This may be more relevant to Australian members of the list.
Food Alliance for Remote Australia: a voice for food security issues in remote
Australia.
http://FARA.bite.to
Author: Roy Price, Remote Community Nutritionist, Alice Springs, Australia
HUMAN RIGHTS
On the 10th December 1948, more than 50 years ago, the General Assembly of the
UN adopted the Universal Declaration of Human Rights. In it Article 25 states
that:
"Everyone has the right to a standard of living adequate for the health and
well-being of himself and of his family, including food, clothing, housing
and medical care and necessary social services, and the right to security
in the event of unemployment, sickness, disability, widowhood, old age or
other lack of livelihood in circumstances beyond his control." 1
In other words, access to a healthy food supply was deemed a fundamental human
right, something we all have a right to expect will be made available to us by
the mechanisms of the society in which we live.
As recently as 2003, the Dietary Guidelines for Adults in Australia went
further to advise us on how to properly utilise our (presumably) healthy food
supply. At the top of the list is advice to:
"Enjoy a wide variety of nutritious foods
· Eat plenty of vegetables, legumes and fruits" 2.
The promise is that if we have our human rights to a healthy food supply
intact, and if we utilise our food supply in a healthy way (by eating a wide
variety of nutritious foods including plenty of vegetables, legumes and
fruits), most of us will live a long and healthy life, and be free of
nutrition related diseases.
In remote areas of Australia however, many people's ability to "enjoy a wide
variety of nutritious foods" and "eat plenty of vegetables, legumes and
fruits" depends on how easily they can access healthy affordable food, that
is, how "food secure" they are. In many remote parts of Australia, it is whole
communities of Aboriginal people that live in an environment of food
insecurity.
Food security is defined as access by all people at all times to the food
needed for a healthy life, regardless of financial status. Food insecurity
exists when a person cannot obtain a nourishing, culturally acceptable diet,
which is important to each and every one of us on a daily basis 3.
Community food security is a relatively new concept with no universally
accepted definition. Community food security concerns the underlying social,
economic, and institutional factors within a community that affect the
quantity and quality of available food and its affordability 4.
INDIGENOUS COMMUNITIES DEFINED
In the Australian Aboriginal context, there are
· 1,223 discrete communities with about 110,000 people (30% of the total
estimated Aboriginal population)
· 73% of the communities have less than 50 people;
· 12% communities have 200 people or more, and
· 35% unemployment rate,
· 29% of people worry about going without food.
· Life expectancy is 16-20 years less than non-Aboriginal people 5.
THE FOOD SUPPLY
The community stores servicing the nutritional needs of the 1,223 discrete
Aboriginal communities throughout Australia have an important role in the
holistic delivery of primary health care 7. The store is a key source of
nutrition for the community and has an important role in ensuring the physical
well being of the people 6. Stores in remote communities are erroneously
viewed as enterprises. They are not. Just as the providers of power and
water are considered essential services, as providers of the primary source of
nutrition for the community, stores too should be viewed as essential
services7.
Surveys conducted in disparate areas of remote Australia testify to the
reality of remote community food insecurity. Indigenous people are especially
at risk, particularly those who live in remote communities where the main
source of food is usually a single community store, often hundreds of
kilometres from a regional centre. The cost of fresh food in remote
communities is much, much higher than the cost in southern cities, averaging
between 150-180% of capital city prices. Market basket surveys of weekly
family grocery costs have found that costs are:
· between 25% and 50% higher for Indigenous communities in Cape York
(Queensland) than in suburban Brisbane;
· around 40% higher in the Torres Strait than in Cairns;
· between 20% and 80% higher for Indigenous communities in the Pilbara and
Kimberley regions of Western Australia than in Perth; and
· more than 60% higher in Indigenous community stores in the Northern
Territory than in Australian capital cities 8.
Apart from cost, availability of nutritious food is a significant factor. Many
isolated community stores carry very limited stocks of fresh foods because of
freight costs, infrequent deliveries, lack of cool storage and display
infrastructure, or lack of store management and governance expertise 9.
Compounding this situation is poverty. The income of Indigenous people
generally declines with increasing geographic remoteness 10, and so people who
are amongst the poorest in Australia have the highest food costs. Research in
central Australia in 1998 established that Aboriginal people living on the
Anangu Pitjatjantjara lands do not have sufficient income to cover the cost of
a nutritious diet and basic hygiene needs 7. And the situation is not likely
to be better in other remote parts of Australia.
People with low incomes who live from hand to mouth for long periods of months
and years have great vulnerability. The constant daily drive to satisfy
hunger and to compensate for anxiety and poverty can lead to either
underweight or overweight in some adults, and underweight in their vulnerable
children 11. Consistent food insecurity results in poor nutritional health,
which has the potential for profound long-term effects on a person's health,
lifestyle, activity level, ability to find work, well-being, and lifespan 11.
It needs to be acknowledged that food insecurity is not the only problem
facing Aboriginal people in remote areas. The causes of the high rates
indigenous ill health are complex and interrelated and poor nutrition related
to food insecurity is just one but central to the problem, and needs to be
tackled on many levels.
In a report released in 1997, the Australian Medical Association made the
following statement, "The overwhelming feeling amongst health professionals is
that poor nutrition is the main factor contributing to the majority of
diseases in remote aboriginal communities" 12. Seven years on and there has
been little change to the food supply in remote areas.
The levels of malnutrition in rural and remote communities in Australia have
not attracted the attention it deserves. Research in the Northern Territory in
the early 1990s, using World Health Organisation criteria, found a minimum
malnutrition prevalence rate of 20% amongst Aboriginal children under two
years of age, a rate that was 2.5 times the rate of 8% considered by
international relief agencies as a nutritional emergency 13.
Northern Territory Aboriginal children aged one to five years admitted to
hospitals between 1993 and 1997 were 120 times more likely to be diagnosed as
undernourished than non-Aboriginal children of the same age 14. In late 2002,
the Royal Darwin Hospital released figures that showed a 25% increase in the
number of children diagnosed with malnutrition and diarrhoea over the previous
three years 15.
Maternal malnutrition, low birth weight, and poor nutrition in infancy and
childhood are all implicated as possible causal factors in the development of
chronic, life-threatening illness in later life 16. Diseases such as heart
disease, kidney disease and diabetes are linked, and many Indigenous people in
remote regions suffer from two or more of these serious illnesses as
'co-morbidities'.
We need to ask ourselves, to whose advantage is it that this situation remains
unchanged and unchallenged? Tax payers? Aboriginal people? The health
system? Australians in general?
SOME IMPORTANT STRATEGIES
Market Basket Surveys are objective measures of food security used to assess
and monitor the food supply. They provide valuable evidence of food
insecurity and lack of change but have not in themselves lead to change in the
food supply. Market Basket Surveys have been conducted in the Kimberley
region of Western Australia since 1987 yet the situation remained unchanged a
decade on 17.
Healthy Food Access Basket surveys conducted in Far North Queensland in 1998
and 2000 are used to identify the extent of food insecurity.
In 1999, the Food Supply in Rural South Australia survey was conducted as a
one off study to identify the extent of food insecurity in South Australia.
In the Northern Territory, where Market Basket Surveys have been conducted
annually since 1998 to monitor success of nutrition interventions, there has
been no change in availability, variety or affordability 18.
The studies show that the proportion of income derived from social security
benefits required to purchase a basket of healthy foods in NT remote community
stores has remained unchanged since 1998, and that the average variety of
fresh fruits and vegetables available in remote NT stores has also remained
unchanged since 1998.
There have been several coordinated attempts to improve food security in
remote Aboriginal communities, and I will now discuss some important ones.
Arnhem Lands Progress Association (ALPA).
ALPA is owned by five Arnhemland Aboriginal communities and has been in
operation now for 31 years. ALPA owns five stores and manages six others on a
"fee for service basis". The foods sold in the ALPA stores is governed by the
ALPA Nutrition Policy. ALPA also offers and conducts training in Certificate
1 and 2 in "Retail". One of the benefits they have as a group is continuity
and this allows them to continually move forward in a progressive manner 19.
The Board of Management is made up of Aboriginal people, allowing for strong
Aboriginal control.
Mai Wiru: Regional Stores Policy and associated regulations for the Anangu
Pitjantjatjara Lands
The Mai Wiru regional stores policy is based on the belief that residents of
the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands, by right of their
citizenship, are entitled to be able to access safe, affordable and nutritious
food. The APY Lands Council has asked for prices to be reduced to the
equivalent of Adelaide prices, and have identified the need for a regional
stores policy. The laws governing the AP lands is being changed to give the
AP Lands Council the power to pass a by-law that all stores on the AP lands
are bound to abide by the Mai Wiru store policy. Mai Wiru is now moving from
policy development to implementation. Essentially, Mai Wiru is grass roots
activism driven by a human rights approach 20.
As stated previously, Market Basket Surveys are conducted extensively
throughout the Northern Territory annually as part of the implementation of
the NT Food and Nutrition Action Plan. The NT MBS is a best practice national
model for monitoring changes (or lack thereof) to the food supply in remote
communities.
FoodNorth
The FoodNorth project was a preliminary study in 2003 in preparation for a
planned longer-term project to address food supply issues in north Australia.
Supported by the health ministers of Qld, NT and WA, the aim of the FoodNorth
project was to compile information about the critical issues impacting on cost
and availability of healthy food and to identify strategies and initiatives
that had been used to improve food supply in remote locations 23. FoodNorth is
driven by NANG, the North Australian Nutrition Group.
The National Aboriginal and Torres Strait Islander Nutrition Strategy and
Action Plan, 2000?2010 (NATSINSAP)
NATSINSAP was developed as part of Eat Well Australia. Its aim was to provide
a framework for action to improve Aboriginal and Torres Strait Islander health
and wellbeing through better nutrition. The strategy and action plan was
developed by an Indigenous working party in consultation with Indigenous
health organisations and state and territory agencies 21. NATSINSAP highlights
seven key areas for action. Since the launch of NATSINSAP, only $100,000 of
funding has been allocated for implementation.
StoreCharter
Developed by the Australian Competition and Consumer Commission (ACCC),
StoreCharter is a voluntary service charter for stores serving remote and
indigenous communities. It applies to stores that have agreed to operate
within its principles and have indicated this to the ACCC. The purpose of
StoreCharter is to help stores to comply with relevant laws, encourage higher
trading standards, and help to further develop understanding and respect
between store owners, operators and staff and indigenous people 22. To date,
the voluntary uptake of StoreCharter has yet to be evaluated.
In summary, if NATSINSAP is inadequately funded, and StoreCharter is
voluntary, what hope does either of these national approaches have in making a
difference to food security in remote areas?
Jawoyn ? Fred Hollows Foundation Nutrition Program
In 1999, the Jawoyn Association (via Katherine NT) asked The Fred Hollows
Foundation to help develop a nutrition strategy to tackle the major underlying
cause of poor health in their communities. The Nyirranggulung('all together as
one mob') Nutrition Project combines interrelated programs that empower local
people to gain long-term improvements in nutrition, in particular by
increasing the availability of affordable, nutritious food in Jawoyn
communities. Their underlying philosophy is to empower by building on existing
initiatives, work in genuine partnership, and build the capacity of local
people. Partnering with other philanthropic and corporate foundations has
gathered funding, expertise and broad-based support for their programs.
An experienced store manager, Barry Orr, was seconded by Woolworths to mentor,
train and advise community store management committees, local managers and
staff. With his help, four communities have progressively regained control of
their stores and transformed them, making remarkable achievements in just over
a year 24.
Recently, the Minister for Indigenous Affairs, Senator Amanda Vandstone,
announced a grant of $1.5M to support the expansion of the Fred Hollows model
25.
GAPS
Small retail outlets selling perishable food products in small or isolated
communities face many challenges, including transport difficulties, and high
overheads associated with maintaining buildings, equipment and stock in remote
locations. Most of the factors that contribute to high costs and limited
supply in these locations lie outside the health sector, and require
commitment and partnerships from a range of sectors to address the problems
26. It has been shown, however, that none of these problems are
insurmountable. Individual store managers, ALPA, and The Fred Hollows
Foundation have all demonstrated that these issues can be overcome. However,
given that there are 1,223 discrete Aboriginal communities Australia-wide,
change that is both sustainable in the long term and widespread is what is
required. Without a high level of long term intervention, these issues are
particularly resistant to LONG TERM change.
The Mai Wiru Stores policy is grass roots activism worthy of our respect and
admiration. However, people of the AP Lands are in a unique situation in that
they have unalienable freehold title over their lands and are therefore able
to pass by-laws. Communities in other parts of Australia (eg the NT) do not
necessarily have that ability.
The Fred Hollows Foundation example shows great promise as a model for
developing community food security in remote areas. However, the model
depends on the goodwill, benevolence and philanthropy of publicly listed
companies. The situation begs the question of just how long will these
institutions be interested in supporting food security issues in remote
Australia? And, in terms of the federal support for the expansion of the
model, just how far will $1.5M go?
There are other important issues to consider, such as poor levels of literacy
and numeracy which sometimes prevent community based Aboriginal people from
fully engaging in the processes to deliver better food security. We need to
work hard to ensure that community people are supported to drive the
processes.
Furthermore, there is little involvement of citizens other than nutritionists
and other health professionals in developing remote community food security.
There are many other people, for example teachers and nurses, working and
living in remote Aboriginal communities who are acutely aware of the issue of
food insecurity. Many choose not to shop at the community store because of
the poor quality, lack of variety and cost. Many have their food supply
freighted in from the nearest district supermarket. In the NT, both the
Education Department and the Health Department assist remote area teachers and
nurses to be independent of the food supply out bush and subsidises the
freight of "bush orders" from district centre supermarkets. Thus, some of our
potential allies in food security issues are immunised from the problem.
While it needs to be recognised that such strategies are required to attract
and retain teachers and nurses in remote communities, perhaps some gentle
involvement of community based non-Aboriginal people in food supply issues
might also lead to improvements.
This situation also begs the question that if the government recognises that
the food supply is not good enough for the teachers and the nurses, why then
is the food supply good enough for Aboriginal people?
One other important gap is the absence of consumer watchdogs. Who, other than
government employed nutritionists, is watching the food supply in remote
areas? Who else gives a damn?
THE BIRTH OF FARA
It was with concern about the above issues that a three-day Food Policy Action
Workshop was organised and conducted in Alice Springs in October 2003. The
workshop was facilitated by Dr John Coveney and Dr Mark Lawrence, both members
of the Australian Public Health Nutrition Academic Collaboration (APHNAC).
Around thirty participants attended the three-day workshop, including
nutritionists, dietitians, nutrition workers, Aboriginal Health Workers,
Environmental Health Officers, and other concerned health professionals,
citizens and taxpayers all of whom had an interest in food security in remote
areas. Over the three days of the workshop, many of the issues above and
others were discussed and debated in great detail 27. At the conclusion of the
workshop the participants felt that the best step forward was to form an
independent advocacy alliance, the intentions of which are clarified in the
following resolution:
"This workshop resolves that the health and well-being of Indigenous
Australians, especially those living in remote areas, can only be improved
when healthy food is readily available, affordable and safe.
"The participants in the workshop have formed an alliance called Food Alliance
for Remote Australia (FARA) to progress these issues, and calls for collective
action to:
· increase the range of affordable healthy foods available in remote
community settings
· rigorous enforcement of current regulations governing retail operations
· training and support for better retail operations, and
· greater community control of the local food supply 27"
NUTRITION ACTIVISM
Given that much of the research, policy making and activity are government
driven, there is an opportunity and need for an independent body, such as the
Food Alliance for Remote Australia, to take on an advocacy role in the push
for improved food security in remote areas of Australia. Nutrition activism
recognises access to adequate food, health and care as human rights embedded
in international human rights law. Rights based approaches offer new
opportunities for strengthening monitoring, advocacy and accountability on
promoting food and nutrition security, calling for academic and non-academic
activism alike. Workers allotment of time to certain activities may be
perceived by peers as lying outside legitimised activities but may actually
prove critical in driving some of the very processes on which empirical and
policy research would in turn be based 28.
The human rights approach represents an unused or under utilised opportunity
for food and nutrition advocacy and action 28. To make a real difference,
nutritionists and other allied health professionals, teachers, nurses,
doctors, need to engage in nutrition activism and work with remote community
people as empowered partners to promote remote community people's right to a
healthy affordable food supply. We need to do more to actively facilitate the
conditions for people to enjoy their economic, social and cultural rights,
including food.
Not everyone can be a nutritionist, but anyone can be a nutrition activist.
The Food Alliance for Remote Australia (FARA) is a forum for non-nutrition
professionals and other citizens with an interest in food security to have
their voice heard. Interactive tools for objectively measuring and monitoring
the food supply in remote areas are available at the website enabling
individuals or groups to have a wider variety of participation in measuring
and monitoring food security in remote areas. Curriculum to skill secondary
and tertiary level Aboriginal students to actively assess and monitor their
own food supply in remote areas is in the planning stages. By becoming a
member of the discussion group you may find support and advice from experts in
their field. Increasing membership and involvement of non-Aboriginal service
providers living in remote communities will enable the development of a
detailed view of the food supply in remote areas. By combining and
coordinating our efforts the Food Alliance for Remote Australia can become a
force with influence to better drive the collaborative effort required to
develop food security in remote areas. With your support FARA can be a voice
for food security issues in remote Australia.
http://www.FARA.bite.to
REFERENCES
1. International Declaration of Human Rights: Online at
http://www.unhchr.ch/html/menu6/2/fs2.htm
2. Dietary guidelines for Australians: Online at
http://www.nhmrc.gov.au/publications/pdf/n31.pdf
3. SIGNAL (Strategic Inter-Governmental Nutrition Alliance) FOODChain (5)
April 2001, http://www.nphp.gov.au/workprog/signal/foodchain/fdchain5.pdf)
4. Community Food Security, Assessment Toolkit, Barbara Cohen, IQ Solutions,
Inc. Electronic Publications from the Food Assistance & Nutrition Research
Program. E-FAN-02-013. July 2002.
http://www.ers.usda.gov/publications/efan02013/
5. Dr. Bruce Walker, Director of the Centre for Appropriate Technology,
http://www.skyrme.com/updates/u65_f2.htm
6. Mai Wiru Regional Stores Regulation: for the Anangu Pitjantjatjara Lands
Policy Principles. In: Store Governance: whose store is it and what is it
for. FoodNorth: Food for health in north Australia. October 2003.
Department of Health, Government of Western Australia (p 48).
7. Nganampa Health Council, Mai Wiru Stores Policy, pp 49-50.
8. Prof Neil Thomson, "Nutrition of Australian Aboriginal peoples ? past and
present", Food ? for Healthy People and a Healthy Planet, Nature and Society
Conference Proceedings, Sept 2001, http://www.natsoc.org.au/).
9. Nutrition and health. The Fred Hollows Foundation Indigenous Program
Briefing Paper 8. Available on line at http://www.hollows.org
10. Australian Bureau of Statistics. The Health and Welfare of
Australia's Aboriginal and Torres Strait Islander Peoples, 2003, cat no
4704.0, p.28)
11. Food Security for all: Building Healthier Communities. Dr Beverley
Wood. In: FoodChain Issue 5 April 2001. Strategic Inter-governmental
Nutrition Alliance (SIGNAL)
12. Australian Medical Association. Research into the cost, availability
and preferences for fresh food compared with convenience food items in remote
area Aboriginal communities, prepared by Roy Morgan Research, Dec 1997)
13. Ruben AR and Walker AC. "Malnutrition among rural Aboriginal
children in the Top End of the Northern Territory", Medical Journal of
Australia, 1995, Oct 16; 163 (8), 445.
14. Condon JR, Warman G, Arnold L (eds), The Health and Welfare of
Territorians, Territory Health Services, Darwin, 2001, p.121
http://www.nt.gov.au/health/health_gains/
epidemiology/welfare_territorians.pdf
15. Australian Broadcasting Corporation, "NT Indigenous malnutrition
growing", Anne Barker, 23 Nov 2002.
16. National Health and Medical Research Council, Nutrition in
Aboriginal and Torres Strait Islander Peoples, July 2000, pp 20-23.
17. Market Basket Surveys in remote north Australia. In: Food cost and
availability in remote north Australia. FoodNorth: Food for health in north
Australia. October 2003. Department of Health, Government of western
Australia. (p 37).
18. Market basket Survey of remote Community Stores in the northern
territory April ? June 2003. Nutrition and Physiccal Activity Program, NT
Department of Health and Community Services.
19. The Arnhem Lands Progress Association. In: Best Practice in retail
management to keep prices down. FoodNorth: Food for health in north Australia.
October 2003. Department of Health, Government of Western Australia p 59
20. Mai Wiru Regional Stores Regulation: for the Anangu Pitjantjatjara
Lands Policy Principles. In: Store Governance: whose store is it and what is
it for. FoodNorth: Food for health in north Australia. October 2003.
Department of Health, Government of Western Australia
21. National Aboriginal and Torres Strait Islander Nutrition Strategy
and Action Plan, 2000?2010: a summary
22. StoreCharter ? a service charter for stores serving remote and
indigenous communities. In: Banking and Credit. FoodNorth: Food for health in
north Australia. October 2003. Department of Health, Government of Western
Australia (p 107)
23. FoodNorth. In: Ensuring a safe and health food Supply. FoodChain
Issue 13 p17-18. December 2003. Strategic Inter-governmental Nutrition
Alliance (SIGNAL)
24. Nutrition and health. The Fred Hollows Foundation Indigenous
Program Briefing Paper 8. Available on line at http://www.hollows.org
25. Media Release: Senator Amanda Vanstone, Minister for Immigration and
Multicultural and Indigenous Affairs. Better Nutrition through better
management of remote Indigenous stores. VIPS 029/04 29 April 2004
26. Amanda Lee in Measuring food supply in Australia Foodchain issue 5,
April 2001. Strategic Inter-governmental Nutrition Alliance (SIGNAL)
27. Food Policy Action Workshop Alice Springs NT 13 ?15 October 2003.
Report available on line at http://www.FARA.bite.to
28. Barth Eide. W. 2001. Breaking conceptual and methodological ground:
promoting the human right to adequate food and nutrition. Ecology of food and
nutrition, Vol 40(6) pp571-595
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