For the longest time, farmers in Kenya’s Migori county and other tobacco growing areas have suffered health risks and illness emanating from growing, nurturing, and curing tobacco. This is because tobacco growing exposes farmers and individuals to non-communicable diseases like cancer, cardiovascular and respiratory diseases. In addition, people in communities are also exposed to Green Tobacco Sickness. The World Health Organization (WHO), in partnership with Word Food Programme (WFP), Food and Agricultural Organization of the United Nations (FAO) and in collaboration with the Kenyan Government, influenced and facilitated farmers’ transition to producing profitable sustainable crops which are less labour intensive and eliminating the negative health effects of tobacco farming, through the Tobacco Free Farms initiative. The initiative was piloted in June 2021 and formally launched in March 2022. WHO Kenya trained 80 community health volunteers in Migori county to sensitize farmers of the harmful effects of tobacco and the benefits to switching to sustainable, healthier alternatives such as high-iron beans. This has resulted in relief from associated health effects of tobacco farming along with health improvements from regular consumption of high-iron beans.
Key WHO Contributions
Joint conceptualization to support farmers’ transition away from tobacco production
Identification and training of community health workers.
Sensitizing community on direct health effects from tobacco production
How did Kenya, with the support of the WHO Secretariat, achieve this?
Tobacco farming accounts for less than one percent of Kenya’s economy, yet while many do not realise the connection, studies have shown the harmful effects of the practice on farmers. In Migori county, tobacco cultivators complained of upper respiratory illnesses and symptoms consistent with Green Tobacco Sickness (GTS) due to nicotine absorption through the skin when handling wet tobacco leaves, exposure to heavy use of pesticides, and to tobacco dust. Nicotine contained in tobacco is highly addictive and tobacco is a major risk factor for cardiovascular and respiratory diseases, for over 20 different types or subtypes of cancers and other debilitating health conditions [1].
A farmer having periodic health checks following transition to high iron bean cultivation.
Photo credit: WHO/Ash Appleton.
Kenya was one of the first countries to ratify the legally binding WHO Framework Convention on Tobacco Control (FCTC) and subsequently adopted the Kenya Tobacco Control Act 2007. Both documents stipulate a need for an alternative to tobacco production that protects those whose livelihoods depend on growing it.
As part of the ongoing collaboration with other partners and the Kenyan Government, WHO Kenya trained 80 community health workers in Migori country to conduct outreach among the many tobacco farmers in the country around the dangers of tobacco farming and the alternatives available. Through WHO Kenya’s network, these community health workers were identified from within the county so that they could better relate to the community members, increasing their acceptability and trust. Once identified, they were trained on GTS and other tobacco-growing related diseases, along with ways to identify tobacco industry interference in the community in order to better sensitize the community on the dangers of tobacco farming on their health.
Complementary to this, WFP and partners through local procurement initiatives provided a long-term market for high iron beans in the county, allowing farmers a steady, reliable source of income, as well as providing the seeds and other inputs for cultivation. The agricultural officers from the county with technical support from FAO were instrumental in training farmers on good agricultural practices, and post-harvest handling of harvested crops.
“This market gives Migori’s tobacco farmers a new way to earn a living with none of the negative health effects that come from growing the high-labour intensive and toxic tobacco plant. This is a new way to fight the tobacco epidemic that has stolen so many lives.”
Dr Abdourahmane Diallo, WHO Representative in Kenya [2]
More and more farmers are now making the switch after realizing the benefits of ceasing to grow tobacco and the alternatives available. Personal experiences shared from farmers have highlighted the positive changes witness on their health and well-being, as well as of their families.
“There are many diseases associated with tobacco farming that affect the environment and people. There were sudden deaths. When we stopped tobacco farming in this region, we saw development in children. The rate of students joining secondary schools has gone up”.
Reginald Omulo, a farmer in Migori County, Kenya [3]
While the Tobacco Free Farms initiative is relatively new, the switch to farming alternatives has reaped the anticipated benefits for health and well-being. The initiative is laying a basis for healthy living and eliminating risks associated with tobacco products. Certain challenges have though been identified. Due to the high demand for iron bean seeds, seed insecurity has been observed in certain areas. To combat this, WHO Kenya together with partners is engaging with seed providers to ensure a steady supply. Equally, WFP is working with the government to train farmers on quality grain production and seed selection for subsequent seasons. Furthermore, champion farmers are being identified to be trained on production of high-quality grain which may be used as seed for other farmers and limit any effects from climate change.
Despite the challenges, WHO Kenya, together with partners, aims to expand the initiative to other counties in Kenya. From January 2023, Meru, Bungoma and Busia counties are next in line to rollout this initiative, targeting a total of 2800 farmers in the coming seasons. WHO Kenya seeks to continue reinforcing the stipulations of the WHO FCTC and the Kenya Tobacco Control Act (2007).
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