NUTRITION FOR HUMAN AND ECONOMIC DEVELOPMENT IN UGANDA: INVEST NOW FOR THE YEAR 2025

Introduction

Uganda has a vision for the year 2025 as stated in the government’s recent Strategic Framework for National Development. The human and economic aspirations of this vision  include, among other things:

Tripling of real per capita gross domestic product from $300 to $900, reducing mass poverty to a fifth of its current level from 26% to 5%, and increasing life expectancy from 43 to 70 years.

These goals are realistic but require  development of a healthy, educated and productive work force over the next 25 years,  which in turn requires that the children conceived and born today are well nourished and well cared for.  Sadly though, too many Ugandan children born today will miss this opportunity because of malnutrition.  Current data indicate that the main nutrition problems affecting Uganda are: inadequate intakes of foods containing energy and protein, iodine deficiency, iron deficiency anemia and vitamin A deficiency.

This presentation will show how timely investments in nutrition interventions are needed if we want to realise our aspirations for the year 2025 and avoid the serious but invisible consequences of malnutrition. Let’s look at some of these consequences.

Consequences of Malnutrition

Vitamin A deficiency and Protein Energy Malnutrition reduce survival, PEM also reduces productivity, while iron deficiency anaemia affects both physical capacity and intelligence.  Iodine deficiency in pregnant women results in intellectual impairments of the foetus, with implications for future school performance and thus for future productivity.

We are now able to quantify these effects and to demonstrate the enormous impact of malnutrition on human and economic development. To do this, we have used a computer programme called PROFILES. 

PROFILES uses current nutrition, demographic and scientific data to relate malnutrition to functional consequences such as child survival, illness, impaired intelligence and reduced productivity.

The consequences of malnutrition are calculated over a 6-year period from 2000 to 2005, which is the first stage of the revised national poverty eradication action plan.

The data used in this analysis are based on demographic data estimates from the 1991 Uganda Census and the 1999 projections from the Uganda Bureau of Statistics.  The nutrition data is based on the Uganda Demographic and Health Survey of 1995, local surveys and  international literature. 3 The targets used to estimate benefits are based on targets of the current National Health Plan.

Let us now describe the consequences of malnutrition on: child health and survival, education and economic development, beginning with child health and survival.

Consequences of Malnutrition on Child Health and Survival

It should be noted that Protein-energy malnutrition, vitamin A deficiency and sub-optimal breastfeeding, significantly lower the resistance of children to infections and increase dramatically their risk of illness and death.

Our most recent national survey found that 26% of children below 5 years of age in Uganda are underweight.  Since malnutrition reduces a child’s resistance to infection, underweight children are more likely to become sick and die.  It is further estimated that in Uganda 43% of child mortality is caused by protein-energy-malnutrition and its interaction with infection.  This makes protein energy malnutrition the single greatest cause of child mortality.

In-fact, using PROFILES we have estimated that if there is no improvement in the prevalence of PEM over the next 6 years, 271,000 children will die due to PEM.   If we are able to achieve the National Goal, to reduce PEM from the current 26% to 16% over the next 6 years, 53,000 lives can be saved over the same period.

Vitamin A also has an immense impact on the levels of child morbidity and mortality.  In Uganda, Vitamin A deficiency affects an estimated 54% of children under 6 years of age, resulting in increased levels of illness and deaths.

Using PROFILES, we estimate that over the next 6 years, 184,000 child deaths will be attributed to Vitamin A deficiency.  On the other hand, if Vitamin A deficiency is reduced from the current level of 54% to 11%, that is by a factor of 80%, over the next 6 years, then 65,000 child lives will be saved. 

There would also be significant financial savings to both government and individual families from the treatment and care of children experiencing vitamin A related morbidity.

One other factor that influences child morbidity and mortality is poor breastfeeding practices.  Breastfeeding protects infants against infections and death.  The National Food and Nutrition Policy (1996) recommends that babies be exclusively breastfed for their first 6 months of life with no other foods or liquids, not even water.  However, by 4-5 months, 64% of infants receive some form of supplement, unecessarily exposing them to possible infection and reducing the protective advantages of breastfeeding.

We have estimated that as a result, if breastfeeding practices remain unchanged, there will be 4,400 infant deaths each year caused by diarrhea and respiratory tract infections that are due to sub-optimal breastfeeding.

We all know that exclusive breastfeeding also contributes to child spacing and therefore improves the health of mothers and infants. 

We have estimated that if all our children were not breastfed, the current total fertility rate in Uganda of 6.9 would increase to 10.7. The monetary value of this contraceptive effect of breastfeeding in our country is 12 million dollars per year and could be even more if the rates of Exclusive Breastfeeding were improved.

Consequences of Malnutrition on Education

Good nutrition is essential for optimal mental development, learning potential and school performance in children. Malnutrition  wastes educational resources.

Protein Energy Malnutrition and Education

For example, stunted children, who are too short for their age, have been shown to have 3lower Intelligence Quotients and 3lower specific factual knowledge than comparable non-stunted children. In addition, children stunted at 2 years have delayed enrollment in school, high absenteeism, 3higher rates of class repetition and 3low  concentration.  The degree of cognitive impairment is related to the severity of stunting.

Vitamin A and Education

Children with vitamin A deficiency can suffer from night blindness or even total blindness. This increases the cost of training in special schools of the blind and prevents enrollment of some of those affected. We have already described the effects of vitamin A deficiency on the immune system. The resulting illnesses 3increase absenteeism and 3reduce concentration at school, further wasting educational resources.

Iodine and Education

Iodine is necessary for the normal development of the baby’s brain during pregnancy and pregnant women living in Iodine deficient regions are more likely to give birth to mentally retarded children. Due to its permanent effects on mental development, iodine deficiency during pregnancy considerably reduces children’s learning ability, school performance and retention rates.  It also causes 3speech and hearing defects.

The total goiter rate amongst school children in six selected districts in Uganda is 60% while visible goiter affects 30% with wide variations noted.   Presence of visible goiter has traumatic effects on the affected children causing absenteeism, inferiority complex and pain, amongst others.

If every household in our country consumes salt fortified with iodine, this simple, low-cost intervention would have an enormous impact on our children’s ability to learn. 

Iron and Education

Iron deficiency anemia also reduces the learning ability of children.

Iron deficiency anemia in young children is associated with reduced physical capacity to do work, mental capacity to think and learn, school retention, 3school attendance and enrollment.  

If anemia among school children, is not urgently addressed, it will reduce the expected benefits of the investments in universal primary education and the contribution our children can make to the future economy.

Consequences of malnutrition on education have physical and social economic losses in terms of time, money, energy, scholastic materials, 3human resource and physical infrastructure.  In addition, reduction in intellectual development occurs due to low intelligence and manipulative skills. All these factors compromise educational achievement, waste investments in Universal Primary Education, and threaten future prosperity, yet Uganda is for our children!

Consequences of Malnutrition on Economic Productivity

In Uganda’s Vision 2025, rapid modernization of agriculture was identified as a primary strategy.

This and other aspirations for increased economic productivity are threatened by three major malnutrition problems, namely:

¨      Stunting, due to protein-energy malnutrition

¨      Mental impairment, due to iodine deficiency, and

¨      Anemia due to iron deficiency,

All of which have adverse effects on economic development.

The Effect Of Stunting

At age 2, 45% of Ugandan children are stunted. The damage caused by stunting by this age is permanent so stunted children become stunted adults who never attain their full productive potential.

Using PROFILES, we estimate that if no intervention to reduce stunting over the next 6 years is adopted, the present value of future productivity lost due to stunting will be 201million US dollars. Yet the country would be able to gain 26 million dollars in productivity over the same period with interventions costing only 12 million dollars, yielding a benefit: cost ratio greater than 2 to 1.

 Goitre

Let’s look next at the effect of iodine deficiency on economic productivity.

We have already seen that iodine deficiency causes mental impairment 3in newborn babies, which is irreversible and that goiter prevalence among Ugandan children of school going age currently stands at 60%.

Using profiles, we estimate that if iodine deficiency remains unchanged over the next 6 years, Uganda will lose 744 million dollars in productivity. Yet with interventions costing only 5 million dollars the country would be able to 3reduce these losses by 380 million dollars over the same period, with a benefit: cost ratio of 73 to 1. Over 2 million newborn babies would be spared from mental impairment over this period.

Anemia

Turning now to anemia, scientific research shows that there is a 1% drop in productivity for every 1% drop in iron status.

Anemia results in:

¨      Poor reproductive health leading to greater risk of death of mother and infant; and

¨      Reduced productivity in manual work.

¨      Current estimates put anemia prevalence in Uganda at 50% in pregnant women and 35% in non-pregnant women.

¨      Using profiles, we estimate that if no intervention to reduce iron deficiency over the next 6 years is adopted, Uganda will lose 120 million dollars in productivity just in the female agricultural work force. Yet with interventions costing only 10 million dollars, the country would be able to gain 21 million dollars in productivity benefits over the same period, with a benefit: cost ratio greater than 2 to 1. 

In SUMMARY, Ladies and gentlemen the overall cost benefit analysis of what we are advocating for can be summarized as follows:

If nutritional deficiencies remain unchanged, the net present value of productivity loss for the 6-year period from 2000 to 2005 would be:

¨      201 million dollars for Stunting

¨      744 million dollars for IDD, and

¨      120 million dollars  for Anemia

This is a total loss of over 1 billion dollars.  This compares with projected gain of 427 million dollars from interventions costing only 27 million dollars, üyielding a benefit: cost ratio of 16 to 1. For every dollar invested, Uganda will reap 16 dollars in return.

Breast- feeding and Economic Development

Poor breast feeding practices have also been already identified as a key underlying cause of malnutrition. Exclusive breast-feeding for about six months has economic benefits from improved nutrition, savings on health care costs and accompanying savings on breast milk substitutes.

Just counting the savings on breast milk substitutes, we estimate that the economic value of breast milk currently consumed by infants in Uganda is 325 million dollars per year.

This analysis, ladies and gentlemen, also acknowledges the huge economic contribution of the breastfeeding mother.

Solutions

These gains cannot be realized without our commitment and effort.

To realize our hopes for the year 2025, Uganda must make conscious efforts to reduce malnutrition, particularly in the most vulnerable groups: infants, children and women of reproductive age. We know that the worst effects of malnutrition occur very early in life, beginning even in the womb. In Uganda most growth faltering occurs during infancy. Whether we look at underweight or stunting, all the damage occurs before age 2, about 40% of infants are affected and there is little or no recovery. We therefore need to act early in this vulnerable period with preventive measures that reach virtually all infants and ensure optimal feeding.

Specifically, we recommend the following nutrition interventions, which experience in Uganda and elsewhere suggests are both feasible and cost-effective.

1.       Promote  child growth through the provision of:

·         better counseling to caregivers on optimal child feeding practices. Counseling should focus on exclusive breastfeeding of infants for the first six months of life, adequate and timely introduction of other foods thereafter while continuing breastfeeding and increased breastfeeding during and after illnesses for full recuperation.

·       Counseling should involve all stakeholders at all levels and take advantage of every available opportunity, especially antenatal and postpartum visits, young child clinics including the Integrated Management of Childhood Illness, during home visits and 3through contacts with agricultural extension agents.

·       To achieve the above, the knowledge and counseling skills of both health and non-health workers involved in health and nutrition related activities need to be improved.

·       To implement these strategies there is a particular need to form and regularly convene the infant & young child nutrition committee as already stipulated in the food & drugs regulations of 1997, which should then oversee a thorough review of policies to enable successful promotion of breastfeeding and child feeding practices.

2. We need to strengthen the micronutrient supplementation programme through:

·       The distribution of vitamin A supplements to lactating women within the first 6 weeks after delivery and to children every 6 months. To do this we can use all health contacts and any other means that will increase our coverage for instance, non-governmental health providers, mother support groups and schools.

·       The distribution of iron-foliate supplements to pregnant women using midwives, traditional birth attendants and other community-based health providers. To control anemia among pregnant women In endemic areas we also recommend anti malarial, bed nets and deforming.

3. Ensure the consumption of iodated salt through:

·       The enforcement of the Food & Drugs (Control of Quality) (Iodated Salt) Regulations of 1997, which require all salt sold in Uganda for human consumption to be iodated; and mandates the formation of a national council for the control of Iodine Deficiency Disorders.

·        We also need to educate households on the importance of consumption of iodated salt.

4.     Promote sustainable food-based strategies for the alleviation of iron and vitamin A deficiencies. Specifically we need to

·       set up a task force on the fortification of foods with vitamin A,

·       promote the production and consumption of micronutrient-rich foods (such as yellow-fleshed sweet potatoes and small animals).

·       Give more attention to food utilization in the agricultural extension programme.

5. Provide appropriate information, education and communication.

This strategy should focus on developing and harmonizing nutrition messages on:

·       Proper feeding practices, such as exclusive breastfeeding, adequate complementary feeding, consumption of vitamin A and iron rich foods and the use of iodated salt.

·       Proper hygiene and sanitation practices to prevent and reduce the incidence of diarrhea diseases, malaria and other parasitic infections.

·       Communication for behavior change using effective mix of interpersonal communication and social marketing approaches.

6.   Use the full potential of the educational system.

·       Schools are effective and efficient channels for transfer of nutrition knowledge, for reaching a large population of children and adolescents with direct health and nutrition interventions (such as de worming and micronutrient supplements) and reaching the larger community beyond the school.

·       Schools also have the mandate, responsibility and opportunity to enhance child development (including nutrition) but the full potential of this opportunity cannot be realized without adequate policies and resources.

•           We therefore need to incorporate mandatory nutrition education into the existing education system, especially at primary and tertiary levels, and 

•           review education curricula to ensure integration of nutrition education at all levels.

7. Ensure that all Ugandans are adequately fed by:

·       ensuring access to adequate nutritious food by all household members; especially pregnant  and lactating women, infants and young children and  especially during periods of food insecurity.

·       Secondly we also need to co-ordinate key sectors in the targeting of populations with food relief.

Conclusion

Ladies and Gentlemen, our presentation shows that an adequate ü investment in nutrition in Uganda would avoid:

·       Massive numbers of infant and child deaths;

·       A drastic lowering of our children’s school performance, and

·       Huge losses in economic productivity.

Three conditions are needed for this poor nutrition situation to change:

·       The first is a strong commitment of our political leaders and decision makers at national, district and community levels.

•           The second is a clear, focused, comprehensive national nutrition strategy, reflecting consensus among the professional nutrition community and coordinated by a multi sectoral body such as the Food and Nutrition Council which should be transformed into a “National Nutrition Authority” and housed in the in the Prime-Minister’s office.

·       The third need should follow from the previous two: an appropriate level of investment in this nutrition strategy with the creation of separate budget line items in the key ministries, and with the full support of all government ministries, donors and multilateral agencies.

Therefore, investment in nutrition in Uganda will reap benefits far outweighing the costs, benefits in terms of child survival, health, education, agricultural productivity and industrial performance, all key determinants of the human and economic development of our country.

With appropriate commitment at the highest levels, Uganda tackled and reversed the deteriorating HIV situation. Though less visible, the nutrition problems that face us are equally serious and equally urgent.  Attainment of the human and economic benefits described here is our only hope of making our Vision for the year 2025 a reality.

Salim Saleh’s plan to address the ‘Acholi question’ and problems in Northern Uganda

Salim Saleh’s plan to address the ‘Acholi question’ and problems in Northern Uganda

Feb 13, 12 6:26 PM

Author ugandansatheart(UAH) Categories Agriculture, Finance, LRA and Kony, POLITICS Edit

 

 

 

 

 

 

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General Caleb akandwanaho salim saleh oriba (res)

By:Lt gen. Caleb akandwanaho salim saleh oriba (res)
Senior command and staff college kimaka
INTRODUCTION

1. The Acholi question is, is it food security when the fighting stops or could food security stop the fighting.

Food Security means ensuring that all people have physical and economic access to the basic food they need to work and function normally. The right to food is the second most important human right after life. But in the Acholi region, the 17 year old Lords Resistance Army / Insurgency has affected peoples livelihood hence denying them the right to food. People have been forced to live in IDPs for fear of abduction and/or killings by the rebels.
This has left them no choice but to depend on donated food as and when the donors feel it necessary. Food security therefore is no longer a community responsibility as a normal in African culture but a gift from humanitarian agencies.

1. Being agrarian community, food security is dependant on access to land, which unfortunately has been limited by insecurity and congestion within the camps hence raising the Acholi Question.
2. According to H. Fritschel. Peace has broken out in a number of countries recently, raising hopes for establishing food security. But restoring food security after conflict can be complicated and dangerous. Whereas there is hardly any doubt that food security cannot arise under conflict conditions, it also follows that there can hardly be peace under food insecure conditions, A HUNGRY MAN IS AN ANGRY MAN.

AIM

1. The aim of this paper is to examine an integrated solution to support food security in conflict areas. This will in turn build a momentum towards peaceful resolution of the conflict and development in the post conflict areas.

BACKGROUND

1. Uganda has achieved remarkable economic and social achievements in the last fifteen years and is now ranked 146 out of 177 countries. This puts it ahead of Zimbabwe, Kenya, Nigeria, Senegal and Tanzania.

1. In spite of the above-mentioned success, there are continued disparities in human well being especially in the Acholi sub region. This region is comprised of GULU, KITGUM AND PADER DISTRICTS. The estimated population is 1,048,207.

1. Gulu district has an estimated population of 468,407, Kitgum has about 286,122 and Pader district has 293,679 people. It has been established that up to 87% of the population are displaced. An average camp is estimated to be one square mile with as many as 15,000 to 25,000 people. These are crammed in small huts with inadequate space and facilities.

1. The appalling food insecurity has attracted both international and national strategies aimed at addressing the crisis. At the international level, the assistance is in the form of food aid and other services not related to food such as medicine, education and community activities.

1. However, there is an acute shortage of basic facilities. There is dire need of a solution to the food insecurity situation that is not dependant on relief food delivered by NGOs and international UN agencies.

1. The supply of food and other aid is not guaranteed because World Food Programme and other agencies are severely limited in their delivery of food and other humanitarian assistance by the high risk of attacks on road convoys. Travel on most roads is possible with armed escorts.

1. The assistance to the IDPs is slow, poorly organized and to a great degree inefficient. The money allocated is badly distributed. Frequently the materials provided for purposes of relief are not adapted to the requirements of the people in the local conditions.

1. In many cases those who come to the assistance of the sufferers lack the expert knowledge of the technique of relief work. The offerings made by the governments of the countries, which are safe to those affected, are in the nature of charitable donations, which tend to embarrass the givers and humiliate the recipients.

1. Academics, consultants and specialists, journalists including conflict resolution experts who are never neutral mainly run the relief agencies. In relation to the on-going conflict relief assistance has an impact. The mere fact of keeping people alive in an internal conflict is political and deserves to be recognized as such. Perhaps the most common subversive impact of foreign relief programmes is that they invite favorable comparison with government’s own effort thus undermining the legitimacy of the government.

1. Any established aid programme creates a local constituency to defend it. As programmes become entrenched they tend to become more conservative and as the donor agency invests more it becomes less willing to change even in obvious cases of wrong priorities. The agency or NGO most determined to get the highest media profile obtains most funds from governments and donors. In doing so it prioritizes the requirements for fundraising. It follows the TV camera, employs young women to appear in the field with graphic and emotive shots of starving kids and helpless women. Here the definition of what the problem is becomes political and bad blood starts flowing between the government and relief agencies.

1. More importantly according to Alex da Wadl (Famine crimes), in a prolonged aid programme, cultural shifts occur in recipient communities. Aid donors increasingly come to define the problems and solutions to the recipient country and their dominant position in major policy debates undermines the country’s possibility to conduct its own domestic debates on the issues. The danger her is that national opinion formers may get over influenced by the perceptions and prescriptions of the donors’ role of aid and the charitable approach at the expense of local policy related and political solutions.

1. The end result is that the recipient communities come to believe that solutions lie entirely in the hands of the aid agencies and not in their own actions. This level of demoralization and dependency is perhaps the most difficult obstacle to overcome in post conflict period. Some form of support in farming and other economic activities needs to be encouraged.

All this shows that when a government assumes that NGOs can plan and implement food security programmes for the people of the Acholi sub-region, it is assuming the impossible.
That is why the government has to realize that it needs to draw up and fulfill “a Social Economic Contract” to ensure food security for the people in the Acholi sub-region in spite of the conflict.

1. If we go by the poverty eradication plan, it is clear that the link between security, good governance and development is well addressed. For example, first and foremost in an agriculturally dependent economy like Uganda, one cannot address economic growth in a sustainable manner without modernizing agriculture.

Secondly, good governance and security are crucial to agriculture. Any other intervention to increase the abilities of the poor to raise income and improving the quality of life is definitely correct. However, PEAP remains a broad plan. It does not focus on any specific target community such as that affected by conflict.

For that matter it remains largely within the general national and local government policy and extension services that are already crippled in the context of Acholi.

EARLIER GOVERNMENT ATTEMPTS IN INTERVENTION

1. In the 1990 the government tried to implement special programmes like the Northern Uganda Rehabilitation Programme NURP I. This programme would have compensated the damage caused by the insurgencies and cattle rustling. The aim was to restore basic social economic infrastructure as well as revive income-generating activities after what seemed like the end of the war. This effort was undermined by sporadic insecurity.

Furthermore, centralized procedures led to poor performance, inefficiency and resource wastages especially during procurement.

1. Lack of ownership of the programmes among the people also impeded the full implementation of the intervention. NURP II was later conceived to compliment NURP I and sought to promote a transition from conflict to peace in the Acholi sub-region and Northern Uganda as a whole. It was also supposed to consolidate the gains if any achieved under NURP I.

NURP II was also supposed to avoid mistakes that caused NURP I to fail. Unfortunately this programme never delivered the expected results. In total about 150 million dollars was spent but to date one cannot point to any outcome of this colossal sum of money. If someone is over flying the area in question, the only evidence that this programme existed is abandoned modern school buildings scattered all over the place.

1. Currently another programme is under way at an estimated cost of 93,000,000 US dollars. It is known as Northern Uganda Social Action Fund. Among other things it is supposed to carry out restocking and capacitate the youth to generate income. The programme is also supposed to address other factors caused by the bad performance of NURP 1and NURP II. Despite these interventions and resource flows, and food insecurity and poverty in this regime remains high. The intervention undertaken and the resource spent have failed to make any significant difference in peoples’ lives. So why have these enormous interventions failed to deliver food security?

1. There can only be two reasons for failure to achieve the set targets of the programmes already mentioned. Either the gravity of the poverty problem in Acholi land is so deep that the interventions and resources spent so far are inadequate to make any significant difference to the lives of the people or the intervention undertaken by the government and its development partners and sect oral and district level are not appropriately designed and implemented to deliver services effectively in conflict situations.

1. I tend to agree with the latter in that as a result of inadequate understanding and appreciation of the complexities of the Acholi conflict by implementers, policy makers and development partners, insufficient attention is paid to potential solutions to the local challenges. The breakdown of governance structures, low absorptive capacity and lack of accurate information abut the most appropriate ways of delivering food security may be contributory factors that slow down implementation of the interventions.

Also centralized procedures, top-down approach and sporadic insecurity created new needs and caused delays in the execution of the planned activities.

1. Lastly the government has never considered food security as one of the items of strategic importance. That is why it was left entirely in the hands of the relief agencies and development partners. If government could realize the relationship between food security and insurgency then appropriate means would be availed to deal with it in a more logical, consistent and planned manner.

CONCLUSION

1. The need for food security is a challenge that requires new tools and wider partnerships. As Prof. Asenath Sigot put it, unless communities, regions and local counterparts get convinced of the validity, importance and priority of concerning themselves with food security, then no amount of pushing will give rise to authentic let alone responses that are effective.

As for the Acholi question, I want us to look at the following calculations.
a)       The amount of money used in relief operations over the years including the said interventions. This is approximately 500,000,000 US$.
b)       Amount of land available for emergency production is over 2 million acres.
c)        The number of people displaced is approximately 200,000 families.
d)       If each family had been assisted to plough, plant and harvest 3 acres of land, the entire displaced population would have needed 600,000 acres of prepared and defended land.
e)        That would have cost government approximately US$150,000,000 and you cannot compare that with the US$500,000,000 already spent.

1. From the above-mentioned calculations, I beg to conclude that food security could stop the fighting.

RECOMMENDATIONS

1. It is recommended that local communities should be given the opportunity to prepare their own strategies for self-sufficiency in food security. An enabling environment will allow people in the communities to express their views on the issues. They will be capable of defining their needs and aspirations and formulating a plan for sustainable food security. To attain food security is a matter of responsible, informed behavior by individuals and groups. Responsible behavior is likely only when people have full control over their lives and access to resources they require. Strengthening self-reliance communities have to be empowered to act in their own interest in order to develop a strong sense of identity, mobilization of under-utilized skills and resources to liberate the emergency of community work, innovate and diversify their livelihood. Finally efficient use of human and material resources.

1. Government should carry out a comprehensive cross-sect oral and integrated approach to food security in the Acholi region in particular and Uganda at large. This should involve a wider range of people in and out of government to develop food security action plans. Experts should be nationals of the country charged with the task to develop a checklist of priority actions that will provide guidelines for sustainable food security.

1. The issue of land holding should be resolved

1. The acholi people have been traumatized but should not be blind of the fact that it is they who could develop them selves.

1. Gulu airport should be upgraded to an international standard.

Dec 2005.
REFERENCES

1. Gulu Food Security assessment: Understanding vulnerability in the Gulu context.
2. Emergency food needs assessment report for Kitgum, Gulu and Pader districts – October 2003.
3. Security and production programme May 2003.
4. Farmer assisted agricultural programme.
5. Conflict and hunger research report – prepared by the Office of the Prime Minister.
6. Past conflict reconstruction. Ministry of Finance. THE case of Northern Uganda.
7. Food Security in Sub-Saharan Africa. The role of government and NGO by Prof. Assenath Sigot.
8. Our task: The question of security and governance by George Kent.
9. Famine Crimes by Alex de Waal.
10. Interventions and sanctions by Sir W R Harcout in 1843.