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Taking food out of the equation

Howard Dalzell is about to retire as Concern's director of policy and education development. Here, he tells Grainne Faller why he remains an optimist and how ending poverty is about justice, not charity. This article is featured in today's Irish Times supplement about Concern and its work.

Back in 1968, Howard Dalzell had two job offers – one from the Department of Agriculture in Northern Ireland, and one for a position as an agricultural educator in India. “Had I accepted the job with the Department of Agriculture, I’d now probably know more about silage than anyone else in Northern Ireland,” he laughs.

As it happened, he took the job in India, marking the beginning of a career spent working with, and on behalf of, the world’s poorest people.

Now, he is about to retire from his position as Concern’s Director of Policy and Education Development, having steered the organisation from one that responded to emergencies in developing countries, to one that takes a longterm and thoughtful approach to problems in the developing world.

It’s an approach that’s informed by his experience on returning to Ireland after 17 years in India. Dalzell had been contracted to write a book but the money was minimal and jobs were scarce in 1985. A year of unemployment followed.

He says: “I was poor for a year...How the hell was I going to support three kids? You

have to question your priorities – do you feed and clothe the kids first? But how do you get a job if you don’t have a suit? The social exclusion is huge.”

It was a formative experience. “In India, I saw poor people,” Dalzell continues. “They’re not educated, they don’t have resources, they’re not literate. You assume that they have no ability to help themselves – but then you recognise their resourcefulness and their ability to cope...Realising what poverty is like from the poverty side and knowing the resourcefulness, the creativity and the determination that poor people have, channels my work with Concern.”

The recognition that poor people have the wherewithal to help themselves if only they are given a chance has revolutionised the way that Concern works and plans its operations, including the emergency relief for which it is particularly well known. Throughout the emergencies of the 1980s and 1990s, Concern would set up therapeutic feeding centres – essentially intensive care units – in rural areas and mothers

came from far and wide, bringing their children for treatment.

Children were fed with special foods that had to be prepared carefully to ensure that they got the correct benefit from it, and nursed back to health over a number of weeks. It was expensive, difficult and hugely disruptive to families. Added to that, it became clear that therapeutic feeding centres were only reaching a tiny percentage of people and doing virtually nothing to combat the causes of food shortages and malnutrition.

It was felt that there had to be a better and more effective way of tackling emergencies

and combating malnutrition. The breakthrough came when a Frenchman called Andre Briend came up with a ready-prepared food called Plumpynut. Essentially, a nutritious high-energy paste, Plumpynut requires no preparation and keeps for several months.

Concern knew that it was on to something that could revolutionise the approach to

malnutrition. “Instead of bringing people in for treatment, we could bring this ready-to-eat food to them,” says Dalzell. With supplies of Plumpynut in local health facilities, more people could be reached and malnutrition could be caught earlier.

Even in emergency situations it was found that most severely malnourished children don’t need major medical attention. “Given food and the minimum medical attention, they get better,” Dalzell explains.

“A few days of observation and if they don’t have any complications you can send them

home with their mother and a few weeks supply of this food…The child recovers in front of the community because of the food the mother is feeding it rather than because of some magic cure by some foreign doctor – the empowerment and value to that mother is enormous.”

Realising the potential of this approach, Concern teamed up with another organisation

called Valid International, and through trials and research compiled whole body of evidence confirming the success of community management of acute malnutrition (CMAM)* as it became known.

The organisations brought the evidence to the World Health Organisation (WHO). “It

doesn’t replace the therapeutic feeding centres exactly,” explains Dalzell. “But those centres now deal with the five per cent of kids who have medical complications. We can get to 75 percent of the rest with this CTC at lower cost, better survival rates and less disruption to the families.” Last year, the WHO changed its policy to recommend this approach to dealing with malnutrition.

Of course, Concern is not just an emergency response organisation. It also deals with communities who, while poor, are not on the brink of a major disaster. “If you don’t have money in your pocket that lets you decide ‘I want this or I want that’ then you’re poor,” says Dalzell. “We say, ‘Put money into their pockets as credit and

let them make the decisions.’”

A small savings and loan programme for the rural population in Cambodia, for example, has now grown into an independent microfinance bank that reaches nearly 68,000 people. Loans are small at about $50 a time and they are usually targeted at women.

“We’re about to borrow eight million dollars from commercial sources to fund more loans and we’ll have expanded to 250,000 people which means 250,000 families by three years time. Profits will be up to two or three million so it’s clearly self financing.”

Technology has greatly improved the potential and scope of such systems. Fingerprint recognition is used to identify account holders thus preventing fraud. Mobile phone technology has assisted in facilitating Western Union-style money transfers within Cambodia.

Similar technology is being used in Malawi where formerly, in times of food shortages,

organisations came into an area, bought food, transported it and distributed it to the people. It was an expensive exercise and had the effect of inflating market prices. In order to combat this, Concern decided to give people half of the usual amount of food and money in place of the other half.

Dalzell says: “We found that some of that money was being spent on seeds for the following year or on school books. People were coping on the food front, maybe by eating less, but they were keeping other things going that wouldn’t have been possible if we had only given them food.”

Now food has been taken out of the equation altogether. People are provided with a smart card which contains details of the amount of money they are entitled to. The owner can withdraw all or part of their money from a teller who visits the villages every two weeks. There is a saving facility, and richer people in the villages can avail of the smart card technology by paying for the privilege.

“That’s the making of another bank,” Dalzell says. The eventual aim is to establish a microfinance facility of the type that has been so successful in Asia.

So much done, and yet still more to do. How does Dalzell feel about the future? “I’m an optimist,” he says. “But we could eradicate any number of problems tomorrow if the political will was there...It is not a question of charity, it is these people’s right. Ending poverty is about justice. When that righteous indignation goes from the agencies such as ourselves and begins to spread to individuals on the street, we’ll be in with a prayer.”