Rwanda is a country that has seen fascinating improvements in multiple sectors including health. Among various factors, there is leveraging decentralised healthcare system and stakeholder engagement with a focus on changing systems rather than treating symptoms. EAF’s Aimable Uwimana’s conversation with Meghan Magee of Gardens for Health International [GHI], Rwanda, about the experience that highlights its outstanding work on providing sustainable agricultural solutions to chronic childhood malnutrition in Rwanda.
What was the inspiration behind the launch of Gardens for Health International? How did you decide on this focus area amongst various health challenges in Rwanda?
GHI was founded with the belief that integrating agriculture and nutrition into the health system is the only sustainable solution to effectively treat and prevent malnutrition. Our work was catalyzed by a little girl named Foybi. When our founders met Foybi, the nine-year-old weighed only 29 pounds. They rushed her to the hospital, where she received the emergency food aid and essential life-saving care she needed. However, they quickly realized this was only a short term fix; the root causes of her malnutrition remained. It was Foybi who inspired us to focus on children and to work with health clinics to meet patients at the point of care. And it was her young aunt Florence, who accompanied her to the hospital, who ultimately helped shape our program. As one of the first employees, Florence contributed to the original design of our curriculum and training materials. Over ten years later, Florence still works with us, overseeing our team of field educators to deliver thousands of training a year. And Foybi, healthy and happily enrolled in school, has aspirations of being a teacher someday.
We appreciate and commend you on your use of a comprehensive view in addressing healthy nutrition. Could you tell us more about your approach, how it was decided, and if/how it has evolved over time?
The majority of the world’s poor are farmers, yet millions are malnourished. In Rwanda, the disconnect between agriculture and nutrition is striking: 72% of families grow food for a living, yet 33% of young children are chronically malnourished. This simple concept, that food alone does not equal good nutrition, is at the heart of our mission. To tackle the root causes of malnutrition, we work toward a world in which all families and communities have the knowledge, resources, and support to meet their nutritional needs. The transformative impact is possible by investing in the nutrition of mothers and young children because well-nourished children get sick less often, perform better in school, and thrive.
Since 2009, we have worked hand-in-hand with local communities to provide agricultural solutions to malnutrition. Our innovative curriculum on agriculture, nutrition, and health topics was designed in partnership with local mothers, our training are led by talented educators who come directly from the communities they serve.
When we first began, we worked exclusively with mothers of malnourished children. Based on feedback from our partner families, we have expanded our focus to include pregnant women - preventing malnutrition before it even begins. Over the years, we have also reached new audiences including school children, refugees, and fathers.
How has focusing on nutrition and a healthier diet helped you contribute to the movement to address preventable non-communicable diseases (NCDs) in Rwanda?
We believe in changing systems, not treating symptoms. We believe in a health system that is accessible to all and that treats the whole person. In our mission for a more equitable, holistic health system, we work closely with the Government of Rwanda because we believe that these interventions need to be sustainably integrated into the national health system. Nutrition is a complex issue - it affects every aspect of health. When children are fed a more nutritious diet, they are less likely to get sick and more likely to live a longer, healthier life.
What are the successes you have observed so far?
Based on the proven success of our model, we have had the opportunity over the past few years to partner with the UN’s World Food Programme in 104 primary schools across the country. This has given us the opportunity to teach our trademark agriculture, nutrition, and health curriculum to over 85,000 primary school children! We empower educators to teach children about how to grow and eat healthy food and help students set up a nutritious vegetable garden at each school. We have been continuously inspired by students’ dedication to their health and nutrition!
What lessons have you learnt in your work so far? Unexpected insights are particularly welcome.
Because agriculture is at the heart of our work, we must work in harmony with the planet. Over the years, climate change has increasingly affected our partner families, and thereby our work. We have increasingly had to adapt our agriculture curriculum to make it more sustainable and climate-resilient. We have to remain flexible and responsive to ever-changing agriculture seasons and unpredictable rainy seasons. Our ability to be nimble helped us incredibly when it came to adapting to the challenges caused by COVID-19 in the past year.
What have you learnt from the communities you work within promoting healthy diets?
We have learned that the biggest resource is our partner families. We have always let the feedback from program graduates guide and shape our program. It was mothers who told us that while they loved the information they were learning about nutrition, they would’ve liked to learn it earlier when they were pregnant; from this, our Maternal Nutrition Program was born. It was mothers who told us that buy-in from every member of the family is crucial for their child’s healthy; from this came our Fathers Engagement Workshops. This community-based, participatory model is crucial to our success.
Which suggestions/advice would you give to individual initiatives or programs that aim to focus on the preventive part of fighting NCDs such as physical activity promotion or healthier diet programs, among others?
We would encourage them to get specific about what they uniquely can do best and to put their heart and soul into that work! It is better to do one thing well than ten things poorly. Health is holistic and there are so many areas where good work is needed!
Where can the EAF community stay abreast of your work?
We would love you to join our network of supporters! You can learn more and sign up for our monthly newsletter at www.gardensforhealth.org. You can also find us on Instagram (www.instagram.com/gardens4health) and Facebook (www.facebook.com/gardensforhealth.), and Twitter (www.twitter.com/gardens4health).
Thank you, Meghan, for sharing Gardens for Health International's experiences with us.
Aimable Uwimana, BA, MSc is a non - communicable diseases advocate and researcher, passionate about addressing the social determinants of health through capacity building, especially among vulnerable and underserved communities. Have a wonderful read of Aimable & his team recently published study on knowledge, perception and mental health impact of COVID-19 amongst students in Rwanda.