and 41% in 1995 and 1996 respectively (Harrigan 2001). The smallholder farmers’ proportion of total tobacco production increased to 70% in 1998 compared to 12.8% in

1990 (Government of Malawi 1999a; Government of Malawi 1999b). Despite the agricultural growth, differences in future directions emerged between the donor community and the IMF on

one side, and the Malawi government on the other, which saw the beginning of the third phase in

the late 1990’s. By 1997, the IMF’s views on Malawi’s sectoral reform made a return to the dogma

of market mechanisms and state minimalism of the 1980’s (see

Table 4.1). The differing views on food security and self-sufficiency re-emerged. The IMF alleged the Malawi government was mistaken to view increased maize production as food security

(Chilowa 1998). The donor community shared this view as they called to question the need for a

strategic grain reserve, stating instead that the focus be on imports and the maintenance of a fiscal reserve (Harrigan 2003). Regarding fertilizer, the donor community also reverted, pressuring the

government to remove subsides, which it did in 1997 (Harrigan 2003).

The reversals of policy by the IMF again lead to problems concerning food security,

particularly considering the 2002-2005 famine. Mkandawiri (1999) argues that the expansion of

tobacco cultivation came at the expense of maize production. With the IMF returning to its 1980’s

views of pushing cash crops and reducing subsidies, maize production again became unattractive.

Harrigan (2003) raises important questions here: does it matter if tobacco cultivation is done at the

expense of maize? And what is the expansion of tobacco cultivation through expansion of smallholder farmers doing for poverty alleviation? The literature on Malawi regarding this issue agrees that liberalization and the production of cash crops largely benefited smallholder farmers

but not the majority of the poor (Chilowa 1998; Smith 1999).

Following the 2002-2005 famine, Bingu wa Mutharika came to power and his statement:

“Enough is enough. I am not going to go on my knees to beg for food. Let us grow the food

ourselves” (quoted in GRAIN 2010, p. 2) best describes his government’s approach to dealing

with food security. Under Mutharika’s leadership, Malawi embarked on a Farm Input Subsidy

Program (FISP) in 2005. The goal of the program was to eliminate widespread hunger within the

country by providing subsidized chemical fertilizers and hybrid speeds to smallholder farmers,

whose poor productivity was attributed to poor soil fertility (Javdani 2012). Following introduction

of the FISP, and good rains, record harvests were recorded in 2006 and 2007. Malawi went from

having a maize shortage of 43% in 2005 to having a 53% surplus in 2007, which enabled maize to

be exported to Zimbabwe (Denning et al. 2009).

Malawi faced stiff objection to the FISP from the donor community, citing concerns

regarding the cost of the program and lack of a clear exist strategy (Denning et al. 2009). Major

donors such as the IMF and USAID argued that the FISP would create market distortions, therefore

impeding growth of the private sector (Chisanga 2007). The donor community had previously

funded the Starter Pack program from 1998 to 2000 that provided small amounts of chemical

fertilizer and hybrid seed to farmers, while at the same time stimulating the private seed and

fertilizer sector (Denning et al. 2009; GRAIN 2010). The Starter Pack program, however, did not

last long because of poor targeting and operational weakness (Denning et al. 2009). Furthermore,

GRAIN (2010) argues that donor activates were squarely focused on enabling the private sector

within a given time frame, regardless of the effect this had on smallholder farmers. Despite

resistance from the donor community, the Malawi government pushed forward using discretionary

funds and logistical support from the United Nations to source and import fertilizer (Denning et

al. 2009). Celia Dugger of the New York Times describes Malawi’s actions as “follow[ing] what

the West practices, not what it preaches” (quoted in Javdani 2012, p. 105). After the clear success

of the FISP at the national level, the donor community began to speak favorably about the program

and even provided support on the condition that strategies be incorporated to strengthen and ensure

participation of the private sector (Denning et al. 2009; GRAIN 2010).

Despite Malawi being able to produce enough food at the national level to meet its

requirements, researchers such as Javdani (2012) argue that the FISP has failed to ensure food

security at the household and individual level and only further reinforces pre-existing inequality, which leaves the poor unable to benefit from the program. Concern regarding the cost of the program – which between 2005 and 2010 varied annually from US$51 million to US$265 million

– relative to its inability to achieve national household food security has garnered scrutiny

(Mazunda 2013). Of particular concern is the opportunity cost of the FISP, which has resulted in

budget cuts in other agricultural and economic sectors such as irrigation, agricultural research,

physical planning, scientific and technological services, and transport and communication services

(Mazunda 2013; GRAIN 2010).

Malawi has indeed been able to produce maize surpluses since the inception of the FISP

(Figure 4:3), however, many millions are still dependent on food aid that flows into the country,

even as exports are sent to neighbouring countries (Denning et al. 2009; GRAIN 2010; Ellis &

Manda 2012). More importantly, to achieve food security for the majority of Malawians, three

limitations need to be addressed: access to land, reliance on costly imported inputs, and the impact

of these inputs on long-term soil fertility (GRAIN 2010). Clearly, the ability for Malawi to produce

enough food to meet its needs is a step in the right direction. The next step is how access and

inequality can be addressed to ensure food security at the household and individual level.

Annual Maize Production and Dietary Supply Adequacy 1992-2014 4000 115

3500 110 Averagedietary supply adequacy (%) 105 3000 100 2500 95 2000 90 1500 85 1000 80

500 75 Average Maize Production (1000 tonnes) (1000 Production Maize Average 0 70

Figure 4:3: Malawi Annual Maize Production and Dietary supply adequacy 1992-2014 (Source: FAOSTAT (2015))

4.3 Malawi and HIV/AIDS

Similar to most countries in sub-Saharan Africa, Malawi has been drastically affected by the HIV/AIDS epidemic –discussed in section 3.4. It is estimated that at least one third of the 15-

59 year age group has been lost to the disease (Floyd et al. 2010). Approximately 1.1 million adult

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Malawians are HIV positive (10 % of the population) (UNAIDS 2014c). Surveys referenced by

the UNAIDS global report find that certain countries, including Malawi, Ghana, Kenya and

Tanzania, have higher infection rates in the wealthier segments of the population (Mishra et al.

2007). The findings are surprising since one would expect wealthier segments of the population to

be more informed about the disease; however, their wealth can provide them access to more sexual

partners. The HIV prevalence rate among men who have sex with men in Malawi is much higher,

at 17.3% down from 21.4% in 2009 (UNAIDS 2009; UNAIDS 2014b). The high prevalence rate

within this population segment is supported by low rates of condom use and application of petroleum-based lubricants, which can lead to condom failure (Baral et al. 2009). Homosexual activity in Malawi is greatly stigmatized, such that engaging in homosexual acts is a crime punishable by death (BBC 2009).

HIV/AIDS has greatly affected food security in Malawi. The Malawi situation ties into de

Waal’s (2003) notion of a New Variant famine, which is seen in parts of sub-Saharan Africa due to the immense societal pressures of HIV/AIDS –see Mtika (2001), and Barnett and Whiteside

(2006) discussed in section 3.4.3. de Waal hypothesizes that the HIV/AIDS epidemic drastically reduces the ability of households at large to sustainably meet their food production needs due to the additional costs that HIV/AIDS places on them. In such a situation, the sick are no longer able to provide their labor in food production, but they still remain a mouth to feed. Furthermore, the infected pull resources away from food and productive activities as the need for care, medicine and nutritious food increases. The added costs to the household/community brought on by

HIV/AIDS makes them more vulnerable and less able to deal with livelihood activities.

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The added societal pressures that HIV/AIDS puts on a society-at-large are quite evident given Devereux’s (2002b; 2002a) assertion that the effects of the 1991/92 famine were not as bad as the 2002 famine, yet the 1991/92 famine saw larger falls in agricultural production. Devereux’s argument denotes an erosion of human and social capital (section 3.4.3) directly related to the

HIV/AIDS epidemic. A similar assertion is made by Mtika (2001a) who compares the 1949 famine to the 2002 famine. Mtika (2001a) finds that the 2002 famine saw higher levels of vulnerability and fewer social and community resources for people to fall back on, with the loss of social capital in light of the famine.

Evidence from studies in Northern Malawi find that anti-retroviral therapy (ART) is greatly reducing adult mortality rates among HIV infected groups, particularly when started in the early stages of the disease (Floyd et al. 2010). ART programs that give the poor access to these vital drugs can greatly reduce both the short and long-term effects of the disease. Floyd et al’s

2010 study finds high and consistent participation rates in ART programs, with a 16% drop in mortality during the first phase and a 32% drop in the second phase. Such findings reinforce the need to make ART treatment more widely available in poor regions of the world.

4.4 Malawi and Urbanization

In 2006, the UN named Malawi the fastest urbanizing country in the world (Chamley

2006) and in 2010, Malawi’s urbanization rate was approximately 4.7% (UN-HABITAT et al.

2012). With a population of 15 million plus, only 15.3% of the country’s population is urban

(Manda 2013). Malawi’s four major cities – Lilongwe, Blantyre, Mzuzu and Zomba – account for

77% of the urban population (UN-HABITAT et al. 2012). Malawi has seen accelerated urbanization since the 1970’s (Table 4.2). Much of this urbanization has been spurred by

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development initiatives instituted after independence, which drew people to the cities looking for

opportunities (Potts 2006a). Furthermore, since the country’s population is still mostly rural,

urbanization rates tend to be higher as people migrate (similar to countries discussed in section

3.2). Urban poverty is a huge feature of urbanization in Malawi, with 68% of residents residing in unplanned settlements/slums that have poor access to basic urban services (UN-HABITAT et al.

2012). The prevalence of slums is exhibited in the majority of housing stock being traditional and semi-permanent, as only 21% of the housing stock is permanent. The urban poverty rate in Malawi stood at 17% in 2012 down from 25% in 2004, however, rates trended upwards between 2007 and

2009, increasing from 11% to 14% (UN-HABITAT et al. 2012; Manda 2013; NSO 2015).

Variation can be seen among different cities, with Lilongwe reporting an urban poverty rate of

22%, Zomba 16%, Mzuzu 16% and Blantyre 8% (Manda 2013). Since 1990, the percentage of urban residents living in unplanned settlements and slums has dropped by 27%; but this hides the fact that there are more people living in slums/unplanned settlements. In 2001, Malawi had 1.5 million slum residents, which increased to over 2 million (12.5% of the total population) in 2012.

(UN-HABITAT et al. 2012).

The main urban centres in Malawi are characterized by large numbers of residents living in unplanned settlements because of poor planning, difficult access to land for housing, and a lack of resources. Housing providers such as the Malawi Housing Cooperation are unable to meet the demand for housing because of red tape and limited resources, which forces eager home owners to find opportunities in unplanned settlements.

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Table 4.2: National and Urban Trends in Malawi Year Population Mean Urban Mean Urbanization Mean Annual Population Urban Level (% of Rural Growth Annual National Annual Rate (%) Growth Population in Growth (%) Urban Areas) Rate (%)

1966 4,039,583 3.3 209.327 6.76 5.21 2.32 1977 5,547,460 2.9 466,081 6.63 8.4 2.97 1987 7,988,507 3.7 850,000 7.83 10.7 4.94 1998 9,933,868 2 1,400,000 4.7 14.4 2.63 2008 13,077,160 2.8 2,003,309 5.2 15.3 2.18 2015 16,310,431 3.15 4,048,000 5.32 22.5 1.84 2020 19,104,275 3.17 5,240,000 5.16 25.5 1.52 2030 26,090,975 3.06 8,395,000 4.54 32.4 1.17 Data Source : UN-HABITAT et al. 2012

For all major cities in Malawi, access to basic urban services such as water, sanitation,

electricity and waste removal is a challenge (as it is for many cities in the developing world –see

section 3.2). Though planned settlements have adequate infrastructure for delivery of urban

services, many times they face service interruptions. Water and electricity cuts often occur daily

and sometimes multiple times a day (Manda 2013). As expected, the unplanned settlements and slums lack the basic infrastructure, making service delivery difficult or non-existent.

Collaborations between NGO’s, community organizations, and government have resulted in the

installation of infrastructure to allow some slum residents access to potable water and proper

sanitation. Most residents in slums access potable water through water kiosks, which has

drastically reduced the frequency of cholera outbreaks. Though some slums/unplanned areas have

seen noteworthy improvements in access to potable water and proper sanitation, there has been a

reduction in access to potable water in urban areas. In 2007, urban access to potable water was

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98%; in 2009 it dropped to 94% (UN-HABITAT et al. 2012). As with the planned settlements,

slums also face widespread service disruption.

Lilongwe is now the largest city in Malawi and has the fastest urbanization rate (4.3%)

(UN-HABITAT et al. 2011b). Blantyre – the financial capital of Malawi – is the second largest

city with a population of 661,265 (Table 4.3). For a long time, Blantyre was the largest city until

all government offices were moved to Lilongwe in 2005 (UN-HABITAT et al. 2011a). Lilongwe’s

growth accelerated in 1971 when President Banda decided to move the capital from Zomba to

Lilongwe (Potts 2006a). Though the move was not supported by the donor community, it did bring

much needed development to the area. Lilongwe’s population swelled from 22,000 in 1971 to

699,021 in 2012 (Chamley 2006; UN-HABITAT et al. 2011b). The four major cities in Malawi have at least 60% of their population living in slums/unplanned settlements (Table 4.3) and with high urbanization rates, slums will remain a constant feature for some time. Of note is that the building of illegal structures is not only restricted to residential buildings. In the case of Lilongwe, the Lilongwe National AIDS Commission building was built on government land without proper permitting (Chamley 2006), which highlights the poor state of governance and planning at the municipality level.

In an effort to address the concern of slums/unplanned settlements, Municipal governments in the four major cities have embarked on a National Participatory Slum Upgrading

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Table 4.3: Population and urbanization in Malawi’s Major Cities City Population Urbanization Rate % Unplanned and Slums Lilongwe 669,021 4.3% 76% Blantyre 661,256 2.8% 65% Mzuzu 133,968 4.2% 60% Zomba 88,314 3.0% 60% Data Source: UN-HABITAT (2012)

Program along with the Centre for Community Organization and Development and the Malawi

Homeless Peoples Federation. The agreed priorities of the project are (UN-HABITAT et al. 2012,

p. 16):

• Managing the National Housing Framework

• Providing adequate housing for all and improving public housing services

• Creating an environment in the housing sector that is conducive to both public and

private investment and development

• Supporting and promoting urban poor initiatives in various thematic areas that impact

their livelihoods

• Mobilizing the poor to work together and address their challenges together

• Influencing and contributing towards policy formulation for urban poor issues

• Intensifying debt or rent collection management

• Capacity building for key departments and stakeholders

In the past, civil governments in Malawi have attempted to curb the expansion of illegal structures by using measures such as removal of illegal structures on land destined for commercial development. However, outcry over these planned evictions gained traction in the media after

Zimbabwe’s controversial slum clearance program (Operation Murambatsvina Potts 2006b) and 106

the planned evictions did not take place. The government has, however, gone forward with measures to better plan the city and provide residents with better living conditions (Chamley 2006).

Some of Lilongwe’s unplanned settlements and slums such as Baghdad, Dubai,

Mtandire, Chinsapo, and Mgona are located both in the city and in peri-urban areas. Although urbanites have traditionally been seen as distinct from rural populations, researchers such as Potts

(2006a) document circular migration where throughout the year, populations float between rural and urban settings depending on different productive activities (also see Englund 2002; Hajdu et al. 2009; Frayne 2005). Andersson (2011) addresses the concept of livelihoods existing along a rural-urban continuum. For many urbanites, rural populations play an important part in food security as they receive food remittances. Andersson (2011) notes the importance that rural maize remittances play in the livelihood of urban residents. In addition, data from the AFSUN baseline survey highlight the importance of food remittances as a source of food (Frayne et al. 2010).

As a capital city, Lilongwe lacks the gravitas one would expect from the nation’s capital.

Established as a colonial administrative center in 1906 due to its strategic location, Lilongwe had been a fishing village for centuries prior along the banks of the Lilongwe River (Pachai 1973).

Substantial growth of Lilongwe began to take place after it became the capital in 1971 (Potts

2006a). Lilongwe’s surrounding area was in need of economic development and as the government offices began to relocate, the much needed development and infrastructure followed. Lilongwe is divided into 4 main sectors, Capital Hill, Kanengo, Lumbadzi and Old Town (UN-HABITAT et al. 2011b). Capital Hill is the newest and modern looking part of the city, while old town is very busy and exhibits the hustle and bustle that many residents partake in to make a living.

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Lilongwe is located in the central region of Malawi, which is a rich agricultural area. As such, tobacco processing and sales is one of the city’s largest industries. Other important industries include grain storage, food processing, construction, banking, finance, transportation and tourism.

Regardless of these activities, Government and Public Institutions dominate the city’s economy, employing about 27% of formal employees in the city (UN-HABITAT et al. 2011b). The private sector employs 40% of formal workers while the informal sector employs 27% of the city (UN-

HABITAT et al. 2011b). The city’s main sources of revenue include property rates (97%), market fees, licencing fees, parking fees, and plan application and scrutiny fees (3%) (UN-HABITAT et al. 2011b). From 2003-2012 the manner in which these fees were allocated by the city could not be verified since no audit of the city’s finances had been done. In addition, while the city is now run by elected councillors, between 2005 and 2014 the city ran without councillors until 2015, when elections were held (UN-HABITAT et al. 2011b; Chilundu 2015).

While the population of the city has continued to grow, development, infrastructure and economic growth have not been able to keep up. As such, 76% of the city’s residents live in informal settlements that lack basic services and urban and social infrastructure as described above. The houses are of poor quality and are vulnerable to risks such as fire and floods. The vast majority of Lilongwe residents rely on pit latrines, as the sewage system only covers 9% of the city (UN-HABITAT et al. 2011b). In addition, the vast majority of residents do not have access to solid waste removal.

The Lilongwe slums of Kauma and Mgona – where data for this study were collected –

are emblematic of the characteristics described above. The major difference between these sites is

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location, Kauma being peri-urban while Mgona is in an industrial zone. The attributes of these

study sites are further discussed below.

4.5 Introduction of research sites: Kauma and Mgona

4.5.1 Kauma

Kauma is situated on the eastern outskirts of Lilongwe and became part of Lilongwe

through reclassification. Prior to the mid-1990s, Kauma was classified as a rural area, however, as

Lilongwe grew and Kauma’s population increased, it soon became a community for new arrivals.

Kauma has an estimated population of over 50,000, divided into 12 villages with a total area of

3.0561 km2(Figure 4.4).Next to Kauma are two other settlements – CCDC and Durban- that

technically are separate from Kauma but are functionally part of the same area. Kauma is run by

the group village Chief Nkumbu and 12 village heads. The villages of Kauma are as follows:

Khoswe, Kumalambo, Kanyangw'a Nchokere, Kauma, Nkhumbo, Mwesambala, Tsoka, Kamkota,

Kachiundo, Maganga, Kainga, and Kalenga. All village heads are appointed by Chief Nkumbu.

On the eastern edge of Kauma is a sewage treatment plant for the city of Lilongwe (Figure 4:4).

Though it is an eyesore and produces foul smells, Kauma residents and others use it as a fertilizer resource. The housing stock in Kauma ranges from permanent baked brick and plastered middle- income housing to traditional temporary mud walled housing. The majority of the poor’s housing is built with mud bricks that notoriously wash away during heavy rains, which took place recently in January of 2015 (Malawi Nyasa Times 2015).

Prior to 1973, Kauma was a fairly stable rural community with low influx of new migrants.

As Lilongwe grew, some high-income suburbs were built close to Kauma, providing opportunities

for employment for maids, garden workers and security guards. Chief Nkumbu credits much of 109

the population increase in Kauma to his ascension to chief as he actively accepted newcomers and

still does so today.

CCDC was created in the late 1970’s by Chief Nkumbu when a flower company by the

same name vacated and left its employees stranded (he did not know what CCDC stood for). The

Durban settlement was created in 2004 with the support of President Bakili Muluzi and Member

of Parliament Mary Banda. Chief Nkumbu says the settlement was illegally established because

of political conflicts. In an effort to appease his supporters; President Muluzi gave his youth league

land that residents of Kauma were using for agriculture.

In 2007, Chief Nkumbu was forced to demarcate Kauma into several different villages for

administration purposes. According to new regulations from the government, a village head was

required for every 30 households. Not all 12 villages of Kauma were created by Chief Nkumbu

but instead, as Kauma grew, it absorbed surrounding villages. Villages that existent before the

growth of Kauma include Kumalambo, Tsoka, and Kalenga. As the population of Kauma grew, so

did Kumalambo and Kalenga. When Kauma was demarcated, these villages kept their names.

At present, there are no immediate pressures of eviction from the city; however, the village of Mwesambala, which is situated close to a new high-income suburb in Area 52, has been informed that they need to upgrade their households to make them look more presentable (Figure

4:5). If this upgrade is not done, there may be plans to evict or relocate residents from the area.

Before my departure, I visited Mwesambala and found a long trench. The residents informed me that the city was putting up a wall to divide the village from Area 52. Chief Nkumbu informed me that city officials may want to use the area of Kauma in the future for other purposes, which may

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require moving some residents, however, they will be compensated; expansion or upgrades to the sewage system could be a possible reason for moving people.

Figure 4:4: Map of Kauma (Sortware ESRI 2011; Basemap source ESRI 2015) Kauma, like many other slums in Lilongwe, has water kiosks where residents are able to buy potable water from the Lilongwe Water Authority. These water kiosks were installed to provide people access to clean water, which has reduced the propensity for cholera outbreaks. The funding for the kiosks was provided by the European Union, installed through Training Support for Partners (a local NGO), and facilitated by the municipal government. Unfortunately, not all 111

villages in Kauma have easy access to potable water. Small villages such as Mwesambala do not have a water kiosk and they still use a nearby stream to get water.

Figure 4:5: Mwesambala village on edge of area 52 (Photo credit: Tatenda Mambo) In Koswe village, a water kiosk was built, but often does not work because of low water pressure; the higher terrain in the region makes it difficult for the water to make it up the hill. Other development initiatives in Kauma come in the form of money for work programs; many of these programs are provided by the Malawi Social Action Fund (MASAF). A number of the MASAF projects have included activities such as tree planting, roadwork and digging of trenches for laying pipes. Through these projects, municipal government and the traditional authorities are able to get some infrastructure built and provide residents with financial resources. However, during my six months in Lilongwe, there had been talk of a MASF project in Kauma but it never materialized.

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4.5.2 Mgona

Through multiple interviews with the chiefs and residents of Mgona, I was able to piece together its history and settlement pattern. Mgona is an unplanned settlement located in Lilongwe’s

Kanengo industrial zone. Mgona is divided into four areas for administration purposes, Mgona A through D, and has a total area of 0.67 km2 (Figure 4.6). Mgona has an estimated population of over 50,000 residents; the 2008 census, which did not include Mgona D, measured a population of 47,000 according to the chiefs. With the inclusion of Mgona D and the continual population growth, the population is now well over 50,000. Mgona is located on land owned by the Railway

Company of Malawi. Railway tracks actually go right through the settlement, separating Mgona

D from the other settlements (Figure 4:6).

Prior to the 1970’s, a small village existed at this location. The area was named Mgona for the chief of that village. The first sign of commercial use of this land came in the 1970’s, when a brick manufacturing company contracted by the government set up operations. Prior to the brick company’s activities, a large number of village residents were relocated by the government to

Dowa and Salima - small towns south east of Lilongwe. The few who remained were employed by the company to make bricks. Company housing was built for these residents, which attracted those who had left and others to come to the area; this led to a sharp population increase in the area.

By the time the brick company’s operations had come to an end in 1989, the settlement had grown much larger in size as residents were able to get employment with other companies in the industrial area. Ownership of the land was then transferred to the Railway Company of Malawi, which constructed a rail line connecting the industrial area to the national rail network. Due to the 113

settlement’s close proximity to the tracks, a number of accidents forced the railway company to send out evictions notices to the residents of Mgona in 1995. The residents resisted eviction and negotiated a settlement through the traditional authority, allowing them temporary status on the condition they would not cross north of the railway tracks (Figure 4.6).

Figure 4:6: Map of Mgona (Software ESRI 2011; Basemap source ESRI 2015) By 2005, Mgona A, B and C were severely overcrowded; the burial site for the area, located in Mgona B, was full and the city allowed a new burial site to be opened north of the rail tracks. Not long after, residents from Mgona A, B and C started forming a settlement across the tracks. This settlement eventually became Mgona D. Zoned as an industrial area, the city had sold 114

the land north of the tracks to a company. When the company tried to take over the land, Mgona

D residents protested and destroyed one of the company’s vehicles. Twenty three Mgona D residents were arrested and eviction notices were sent to the remaining Mgona D residents.

Officially through the traditional authority, a negotiated settlement was reached that allowed the residents to stay and care for the burial site until it was full. After that time, they would then be expected to leave. Some residents I spoke to in Mgona D said there were mixed messages from the city, as some city officials were taking bribes from residents to allow new structures to be settled, while other city officials wanted the residents gone. One of the chiefs expressed feelings of being used by city officials and politicians, for they acknowledged their existence during elections and cholera outbreaks, but when they approached officials for development and infrastructure, they were told Mgona is not in their plans since it is a temporary settlement.

As some Mgona residents do well, they are able to move out of the area to find better housing, creating openings for new rural migrants in search of cheap housing. Some residents who do well, however, choose to stay, opting instead to upgrade their homes by building more permanent structures and even connecting to the electricity grid. There exists a wide spectrum of living conditions in Mgona; two houses may be close to each other, but the qualities of life within those homes can be drastically different. These differences are shown in the description of my research participants taken from both Kauma and Mgona.

4.6 Description of Research Participants

A total of 47 participants in Kauma and 50 participants in Mgona took part in this study. I interviewed all participants in their respective neighborhoods, and included both women and men in an effort to understand both sides of the gender perspective. I interviewed 35 women and 12 115

men in Kauma, and 39 women and 11 men in Mgona. In both case studies, the majority of the participants were below 50 years old; the average age of participants in Kauma was 39 years old and 34 years old for participants in Mgona. Mgona participants were in a younger cohort, with

70% under the age of 40 (Figure 4.7).

50%

40%

30%

20% % of % Participants 10%

0% 18-29 30-39 40-49 50-59 60> Age Group

Kauma Mgona

Figure 4:7: Percent of participants in each age group for Kauma and Mgona

Marriage was common in both study locations: 80% of all participants were married; no participants in Kauma were single and only 1 participant was single in Mgona (Figure 4.8). This under-reporting of single participants can be explained by the time of day I conducted my interviews; single individuals may have been working during the day and thus were absent from the home at the time I conducted my study.

Over 80% of households were dual-headed (Figure 4.8), though some households were without a male head for extended periods of time. This absence was due to the polygynous nature of many marriages: in both study sites, each wife had their own household, and husbands would

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choose which wife they wanted to spend time with and would therefore be absent from other

households. As one participant stated:

“He did not leave me completely but he comes occasionally, maybe once and he spends three days and then goes off again. His system is that when he is gone and he would like to impregnate me, he comes back and stays for a month or more than a month and then he sets off again. After that, he comes home once in a while” Estridah (female, Kauma. Additional demographic data provided in appendix 2).

While Estridah’s husband was away with his other wives, he did not provide support for

her household thus making it a de facto female headed household, even though she reported

it was a dual headed household. Other female participants also reported that their husbands

would depart for extended periods of time indicating that while some households were

technically dual headed, they were functionally female headed households. The low representation of female headed households is also likely a result of the sampling times while in the field.

100%

80%

60%

40%

% of % Participants 20%

0% Married Single Widow/Widower Divorced Single Headed Dual Headed Marital Status HH Status Marriage and Household Status

Kauma Mgona

Figure 4:8: Percent of married participants and heads of household for Kauma and Mgona

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Mgona had smaller households compared to Kauma, with an average of 5.2 and 6.2 people

per household respectively (Figure 4.9). Mgona had substantially more households with 1-4

residents, while Kauma generally had 5-8 residents per household, and both locations had notably

large household sizes with 9-12 residents. These larger household sizes are due to extended

families joining nuclear households either as orphans or as a landing place after leaving the rural

areas. Moreover, because Kauma is in a peri-urban area, its larger area and lower premiums on land facilitate larger households and results in cheaper rents (see Figure4.9). Mgona, being located on such a small piece of land, has higher densities making it harder to accommodate larger households. Interestingly, however, one household in Mgona reported 14 residents.

100%

80%

60%

40% % of % Participants 20%

0% 1-4 5-8 9-12 13>

Number of Residents per Household

Kauma Mgona

Figure 4:9: Number of residents per household in Kauma and Mgona

A total of 13 research participants self-reported as being HIV positive, 9 in Kauma and 4 in Mgona. A greater number of participants were interviewed in Kauma thanks to the home-based care group, where 5 participants were interviewed. The same number of self-reporting individuals were randomly found in each study site, 4 in Kauma and 4 in Mgona. Of the HIV positive 118

individuals interviewed in Kauma, 5 were female and 4 male. The women in Kauma ranged from

32 to 44 years; men on the other hand ranged from 33 to 67 years. Predominantly, participants

who were not part of the home-based care group tended to be younger, with only one participant

over 40 years; the opposite was true for the home-based care group where only 1 participant was under 40 years. For Mgona, HIV positive participants ranged in age from 35 to 46 for both men and women. Among the Mgona participants, one of the female respondents did not know her age.

Participants from Kauma report having spent more years living with HIV/AIDS, with an average of 7.7 years compared to 3.75 years in Mgona. Three of the Kauma respondents had lived with the disease for more than 10 year (22, 15 and 12 years) while only 2 had lived with the disease for 1 year or less. For Mgona, the most years lived with the disease is 6 years.

For both study sites, either 1 or 2 people were infected with HIV/AIDS in the household; most commonly it was either one of the spouses or both of them. One Kauma household reported that one person infected was an older daughter living at home, while another household reported a father and daughter were infected. Only 1 household in Mgona reported having 3 people in the household infected, which included a child. All participants reported they were taking medication either in the form of Antiretroviral Therapy (ART) (provided free by the government) or Bactrim

– a brand name for cotrimoxazole, which is a combination of antibiotics used to prevent or stop

Pneumocystis carinii pneumonia (PCP) in HIV positive patients.

Both sites had low overall education levels. In both study sites, 65% of participants had a primary level education, and no participants had education levels higher than secondary (Figure

4.10). Interestingly, Mgona reports higher secondary education levels (32% of participants) than

Kauma (15%). Moreover, 19% of Kauma participants had no education compared to 6% in Mgona.

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More women (71% of participants) had primary level education than men (50% of participants) in

Kauma, but women reported lower levels of both secondary (11%) and no education (17%) than

men (25% for both categories). I found similar trends in Mgona: more women had primary level

education (64% of participants) than men (55%), but more men had secondary level education

(45%) than women (28%). However, only women reported having no education (8%) in Mgona.

100.0%

80.0%

60.0%

40.0% % of % Participants 20.0%

0.0% Primary Secondary None Education Level

Kauma Mgona

Figure 4:10: Overall education levels of participants in Kauma and Mgona

4.7 Employment and Income

Residents of both Kauma and Mgona engaged in a variety of employment/income generating activities, which comprised formal and informal activities. It is no surprise that participants reported earning low-income, especially in light of the areas in which they reside.

Some typical employment activities common to both study sites included ganyu (piece work/casual labor), brick molding/laying, security guards, farming, and selling various food and household needs such as firewood, tomatoes and doughnuts. Some of the rare/unique employment

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activities participants reported include theater directors, and selling sand (Figure 4.11). In Kauma,

27% of participants had informal businesses and employment. These trends are not surprising as

my research was conducted in an informal settlement; 16% of participants had formal employment

and no employment. The most common formal employment activity for both study sites was being

a security guard, which is a job that does not require much education. The “Other” category found

in Figure 4.11 comprised women who were part of a savings groups. Employment activities in

Mgona varied greatly compared to Kauma. Most participants in Mgona were unemployed (42%),

followed by practicing informal business activities (28%). This high percentage of unemployment

is surprising but can be explained by the limited opportunities for economic activities in Mgona,

such as ganyu. These trends may also be an inadvertent effect of interviewing people who were

available (during the day) for an interview because they were unemployed. In Mgona, informal employment (16% of participants) was more than 10% lower when compared to Kauma. Formal employment (6% of participants) was also lower than Kauma, which is surprising given that

Mgona is located in the Kanengo industrial area; however, this location may explain why Mgona has 4% more participants involved in formal business activities. Expectedly, farming activities in

Mgona were low (2% of participants) because of its location; further inquiry explained that

farmers only resided in Mgona to get better access to markets in Lilongwe, and their farming

activities were conducted in the rural areas.

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50.0% 40.0% 30.0% 20.0% 10.0% % of % Participants 0.0%

Employment Activity

Kauma Mgona

Figure 4:11: Employment activities for participants in Kauma and Mgona I collected individual monthly income data from participants in both study sites. Of all the data I collected, income data were the most incomplete and therefore posed challenges with regard to reporting, understanding and interpreting. Almost 50% of participants in Mgona were unemployed and therefore had no income data. Furthermore, because of gender relations, women tended not to know how much money their husbands made, making it impossible for them to report how much household income was generated. Given that I interviewed more women than men in both study sites, household income data were largely incomplete. As such, for clarity, I report two frequency values in my results: “Total Percent” refers to the number of participants in each answer category divided by the total number of participants in each study site; “Valid Percent” refers to the number of participants in each answer category divided by the total number of participants who answered the question. All income data is reported in Malawi Kwacha (MWK), which at the time of data collection (July 2012) had an exchange rate of MWK 278 to the US dollar ((June2016)

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MWK 705 to the US dollar2). According to UNICEF (2011), 61.6% of the Malawi population lived below the international poverty line (US$1.25 per day) (UNICEF 2011).

Figure 4.12 shows that the average monthly income in Kauma was MWK 9,076 (US$

32.65) (provided by 44 participants) versus MWK 11,660 (US$41.94) in Mgona (provided by 25 participants); 50% of the participants in Mgona did not report an income, which made comparison between the two sites difficult. Data reported in Kauma showed the majority of participants (38%) earned less that MWK 5,000 (US$ 17.99) per month (Figure 4.12, Table 4.4), with individual income decreasing with increasing income brackets except for a slightly higher number of participants earning MWK 20,000 – MWK 24,999 (US$71.94 - 89.92). Individual income data from Mgona showed that the majority of participants (32%) also earned less than MWK 5,000

(US$17.99) per month. In Mgona, 20% of the participants earn MWK 5,000 - MWK 9,999

(US$17.99 - 35.97), and another 20% earn between MWK 20,000 and MWK 24,999 (US$71.94 -

89.92). Unlike Kauma, however, no Mgona participants earned MWK 10,000 - MWK 14,999

(US$35.97 - 53.95) (Figure 4.12).

2 The Malawi Kwacha’s drop to the US dollar has largely been influenced by currency devaluations due to poor economic performance, weak fiscal discipline, and a sharp reduction in aid by the donor community (World Bank 2016). Malawi has experienced aid reductions since the ‘Cashgate’ scandal in 2013 (see Africa Research Bulletin 2014; The Economist 2014); more recently Britain, Malawi’s largest donor has slowly been shrinking its aid package to the country in an effort to encourage self-reliance (Khamula 2016). Malawi is also experiencing challenges in the export sector due to low commodity prices for all its largest export products, tobacco, sugar and tea (Malawi Nyasa Times 2016). 123

50% 40% 30% 20% 10% % of % Participants 0% Kauma Mgona Kauma Mgona Kauma Mgona Kauma Mgona Kauma Mgona Kauma Mgona MKW 0-4999 MKW 5000- MWK 10000- MWK 15000- MWK 20000- > MWK 25000 ($0-$18) 9999 ($18-$36) 14999 ($36-$54) 19999 ($54-$72) 24999 ($72-$90) ($90) Average Monthly Income Total Percent Valid Percent

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Table 4.4: Number of participants and percentage in each income bracket in Kauma and Mgona Kauma Mgona Average Income No. Total Valid No. Total Valid Participants Percent Percent Participants Percent Percent MWK 0 - 4,999 18 38% 41% 8 16% 32% (USD 0-17.99) MWK 5,000 - 9,999 10 21% 23% 5 10% 20% (USD 17.99-35.97) MWK 10,000 - 14,999 6 13% 14% 0% 0% (USD 35.97-53.95) MWK 15,000 - 19,999 4 9% 9% 4 8% 16% (USD 53.95-71.94) MWK 20,000 - 24,999 2 4% 5% 5 10% 20% (USD 71.94-89.92) > MWK 25000 4 9% 9% 3 6% 12% (USD 89.95) Total responses 44 94% 100% 25 50% 100% Missing responses 3 6% 25 50% Total number of 47 100% 50 100% participants

Forty participants (85%) responded to questions on household income in Kauma compared

to 23 in Mgona (46%) (Figure 4.13). Missing data was due to participants being unaware how much income the household generated, either because of ignorance or gender relations (e.g. wives not knowing). Average household monthly income for Kauma and Mgona were MWK 16,266 and

MWK 14,995 (US$58.51 and US$53.94) respectively. The majority of households in Kauma earned under MWK 20,000 (US$71.94) per month, which accounted for 64% of the entire sample and 75% of those who reported household data. Mgona was similar to Kauma, with the majority of households reporting earning less than MWK 20,000 (US$71.94), accounting for 78% of the participants. For both study sites, the majority of the remaining households earn MWK 20,000 -

MWK 29,999 (US$71.94 - 107.91) (Figure 4.13).

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100%

80%

60%

40%

% of % Participants 20%

0% Kauma Mgona Kauma Mgona Kauma Mgona Kauma Mgona Kauma Mgona MKW 0-9999 ($0- MWK 10000- MWK 20000- MWK 30000- > MWK 40000 $36) 19999 ($36-$72) 29999 ($72-$108) 39999 ($108-$144) ($144) Household Monthly Income Total Percent Valid Percent

4.8 Housing Situation

The housing situation of residents in each study site is partly a reflection of their geography.

Kauma, being peri-urban, is larger and has wide variations is housing conditions and access to utilities. Among its 12 villages, a large amount of variance is found between and within villages.

Villages located on the southern outskirts of Kauma and heading inwards in a north-east direction showed more use of electricity. Such villages include CCDC, Durban, Kanyangw’a Nchokere and

Tsoka (Figure 4.4). Residents in these villages also tended to have better access to potable water because of the terrain, which did not require high amounts of water pressure. Houses in these villages were overall built with better materials such as burned brick, cement, iron roofing

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sheets/asbestos, and tended to be plastered and painted. Figure 4.14 shows images of houses in

CCDC and Kanyangw’a Nchokere.

Figure 4:14: Examples of house in Kauma for a. CCDC village and B Kanyangw’a Nchokere (Photo credit: Tatenda Mambo)

Even though some of the houses in these villages were physically in better conditions, none

of the participants interviewed lived in houses with burned bricks or made with cement block

(Figure 4.14); all walls of participants’ houses in Kauma were made of mud bricks. Mgona like

Kauma exhibited great levels of variance in the condition of houses within and between villages.

The greatest difference between villages was seen between Mgona D and the other three: because

Mgona D is the newest village, housing lots are relatively larger (see Figure 4.6) and some are made with better materials. In this study, 92% of participants’ houses were made with mud bricks

(Figure 4.15). In Mgona, no village had increased access to electricity or water; all 4 villages had

access to potable water through water kiosks. Select residences and businesses in all villages had

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electricity depending on whether the residents were able to afford the cost of connection and usage

fees. As Figure 4.6 shows, Mgona A through C had very high densities.

Participants of both sites used a variety of roofing materials depending on their level of wealth and assets; 50% of participants used galvanized iron sheets as roofing material, while 40% of participants used grass, leaves and bamboo (Figure 4.15). Roofing tiles were unique to Mgona

participants, indicating a larger investment and desire for something more esthetically pleasing.

The advantage of using materials such as iron sheets and roofing tiles is their durability (which

means they will not need to be replaced every year) as is the case with grass (needing replacement

every few years). These durable materials provide another advantage in enabling rain water

harvesting.

100%

80%

60%

40%

% of % Participants 20%

0% Block/cement/ Baked/burnt Mud bricks Galvanized iron Grass/leaves/ Roofing Tiles Other concrete/stone bricks sheets bamboo Home Walls Home Roof Housing Material

Kauma Mgona

Figure 4:15: Housing material for participants in Kauma and Mgona

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Renting within the study sites also showed geographic variance: more participants in

Mgona were renters compared to those in Kauma (60% vs. 23% respectively). Given the housing densities in Mgona, these results are not surprising due to the lack of space. Many households in

Mgona and Kauma lived in single rooms with as many as 7 people together, though these trends were more evident in Mgona because of the densities.

On average, Mgona had higher rental costs compared to Kauma. The average cost of renting in Mgona was MWK 2,257 compared to MWK 1,682 in Kauma. Kauma’s low average rental price was consistent with its peri-urban location. The highest rental cost reported in Mgona was MWK 6,500 whereas for Kauma it was MWK 2,500. Most residents (43.3% of participants in Mgona and 54.5% in Kauma) paid between MWK 1,000 and MWK 1,999 (Figure 4.16).

Additionally, both sites had another substantial group of renters paying MWK 2,000 to MWK

2,999 in rent.

60.0%

50.0%

40.0%

30.0%

20.0% % of % Participants 10.0%

0.0% MWK 0-999 ($0- MWK 1000-1999 MWK 2000-2999 MWK 3000-3999 MWK 4000-4999 >MWK 5000 ($18) $4) ($4-$7) ($7-$10) ($10-$14) ($14-$18) MWK

Kauma Mgona

Figure 4:16: Rent paid by participants in Kauma and Mgona

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4.9 Migration Patterns

Given that the majority of Lilongwe’s population growth since the 1970’s has been the result of rural-urban migration (Potts 2006a), it is important that migration patterns of the participants be examined to assess whether this growth is still the case, and explore the notion of people living on a rural-urban continuum. The majority of participants in each study site were not

native to Lilongwe (66% of participants were migrants to Kauma and 78% were migrants to

Mgona). Kauma, which became part of Lilongwe through reclassification, had more Lilongwe

natives because the community was already well established. Mgona on the other hand, which is

an illegal settlement, had fewer Lilongwe natives.

Data on the amount of time participants spent in their current residences were consistent

with expectations based on the history and geography of the study sites. Participants in Kauma on average had lived in their current houses for 25 years compared to an average of 12 years in Mgona.

Over 70% of Kauma participants spent over 10 years in the same home, indicative of a more stable community with less turnover (Figure 4.17). In Mgona, the majority of participants (28%) spent less than 1 year in their current house, followed by 26% of participants residing in their homes for over 15 years.

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60%

50%

40%

30%

20% % of % Participants 10%

0% <1 2-5 6-9 10-14 15> Years Spent in Current House

Kauma Mgona

Figure 4:17: Time (in years) spent living in current house for participants in Kauma and Mgona

Regarding the notion of people living on a rural-urban continuum, data from the study sites showed that the situation differed largely between them. In Kauma, most participants returned to rural areas once a year or not at all (Figure 4.18), whereas just over 10% of participants returned to rural areas over six times a year, lending more credence to the rural-urban continuum notion. In

Mgona, 44% of participants were not making an annual return to rural areas and only 32% returned only once. Unlike Kauma, no Mgona participants return more than 4 times a year.

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50.0%

40.0%

30.0%

20.0%

% of % Participants 10.0%

0.0% 0 1 2 3 4 5 6> Annual Rural Return (Years)

Kauma Mgona

Figure 4:18: Annual rural return for participants in Kauma and Mgona

When considering the amount of time spent in rural areas, most people who did return during the year visited for one week or less (69% of participants in Kauma and 48% of participants in Mgona – Figure 4.19). Notably, more participants in Mgona (41%) spend upwards of two weeks in the rural areas when they visited compared to participants in Kauma (14 %).

100.0%

80.0%

60.0%

40.0% % of % Participants 20.0%

0.0% 1-7 8-14 15 > Days spent in Rural Areas

Kauma Mgona

Figure 4:19: Days spent in rural areas for participants of Kauma and Mgona

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Since Malawi gained its independence in 1964, little progress has been made in reducing poverty. With the exception of the 1970’s –when the country saw huge economic growth–, living standards have generally been poor because of various factors ranging from SAP’s, drought and floods, corruption, poor commodity prices, and poorly targeted policies and programs. The effect of these varying factors can be seen in the challenges the country has had with food security over the last few decades as famine has been a consistent theme, and even though the FISP has yielded positive results with regard to maize production, many poor Malawians are dependent on food aid.

While HIV/AIDS has largely affected the country –including household food security–, there have been positive step in the last 10 years as the rate of new infections and HIV/AIDS related mortality has fallen, and more people are on ART. Like many other countries in the region, the urbanization rate is high and because of poor economic performance –among other things– urban poverty is an alarming concern as it is increasing faster than rural poverty. All of this urban poverty in leading to the creation of slums where on a daily basis, residents decision making centers around food, either directly or indirectly. The research sites of Kauma and Mgona are good representations of the attributes described above and will be used to explore these issues in Lilongwe.

The following chapter shall present data collected of the issues of food security, HIV/AIDS and gender in both Kauma and Mgona. The chapter presents both quantitative and qualitative data.

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Chapter Five: Food Security, Gender and HIV/AIDS

Getting access to food in the urban environment is a challenge for the urban poor. Adding to

this challenge, HIV/AIDS makes it difficult for households to thrive when a member gets infected,

especially considering that it is the household breadwinner who is most likely to become ill. This

chapter presents data on food security, issues related to gender, and HIV/AIDS collected from

Kauma and Mgona. These data were collected to answer the following research questions: what are the levels of food insecurity? What are the coping strategies of women in food insecure households? and how is HIV/AIDS affecting the food security of households? The data regarding

HIV/AIDS were largely collected from participants who were HIV positive. Perspectives from non-infected participants appear in section 5.3.2, which addresses the drivers of HIV/AIDS: poverty, sexual behaviour and stigma. While this chapter presents data related to these questions, a more detailed analysis is provided in Chapter 6. For ease of comparison and discussion, both case studies are discussed together based on the type of data reported.

5.1 Food Security

“Life here in the city is different from the rural setting, in the village most of the food is produced while here you need to buy the food to consume and that makes it hard” Madalitso (female, Mgona)

The quote by Madalitso highlights one of the major hurdles that people face in the city, in that access to food is largely dependent on money. This becomes especially pressing in an environment where poverty and unemployment are rampant, and since many necessities are cash dependent, food expenditure generally lands on the chopping block.

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5.1.1 What it means to be food secure

According to the FAO, “Food security is achieved if adequate food (quantity, quality,

safety, socio-cultural acceptability) is available and accessible for, and satisfactorily utilized by

all individuals at all times to live a healthy and happy life” (Gross et al. 2000 p.4). Differences in

the perception of food security exist, and as such, changes how the issue is addressed. For example, discussions with researchers at Bunda Agricultural College highlighted that Malawi’s government discusses food security in terms of maize production, specifically whether the country is producing adequate levels for the country (see section 3.3).

In Kauma and Mgona, participants had a more diverse notion of what food security meant to them. Overall, more than 15 different perspectives were provided for each study site, ranging from “being healthy”, “not sleeping without food”, and “having excess food to sell”. In Kauma, the most common responses given to the question “what does food security mean?” were being healthy, eating enough food, and eating a good variety of food, all mentioned by at least 10 respondents. Less common responses included having maize/nsima, peace of mind, and having their children eating enough (mentioned by at least 3 respondents). Responses in Mgona had slightly different perspectives, though along similar lines: 20 participants said food security meant having enough food, and 13 participants said having enough food at any time. Other notable responses included having maize/nsima, being a “well to do” person, eating a variety of food, and being able to eat every day. Health did not come up as a theme with Mgona participants. Significant among the study sites was the notion of eating enough food. Other notable similarities included having adequate maize and eating a variety of food. Unlike the government’s view on food security, participants’ view of food security included a range of additional considerations. Most

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participants in both study sites self-reported that they were food insecure (76% of participants in

Kauma and 77% in Mgona). Additionally, Kauma participants expressed the sentiment that they

were not food secure if they had to buy food because food prices were very high when they ran

out.

Participants said the following when asked if they were food secure:

Turai (female, Kauma) “no I am not food secure in my household right now. And I guess that’s why I do not look very healthy and strong.” Chirumu (male, Kauma) “I have little food and I am anxious about this; I do not know what we will be eating after the food we have is finished.” Melina (female, Kauma) “As for me, I count it that I have enough food since I have a half granary while others do not have the maize; they rely on buying from the market.” Chisomo (female, Kauma) “Yes, I have enough food because as of now I have 10 bags of maize.”

5.1.2 Annual/Seasonal Variability of Food Security

Participants’ levels of food security differed at different times of the year. This variability was mostly determined by the season and how bountiful the most recent harvest was. As Mesi

(female, Kauma) remarked,

“Some foods are seasonal especially things like cowpeas, they are mostly available during the harvesting period. After some period, they become scarce. After harvesting period some of the foods are cheap, but later on, they become very expensive and this affects our budget.”

Following the harvest, staple foods such as maize are at their lowest price; with time, the price slowly rises. The hunger/lean season in Malawi is between December and March - the time between planting and harvest. During this time, people are said to be surviving on green mangos, as these are some of the most widely available foodstuffs in the market after winter. In order to make it through this difficult period, when people have eaten through their harvests, when food 136

prices have gone up or when money simply becomes hard to come by, participants of Kauma and

Mgona employed a number of coping strategies, including cutting meal sizes, skipping meals and not eating the whole day. The following sections present data reported by participants regarding their experiences with food at different scales and time of year.

5.1.2.1 Annual perspective

When asked to describe their situation within the last 12 months, the majority of residents in Kauma (53% or participants) and Mgona (75% or participants) reported that they “sometimes did not have enough to eat” (Figure 5:1). The category reporting people “often don’t have enough to eat” showed some marked differences between study sites, with Kauma residents reporting

23.4% and Mgona residents reporting only 2%. The remaining two categories where people report

“having enough food and the kinds they want”, and “having enough food but not the kinds they want” showed relatively similar numbers. The reasons why people’s situations reported in Figure

5:1 were as such varied, but were mostly due to money.

100%

80%

60%

40%

% of % Participants 20%

0% We always have enough We have enough to eat Sometimes we don't have Often we don't have food to eat and the kinds but not always the kinds of enough to eat enough to eat foods we want food we want Food situation in the last 12 months

Kauma Mgona

Figure 5:1: Food situation in the last 12 months for participants in Kauma and Mgona 137

Figure 5:2 shows how respondents ranked the reasons why they have been in the food situations described above over the last 12 months. Participants in both sites consistently ranked money as the most important factor for obtaining food. For Mgona, money was the only factor ranked number 1 and did not appear in any other ranking whereas in Kauma, money was the main factor affecting participants’ ability to obtain food, but other factors, such as not being able to grow enough food, lack of farm inputs and poor/no availability of food to buy, were also reported.

Interestingly, for Mgona, ‘no/poor availability of food to buy’ and ‘lack of farm inputs’ were never selected. The geography of the two site locations and their inherent opportunities explain the differences in the ranked factors.

15 Number of Participants of Number 10

0 Kauma Mgona Kauma Mgona Kauma Mgona Kauma Mgona Kauma Mgona Kauma Mgona Not enough Not able to cook No/poor Do not have Lack of farm Not able to grow money for food or eat because of availability of enough land to inputs enough food health problems food to buy grow food Factors affecting the ability to obtain food

Rank 1 Rank 2 Rank 3

Figure 5:2: Factors affecting participant’s ability to obtain food, ranked by participants of Kauma and Mgona

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At least 70% of participants in Kauma and Mgona reported not eating enough food because there wasn’t enough money to buy food. However, this scenario happened rarely for most participants (Figure 5:3).

80.0%

60.0%

40.0% % of % Participants 20.0%

0.0% Every Month Some Months Rarely/Few Months

Kauma Mgona

Figure 5:3: Occurrence rate of not eating enough food because of insufficient money

At least 50% of participants in both Kauma and Mgona reported that within the last 12 months, they were hungry but did not eat because they could not afford enough food; the frequency of this practice was reported as “rarely” by 64% of participants in both study sites, and as “in some months” by 28% of participants in Kauma and 18.8% of participants in Mgona (Figure 5:4).

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80%

70%

60%

50%

40%

30%

20%

10%

0% Every Month Some Months Rarely/Few Months

Kauma Mgona

Figure 5:4: Frequency of being hungry but not eating because not able to afford enough food Questions on meal skipping further explain how participants failed to consume enough food. In Kauma, 59% of participants reported skipping meals within the last 12 months compared to 63% of participants in Mgona. Most participants (67% of participants in Kauma and 61% of participants in Mgona) reported that this practice happened “rarely” (less than 3 months – Figure

5:5). In Mgona, 19% of respondents reported a higher propensity of meal skipping “every month,” and the same amount reported skipping meals “some months” (4-11 months). These numbers were lower in Kauma, where meal skipping occurred “every month” for 15% of participants, and “some months” for 18.5% of participants. Not eating the whole day was not as common an occurrence in

Kauma (30% of participants) compared to Mgona (46.9% of participants).

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100% 80% 60% 40% 20% % of % Participants 0% Kauma Mgona Kauma Mgona Kauma Mgona Every Month Some Months Rarely/Few Months

Figure 5:5: Frequency of meal skipping because of insufficient food

5.1.2.2 Daily Perspective: Meal Consumption on a Daily Basis

It is important to note that these data were collected 1-2 months after the harvest, when

food prices for staple foods tended to be lower and granaries had been replenished. People’s daily

experience with food in Kauma and Mgona were unsurprisingly determined by the amount of

money they had at their disposal and the time of year. Many participants made food purchases

based on how successful their business endeavors had been, or they engaged in ganyu to enable

them to buy food. As participant Kantanyeni (female, Kauma) said: “It depends on how your business is progressing; if I made a good sum of money, I am able to buy good breakfast.” Almost all participants reported buying food on a daily basis as needed, especially with perishable foods such as relish. In Malawi the term relish3 is used to refer to anything eaten with nsima to give it

3 Relish comes in many forms including meat, vegetable, fish and beans. In general, relish does not include starchy foods. 141

flavor. The staple food of Malawi is nsima – also known as pap in South Africa – a thick porridge with a dough-like consistency made from ground maize. In the northern part of Malawi, a similar thick porridge called kondowole is made from cassava which has a smoother and stickier consistency. Nsima is eaten both for lunch and dinner, however, maize meal is also used to make a thinner consistency porridge for breakfast. Rice is also grown and eaten in Malawi, however, participants reported only eating rice on special occasions because of its higher cost, though some respondents in Mgona reference eating rice for breakfast.

Breakfast was the first meal consumed for most participants, and what they consumed differed based on what foodstuffs were in season, available money and/or available sugar.

Breakfast foods for most participants in both study sites was porridge (either from maize meal or ground soy beans) and tea, which was either drank with sweet potatoes, scones or futali (potatoes mixed with groundnut flour). It is important to note that sugar is an essential determinant for drinking tea. Many respondents made this clear with statements such as: “Yes, in the morning when we have sugar available, we drink tea but if we do not have sugar, we eat porridge” Sigele (female,

Kauma).

The most notable difference between the study sites was the higher propensity for people to skip breakfast in Mgona if they were low on money; however, this practice was not exclusive to Mgona. In Kauma, the majority of people who reported skipping breakfast were HIV positive members of the home-based care group. The following statements from respondents illustrates this practice:

“When money is available, we buy breakfast, but if the money is out of reach, we just wait for lunch as our first meal for the day” Asale (female, Kauma).

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“In the morning we take porridge, if the flour is not enough we will wait until the afternoon. I prepare some vegetables and nsima if it’s possible and we eat the same in the evening then we call it a day” Thokozani (female, Mgona).

“In the morning I just drink several glasses of water, in the afternoon, nsima wamgaiwa with vegetables and the same in the evening” Mphatso (male, Mgona).

All participants’ lunches in both study sites consisted mostly of nsima and some type of

relish bought earlier in the day. Typical relish options included different types of fish (usipa, bonya

or mcheni,- which are typically dried), soy, meat, beans and leafy greens, such as mustard greens, rape, Chinese cabbage, pumpkin leaves, and okra. Other relishes that tended to be eaten on special

occasions include goat, beef and poultry, as well as fresh fish such as chambo (similar to bream).

As expected, money was the greatest factor affecting relish purchases. Relish such as mustard

greens and small dried fish (usipa) were the most common because they were inexpensive, as highlighted by a quote from participant Tauya (male, kauma) who states it is a common

occurrence:

“…. we have nsima for lunch with vegetables which we usually just boil and add tomato and sometimes we have the nsima with dried fish, but we have it mostly with vegetables. We would have loved to be eating other sorts of food but we cannot because I do not earn that much money for that. So it is just vegetables and dried fish mostly, and meat, especially beef, we may have it just once a year during the festive season”.

Most participants reported eating the same meal for dinner that they had for lunch – they would buy adequate amounts of the same relish for both meals and either cook it all at once or keep some to be cooked for dinner. Few participants in either study site made reference to skipping dinner, however, one participant referred to skipping either lunch or dinner as a common daily practice. The participant was a member of the Kauma home-based care group and said the following:

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“We drink tea or eat porridge in the morning, in the afternoon we eat nsima. As I have already told you, we eat nsima once a day. If we eat nsima in the afternoon, we do not eat nsima in the evening and vice versa” Mesi (female, Kauma).

Data on weekly food consumption showed results consistent with the above trends. Of all

3 meals eaten per day, breakfast was skipped most often, with only 43.3% of participants in Kauma and 57.1% of participants in Mgona eating breakfast every day of the week (Figure 5:6).

Interestingly, although no participants in Mgona reported always skipping breakfast, many participants reported not eating breakfast 1-2 days per week. Moreover, lunch was eaten consistently in both locales, with 70% of participants eating lunch every day in Kauma and 91% in Mgona. The numbers for dinner again showed similar trends, with at least 80% of participants in both locales eating dinner every day. Few participants had dinner less than 3 times a week – again, it is important to note that these data were recorded just after the rainy season so meal skipping was likely to be higher at other times of the year.

100%

80%

60%

40%

% of % Participants 20%

0% Lunch Lunch Lunch Lunch Dinner Dinner Dinner Dinner Breakfast Breakfast Breakfast Breakfast Not at all 1 or 2 days per week 3 or 4 days per week Every day of the week Occurrence of meal skipping

Kauma Mgona

Figure 5:6: Frequency of meal consumption in Kauma and Mgona

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5.1.3 Cost and Sources of Food

As the income data suggests, research participants in Kauma and Mgona had financial difficulties that prevented them from getting easy access to food. For many, food was a large expenditure. The practice of buying food on a daily basis was done for practical reasons such as limited ability to store perishable goods, however, for most participants, daily food purchases were a function of living hand-to-mouth, which overall made food more expensive (see section 3.3).

The average monthly cost of food for both Kauma and Mgona was relatively high when compared to average income. Average household food expenditure for Kauma was MWK 11,356 vs. a MWK

16,266 average household income. For Mgona participants, the situation was worse, with a household food expenditure average of MWK 15,825 vs. MWK 14,995 average household income. Figure 5:7 shows household food expenditures as a percentage of household income. At least 35% of households in both Kauma and Mgona had food expenditures that accounted for more than 100% of their income. For Kauma, only 25% of the respondent’s food expenditures accounted for less than 50% of their household income, while for 37.5 %, food accounts for between 50-

100% of household income. The remaining 37.5% have food accounting for over 100% of household income. Mgona’s numbers were worse with 9% of participant’s food expenditures accounting for less than 50%, 45.5% accounting for 50-100%, and 45.5% accounting for more than 100% of household income. As with the income data presented in chapter 4, results for both

Total percent and Valid percent are reported

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100.0%

80.0%

60.0%

40.0%

% of % Participants 20.0%

0.0% Kauma Mgona Kauma Mgona Kauma Mgona < 49.99% 50-99.99% 100% > Percent of Income

Total Percent Valid Percent

Figure 5:7: Monthly household money spent on food as a percentage of income

The majority of household food purchases occurred on a daily basis, however, not all food

items were bought in this manner. Figure 5:8 represents commodities that were typically purchased on a daily basis and the average amount spent. Overall, the same commodities were popular in each study site. Water and relish were the most common in both locales, however, average cost of relish differed by more than MWK 100. Of the 13 commodities listed by participants, 4 were not foodstuffs but fuel/light sources. Under difficult circumstances, staple foods such as maize meal

were bought in very small packages called wokomani- cooking flour – which allowed households

to eat for the night.

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MWK 250.00

MWK 200.00

MWK 150.00

MWK 100.00 Average Spent MWK 50.00

MWK 0.00

Foodstuffs

Kauma Mgona

Figure 5:8: Average spent on daily foodstuffs by participants in Kauma and Mgona

Participants had multiple sources of food and these sources had varying rates of use

depending on the study site. The most common food sources included local markets and urban

agriculture. Some differences were observed between participants’ sources for staple foods

compared to other foods. Participants in Kauma, with its peri-urban location and greater reliance

on agriculture, had less dependence on the local market for staple foods such as maize. As Figure

5:9 shows, 27 Kauma participants ranked self-grown food as their main source for staple foods, followed by local markets (17 participants). Of particular note was the presence of food remittances, which played a role in people’s source of staple foods; despite the small number of participants receiving food remittances, these data lend credence to the notion of a rural-urban continuum. The local market in Kauma ranked second place as a food source (by 20 respondents), followed by hawkers (8 respondents). In Mgona, the market was clearly the most dominant with

48 responses ranking it 1st; the only other category ranked as first was self-grown food. 147

Mgona

Other Kauma 1 1

Mgona 2 s/ Kauma 2 1 3 Assistance Remittance Mgona 1 2

Kauma 27 3 1 Self Grown 1 Mgona 48

Markets Kauma 17 20 3 Venders/ Staple Food Sources Food Staple Mgona

Hawkers Kauma 1 8

Mgona

Outlets Kauma 1 2 Main Store

0 10 20 30 40 50 60 Number of Participants Rank 1 Rank 2 Rank 3

Figure 5:9: Ranking of Staple food sources by participants of Mgona and Kauma

Sources for non-staple foods were more dominated by the local market compared to staple foods

(Figure 5:10). In Kauma, 37 respondents got their non-staple foods from the market, followed by

5 participants who grew it themselves, 3 who purchased non-staple foods from small grocers then finally 2 participants who obtained food from main/larger stores. For categories ranked in second place, small grocers had the highest number of participant buyers (15), followed by 9 participants who used the market. Mgona participants followed similar trends, with the majority of participants buying their non-staple foods at the market (48 participants), followed by self-grown – the only

other category ranked as number 1.

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Mgona 1

Other Kauma 3

Mgona

Hawkers Kauma 1

Mgona 2

Kauma 2 /Assistance Remittances

Mgona 1 1

Kauma 5 4 2 Self Grown Staple Foods Staple - Mgona 48 1 Markets

Vendors/ Kauma 37 9 1

Mgona Sources Non of Sources Kauma 3 15 6 Small Grocer Mgona

Outlets Kauma 2 2 6 Main Store

0 10 20 30 40 50 60

Number of Participants

Rank 1 Rank 2 Rank 3

Figure 5:10: Sources of non-staple foods ranked by participants in Kauma and Mgona

Overwhelmingly, respondents in both Kauma and Mgona noted that foods were readily available at their local market. The challenge of getting food was not one of insufficient quantities available, but rather one of insufficient funds with which to buy food. This point is referenced by

the following statements from participants:

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Yanikani (female, Mgona) “More often we fail to buy the food not that it is not available, but because we do not have money to buy what we want.” Kwasausya (female, Kauma) “The food is available at the market. Almost everything is available; a person just needs money to get the food from the market.”

Another source of food in the slums was street food, which brings with it many advantages and drawbacks (see section 3.3). On the whole, respondents in both study sites had easy access to street food, such as French fries (chips), roasted fresh maize, fritters, and relish such as bbq meat, cooked vegetables, and boiled potatoes. Overall, street food consumption was more common in

Mgona. Mgona participants relied on street food for foods that were expensive or difficult to prepare at home; this sentiment was shared by 20 participants. Other common reasons for consuming street food in Mgona were as a time saver, cheaper for buying a complete meal compared to buying the individual ingredients, a way to amend meals, a good option for snacks, and as a way to introduce variety into the diet. Reasons cited in Kauma for eating street food included it being a last resort and as a time saver. Both study sites expressed negative views about eating street food, the most common was concern over hygiene and safety as expressed by the following respondents:

Sigele (female, Kauma) “Sometimes I buy such foods but I choose not to buy from time to time since…. already cooked foods are not hygienic. I still buy because it is the only food, which I can eat without taking time to cook.” Tafadzwa (female, Kauma) “Foods bought from the streets are our shortcut foods, but they are not hygienic thus, it is better to cook food for ourselves. We buy the food when we are in a hurry…” Dumi (male, Mgona) “No we don’t buy because I am not sure of how the food is prepared in terms of hygiene, so I prefer to buy whatever I want and prepare it myself at home.”

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Other negative views related to street food was its high price, hence some participants only

consumed it when they were away from home. Some female respondents remarked that buying

street food was a selfish way of spending money, while men typically bought bbq meat while

drinking beer or bought precooked meat to avoid relish they don’t like. Mesi (female, Kauma) said the following:

“Some men are very selfish; if their wife has cooked relish that he does not want, he tells the wife to serve him alone. The wife eats okra together with children while the husband buys some good relish like precooked chicken meat or goat meat and he eats alone.”

Few participants also noted that street food was typically bought to please their children.

Urban agriculture proved to be another important source of food, however, its relevance and utility was different between Kauma and Mgona. Kauma reported higher rates of agriculture, though not entirely urban. Just over 60% of Kauma participants practiced agriculture but only 25% of them practiced it in the city. In Mgona on the other hand, only 10% of participants practiced urban agriculture compared to 20% who farmed in rural areas. There was a marked difference in the crops grown in Kauma and Mgona. Easier access to land in Kauma allowed participants to grow crops such as maize, soy beans and groundnuts. Most of these crops were produced for subsistence, with any excess being sold. The much smaller plots of land in Mgona allowed those who did practice urban agriculture to grow only crops such as tomatoes, leafy greens and pumpkin leaves. The greatest impediments to urban agriculture in both study sites was the availability of land and its resultant cost. Residents in Kauma often referred to the prohibitive cost of renting land, which was compounded with the additional costs for inputs and labor thus making it a nonstarter for many. Many participants in Kauma rented land much further out of the city, which allowed them to grow food they would otherwise be buying. For Mgona, what little land was 151

available for rent was typically far too expensive. Participants noted renting land in previous years

but were not able to continue because of high costs: “…in my case I rented a place in Kanengo a

certain year, for that year I harvested and my poverty was reduced but since then I cannot afford to farm again” Wema (female, Mgona). Residents of Mgona who did farm but not in the city tended to do so in their rural homes. One respondent remarked that the produce from her rural home was sold in the rural areas and the money sent to the city. Whatever urban agriculture that took place in Mgona merely provided a short reprieve from buying relish from the market on a daily basis, or served as a safety net when funds were low. As Chifundo (male, Mgona) remarked:

“Yes I grow though it is just this horticulture like vegetables and tomatoes to supplement on the food that I have, (so) in case of no money I should be able to use these vegetables as relish on the household”.

5.1.4 Determinants and Challenges to Food Security

In order to gain a complete view of food security, participants discussed determinants of food security in their households and the challenges they faced in acquiring food security. For both

Kauma and Mgona, money was the most determinant factor for food security. Statements such as the following were typical:

Faye (female, Kauma) “It depends on how much money is available. If you do not have money, it is very hard to access food”. Tauya (male, kauma) “it depends on the money I make from my job” Rumbidzai (female, Kauma) “it mostly depends on money and also the crops we grow on our own. But most of our food availability relies on money” Tiyamike (female, Mgona) “money has the final say at the market”

Marked differences did appear, however, between the study sites. For Mgona, participants mentioned three factors: money, employment and family support. Participants in Kauma on the other hand, where there was a greater reliance on agriculture compared to Mgona, included factors 152

that aided people in growing their own food. Of the 7 factors discussed in Kauma, 3 were related

to agricultural production. Participants’ challenges to food security mirrored the discussion on

determinants. Mgona residents reported that challenges to food security were centred on business,

employment and money. Many statements suggested survival in the city was entirely dependent

on the money in their pockets. Kauma again showed a wider array of responses, though money

and employment were the most constant. Other notable issues mentioned include fertilizer, access to land, and good weather for growing crops. Gender dynamics were also mentioned by a number of women who remarked that their husbands did not allow them to work, making it harder for the

household to get by (see section 5.2). A small group of residents in Kauma noted that getting

adequate food was not a challenge for them; as Kantanyeni (female, Kauma) remarks, “To say the

truth, I do not face any challenges in terms of food since we eat properly from day 1 to 30th of the month. We do not even sleep on an empty stomach.”

Though some participants did not have trouble getting access to food, the vast majority did.

During the hunger season, they were forced to resort to a few coping strategies. The most common coping strategy when food became difficult to access was performing ganyu (piece work/day labor). For participants in Kauma, this strategy was employed by most and they were either paid in cash or foodstuffs such as maize or flour. Ganyu activities ranged from household work to agriculture labor, to working on extraction of quarry stones – anything to get access to money.

Ganyu was relevant in Mgona as well, but to a lesser extent compared to Kauma. Mgona residents looked for maize outside the city where prices tended to be lower. Many, however, resorted to cutting their meal sizes; this practice was commonly done by purchasing maize flour in small quantities (wokomani). The wokomani did provide food in small quantities enabling people without

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much money to buy something; however, the per-unit cost was much higher. In both study sites, residents remarked that they simply started to buy food in smaller quantities based on what they could afford. Participants with means mentioned buying large amounts of maize when the prices were low, providing them with food during the lean time. This strategy did not always see them through the hunger season, but it did provide some reprieve until the stock piles ran out. Family support was another important means by which participants got by during the hunger season.

Participants in Kauma commonly got food from family in the rural areas; as Olivia (female,

Kauma) says: “We go to the village and get food from there and sometimes we just call them

asking them to bring us the food.” Support from family living in the city was vital for some

households as they were able to borrow money. Some residents also got loans from fellow Kauma

residents – one participant mentioned getting loans with interest rates of 50%: “Considering that

I am the only breadwinner, I try my best to get a loan from people in the neighborhood. Mostly, it is with 50% interest or sometimes 100% interest” Chirumu (male, Kauma). The last strategy to get by was one of last resort, participants reported simply not eating or sleeping on an empty stomach. Though some went without, they did their best to ensure that the children had something to eat showing their resiliency, as Tiyamike (female, Mgona) shares: “during that time with the little money I have I buy already cooked food just for the children even if I go on an empty stomach but sometimes I buy a pail of maize at the market to feed on for a few times.”

5.2 Gender: Women’s Importance to Food Security

As outlined in chapter 3, the notion of food security is gendered because of the vital role

women play in facilitating food security within their households. The following data highlight

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participants’ responses to questions regarding the roles women play in Kauma and Mgona. Also presented is data on gender relations and dynamics that have an effect on food security within households; such topics include women’s self-determination, the practice of income hoarding and renegotiation of gender roles.

Predominantly, residents in Kauma and Mgona viewed household and societal roles as being gendered; there are specific tasks that are the exclusive domain of either gender. Some, however, did not see the situation as black or white, but instead saw grey areas where some roles are interchangeable. A minority believed that there was no differences between the sexes and that roles should not be assigned to any specific gender. These different perspectives were exhibited by the following participants:

Rumbidzai (female, Kauma) “There are no differences these days, men can do what women do and women are able to do what men can do. If there are any variations, it is because of people not being able to understand the concept of gender otherwise there isn’t any differences”. Dembo (male, Kauma) “There are some things that women cannot do and are explicitly meant for men. But men can manage to do almost everything that women do. Because as for my case I can even wash clothes for my wife when she is busy with something or even cook. But for her, she cannot manage to help me with other stuff like moulding bricks, building a house. I do mould the bricks sometimes and when I get tired, my wife cannot take over. In case of when I am not available, my wife can go to an extent of paying someone to do the job but not her” Asale (female, Kauma) “Personally, I think it is very difficult for a woman to take the role of a man since a man is a man and a woman is a woman, they can never be the same” Alinafe (female, Mgona) “Gender means love, when a man does the work that a woman does for the sake of his wife”

An exchange with Chisomo (female, Kauma): Interviewee: “From what I see, I believe that God created a man and women with their own roles. A woman’s role is to stay at home while the man's role is to procure income for food for the household. Interviewer: Are women supposed to stay at home all the time?

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Interviewee: The woman stays at home or she can do business but the problem is that she may start admiring friends and would want to increase her income base through wrong means (sleeping around with men). It is good to be satisfied with what your husband is doing for you.”

With respect to household roles regarding food security, there was a lot of variance in the responses provided, but they did not necessarily differ by study site. The overwhelming view was that food procurement – particularly in the city – was a man’s role, while preparation was a woman’s role. Participants supported this point of view, stating that men as household heads had

the responsibility to provide for their families; women, on the other hand, prepared food for their

household as a traditional role and because they knew best everyone’s needs and how to care for

them. Some women, however, expressed the view that food procurement was a shared

responsibility since they could both contribute resources acquired through business activities and

ganyu. What allowed these women to share this role with their husband was what they as a family

had agreed on; other participants said it depended on whether the husband gave his wife permission

to work or conduct business. A number of women in both Kauma and Mgona complained about

or were resigned to their husband’s desire that they stay home and not work. Turai (female, Kauma)

said the following on this issue:

“I sometimes play cards with other women where we bet money, but I do that because I have no choice. My husband does not support my family, but he cares about his other two wives. I can’t even go to look for a job, he stops me.” Madalitso (female, Mgona) also adds: “Here we just stay waiting for the husband to provide food for us, some men are jealousy, they stop their wives from working and most women agree to that with the aim of saving their marriages.”

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Participants noted that the notion of men being the sole procurer of food was largely unique

to the city because women had limited access to resources and employment opportunities to

contribute to the household. Participants said the following regarding this issue:

Kumbokani (female, Mgona) “No in the city a woman doesn’t have much power as the rural woman because in town we do not do any activity to empower ourselves while in the rural areas women are in the front cultivating, fetch water, look for firewood, in the end she has influence in her family even economic empowerment. Unlike a city woman she will wake up in the morning and watch as the days goes”.

The following is an exchange with Tadala (female, Mgona), Interviewer: How is the situation in the village? Interviewee: They all farm and produce food, but it’s a woman who takes the leading role in proving for the family. Interviewer: why does this role change when they come to the city? Interviewee: It’s because life in town is different, in the village most things are free like water, housing and more. In town women are not empowered as much to the extent of income generation as needed. Interviewer: Meaning that when a woman moves to the city she loses her ability to influence and empowerment at her household? Interviewee: When we are doing business, things are easy because I have an income making me empowered, but when it is the only husband providing for the home, it will depend on his will to share his money to me or not basing on his personal budgets

Once women are unable to financially contribute to the household, as they are dependent

on their husbands, they lose a lot of decision-making power, which has a huge impact on women’s

self-determination. The relationship between women and self-determination, however, is not

simply governed by how much women contribute to the household, since as noted above, some

men stop their wives from contributing to the household and prefer to have them stay home.

Therefore, the ability for women to contribute to their household is a function of both gender

dynamics within their household, and potential opportunities for them to exploit in the city.

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One particular place where gender dynamics plays an important role is income hoarding.

The extent of income hoarding is household specific; the relationship between wife and husband determines how their home is run. In both Kauma and Mgona, women complained about their husbands hoarding income. Some of the men interviewed instead said that it is women who hoard income. Other households, however, reported that they openly talked about money, but they were in the minority. Many women did not know how much their husbands made, as reflected by the incomplete income data reported earlier in chapter 4, hence they did not know what their husbands spent their money on. Women noted that the problem of income hoarding largely had to do with men because they had ‘other budgets,’ which typically included beer and things that go along with that activity. Below are some views expressed by participants:

Turai (female, Kauma) “The way I look at it, the amount of money my husband possesses does not even match. I don’t even know what he does with the money, maybe if he were saving it up at the bank I would have known but I am not certain about it. But I do know that he drinks too much. And when there is an urgent need for money, he tries to go about and borrow from people which means he spends carelessly when he has some money. He is a chief so he can have about K200, 000 per month after maybe selling a piece of land to people.”

An exchange with Tauya (male, kauma): Interviewer: Does income hoarding occur in your household? Interviewee: Very much! I am actually one of the people who hoard and in my family, I don’t disclose how much I earn to my wife and my wife does not tell me how much she makes as well. She has a job too, only that she was on maternity leave. What usually happens with my wife is that when she receives her salary, she spends it on herself, and does not tell me how much she has made and I also do the same Interviewer: Why is that the case? Interviewee: I actually think that when a wife has a job, she becomes unruly. Interviewer: But in your household, who provides money for food? Interviewee: What happens is, when my wife is being secretive about her income, I do my own thing and not buy food. She buys food with her income and for my money, I spend it alone.

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Interviewer: What do you do with it? Spend it at this beer joint? What do you do with your money? Interviewee: (just laughed) Well I cannot say

Estridah (female, Kauma) said the following: Interviewer: Does income hoarding occur in your household? Interviewee: Yes, as for me when my husband has money he does not tell me, he just gives me some of the money to buy food, similarly if I get money, I do not tell my husband because I am afraid I may not be able to fulfil my budget. Because he has seen that I have money he does not bother to leave me money for food, because he says "she has the money, thus she will use her money" I just keep my money for later use when the husband does not have the money. Finally Leoni (female, Kauma) had this to say: Interviewer: Does income hoarding occur in your household? Interviewee: No, my husband and I tell each other about how much money each one has made. As for my husband while he was still working, he used to call out the whole family and show us the amount of money he has received. Together as a family, we sat down and budgeted for the household.

5.3 HIV/AIDS, food security and gender

“The coming of this pandemic has escalated poverty among the patients and the caregivers because most of the productive time is spent on sickness and taking care of the patients, affecting the community development because you cannot participate when you are sick.” Limbani (female, Mgona)

5.3.1 HIV/AIDS and Impact on Households

As demonstrated above, life in Kauma and Mgona is already challenging and many households struggle to achieve food security. Chapter three outlined the stresses HIV/AIDS places on individuals, compromising their health, their ability to work and therefore the entire household through the need for care (see section 3.4). HIV-positive residents in both study sites reported on the impacts brought on by the disease, which limited their ability to work, their access to food, and which disrupted their livelihood activities –indicated by Limbani’s quote above. HIV/AIDS

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affected the household because infected participants required care, placing more pressure on other household members as they were pulled away from livelihood practices in light of increasing demands. Participants also reported on the plight of orphans who in some cases were taken in by family and in others were left without caretakers.

The impact of HIV/AIDS on households was consistent for both study sites, however, households differed based on the health of the infected individuals. Some respondents reported being on antiretrovirals (ARV’s) for multiple years, but the disease took less toll on their bodies; as Focus (male, Kauma) exhibited: “We are affected, but since we follow what we were advised to be doing; we can see that we are coping.”

Other participants, however, were on medication but their health was poor, limiting their ability to participate in livelihood activities and putting more pressure on the household, as expressed by Mesi (female, Kauma) and Dumi (male, Mgona):

“As I have already told you that I am failing to do work as how I used to since I became sick. It is my child and my mother who do most of the work at home. For instance, I cannot go to fetch water since my legs are numb, I cannot even walk long distances.” Mesi “Because of being sick often I cannot work as I used to. Like this year I was suffering from Tuberculosis for the second time, I’ve just finished my medication, so with the current state of my poor health I haven’t been able to work as expected.” Dumi (male, Mgona)

Access to food and good nutrition is particularly important for HIV positive individuals to slow progression of the disease. All but two participants in both study sites reported being food insecure. Participants reported either difficulty accessing adequate amounts of food, or accessing the necessary variety of nutrients to maintain their health. Focus (male, Kauma) made particular reference to being unable to access certain nutrients, “I manage to get enough food, but it is not at all times since I find it hard to have fats in our diet. Fats are lacking in our diet”. Other 160

respondents, such as Mesi, reported only being able to eat either lunch or dinner but never both

on a daily basis. HIV/AIDS participants exhibited greater knowledge about nutrition and some did

what they could to make healthier choices, for example, by using a more nutritious type of flour

to make nsima. Most of the HIV/AIDS positive participants reported eating ‘mgaiwa,’ which is the least processed flour for making nsima and is the most nutrient dense; the remainder of the participants consumed ‘grind meal’ flour, where the bran of the seed is removed taking with it minerals, vitamins and fiber. No HIV/AIDS patients reported eating ‘ufa woyera,’ which is further processed to give it a smoother texture and whiter color, though they expressed a greater preference for this type of flour. The vast majority of the non-HIV/AIDS participants in both study sites reported eating ufa woyera even though some knew it was a less healthy option. The main reason given for consuming it was that it tasted good with all types of relish.

HIV/AIDS participants discussed how their illness made getting household access to food more difficult. Dumi (male, Mgona) reported that his wife had to take the lion’s share of procuring food as the sickness weakened him:

“Basically being the head of the house and being sick, my wife has to take over providing for the family. Food availability was greatly affected because there was no one to provide for food, in fact we had to live on donations, people had to help us.”

For most participants, as the disease progressed, access to food only became more challenging. Dumi (male, Mgona) and his wife were eventually forced to send their children to go and live with their grandparents because they were unable to care for them. For other infected participants such as Mesi (female, Kauma) and Chirumu (male, Kauma), meal skipping was one of their coping strategies as they were not able to work consistently. Chirumu (male, Kauma) said the following regarding their food situation: 161

“In the morning, we eat nothing while in the afternoon and in the evening, we eat nsima... I have little food and I am anxious about this; I do not know what we will be eating after the food we have is finished.”

For some, however, their challenges to food security are not different from non-infected

participants. Some HIV/AIDS infected patients report being able to work thanks to medication.

Rhoda (female, Kauma), when responding to how the infection has affected daily livelihood

activities, said “Before I was tested, I used to get sick often, but after I tested, I started following instructions. Ever since I tested, I rarely get sick.” Work interruptions were common for infected

participants because of the disease yet they were still able to work and provide for their families,

highlighting the positive effect of access to drugs.

Infected participants also reported experiencing work disruption due to the need to visit the

hospital for drugs and treatment. Rutendo (female, Kauma) reported that trips to the hospital took

time away from working: “Most of the times the person who is suffering from the disease makes

frequent visits to the hospital and thus have little time to work.” In addition to the time spent going

to the hospital, participants noted that the frequent trips to the hospital were also costly, putting

more pressure on their household budget. Focus (male, Kauma) mentioned the following when

asked about how the disease was affecting his day-to-day activities:

Interviewee: “I do not work to my full potential. I easily forget what I am doing; I also have a tight schedule since I am supposed to go to the hospital frequently to get medication. Interviewer: Where do you get medication? Interviewee: Lighthouse, at Kamuzu central hospital; this is very costly since I am supposed to use transport each time I visit the hospital. However, nowadays they are giving us medication to last us three months than in the later days. However, when the medication is scarce, we visit the lighthouse once or twice a month.”

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With occurrence and progression of the disease comes the need to care for the sick, and the

literature suggests that women take up this duty (Grant & Parpart 2010; Mtika 2001b). However,

I found that infected participants reported both men and women helping each other in the duties of

care, though women expressed having a larger share of the burden with statements such as:

“Though we are women, we are the ones affected so much when it comes to care giving because

the primary responsibility as women lives in us” Takondwa (female, Mgona); and “it is a woman who is there to care for the sick; men don’t have a heart to care for people” Ganizani (female,

Mgona). The propensity for men to participate in care duties when their wife or household member was ill came from the counseling they receive from the hospital; as expressed by Chirumu (male,

Kauma):

“Since two of us are affected in our household, I make sure that I help my daughter perform some of the duties. For instance, I go to the maize mill to help her out with the load of work that she is supposed to do. I also cook, or her brother cooks. We help each other since we were advised to do so at lighthouse.”

Focus (male, Kauma) and his wife were both HIV positive and he reported helping his wife in the following ways: “washing, cooking and carrying her on my back when my wife she is sick.”

Other male respondents such as Thembiso (male, Kauma) reported the following with regard to caring for his family since his wife got infected:

“It is very hard, sometimes she gets very sick to an extent that I do not go to do ganyu because I have to take care of her and the children, cooking for the children and her, bathing the kids, washing and boil some bathing water for her.”

Participants noted that household dynamics could transpire very differently depending on who was infected. If the husband was infected and the wife was not, participants reported that she was more likely to stay and care for her husband and family; however, if the wife was infected and

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the husband was not, then it was more likely that he will leave her. Focus (male, Kauma) who is

a member of the Kauma home-based care group said the following:

“There is a big problem when the wife is HIV positive and not the husband, he refuses the wife. This induces the husband to stop having sexual intercourse with the wife, instead he starts sleeping around with other women. However, if the husband and wife are very cooperative there are no differences since the husband takes medication and they stay properly with the wife.”

In the worst of situations, children were usually left as orphans. Unfortunately, I was unable to locate a child-headed household despite following up on multiple leads. Both HIV infected participants and non-infected participants shared varying perspectives on the plight and occurrence of children becoming orphans due to HIV/AIDS. Occurrence of orphaned children was common in both Kauma and Mgona. However, Kauma had an orphanage called Adziwa (run by the Capital

Baptist Church of Australia) which was still operational, whereas Mgona used to have an orphanage whose doors had closed due to illness and mortality from HIV/AIDS. I found only two households where orphans had been taken in. In most cases, respondents reported that orphans were left with no one to care for them or they were sent to the village –rural area. Wema (female,

Mgona) took in a baby left by her late child thus creating a skipped generation household. Wema reported that taking in this grandchild had put a lot of pressure on the household to provide for everyone. My discussion with Tafadzwa (female, Kauma) illuminated the challenges of taking these children in and providing for them:

Interviewee: “There are an increasing number of orphans and many deaths. Some of the orphans go around begging while others pick foods in the streets. Interviewer: Why are the kids not being absorbed into other people's households? Interviewee: It is a very difficult thing to do nowadays considering how expensive things are nowadays. You first consider that, you have your own kids, which you are struggling to take care of; therefore, the orphans are 164

left at their granny's place. However, it is hard for the grandparents to source food for the children that is why they pick up foods and beg for food.”

All things considered, HIV/AIDS is only acting to make poverty and access to food more difficult, as households have more challenges but not additional resources or options.

5.3.2 Perspectives on the Causes and Drivers of the Disease

Participants shared many different perspectives on the persistence of HIV/AIDS and its spread. Common themes such as poverty were directly related to the spread of HIV/AIDS, as people were forced into risky behavior because of poverty. Other themes, which include sexual behavior and a reluctance towards HIV testing, were indirectly related to food security and facilitated an environment which allowed for the persistence of the disease.

The association between poverty and the spread of HIV/AIDS was very common.

Respondents remarked on how women without means to feed their families would be forced to use sex to feed their children, and this practice also involved married women. Some respondents said the following:

Blessing (Male, Kauma) “For HIV and AIDS to affect us in this area it is because; firstly, people have nowhere to run to and secondly, lack of knowledge. For instance, a person may sleep for 2 or 3 days without food. Assuming I am your husband and am just drinking beer, I picked you up from the village but am not taking care of you, will you not find someone who can help you in return with sexual favours? This is how the virus is spreading, it is because of poverty.”

Tauya (male, kauma) “In some families who are not able to support themselves, it leads to the wife resorting to bad behaviour in order to be able to support the family and this leads to further spread of the disease all due to poverty. And we have seen this resulting in death of the parents leaving behind their children as orphans with no one to support them.”

Melina (female, Kauma) “For the disease to spread in this village it is due to people’s behavior. It is a common practice for women to get money from men by sleeping around with them. Little do they know that by doing that, they are exposing 165

themselves to the virus? Other women do it because they have fewer options to get food to feed their children.”

Thembiso (male, Kauma) “…the major problem is lack of understanding between partners because it is a common practice among married women to be sleeping around with other men for money. This is what is exposing many people to the virus.”

Prostitution was also described as an option for women who were lazy or wanted to make quick money. Mary (female, Mgona) said: “There, is a lot of prostitution because of these high level of poverty people would rather make quick money. But I made a decision to be myself until

God helps me”

Sexual behavior is another theme discussed by respondents. Participants reported that unprotected sexual activity was common in both normal and disturbing circumstances. Some reported young adults engaging in unprotected sex, married spouses straying from their partners, women seeking money and abuse of underage girls. The following quotes highlight some of these scenarios:

Mtima (female, Kauma) “Men go into other man's houses to sleep with their partner. The problem is that the men are not satisfied with their wives, so they may go to their neighbor’s house.” Kwasausya (female, Kauma) “in this area, the disease is spreading because women and girls like sleeping around with men. Interviewer: “Why do you think women and girls are doing that? Interviewee: I do not know, but maybe they have a problem to have capital for a business or they are lazy to obtain money through business or ganyu, so they would rather get it fast through that means.” Charmanie (female, Kauma) “Some have been infected by their husbands while others were doing it deliberately by going to the bars…” Kantanyeni (female, Kauma) “But this disease is spreading due to people's behavior of sleeping around with men. For instance, I have seen young girls around 9 years of age are sleeping with older men who are living on antiretroviral medication and the kids are contracting the disease before they even reach puberty. When they start moving around with boys of their own age, they are just passing on the virus and when they get pregnant, they are giving birth to children who are 166

living with the virus. This is so touching because it just shows that we will never come to the point of defeating this disease if people continue with their behavior.”

One phenomenon that was only mentioned once during data collection was the belief among women that they need to engage in sex with men in order to get nutrients or vitamins. When asked if anyone in her household suffered from HIV/AIDS, Leoni (female, Kauma) said the following:

“No, my last-born gets sick often, due to Blood Pressure, I usually ask her "did you get involved with anyone?" so I took her to a private hospital and the doctors tested her and told me that she is depressed with thoughts. I asked the doctor not to hide anything from me, because I may lose my child. He then told me that she has high blood pressure and advised her to stop thinking a lot because it is making her sick. However, her friends advise her to sleep with men to get vitamin E, which is essential for her body.”

Another factor reported by participants as a cause for the spread of HIV/AIDS was the fear/reluctance for people to get tested. Part of this reluctance was fueled by the fear of stigma which may then follow. Generally, this reluctance seemed more prevalent in men. I interviewed two households where one spouse was infected and the other refused or was reluctant to go for testing. In both situations, it was the husbands who had refused to go for testing. The following is an exchange we had with one of the wives- Rhoda (female, Kauma);

Interviewer: Are you the only one infected in your household? Interviewee: Yes, my husband refuses to go for testing. I tested positive in 2005. I tested because I was pregnant. In fact, my current husband is the second one since my first husband died then when my current husband asked to marry me. I did not hide my status from him. He told me that, he did not know his health status… I have asked him, several times to go for testing, but he refuses and always tells me that he is comfortable to stay without testing… Interviewer: Why is your husband reluctant to test? Interviewee: He is afraid that they might tell him that he needs to start ARV treatment immediately. Interviewer: Is that not a good thing for him? 167

Interviewee: I always counsel him but he always refuses because he says that he is not sick; thus, I decided to bargain with him to be taking bactrim with me, and he agreed. He takes the bactrim with me.

Leaders at the Kauma home-based care group reported that there were many residents in

Kauma who chose not to get tested for fear of being embarrassed and experiencing stigma. Other members of the care groups reported they had friends who were infected but chose not to join the group because community members would start whispering behind their backs. Respondents said the following regarding their reluctance for testing:

Mphatso (male, Mgona) “I have not tested because most of the times I am too busy for testing. Though my wife got tested earlier this year and she is ok. That gives me the confidence to say that I am also ok since the bible says that we are one body Fatsani (female, Kauma) “There are still many things that are happening due to people's ignorance on issues of HIV/AIDS. They do not understand the importance of being tested; mostly it is due to fear of discovering that they may be found HIV positive.”

Though there was a general reluctance toward testing, many respondents reported that they had been tested; some got tested routinely because they did not trust their husband’s behavior.

Mayeso (female, Mgona) said the following, “yes I go for testing at least three times a year, because my husband drinks beer and I cannot tell what he does when he has gone for drinking.

That’s why I thought that you have come for household testing.”

The data reported by participants showed a multitude of factors determining food security.

Food security shows seasonal variance as the time following harvest gives households either reprieve from the market or lower prices resulting from the increase in supply, therefore reducing food insecurity. Participants in Kauma experienced more reprieve from the market compared to

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Mgona residents given their increased dependence on self-grown food. The precarious nature of food insecurity in both study sites was exhibited by the proportion of income participants spent on food, with a vast majority spending over 50%. Mgona participants overall showed worse numbers that Kauma with only 9% of participants spending less than 50% of their income on food compared to Kauma where 25% of participants spent less than 50% of their income on food. While similarities exist between Kauma and Mgona, differences between them can largely be expressed by their geographies, particularly their sources of food and level of dependence on the market, coping strategies, and the determinants and challenges to food security. The major difference in this regard was that Kauma’s peri-urban location allowed residents to practice agriculture, which gave them an alternative source of food besides the market. Clearly money was an imperative factor in both study sites, however, Kauma reported other factors that highlighted the importance of self-produced food.

Results from my interviews suggest that HIV/AIDS is only compounding the poverty participants are facing, and hence access to food for those affected. Most of this is being expressed through reduced labor to participate in livelihood activities and care duties making it difficult for other household members to meet household needs in both study sites. Though ARV’s have made an impact by reducing the level of mortality and allows breadwinners to potentially provide for their households, these measures have not achieved their full potential, as discussed in the following chapter. A greater impact could be achieved with a reduction in stigma and a reluctance towards testing.

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Clearly, many participants faced hurdles getting access to food as the data on meal skipping and coping strategies suggest. As Madalitso said at the beginning of the chapter, life in the city is all about buying food, which means you need some money if you want a meal.

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Chapter Six: Analysis

Interviewer: “What is the main determinant to you accessing food for your household?” Interviewee: “It mostly depends on money and also the crops we grow on our own. But most of our food availability relies on money… When my business does not perform well my availability of money is affected, and also when my husband does not make enough or if expenses on other requirements become too much, then little is left for food.” Rumbidzai (female, Kauma)

The above quote illustrates the juggling act that participants in Mgona and Kauma deal with

when acquiring food for their households; it is a delicate balance between assessing what inputs

and resources are available, comparing them to other, more pressing needs, and determining what

“is left for food”. The majority of participants in this study dealt with this struggle on a daily basis.

Data presented in the previous chapters highlighted the challenges participants face with regard to

food security and HIV/AIDS. In this chapter, I use a holistic approach to show how food security,

HIV/AIDS and gender interact in co-dependent relationships within the larger context of the urban

slum environment (Figure 6.1).

The first step to understanding the participants’ realities is to take into account the context

and backdrop of the urban slum environment. As sections 3.3 and 4.5 highlight, both Kauma and

Mgona are characteristic of slums in sub-Saharan Africa. In both study sites, respondents have poor access to sanitation, housing, basic services and employment, which are symptomatic of the embedded poverty that exists in these slums. Eighty four percent (n = 37) of the participants in

Kauma and sixty eight percent in Mgona (n = 174) earned less than MKW 17,000 (US$61.15) per

4 an additional 25 participants reported no income and were not included in the 68% 171

month, equivalent to US$2 per day, highlighting the deficiencies with which participants contend, especially considering the cash intensive nature of the urban climate. According to the World Bank

(2010), 50.7% of Malawians live below the poverty line. The low education levels (see section

5.1) found in each study site further reinforce poverty by limiting the opportunities that residents are able to exploit, either through employment or business ventures, resulting in low wages.

Figure 6:1: Interactions of food insecurity, gender and HIV/AIDS within the slum environment

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6.1 Food Security

An important factor to consider is the different ways food security is viewed by the

government compared to the research participants. The government’s narrow view of food

security, which focuses solely on maize production, lays a poor foundation for its population to

meet their nutritional needs. The government’s strategy appears to be focused more on preventing

starvation rather than achieving food security. While this objective is understandable given the

challenges Malawi faces, failure of the government to create a vision for food security will

ultimately impede its achievement. Authors such as Kyeyune and Turner (2016) argue that it is important that notions of food security be more inclusive and actor-oriented, allowing broader views that go beyond availability of food (Jacobson 2007).

Madalitso’s remark above ties food in the urban environment to money. Virtually all necessities in the urban landscape – housing, transportation, water, healthcare – are tied to money and thus compete for the low-incomes of participants. Therefore, in order to cope, participants made cut-backs where possible. Participants were forced to cut back their food consumption in an effort to cope with the scarcity of financial resources, leading to small purchases of food, street food consumption and meal skipping (Figure 6.2). These practices support Dowler’s (2003) notion of ‘food poverty,’ which then becomes a measure of urban people’s poverty.

In the context of the slum environment, unemployment and limited livelihood opportunities create a situation where participants have very low-incomes. These low-incomes, in light of the

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other competing urban expenses, result in participants employing various food consumption and coping strategies.

Figure 6:2: Causes of food insecurity within the slum environment (adapted from Crush, Grant & Frayne 2007)

Data reported in chapter five showed high levels of food insecurity in both study sites; however, Mgona reported worse numbers in most categories. The levels of food insecurity were exhibited by the amount of meal skipping, not eating the whole day, and the frequent purchasing of food in small quantities. For both Kauma and Mgona, the majority of participants self-reported 174

being food insecure (76% participants in Kauma, 77% in Mgona). Moreover, Kauma and Mgona

participants reported that annually, they sometimes (53% and 76% respectively) or often (23% and

2% respectively) did not have enough to eat. Meal skipping was common in both study sites (59%

of Kauma participants and 63% of Mgona participants), but more Mgona participants reported not

eating the whole day (47%) compared to Kauma (30%). Moreover, the qualitative data on daily

meal consumption showed that Mgona respondents had a higher propensity to skip breakfast when compared to Kauma, with statements such as: “In the morning I just drink several glasses of water, in the afternoon, nsima wamgaiwa with vegetables and the same in the evening” Mphatso (male,

Mgona).

The most compelling measure illustrating food insecurity is the proportion of income

participants spend on food. In both study sites, many residents spent upwards of 100% of their

income on food, making it the largest single budget item. Again, the situation was worse in Mgona,

where, for only 9% of participants, food purchases accounted for less than 50% of their income,

for 45.5% of participants, food purchases accounted for 50-100% of their income, and for the

remaining 45.5% of participants, food purchases accounted for over 100% of their income. Kauma

had relatively better numbers, where for 25%, 37.5%, and 37.5% of participants food expenditures,

accounted for less than 50%, 50-100% and over 100% of their income respectively. I suspect these

numbers are what participants need to make it through the month; however, when they don’t make

the money, they simply go without food. These numbers are within the range of Banerjee’s (2007)

study, which reports that urban residents in developing countries living on less than US$1 per day

spend between 56 and 74% of their income on food. Participants’ inability to explain how they

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spend more on food than they make highlights their precarious situation, as they live hand to

mouth.

One ironic practice participants engaged in was the consumption of highly processed maize

meal ufa woyera; the vast majority of participants were aware of its nutrient reductions, however,

they preferred it to ‘grind meal’ and ufa wamgaiwa which were both more nutritious. The irony is

really twofold: first, it costs participants more money to process ufa woyera, and in light of their

low-incomes, this seems to be an unnecessary expense. Second, by processing their maize into ufa

woyera, participants were removing essential nutrients; given their high levels of food insecurity,

this seems to be another unnecessary activity. In essence, low-income food insecure people were using their limited resources to make their food less nutritious, which reinforces the power of cultural preference over nutritious choice (Pinstrup-Andersen 2009). The maize meal participants consume, however, changes when times are tough, making ufa wamgaiwa the preferred choice because they cannot spare the expense – in fact, wokomani (small packages of maize meal) were

only sold as ufa wamgiwa. Generally, the preference for highly processed carbohydrates is not

unique to Malawi; a large contributor to obesity and diabetes in North America is the widespread

consumption of highly refined carbohydrates (Algert, Agrawal & Lewis 2006). The difference,

however, is that highly refined carbohydrates in North America cost less and use a lower

percentage of household income.

Though it is clear that respondents in both Kauma and Mgona were food insecure, what does it really mean on a day-to-day, practical level? It can be difficult to understand what hunger is and feels like without experiencing it. The worry and concern generated from not knowing when or

where your next meal will come from can completely consume the mind. In the west, for some

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segments of the population, hunger is an urge people try to suppress in an effort to control their

body image. For others in less fortunate parts of the world, hunger literally means life and death.

For those people, Mahatma Ghandi says: “There are people in the world so hungry, that God

cannot appear to them except in the form of bread” (quoted in Lappé 2008). Though many will

not die from hunger, the lack of nutrition severely impairs their ability to live productive lives. The

hunger does not kill them but instead strings them along a journey of physical and mental suffering.

Food insecurity - which occurs “whenever the availability of nutritionally adequate and safe

foods or the ability to acquire acceptable foods in socially acceptable ways is limited or uncertain”

(Hamelin, Beaudry & Habicht 2002 p. 119) - manifests in both physical and psychological symptoms. Furthermore, the impacts of food insecurity are far reaching, even after the period of hunger has passed. The initial impact of food insecurity among adults is typically psychological, prompted by not knowing where the next meal will come from and a sense of failure/frustration to provide for the household. Mental health conditions that result from food insecurity typically receive less attention, but are no less impactful; these include conditions such as high stress levels, anxiety, irritability, social isolation, eating disorders, heightened emotional response, depression and impaired cognitive ability (Collins 2009). Dalitso (male, Mgona)’s statement illustrates the anxiety brought on by food insecurity: “…as the breadwinner I provide everything needed at home, when I have nothing in terms of money, it troubles my mind.” As the participant illustrates, the prospect of not knowing when one will eat again “wears on the mind,” leading to problems of focus, concentration and preoccupation with food. These problems in turn make affected individuals less effective in economic and social roles such as parenting (Collins 2009). Collins

(2009) notes that even though parents may sacrifice their own food security to ensure that their

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children eat, the child nonetheless suffers psychologically because of the atmosphere resulting

from the mental health problems with which the parents are dealing.

Children, like their parents, suffer psychological impacts from food insecurity, which

disrupts their cognitive development well into maturity. Research suggests that these disruptions

can originate from poor maternal health in the womb, especially for thin and small babies who

grow poorly in the first year of life (FAO/WHO 2003; Dowler 2003). Lelijveld et al’s (2015)

research shows that Malawian children who experienced acute malnutrition at age 2, showed

significant stunting, abnormal body composition and functional impairment seven years later.

Considering that Malawi has the highest stunting rate in southern Africa (42%) acute malnutrition

is pervasive (WFP 2015 p.1; UN OCHA 2014).

Anaemia is another concern across Africa, with 67% of children under 5 years affected

(WHO 2008). Anaemia among school-going children in sub-Saharan Africa is high: over 40% of

children are affected (Turyashemererwa et al. 2013). This problem has major implications for

health and educational achievements, as iron and vitamin A deficiencies – which cause anaemia –

lead to reduced mental capacity, impaired immune function, impaired vision, and increased risk of

morbidity and mortality (Turyashemererwa et al. 2013). Girl children are particularly at higher risk for anaemia as they mature and start regular menstrual flow because of the related blood loss; if left untreated, this will create complications around pregnancy and child birth (Turyashemererwa et al. 2013).

For adults, food insecurity also manifests physiologically. Citing evidence from developing countries, a FAO/WHO (2003) study highlights the importance of nutrition in avoidance of morbidity and premature mortality in relation to chronic, non-communicable diseases such as

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cardiovascular disease, non-insulin dependent diabetes, certain cancers, and obesity to name a few.

The notion of these diseases being referred to as “diseases of affluence” is a misnomer given how

prevalent they are in poor countries (FAO/WHO 2003).

6.1.1 Comparing Food Insecurity in Kauma and Mgona

Geography – the study of the different ways in which human societies develop and operate in relation to their physical environment (Cambridge University Press 2008) – is an essential component in this study, providing the context and backdrop for understanding the processes and interactions seen among the research themes and the differences between the study sites. The most prominent differences between Kauma and Mgona are largely due to their geographic locations

(Figure 6.3). Mgona is located in the inner city industrial zone and is an illegal settlement. As such,

land is a scarce commodity making land prices higher, increasing rental/housing prices, and

limiting respondents’ opportunities for urban agriculture. The cost-prohibitive nature of urban agriculture in Mgona results in some participants practicing subsistence agriculture at their rural homes; however, this number is small because of the expense of travel. The market is therefore the predominant source of both staple and non-staple foods in Mgona, making money the sole determinant for achieving food security (Figure 6.3). This pattern is seen in the participant’s

responses to the question “What is the main determinant to you accessing food for your

household?”

Pilirani (female, Mgona): “We live in town, and therefore money says it all” Tiyamike (female, Mgona): “we don’t have farming lands, making money have the last say on the availability of food” Tadala (female, Mgona): “Money, when my husband gets he’s salary that’s when we think of food according to the needs of the household for that time”

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Mgona’s location also limited opportunities that participants could exploit under difficult

circumstances. Participants cite that ganyu was more difficult to come by, and as a result, their

most common coping strategy was to buy food in smaller quantities. Another coping strategy that

was more common in Mgona was the purchase of street food. As Ruel (1999) notes, street food is

advantageous because it allows residents to get a meal without having to buy other inputs such as

fuel and water to prepare meals. Mgona residents relied more on street food because it enabled

them to get through situations with limited money.

Kauma, on the other hand, is peri-urban and became part of Lilongwe through

reclassification. Kauma has lower land prices than Mgona, which translates to cheaper rents and

access to cheaper land in nearby rural areas, thereby allowing residents to engage in agriculture

(Figure 6.3). Kauma is also located on a larger plot of land, which reduces resident density

compared to Mgona. Some Kauma residents practice urban agriculture, however, the vast majority

who practice agriculture do so in the surrounding rural areas where they are able to find land at

lower prices. This phenomenon of ‘urban satellite farming’ allows urban residents to exploit

farming opportunities in surrounding rural areas, which differs from the rural-urban continuum discussed by Andersson (2011), where urban residents exploit opportunities in their rural homes.

It is important to note that though urban satellite farming is an option for some Kauma respondents, many reported that getting into farming was out of their financial reach because of the many initial costs.

The ability for some Kauma participants to engage in urban satellite farming means that a mixture of factors determines their food security; these include economic and employment factors,

as well as agricultural factors such as weather and inputs (e.g. fertilizer and seed) (Figure 6.3).

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Agriculture for Kauma residents has the greatest impact on staple foods. Participants were able to

produce enough maize to keep them away from the market for at least a few months, freeing up

money to spend on other necessities such as rent and school fees. Some participants even perceived

buying staple foods from the market as a sign of food insecurity. Urban satellite farming also

provided relief from the market regarding the purchase of non-staple foods, but the impact was more subdued since participants mostly produced maize for subsistence (see section 5.1.3). Both

Kauma and Mgona participants reported high levels of reliance on the local market for non-staple foods.

Kauma’s location next to high-income neighbourhoods also afforded participants better opportunities for ganyu. Participants reported performing ganyu as one of their coping strategies when food was hard to come by. Compensation for this casual labor was provided either in cash or in kind, providing yet another strategy to help participants achieve food security.

Though the geographies of these study sites create different survival strategies and livelihood activities, both report high incidence of food insecurity, indicating that the backdrop of poverty in the slum environment remains powerful. Even though Kauma respondents cite other factors as determinants and challenges to food security, money is still the most common. Scholars such as Hampwaye (2008) argue that urban agriculture provides little benefit to urban residents and its utility has been grossly exaggerated. Even for most residents in Kauma, urban agriculture or urban satellite farming is not an option because of poor land availability and prohibitive costs.

Nonetheless, evidence from Kauma shows that the multiple livelihood opportunities offer some reprieve for participants. Mkwambisi et al (2011) argue that urban agriculture provides insurance

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against income losses. While residents may still be food insecure, their multiple options give them alternatives.

Figure 6:3: Geographic differences in Kauma and Mgona and how they affect food insecurity

6.2 Food Security and Gender

In addition to playing a role in food security, geography also influenced how gender dynamics within households affected food security, particularly in Mgona. A theme that I noticed half-way through data collection in Kauma was the limited role some women reported in acquiring

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food for their households once they had moved to the city. Figure 6.4 shows the importance of

gender dynamics within households in both the urban and rural environment, determining

women’s contributions of food within the household and the amount of autonomy/decision-

making power they have. In the rural environment, men and women share livelihood activities –

particularly in acquiring food – resulting in women making large contributions to the household.

These contributions give women more leverage to assert self-determination and grants them more decision-making power within the household.

Within the urban environment, however, the underlying forces change due to limited

opportunities and gender dynamics within the household (Figure 6.4). The limited livelihood

opportunities in the city leave women with few contributions to make in food acquisition; as such,

acquiring food largely becomes a man’s role and with that, women exercise less self-determination

and decision-making power. This notion contradicts the idea that cities are vehicles for liberation

and self-determination for women (UN-HABITAT 2013c). Moreover, gender dynamics within households determine whether women are allowed, by their husbands, to pursue economic activities in the city thus affecting intra-household food security. Participants such as Mayeso

(female, Mgona) reported that her husband did not allow her to work or do business activities for fear ‘she would misbehave’ (infidelity).

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Figure 6:4: Gender dynamics and food security

With only one household member responsible for acquiring food in the tough slum environment, households are more vulnerable to food insecurity. In other households, women were able to pursue entrepreneurial activities, reflecting a difference in gender dynamics; however, they were still mostly dependent on their husbands to provide for the family.

Intra-household food security and gender dynamics in the urban environment are further complicated in cases of polygyny. Given that women have limited opportunities to pursue in the city, the husband’s resources grow in importance; furthermore, these resources then often need to

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be spread across multiple households (Omariba & Boyle 2007; Sellen 1999). In rural areas,

polygynous marriages can share resources as part of a homestead; urban polygynous marriages,

where the wives have separate and independent households – which was the case with all

participants in polygynous marriages (n = 3) – further makes life more expensive. Omariba et al’s

(2007) cross-sectional study in 22 sub-Saharan African countries (including Malawi) and Sellen’s

(1999) research from Tanzania found that polygyny results in poorer health outcomes for maternal-child welfare in polygynous families compared to monogamous families. The only exception was in households that had urban residency and where maternal education and socio- economic status were high (Omariba & Boyle 2007).

Unlike in Omariba et al’s (2007) study, urban residency did not have a positive effect on household food security in this study. All the households in this study had trouble getting by because husbands were limited in their ability to support multiple households or had no desire to support them. In the case of my participants, the wives had to fend for themselves when the husband was visiting with a different wife. Turai’s husband was often away with his most recent wife and did not support her and her children. Worse still, she complained he would not let her find work. Estridah (female, Kauma), on the other hand, remarked that her husband would only return to impregnate her, then leave to be with a different wife. She also complained that he did not support her household of three children. All three participants who were in polygynous marriages remarked that their husbands consistently hoarded income (see below) for personal uses such as drinking beer. Polygyny has been a part of Malawian cultural for many generations and unlike in Islam, where polygyny is only permissible when a man can care for his household, no such moral obligations are enforced or practiced today: a man need only pay the bride price.

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Therefore, polygyny in circumstances where a husband is unable or unwilling to support all his

wives and their households renders them to poverty that is partly exhibited through food insecurity.

Another gendered aspect affecting food insecurity is the practice of income hoarding.

Income hoarding affects household food security as the retained (hoarded) income is used for personal consumptions rather than caring for the household. Participants reported that this activity was most common among men because they have ‘other budgets,’ the opportunity cost of which is household spending (Gwagwa 1998). In this study, evidence of income hoarding was highlighted by the number of female participants who were unable to discuss their household income because they did not know how much their husbands made. Moreover, participants reported rampant mistrust and secrecy between partners, such that when the wife had money, the husband would not contribute to the household expenses and expect the wife to use her money. This expectation plays into the notion expressed by Gwagwa (1998) that women see their resources as household resources, whereas men see their resources as their own, of which they contribute some to the household. While both partners may participate in secrecy regarding their income, women will nonetheless use their income on the household whereas men will hoard their income for personal uses. Wema (female, Mgona) illuminates this point with the following statement:

“... a man gets the whole salary envelope and hides it, but continues saying he has no money...even if they know there is nothing to eat at home. But after I work on my casual labour and I buy food you will find him eating.”

In essence men are let off the hook and it appears women are being punished for acquiring financial resources. What then results is only one household member contributing to the household, leading to food insecurity. Few households reported not being affected by income hoarding, and some non- polygynous households were quite progressive in how they worked together to compile a 186

household budget. As such, intra-household food security differed among participants, highlighting that improved gender dynamics clearly have potential to make a significant difference in household food security.

6.3 Food Security and HIV/AIDS

Food insecurity was clearly a pressing issue in both Kauma and Mgona, and HIV/AIDS in both study sites only made it more difficult for households to get by and achieve food security.

Figure 6.5 below shows how food insecurity directly leads to the spread of HIV/AIDS, which in turn feeds back into food insecurity and reinforces poverty and risky survival strategies. The extent to which households were affected was largely dependent on the health of the infected individuals.

Some participants’ health was poor, and their household contributions were consequently limited.

These diminished contributions placed more pressure on the rest of the household, forcing other household members to step up and take on additional roles. Other participants, however, reported being in relatively good health since being on ART, which greatly limited disruptions to their daily lives and reduced the cascading effects on the rest of the household. Phenomena such as these are supported by scholars that include Floyd et al. (2010), who cite how greater variability of ART treatment is extending the productive years of HIV/AIDS-infected breadwinners, thus reducing mortality and its far reaching negative effects.

Data reported by participants in chapter five make the case for a direct relationship between food insecurity and the spread of HIV/AIDS. Numerous participants reported that hunger pushed women to engage in sexual activity in order to get money or food. The following statement was typical: “…women do it because they have fewer options to get food to feed their children” Melina

(female, Kauma). Participants in both Kauma and Mgona also reported high levels of sexual

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activity; as Mtima (female, Kauma) put it, “men are not satisfied with their wives so they go into

‘another man’s house’”. Understandably, hunger can lead to prostitution; unfortunately this leads

to the spread of HIV/AIDS, particularly in an environment where there is reluctance towards

testing that is reinforced by a fear of stigma.

Figure 6:5: Food security and HIV/AIDS (adapted from Crush, Grant & Frayne 2007)

People in Kauma and Mgona engaged in sexual activity as people do the world over – there was nothing particularly unique about participants reporting that people had multiple sex partners,

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including married people. The presence of HIV/AIDS in these communities, however, made having multiple sexual partners a risky endeavor, especially given that symptoms do not present themselves for years when a person is infected. The cloud of ignorance, propelled by people’s reluctance toward testing, creates an environment where spread of the disease unknowingly takes place, putting more people at risk. This reluctance towards testing is enforced by a fear of stigma that only makes things worse. According to participants, men were typically the ones who feared testing, and some were in such denial that they would take medication without knowing for sure if they were HIV positive.

The prevalence of stigma was confirmed by chiefs in both Kauma and Mgona. Chief

Nkumbu in Kauma confirmed that stigma was present but it was much reduced due to education campaigns. In Mgona, however, the chiefs noted that even though government officials had encouraged them to openly talk about HIV/AIDS at funerals, they never did unless the deceased’s relatives granted permission, otherwise they would be accused of witchcraft. Though chiefs engage in civic education to sensitize people about HIV/AIDS, many infected residents are still reluctant to come forward; thus some unnecessarily accept a death sentence when they could potentially have many more productive years. The persistence of this cloud of ignorance facilitates the spread of HIV/AIDS, which feeds back into the cycle of poverty, having a negative impact on food insecurity.

Figure 6.5 also shows that food insecurity also has the effect of speeding the progression from HIV to AIDS because of poor nutrition. As Ivers (2009) shows, it is important that medication be accompanied with good nutrition, as it makes medication more effective and slows progression of the disease. HIV positive participants remarked they were unable to acquire adequate nutrition

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(such as protein) to maintain good health. Worse still, meal skipping was also common among

HIV/AIDS participants, reducing their ability to fight opportunistic diseases such as tuberculosis,

making it harder to maintain energy, and increasing their likelihood of becoming more ill. Though

they were knowledgeable about nutrition, none of the HIV/AIDS participants ate ufa wamugaiwa,

which was most nutritious, though none ate ufa wayoyera, which was much less nutritious. Most

HIV positive participants reported being food insecure and that they ate monotonous diets mainly

consisting of nsima and vegetables because they could not afford anything else. Lovemore (male,

Kauma) reported selling household items such as chairs when there was no money for food.

As HIV/AIDS becomes more prominent, infected participants reported reduced ability to work, reducing their contributions to the household and worsening their food situation. The inability to work – especially for breadwinners such as Dumi (male, Mgona) (see section 5.3.1) –

meant reductions in income; however, their expenses remained the same and extra expenses were

often added. Infected participants saw additional pressures from incurring expenses because of the

disease, mostly in the form of transportation costs for hospital visits. At the same time, the hospital

visits cost them money due to work day disruptions, taking them away from livelihood and

economic activities. Depending on the health of the infected household member, the need for care limited the amount of work other household members could engage in, further limiting the amount of money entering the household. This situation was the case with Thembiso (male, Kauma), who was forced to stay home and care for his wife and children instead of going to do ganyu (see section

5.3.1).

The burden of care according to the literature is typically one that falls to women (Topouzis

1999), and most participants supported this view with statements such as: “it is a woman who is

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there to care for the sick; men don’t have a heart to care for people” Ganizani (female, Mgona).

However, some participants reported that men were sharing in the role of care giving. The majority

of participants who expressed this view were members of the home-based care group. Men’s participation in this role comes from the counselling they received from the hospital. Chirumu

(male, Kauma) reported that he helped his daughter with her chores, and Focus (male, Kauma)

reported helping his wife by cooking, washing and caring for her. The importance of these actions

is that they could result in more widespread cooperation between men and women, and improve

the functioning of households and a change in gender dynamics.

The progression of HIV/AIDS places more stress on households as members are expected

to do more with less. Section 3.5 shows how mortality from HIV/AIDS eventually leads to the

erosion of social and human capital. As Figure 6.5 shows, mortality results in the disruption of households when caregivers are pulled away from economic activities (Grant & Parpart 2010).

Participants reported having so much difficulty coping that they were not able to keep their households together. Some participants were not able to rely on family members for help because they were never able to find stability and were always in need of support, which eventually eroded social capital and cohesion (supported by Mtika 2001a);

“…my sister lost her husband and because of that she comes to me to ask for assistance because the breadwinner in their family was her late husband and it is difficult for me because I have my own household problems as well.” Tauya (male, kauma)

This erosion of social capital was exhibited by the few households that took in orphans, as these households already faced their own challenges. Loss of social capital and informal safety nets resulted in the reinforcement of poverty which cycled back into risky survival strategies and the circumstances that lead to food insecurity (see Figure 6.5). As much as family and community 191

members may want to help, the realities in their own households does not allow generosity. As

Teleza (female, Kauma), a volunteer with the Kauma home-based care group, explains:

“People who are affected have less capacity to do daily activities; this situation is aggravated when they are not eating sufficient food. Due to this, we have struggles to help such people with food…. We cannot manage to get food from our household to give these people, we are needy people in our households as well.” Teleza

6.3.1 Some Notes on Gender and HIV/AIDS

An interesting theme that emerged regarding HIV/AIDS was who was responsible for its

spread. For some participants, the spread of HIV/AIDS was taking place because both men and

women had many sexual partners and did not practice restraint. For others, however, women were

to blame for the spread of HIV/AIDS because of prostitution, not being content with what their

husbands could provide for them, and being too easily convinced to ‘go the bed’. The placing of

blame at women’s feet particularly stood out during my interview with a chief in Kauma. Below

is a portion of our conversation:

Interviewer: How do people in the area perceive members of the home based care centre? Interviewee: People are very free and open to attend the home based care centre. They do not mind what people say because they know that they have to receive treatment. Many people who are affected with HIV in this area are women. They easily are carried away with men. Interviewer: What do you mean by "women get carried away easily"? Interviewee: Men have sweet talk thus they can coax women in any way to get them to bed. Interviewer: But it takes two people to do that, can you not blame the men also? Interviewee: As much as women get the disease from men, the fact is, women easily are carried away. For example, I have my daughter in Khoswe village that is moving around with a man way too (old) big for her. The man had two wives who passed away with HIV/AIDS. Interviewer: Do you not advice your daughter? Interviewee: We told her but she said she does not mind, she is interested with the money.

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Regardless of the reason why women engage in sexual activity, it is not a practice they alone partake in. By assigning this blame to women alone, it absolves men of their responsibility. Taking into account the chief’s personal experience with his daughter, the trajectory of his perspective may be understandable, nonetheless, it does not justify it especially considering his leadership position within the community.

Women reported facing challenges when trying to advocate for their sexual health with their partners, and two particular challenges were contraception negotiation and couple HIV testing.

Female participants in both study sites noted that suggesting contraception use was a sure way of being accused of infidelity. The following statements by Mayeso (female, Mgona) and Mphatso

(male, Mgona) during a group interview sums up the difficulty:

Interviewer: are you able to talk about contraceptives or protection considering that you are not sure of your safety? Interviewee A: It is very difficult for me to tell him about protection because with such a statement he will doubt, and think I am being unfaithful and I just want to clear my conscience Interviewer: under what circumstance will you tell your husband about protection when having sex? Interviewee B: it is so hard because as a woman you have no say as regards to the use of condoms Interviewee A: as I said, it is very difficult to tell him because he is often away, and after he has come, for me to tell him that we should use protection will be very unfair to him, even though I doubt his faithfulness

Suggesting couple HIV testing was another challenge for some for women, who resigned the notion of their partners joining them for testing because it was such an obstacle. During another group interview, participants noted that their husbands often refused to go for testing and they had stopped bringing it up. One of the participants said: “…with the general AIDS awareness around it is easy for any reasonable man to go for testing.”

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The gender dynamics within households makes it such that women have difficulty speaking out for their own health interests; unfortunately the finger ends up being pointed at them. Because women have low levels of education and poor access to resources, they have little power to advocate for their own needs/self-interest. Women in such circumstances are put between a rock and a hard place, for if they speak out, they risk destitution and abandonment because their husbands can easily replace them with another wife. This type of climate creates a breeding ground where HIV/AIDS can easily spread between partners that, as demonstrated above, leads to negative outcomes regarding food security.

6.4 Conclusion

Food insecurity is affected by a number factors that contribute in both simple and complex ways.

The different outcomes seen in Kauma and Mgona, and the varying abilities women have to contribute to household food security, emphasized the importance of geography and determines the opportunities participants could access. HIV/AIDS is an additional obstacle to attaining food security, as it eliminated the breadwinners and forced other household members to do more with less. Moreover, access to food is further complicated by gender dynamics –see in both study sites, particularly because these dynamics are not set in stone and are a reflection of how well partners or households can balance their needs, interests, values, insecurities and opportunities to acquire food. Failure to attain adequate nutrition has damaging impacts in the present and the future, which creates great urgency for effective interventions, especially for children. The following chapter will look at food security in Kauma and Mgona within the context of the research questions proposed in chapter two. In addition, recommendations will be proposed regarding potential interventions that could reduce food insecurity for each study area.

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Chapter Seven: Conclusion

“I think the availability of money will help a lot. Like here in Mgona we are in town, people don’t have farmlands; availability of food always depends on money. Most people were working in companies and most of the companies have closed now affecting the availability of food in homes. The food is there at the market but to find money to buy the food is a problem.” Wema (female, Mgona)

The respondent above iterates the importance of money for accessing food in the urban

environment. While financial resources are imperative in the urban environment to access food, other factors such as household gender dynamics, health and geography also have a large impact on food security, making the situation more complex. In this final chapter, I address the research

questions proposed in chapter two and provide recommendations in the form of interventions or

policy recommendations aimed at reducing household food insecurity. Finally I explain how my

research design was effective for conducting this study, illustrate how this study contributes to the

literature on urban food security in Malawi and more broadly in Southern Africa, and identify

areas for future research.

7.1 What are the levels of food insecurity?

Food insecurity in both Kauma and Mgona is widespread and extensive, and is demonstrated

by the fact that over 70% of participants in both slums self-reported as food insecure. Furthermore, meal skipping, not eating the whole day, and the purchasing of food in small quantities was very common. Although small food purchases was practiced in part for practical reasons (in response

to lack of refrigeration for example), the practice is mostly prevalent because people live hand-to-

mouth - i.e. they only eat at night if they made money during the day. Also quite telling was the

proportion of income participants spent on food. In the USA, households that spend more than 195

30% of their income on food are considered food insecure (Frazão 2007). Globally, there is a strong correlation between the percentage of income spent on food and malnutrition (measured here by the prevalence of stunting in children less than5 years old) as shown in Figure 7.1.

Countries such as Nigeria, Cameroon, Guatemala, Philippines, and Pakistan that have malnutrition rates of at least 30% spend upwards of 40% of their annual household income on food. Well over

40% of participants in Kauma and Mgona spend upwards of 50% of their income on food, further illustrating the impact of food insecurity in these areas. These results are particularly significant given that the city is cash-dependent, and residents must also juggle the costs of rent, cooking fuel, transport, school fees, health costs and other basic necessities.

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Figure 7:1: Global distribution of annual income spent on food and percent under 5 years stunting prevalence (Data Sources: (% income spent on food USDA/Economic Research Service 2014; % stunting children < 5 years WHO 1995-2014) 197

7.2 What are the coping strategies of women and food insecure households?

In food insecure households, certain practices– meal skipping, not eating the whole day and

buying food in small quantities, all discussed above – can be called coping strategies, yet

simultaneously they are simply the reality of what one must do when one runs out of options.

Participants also use another set of coping strategies to address or delay food insecurity; these include performing ganyu, engaging in urban satellite farming, consuming street food and borrowing or getting assistance from family. However, these practices vary in their effectiveness between slums.

In Kauma, the practice of ganyu and urban satellite farming are successful due to Kauma’s

favourable geographic situation, giving participants alternative strategies and some reprieve from

the market. While not a silver bullet, these strategies are nonetheless part of a matrix people

employed to attain food. Consumption of street food was more common in Mgona, giving cash-

strapped respondents an opportunity for a quick meal to tie them over, and avoid additional

expenses associated with meal preparation, such as fuel. Even though street food may be an

effective short term option, in the long run it results in higher food costs (as the per-unit price of

food is higher) and leads to poor health (as such foods are high in fat and refined carbohydrates).

Street food comes with another disadvantage: poor hygiene, making it potentially unsafe and it is

the cause of most gastrointestinal infections (Ruel & Garrett, 1999).

Respondents also cited getting assistance from family and friends to aid with food insecurity,

either in kind or through borrowing; however, this strategy was not a long-term option because it

eroded informal safety nets. A number of participants noted how they were no longer receiving

assistance from family because their families had their own challenges to deal with. By the same

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token, participants also expressed desire to assist food insecure family members, but their own demands would not allow this. Few participants mentioned borrowing as an option. Chirumu

(male, Kauma) noted that at times he would borrow but the exorbitant interest rates made it a rarely employed strategy.

7.3 How is HIV/AIDS affecting the food security of households?

The answer to this question is best illustrated by Figure 6.5; HIV/AIDS further compounds the challenges food insecure households already have in acquiring adequate food. The illness debilitates households by eliminating the contributions of breadwinners, while at the same time placing more demands on the family unit due to the illness. Such demands come in the form of additional expenses that include transportation to the hospital, medication and more nutritious food for the infected household member. Very quickly households are forced to make difficult choices regarding what they must do without in light of scarce resources. As the infected household member/s become more ill and require more care from family members (which means they are forced to miss work), resources entering the household are reduced. Households are then forced to cut back on food needs, in so doing exacerbating food insecurity and pushing household members into behaviours that lead to the spread of HIV/AIDS which mostly affect women. Women are further impacted due to their role as caregivers; caring for HIV infected household members adds additional work to women and negatively impacts their other role as household food custodians.

In a nutshell, HIV/AIDS in a food insecure household leads to a chain of events that results in more food insecurity.

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7.4 What social and economic interventions can be employed to combat food insecurity?

Participants in both study sites reported that money was the main determinant to getting access to food, and as such, economic interventions are the logical starting place. Going beyond that gets very complicated rather quickly, which in essence is the challenge of urban food security.

Economic development is dependent on a vast array of factors such that trying to control or target these factors toward either Kauma or Mgona is very difficult and complex. The literature addresses the problems of urban food security but it is rather silent on solutions. The majority of recommendations proposed largely fall into the category of economic development projects (see

Mvula & Chiweza, 2013) that do not have successful track records, particularly in the southern

African context.

One intervention that is already being utilized in Kauma is money for work programs that are used to build/upgrade infrastructure, build model toilets for residents to replicate, and plant trees. The majority of these projects are financed and run through the Malawi Social Action Fund

(MASAF). The money for work programs are effective at putting money in people’s hands and empowering residents financially, while making improvements to the community. However, the problem is the infrequency of the projects in Kauma. During my 5 month stay in Lilongwe, the chief informed me a MASAF project was coming and that I was welcome to see it in action.

Unfortunately, the project never materialized. My interview with the deputy director of city planning revealed that the project was on hold “until we figure out the politics.”

In the same vein of putting money in people’s hands, creating employment opportunities would do the same (Mvula & Chiweza, 2013). Areas such as Kauma and Mgona have large supplies of cheap, low-skilled labor from which companies could benefit. Unfortunately,

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conditions for private sector employment creation in Malawi are poor, evidenced by its dismal economic performance over the last few years. Mgona, which could benefit most from employment opportunities because of its proximity to the Kanengo industrial area, has not benefited because of retraction in the economy.

A strategy that could be more widely utilized in Kauma and Mgona is the purchase of maize in large quantities just after the harvest period, when prices are lower, to store and consume during the hunger period when prices increase. Few participants utilized this strategy because it was too expensive on the front end. An alternative would be to establish a community food bank type operation that could buy large quantities of maize and other non-perishable goods after the harvest season, and then sell the food to poor residents at prices similar to the harvest period. This would buffer participants from the large price fluctuations and provide them an option for affordable food when market prices are out of reach. Measures to avoid abuse would need to be incorporated, but in principle the strategy could be viable.

By far, participants reported that opportunities to engage in business would be the most important endeavor to aid them in combating food insecurity. Female participants mostly addressed the need for capital to start businesses. Micro-finance – which did not exist in Kauma and Mgona – would be a valuable resource to enable women access to capital to pursue entrepreneurial opportunities. The impact and success of micro-finance has been documented in other development contexts (Schicks, 2007; Selinger, 2008). The target of women in this context would be particularly beneficial because empowering women has a greater impact on household food security and could potentially improve gender dynamics.

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An “outside the box” solution that has been rather successful in slums of developing

countries is the use of complementary currencies. Complementary currencies “involve the

development of a medium of exchange, physical and/or digital, that can be used for a variety of

purposes including: facilitating trade, targeting development, and creating customer loyalty”

(Ruddick, 2011 p.2). By design these currencies are not meant to replace legal tender but instead to work alongside it. Complementary currencies are referred to by other names, including local

currencies (designed to operate within a more limited local community), and cooperative

currencies (created to encourage cooperation instead of competition among users) (Lietaer &

Dunne, 2013 p. 58-59). Complementary currencies have seen wide range use in situations where

monetary and financial crisis persists, impeding people from getting back on their feet; the general

aim of which is to connect “unused resources with unmet needs” (Lietaer & Dunne, 2013 p.6).

Complementary currencies are particularly advantageous because they tend to increase trade and

allow the profits generated to remain inside the target area (Ruddick, 2011).

One of the most popular success stories of complementary currencies in the developing

world comes from the city of Curitiba, Brazil. Although its public transportation system receives

the most attention, Curitiba was able to solve a waste management problem in the city’s slums and

earned an award from the United Nations Environment Programme (Rabinovitch, 1992). Garbage

was a major problem in Curitiba’s slums during the in 1980’s; the knee-high garbage piles spread

across the area and were a health hazard and caused multiple deaths a year when people slid down

them (Lodhia, 2015). The municipal government initiated a program where they encouraged

residents to bring their garbage to waste stations in exchange for public transportation tokens. The

success of the program saw one of the garbage sites converted into a park, and the program was

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further expanded to encourage residents to separate their garbage into recyclables, organics, and

non-organics using the slogan: “garbage that is not garbage” (Rabinovitch, 1992 p.68). In

exchange, residents were compensated with public transportation tokens, food and school books.

The program has been effective at keeping the slums mostly garbage free and funds generated

from the recycling programme were reinvested in the community to support social programmes

(Rabinovitch, 1992).

Another example of effective complimentary currencies includes the Eco-Pesa currency

introduced in three informal settlements of Kongowea, Kenya. Eco-Pesa was introduced in August

of 2010 with the aim of empowering “impoverished people to increase their incomes in a manner

that provides for public health and environmental conservation” (Ruddick, 2011 p.2). Inspired by

three other complimentary currency programmes – Berkshire, Massachusetts; Curitiba, Brazil and

Palmeras, Brazil – residents in Kongowea received Eco-Pesa for garbage collection and tree planting. Residents were then able to spend their Eco-Pesa at 75 participating small businesses in the area. Eco-Pesa was supported by the national currency, allowing participants to buy them at a

20% discount and sell them at a 20% loss. This practice encouraged a higher likelihood for the value generated to stay in Kongowea (Ruddick, 2011).

Through the Eco-Pesa programme, 20 metric tonnes of waste were collected from the community that spurred the start of a youth-led tree planting operation, for which they were paid in Eco-Pesa. Data from Ruddick’s (2011) study over a 3 month period reports an estimated US$

4176 worth of trade facilitated by US$352 worth of Eco-Pesa. Furthermore, 80% of the businesses that participated reported a 22% increase in monthly revenue and a positive increase in customers.

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Ruddick (2011 p.6) quotes a business owner: “Eco-Pesa has brought the youth together and cleaned our village and brought work for the youth.”

The benefits brought by complimentary currencies to Curitiba and Kongowea could also be

realised in Kauma and Mgona and can have wide ranging development impacts, especially

considering the transformation they could have on the built environment and the ability to keep

wealth in target areas. The key is to come up with the optimal complimentary currency that will

match a need with a resource. This option requires leaders on the ground to look past solutions that come from abroad, work with the communities and employ some creativity. There is no need for a lack of funds to stop a community from solving a problem (Suzuki, Dastur, & Moffatt, 2010)

7.5 What policy gaps exist and how can policy be used to address food insecurity?

An area that needs urgent policy attention is the relationship between slums and the city.

Evidence from developing countries such as Kenya, Ghana and Brazil shows that providing slum

residents with legal land tenure is an instrumental step in formalizing slums and improving living

conditions (Nyametso, 2012; Toomey, 2010). Toomey’s (2010) study of the Kambi Moto slum of

the outskirts of Nairobi found that granting residents land tenure – one among other important

factors – lead to improved environmental conditions (permanent housing, utility provision,

sanitation infrastructure, etc.), improved health outcomes, increased economic activity, and

improved self-esteem and image. As Kambi Moto formalized, this resulted in an overall increase

in living costs that included mortgage fees, utility fees and city services. Unfortunately, wages in

the area have remained stagnant (Toomey, 2010). Alternatively, scholars such as Handzic (2010)

argue that legalization of land tenure is not a necessity or prerequisite to transform slums into

formal neighborhoods and can be disadvantageous, particularly because of the increased living

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costs – which inflate with the state’s involvement through taxation – that will push the poor out to

more distant squatter settlements. The necessity for land tenure to be secured in order to upgrade

slums is a reflection of a western capitalist worldview, whose building block is individual land

ownership (Handzic, 2010). Handzic’s (2010) study of Rio de Janeiro’s Favela Bairro Program

illustrates how slums residents can still acquire residential security through government

investments in slum upgrading and allowing residents land use rights instead of outright

ownership.

Lilongwe city council faces similar challenges with Kauma and Mgona, but unfortunately

the city is largely ignoring the issue. As Mr. Kamela (deputy director of city planning) very

succinctly explained, slums are not on the city’s agenda and many in the municipal government

choose to ignore their existence, referring to Kauma as “forest areas” – which is how it was zoned

– rather than quasi-residential – which signals a transition to formalization. The Lilongwe city council has largely remained inactive while informal settlements have grown; their lack of participation stems from an inability to come up with new ways of dealing with the slum phenomenon that has no place in traditional or western-oriented city planning. As such, because they cannot convert these slums into residential areas that comply with city codes, the city is not influencing future growth patterns. Mr. Kamela notes that the city’s inaction is short-sighted because while they sit on the sidelines, the residents move the settlements forward, and since these slums are within the city’s jurisdiction, they will inevitably be the city’s problem to solve. If the

Lilongwe city council chose to engage the chiefs within these slums, they could influence future growth, and potentially reduce future problems. Mr. Kamela reports that the biggest challenge within the city council is acknowledging the existence of slums. That being said, the city council

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needs to create a policy framework that will lead to the formalization of these slums. The process

will be difficult and will not benefit everyone as some may be forced out, but to stand on the

sideline and claim ignorance only worsens the situation.

Another area where policy can help address food security in Kauma specifically is

agriculture. While Kauma receives fertilizer coupons through the farm input subsidy programme

(FISP), greater emphasis should be applied to peri-urban residents who practice agriculture. Only one participant reported ever receiving fertilizer coupons, and unfortunately only for a single year.

All other participants who practiced agriculture reported hearing of the programme, but they had never been beneficiaries. Some participants stated that the Chief and his relatives were the ones benefiting from the coupons, while other Lilongwe residents reported coupon recipients were selling their coupons to farmers as they had no use for them. This corruption/nepotism highlights some of the donor’s critiques of the programme (and the starter pack program), citing poor targeting of participants (Denning et al., 2009). Other scholars note that the failures of the FISP to target the poorest is a societal reflection of how the poor are denied access to resources (Javdani,

2012); unless societal issues of access to resources by the poor are addressed, the FISP program will only enhance the inability of the poor to access food.

In addition to poor targeting of the fertilizer coupons, Kauma residents reported rampant corruption when trying to redeem their coupons. The regular price for fertilizer was MKW 11,000

(US$39.57), and with the coupon, holders could receive fertilizer for MKW 500 (US$1.80). In some cases, however, coupon holders were expected to pay government clerks a bribe in addition to the MKW 500, thereby undermining the coupon subsidy. The programme clearly has its benefits

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(see section 3.3), however, measures need to be put in place to avoid abuse and to better target

beneficiaries (Javdani, 2012).

7.6 Impact of Research Design on the study

The importance of pragmatism in conducting this research was its focus on context and

solutions expressed through the rejection of foundational truths –allowing me to conduct this study

in a manner that would discourage preconceived notions of food security, the belief that knowledge

is socially created –which allowed notions such as food security to be defined by participants, and

a belief in radical contingency –enabling interventions to be based on the understanding gained

from the particular study sites in question. Given that this study employed a case study strategy of

inquiry that looked to capture the uniqueness of cases rather than generalizable results,

pragmatism’s focus on context ties in well with the case study approach, and allowed me to explore

the uniqueness of Kauma and Mgona. It is through the exploration of these unique study sites that

the importance of geography was expressed. While pragmatism has been criticized for not having

a particular methodology, in my research its openness to multiple points of view provided me with

a footing for utilizing a mixed methodology.

This study benefited from employing a mixed methodology approach, using both quantitative and qualitative approaches. The quantitative approaches were effective at gathering demographic data on the participants, data on food consumption and data on food sources and spending. The qualitative approaches were effective at collecting data on HIV/AIDS, gender and

food security. While my quantitative approach allowed me to examine food security in measurable

ways that can be compared and contrasted to other studies, or monitored over time, the qualitative

data provided me with in-depth rich detail and allowed exploration of the distinctiveness of

207

situations with regard to the participants and the study sites in general. Moreover, the qualitative

nature of the study design allowed participant’s voices to shine through the numbers, enhancing

the understanding of their circumstances.

7.7 Research Contributions

My study contributes to the literature on urban food insecurity in Lilongwe slums, and accounts for the influencing factors of poverty, HIV/AIDS, and gender. This study highlights the importance of considering the interrelationship of these themes, as my results from Kauma and

Mgona demonstrate how each one of these themes has dramatic effects on how residents access food for their households. For example, a change in gender relations alone can have the effect of improving a family’s access to food, due to the nature by which women regard and allocate their resources compared to men. Furthermore, the importance of adequate nutrition in slowing the progression of HIV to AIDS will in turn reduce the propensity for the affected household to engage in risky survival strategies. These examples highlight the need to consider poverty, HIV/AIDS, gender relations, and their interactions within the urbanizing context of slums in order to establish more a comprehensive understanding of food security and a basis for solutions.

Importantly, this study highlights the significance of geography when considering the effects of food insecurity. The geographic differences between Kauma and Mgona affected the livelihood strategies participants had at their disposal and as such, how they combated food security through coping strategies and food acquisition possibilities. Urban satellite farming is a good example of this and is a topic not often discussed. More commonly addressed is urban agriculture – taking place within cities and the peri-urban areas. In my study, however, participants

208

in Kauma were unable to financially access land in the city and therefore sought farming opportunities in the surrounding rural areas where land prices were lower. Such phenomenon is likely common in slums located in peri-urban locations in other parts of Malawi and even in southern Africa. The recognition of geographic variance within the same city emphasizes the need to tailor any solutions or strategies to the area in question: there is no “one size fits all solution” and geography has an immediate impact on the opportunities available to residents.

Finally, this study illuminates the role gender dynamics play in urban environments, and its effect on food security. The contributions women can make to their household’s food security is determined by both gender dynamics within the household and their available opportunities in the urban environment. The notion argued in the literature that cities advance women’s options and lead to more liberty and self-determination is not always true, and depends largely on the context of urbanization, as argued by authors such as Tacoli and Satterthwaite (2013). Due to limited opportunities in the city, women can find themselves with fewer livelihood strategies than in rural areas, making them completely dependent on their husbands, and resulting in a loss of decision making power and self-determination. Moreover, gender dynamics within the household can inhibit women’s ability to succeed in the urban environment (Tacoli, Satterthwaite 2013). For example, some female participants reported their husbands did not allow them to work or engage in business activities for fear too many men would see them or they would be unfaithful. As such, how couples are able to negotiate such issues has a critical impact on the amount of resources available to the household and therefore on the food security situation.

Findings from this study are echoed by other studies done in the region. Similar to Riley and Dodson’s (2014) findings in Blantyre, my study found that gender negatively influences the

209

earning ability of women making it harder for them to provide for their households. While there is

great variance in the levels of food security in the AFSUN study, Kauma and Mgona are emblematic of food insecurity, similar to results reported in cities such as Harare, Lusaka, and

Manzini (Frayne, Crush & McLachlan 2014). While Crush et.al (2011) argue that residents growing their own food does not provide much benefit, data from the AFSUN survey shows great variance in that cities such as Harare and Blantyre report getting benefits from this activity, as was the case in Kauma. Food secure participants in Tawodzera’s (2014) study in Harare, Zimbabwe, cultivated 66% of their field crops, which greatly improved their situation, also similar to Kauma, those who practiced agriculture mostly grew field crops such as maize. Though Mgona is part of the same city as Kauma, residents there benefited less from growing their own food, again emphasizing the importance of geography, and being cautious when generalizing research findings.

While interest in the study of urban food security in southern Africa has grown in recent years, there remain areas that require further inquiry. Based on the findings from this study, gender dynamics play an instrumental role in household food security. Some participants were able to work together in an environment of trust that enabled households to cooperatively work towards household food security. Further research is needed to understand the factors that made this possible and how to foster better cooperation within households that improves women’s empowerment. In addition, further research is needed on the extent and impact of urban satellite farming in southern Africa and measures by which to encourage it as an avenue for the urban poor.

Based on the success of complementary currencies in other contexts, there is need to research other ways by which unused resources and unmet needs can be matched in order to address concerns in

210

slums. Lastly, as alluded to by authors such as Javdani (2012), there is need to research the manner

by which interventions such as the FISP can be implemented in order to reduce societal inequality

and that could result in the poor and the powerless being better served by such programs.

In an effort to make this research accessible to possible end users, sections of this

dissertation will be published in academic journals enabling other researchers, policy makers and

interested parties to access it. In addition, I will share a summary of the findings and

recommendations with stakeholders and community representative in Kauma, Mgona, Lilongwe

Urban Poor Peoples Network, and the City of Lilongwe. Prior to my departure from the Lilongwe,

I shared early versions of the maps I created in Kauma and Mgona with the chiefs of the respective

study sites, which they said would help them with their activities. Ideally the findings in this dissertation will have a life beyond discussions among academics.

Urban food security is a global problem. In southern Africa, this problem is further compounded by poverty, HIV/AIDS, gender inequalities and high rates of urbanization. For most residents in Kauma and Mgona, the complexities of these inter-related factors impact their health, ability to work, daily survival and their overall ability to subsist. Many residents struggle day-to-

day, subsisting hand-to-mouth, and in other cases engaging in risky sexual behaviour to merely

put food on the table. Although people struggle, important to highlight is the resiliency exhibited by my research participants. In the face of limited resources and opportunities, people continually

strive and are ever resourceful, problem solving and coping with the little they have. Without a

doubt, people in these situations have not given up on life nor have they simply accepted the predicament they are in. Although acquiring food is a challenge they face, it is one they face head

211

on. As such, food security is interwoven into their daily lives. Only by understanding these issues and how they interrelate, can we begin to find comprehensive solutions.

212

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248

Appendix 1: Survey Questionnaire and Interview Questions

Survey Questionnaire and Interview Questions for: Perilous Connections: Poverty, Food Insecurity, HIV/AIDS and Gender in Lilongwe, Malawi. Interviewers name: ______Interview number:______Background Information 1. Area: ______2. Gender: ______1.Male 2.Female 3. Age:______4. Education Level (kodi sukulu munalekeza pati?): ______1.Primary 2.Secondary 3.Diploma 4.University Degree 5.Other 5. Marital Status (ndinu okwatira?):______1.Married 2.Single 3.Widower/Widow 4. Divorced 6. Household Head (pakhomo panu, mutu wabanja ndi ndani?):______1. Yes 2.No Indicate whether it’s single or dual headed household 7. Number of people in the household (pakhomo panu mukukhala anthu angati?): ______8. Number of people in the household 18years and below (nanga mukukhala ndi ana angati omwe ali ndi zaka 18 ndi zochepera apo?): ______9. Number 18years and below who are in school (nanga ndi angati mwa anawa omwe akupita ku sukulu?): ___ of ____ 10. What do you do for a living (mumapanga chani chomwe chimakubweretserani ndalama pakhomo panu?) Specify the profession:______1. Farming 2.Informal business 3.Formal Business 4.Formal employment 5. Informal employment 6.Nothing 7.Other (specify) ______11. What is your average monthly income and what is your average Household monthly income (Kodi pamwezi mumapanga ndalama zingati)? Interviewee______Household______12. If seasonal, what is your seasonal/annual income (Indicate number of months it is accumulated) :Interviewee______Household______

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13. How much money does your household spend on food per month (pakhomo panu mumagwiritsa ntchito ndalama zambiri bwanji kugulira zakudya)? ______

Length of Migration 1. How long have you lived in Lilongwe (mwakhala muno mu Lilongwe kwa nthawi yaitali bwanji)? ______2. How long have you lived in this particular area of Lilongwe (nanga mu dela lino mwakhalamo nthawi yaitali bwanji)? ______3. Do you rent (kodi malo mukukhalawa ndi anu kapena a rent)? ______4. If so, how much rent do you pay (ngati ali a rent, mumalipira ndalama zingati pamwezi)? ______5. How often do you return to the rural areas during the year (kodi mumapita kumudzi kangati pachaka)? ______6. What length of time do you spend in the rural areas (nanga mukapita kumudzi mumakhalako nthawi yochuluka bwanji)? ______

Household Income, expenditure and assets 1. Walls of the house |___| 1 = Block/cement/concrete/stones, 2 = Baked/burnt bricks, 3 = Mud bricks, 4 = Mud and poles, 5 = others (Specify) 2. Roof of the house |___| 1 = Galvanized iron sheets, 2= Roofing tiles, 3 = Grass, leaves, bamboo, 4= Others (specify) 3. Main source of power for cooking in the house |____| 1 = electricity, 2 = Industrial gas, 3= Biogas, 4= Paraffin, 5 = Charcoal, 6 = Firewood, 7 = others (specify) 4. Source of water for drinking |____| 1= indoor tap water, 2= water kiosk, 3=bore hole, 4 = well, 5= Others (specify)

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5. Costs for daily purchases (Lighting, energy, water, food) MATERIAL: (specify) USED; 1=yes, 2=no DAILY COST (MK) Lighting Water Food

6. Number of livestock owned by household Chickens __, Goats ____, Ducks _____, other (specify) ______Food Security 1. Within the last 12 months which statement best describes your situation (Miyezi khumi ndi iwiri-12 yapitayi, ndi ziti zomwe zikukamba za inu) (Please tick only one box)

We always have enough to eat and the kinds of food we want (Timakhala ndi chakudya (1) chokwanira chomwe timafuna)

We have enough to eat but not always the kinds of food we want (Timakhala ndi chakudya (2) chokwanira koma osati chomwe timafuna)

Sometimes we don’t have enough to eat (Nthawi zina chakudya sichikwanira) (3)

Often we don’t have enough to eat? (nthawi zones sitimakhala ndi chakudya chokwanira) (4)

2. Rank the reasons why you don’t always have enough food (chifukwa chachikulu ndi chani chimakupangitsa kuti musamakhale ndi chokudya chokwanira?) Not enough money for food (Ndalama zimakhala zochepa) Too hard to get to the store (Ndikovuta kupeza malo ogulitsa chakudya) No working stove available (Palibe chida chophikira)

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Not able to cook or eat because of health problems (Sinditha kuphika kapena kudya chifukwa cha kudwala) No/poor availability of food to buy (Chakudya sichipezeka) Not able to grow enough food (sitikwanitsa kulima mbeu za chakudya) Not able to make ends meet due to health problems (sitikwanitsa kupeza zones timafuna chifukwa cha kudwala) Do not have enough land to grow food (tilibe malo okwanira olimapo chakudya) Lack of agricultural inputs

3. From the options below, rank the main sources of your staple food (Kodi chakudya makamaka chimanga kapena mpunga chanu chambiri chimachokera kuti).

Main store outlets (ma shop akulu akulu)

hawkers (ma okala)

Venders/Markets (ku nsika)

Self grown (timalima tokha)

Remittances/Assistance (kupatsidwa ngati chithandizo)

Other-specify (njira zina):

4. From the options below, rank the main sources of your other food stuffs (nanga zakudya zina zimachokela kuti)? Main store outlets (ma shop akulu akulu)

Small grocers (ma okala)

Vendors/Markets (ku nsika)

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Self grown (timalima tokha)

Remittances/Assistance (kupatsidwa ngati chithandizo)

Other-specify (njira zina):

5. In the last 12 months, did you ever eat less than you felt you should because there wasn’t enough money to buy food (Kodi miyezi khumi ndi iwiri-12 yapitayi, munasowapo chakudya chifukwa chosowa ndalama zogulira chakudyacho)? 1.Yes 2.No (If NO skip item 7) 6. If yes, how often did this happen (ngati zinachitikako, zinachitika mochuluka bwanji)? (Please tick only one box)

Every Month (All months of the year)

(1)

Some months (Many but not all months)

(2)

Rarely/ Few months (one or two months)

(3)

7. In the last 12 months, were you ever hungry but didn’t eat because you couldn’t afford enough food (Miyezi khumi ndi iwiri-12 yapitayi, munakhalapo ndi njala chifukwa cholephera kugula chakudya chokwanira)? 1.Yes 2.No (If NO skip item 9) 8. How often did this happen (ngati zinachitikako, zinachitika muchuluka bwanji)? (Please tick only one box)

Every Month (All months of the year)

(1)

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Some months (Many but not all months)

(2)

Rarely/ Few months (one or two months)

(3)

9. In the last 12 months, did you ever cut the size of any of the children’s meals because there wasn’t enough food (Miyezi khumi ndi iwiri-12 yapitayi, munachepetsako chakudya cha ana anu chifukwa chosowa ndalama yogulira chakudyacho)? 1.Yes 2.No (If NO skip item 11) 10. How often did this happen (ngati zinachitikako, zinachitika mochuluka bwanji)? (Please tick only one box)

Every Month (All months of the year)

(1)

Some months (Many but not all months)

(2)

Rarely/ Few months (one or two months)

(3)

11. In the last 12 months, did any of the children ever skip meals because there wasn’t enough food (Kodi miyezi khumi ndi iwiri-12 yapitayi, ana anu ena anakhalapo osadya chifukwa chakuchepa kwa chakudya)? 1.Yes 2.No (If NO skip item 13) 12. How often did this happen? (ngati izi zinachitika, zinachitika mochuluka bwanji)? (Please tick only one box)

Every Month (All months of the year)

(1)

Some months (Many but not all months)

(2)

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Rarely/ Few months (one or two months)

(3)

13. In the last 12 months, did any of the children ever not eat for a whole day because there wasn’t enough food? (Kodi miyezi khumi ndi iwiri-12 yapitayi, ana anu anakhalapo tsiku latunthu osadya chifukwa chosowa ndalama zogulira chakudya) (Please tick only one box) 1.Yes 2.No (If NO skip item 15) 14. How often did this happen (ngati zinachitika, zinachitika mochuluka bwanji)? (Please tick only one box)

Every Month (All months of the year)

(1)

Some months (Many but not all months)

(2)

Rarely/ Few months (one or two months)

(3)

15. In the last 12 months, did you ever skip a meal because there was not enough food (Miyezi khumi ndi iwiri-12 yapitayi, munaphonyako chakudya nthawi inayake ya tsiku chifukwa chakuchepa kwa chakudya)? 1.Yes 2.No (If NO skip item 17) 16. How often did this happen (ngati izi zinachitika, zinachitika mochuluka bwanji)? (Please tick only one box)

Every Month (All months of the year)

(1)

Some months (Many but not all months)

(2)

Rarely/ Few months (one or two months)

(3)

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17. In the last 12 months, did you ever not eat for a whole day because there wasn’t enough food (Miyezi khumi ndi iwiri-12 yapitayi, mwakhalapo osadya tsiku lonse chifukwa chakuchepa kwa chakudya)? (Please tick only one box) 1.Yes 2.No (If NO do not answer question 18)

18. How often did this happen (ngati zinachitikako, zinachitika kochuluka bwanji)? (Please tick only one box)

Every Month (All months of the year)

(1)

Some months (Many but not all months)

(2)

Rarely/ Few months (one or two months)

(3)

19. How often do you normally eat each of the following meals?

Not at all (1) 1 or 2 days per 3 or 4 days per Every day of the week (2) week (3) week (4) Breakfast Lunch Supper

______

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DRAFT INTERVIEW QUESTIONS

Food Security 1. What are your favorite foods to eat (Kodi mumakonda kudya zakudya zanji)? 2. How often do you get to eat them (nanga zakudya zomwe mumazikondazi mumazipeza nthawi zochuluka bwanji)? 3. What does it mean to you to be food secure? [Being content that your getting enough food in right contents, knowledge of food groups] (kodi kukhala ndi chakudya chokwanira kumatanthauza chani?) 4. Are you food secure right now? (kodi pano muli ndi chakudya chokwanira pakhomo panu)? 5. What types of food compose your diet and how often do you eat them- in terms of food diversity (kodi zakudya zomwe mumadya ndi ziti? Nanga mumadya mowirikiza bwanji? 6. Could you walk me through a typical day with your experience to food? (probing will be used to explore meals, cooking, sources (Mundilongosolereko mmene madyedwe anu amakhalira patsiku kapena mbiri ya chakudya chanu patsiku? (Tchulani kepezekedwe, kaphikidwe ndi kadyedwe). 7. From where do you get your food (stores, venders, self grown, remittances, etc)? To what degree does each of these factor into your food consumption patterns? (kutengera mmene munandilongosolera za komwe mumapepeza zakudya zanu, ndi kuti komwe kumachokera zakudya zambiri)? 8. How does street food factor into your daily consumption of food? Why is this the case? (Nanga chakudya chophikaphika chogulitsidwa munsewu ndi anthu ndi chiti chimene mumagulira anthu apa banja lanu?) Izi zili choncho chifukwa chani?) 9. How accessible is food both in quantity and variety where you live (Kodi mdera lanu mumapezeka chakudya chokwanira ndinso chamitundu mitundu)? 10. What is the main determinant to you accessing food for your household (nanga kapezedwe ka chakudya pakhomo panu kamatengera chani)?

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11. What is the most difficult challenge you have in terms of getting access to food (vuto lalikulu lomwe mumakumana nalo lokhudza kapezedwe ka chakudya ndi chani)? 12. What do you think would best improve access to food where you live (kodi mumaona kuti chofunika kuchitika mu dela lanu lino ndi chani polimbikitsa kapezekedwe ka chakudya)? 13. What assistance if any do you receive from government in accessing food (kodi boma limakuthandizani mu njira iliyonse pakhani ya zakudya? Ndi thandizo lanji)? 14. What assistance, if any, do you receive from other organizations in accessing food? If so, which organizations (nanga pali ma bungwe omwe amakuthandizani pakhani ya zakudya? Ndi mabungwe anji ndipo ndi thandizo lanji)? 15. To what extent are you involved in urban agriculture? What types of food do you produce. What factors have influenced the types of crops you are producing (essentially why those crops)? 16. To what extent does urban agriculture address your food needs (Nanga umakuthandizani bwanji kumbali ya zakudya pakhomo panu?)? 17. What do you think of urban agriculture as a solution to improve access to food where you live (kodi ulimi wa ntauni ungakhale yakho papititsa patsogolo mapezedwe a chakudya mdela lanu lino?) 18. What constraints do you find to urban agriculture (kodi mavuto omwe mumakumana nawo pochita ulimi wa ntauni ndiotani)? 19. What things do you do to get by when it is difficult to get access to food (kodi mumatani nthawi yoti mapezedwe a chakudya avuta)? 20. What interventions could best improve your access to food (nanga mumaona kuti pakufunika kuchitika chani kuti mapezedwe anu azakudya akhale osavuta)?

HIV/AIDS and Food Security 1. How has HIV/AIDS affected daily activities in your community? (Kodi matenda a HIV ndi AIDS akhudza bwanji ntchito za tsiku ndi tsiku mdera lanu)

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2. Can you tell me some stories of what you have seen in relation to the effects of HIV/AIDS? (mungandilongosolereko zina zomwe mwakhala mukuziona zikuchitika mdela lanu lino zomwe zabwera ndi matendawa) 3. Have any of these things happened in your household (pazimene mwandilongosolerazi, zilipo zomwe zachitika pakhomo panu pano)? 4. How many people in the household suffer from HIV/AIDS (pakhomo panu pano alipo ali ndi matendawa? Ndi anthu angati)? 5. How long have they been infected (ngati alipo, akhala ndi matendawa kwa nthawi yaitali bwanji)? 6. Are they taking medication (nanga akumwa mankhwala)? 7. How has their infection affected the day to day activities in the home (nanga kudwala kwawoku kwakhudza bwanji ntchito zatsiku ndi tsiku za pakhomo panu pano)? 8. How if at all does living with infected people affect your experience based on your gender (kodi makhudzidwe anu ndi matendawa asiyana mnjira iliyonse kutengera ndi kuti ali ndi matendawa ndi bambo kapena wa mayi)?

Gender 1. In what ways are gender differences most demonstrated or practiced in your view? (Kodi ndi mu zinthu ziti m’mene kusiyana kwa akazi ndi amuna kumaoneka kwambiri) 2. In your view how do gender differences express themselves with regard to food (procurement, preparation, access, quantity)? (Kodi kusiyana kwa amuna ndi akazi kumaoneka bwanji pa zakudya? ( Longosolani pakuphika, kupeza, kuchuluka ndi zina zotero). 3. Is one gender in a better position in terms of access, consumption or provision of food? How drastic are the differences and under what circumstances do they change? (Nanga pali kukondera kwina kuli konse pakati pa amuna ndi akazi pa nkhani zachakudya? Nanga kusiyanaku ndi kochuluka bwanji ndipo kumasintha nthawi iti?) 4. Does income hoarding occur in your household? (kodi pabanja panu zobisilana kapezedwe ka ndrama pakati pa amai ndi bamboo zimachitika)

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5. To what degree does an increase in income result in improved access to food within the household depending on whether the increase is realized by a men or women? (Nanga kuchuluka kwa kapezedwe ka ndalama kumathandiza bwanji pakapezekedwe ka chakudya pakhomo panu polingalira ngati ndalamayo yikubweretsedwa ndi mwamuna kapena mkazi pakhomo)

6. What role do you play with regards to providing food for your household? How negotiable are these roles within your household (Kodi udindo wanu ndi wotani pa nkhani yopeza chakudya pakhomo panu? Kodi udindowu umasinthasintha pakati pa mkazi ndi mwamuna)? 7. Could a renegotiation of gender roles allow your family better access to food? If so, how (kodi patakhala kusinthana kwa ntchito pakati pa amai ndi abambo mukuona kuti kungathandize mapezedwe a chakudya pakhomo panu pano)? 8. (Question for women) What would better empower you as a woman to enhance your ability to provide for your family and household?

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Appendix 2: Demographics for quoted research participants

Ave mnth Interview Highest Number in Incm Pseudonym No. Area Sex Age Education Marital Status household Occupation (MKW) Alinafe M90714 Mgona F 31 Primary Married 5 N/A N/A Asale K72714 Kauma F 21 Primary Married 6 N/A 0 Blessing K72611 Kauma M 43 Primary Married 6 Selling sand 6000 Charmanie K80114 Kauma F 48 None Widow/Widower 6 sells tomato n fish 20000 Chifundo M91111 Mgona M 58 Primary Married 7 Security Guard 22000 Chikondi M90610_3 Mgona F 20 Secondary Married 3 N/A 0 Chimwemwe K80112 Kauma F 26 Primary Married 6 vender 25000 Chirumu K80610_37 Kauma M 48 Primary Widow/Widower 4 Security guard 8000 Chiso K72612 Kauma M 50 Primary Married 8 Security Guard 10000 Chisomo K73115 Kauma F 35 None Married 7 N/A 0 Dalitso M91308 Mgona M 24 Primary Married 5 sells groundnuts 20000 Dembo K27264-4 Kauma M 44 Primary Married 6 flowerist 45000 Dumi M91009 Mgona M 41 Primary Married 2 Ganyu (piecework) 6000 Estridah K73114 Kauma F 29 Primary Married 5 Ganyu (piecework) 3000 Fatsani K80614_3 Kauma F 40 Primary Married 9 N/A 1000 Faye K73113 Kauma F 30 Primary Separated 6 Ganyu (piecework) 13950 Focus K80610 Kauma M 50 Secondary Married 10 Security Guard 19000 Ganizani M90614 Mgona F 40 Primary Married 5 N/A N/A Kantanyeni K80111 Kauma F 31 Primary Married 5 Ganyu (piecework) 10000 Kumbokani M90710 Mgona F 24 Secondary Married 3 sells maize 20000 Kudzai K73013 Kauma M 41 Secondary Married 5 Security Guard 15000 Kwasausya K80110 Kauma F 21 Primary Married 3 N/A 0 Leoni K72710 Kauma F 66 Primary Married 9 Farming N/A 261

Limbani M90709 Mgona F 46 Primary Widow/Widower 1 Ganyu (piecework) 3000 Lovemore K80612 Kauma M 67 None Married 9 Security guard 5000 Madalitso M91114_A Mgona F 21 Primary Married 3 N/A N/A Mary M91012 Mgona F 23 Secondary Single 3 Ganyu (piecework) 4500 Mayeso M91110 Mgona F 31 Primary Married 3 N/A N/A Melina K72711 Kauma F 32 Primary Married 5 N/A 10000 Mesi K80611_3 Kauma F 40 Primary Widow/Widower 4 Ganyu (piecework) 1800 Mphatso M91111_B Mgona M 40 Secondary Married 5 brick layer 15000 Mtima K73015 Kauma F 26 Primary Married 6 N/A 0 Olivia K72610 Kauma F 29 Primary Married 5 N/A 0 Pilirani M90607 Mgona F 40 Primary Married 8 sells groundnuts 25000 Rhoda K80613 Kauma F 36 Secondary Married 5 Sells groundnuts 5000 Rumbidzai K27265-5 Kauma F 45 Primary Married 5 sell doughnuts 40000 Women savings Rutendo K72614 Kauma F 44 Primary Married 11 group 7500 Sigele K72712 Kauma F 28 Secondary Married 6 Ganyu (piecework) 4000 Tadala M90708 Mgona F 35 Primary Married 7 sells groundnuts 20000 teaches nursary Tafadzwa K80113 Kauma F 32 Secondary Married 5 sch 5000 Takondwa M91115 Mgona F N/P None Divorced 3 Ganyu (piecework) N/P Tauya K27262-2 Kauma M 30 Primary Married 7 Security Guard 10000 Teleza K80614 Kauma F 51 Primary Widow/Widower 4 Ganyu (piecework) 5000 Thembiso K72715 Kauma M 33 Secondary Married 6 Ganyu (piecework) 9500 Thokozani M90610 Mgona F 46 None Married 7 Ganyu (piecework) N/P Tiyamike M90615 Mgona F 22 Primary Married 5 N/A N/A Tracy K27263-3 Kauma F 48 Primary Married 7 sell doughnuts 3000 Turai K27261-1 Kauma F 34 Primary Married 8 N/A 0 Wema M90610_B Mgona F 48 Primary Married 10 Ganyu (piecework) N/P 262

Yanikani M90711 Mgona F 32 Primary Married 7 N/A 6000

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