Many of the patients that PIH serve are rural subsistence farmers. Hunger and malnutrition are frequently seasonal, or have environmental underpinnings. Supporting and sustaining agricultural capacity is a critical aspect to ensuring food security in the long term.

PIH's agricultural initiatives, though modest and nascent, provide seeds, livestock, tools, and training to local farming families. Through community-based training and support on soil conservation, establishing home gardens and raising livestock, these initiatives encourage agricultural improvement and aim to ultimately improve health at the community level.

Planning considerations

• Identify the major obstacles to local agricultural productivity. Consider issues such as climate, soil conditions, land ownership, common crops, irrigation techniques, livestock management, etc.
• Respect local mores regarding men and women's roles in agriculture.
• Determine what supplies and materials to provide to farmers that would best support increased agricultural output, whether tools, seeds, livestock, fertilizer, irrigation support, etc.
• Partner with other organizations that can help provide resources and know-how.
• Engage and train productive farmers who can work with other members of the community to increase overall agricultural production.

Suggested staffing

• Agricultural program supervisor
• Agronomists
• Staff responsible for the transport and storage of tools and seeds
• Staff responsible for tracking tools and seeds
• Community-based agricultural workers

Implementation

Zanmi Lasante, Haiti

PIH's model of care is based on the training and employment of community health workers to deliver care. Building on that model, Zanmi Lasante, in close partnership with the local agronomists of Zanmi Agrikol, (a sister organization that focuses on agricultural initiatives) recruits and trains a cadre of local ajan agrikol (community agricultural workers) to assist families in improving their agricultural yield and ensuring food security. This small pilot project is a promising model for community-based support and solidarity around agricultural issues.

Many of the ingredients for Nourimanba and Nourimil are grown at Zanmi Agrikol's 35 acre farm or they are bought directly from local farmers. Both Nourimanba and Nourmil are prepared and packaged in Zanmi Lasante's processing center, where local staff are employed and trained in the roasting, mixing, packaging and distribution of these products.

Inshuti Mu Buzima, Rwanda

In Rwanda, the PIH team is collaborating with the Clinton Hunter Development Initiative (CHDI) to address food security and agricultural issues. Local agronomes are assigned 500-600 households to train and support their farming efforts. Seed and fertilizer distribution is also a component of the program. Furthermore, the PIH/CHDI program also supports local farmers by issuing loans to HIV associations. Some of these loans have been used to purchase mills and grain storage so that crops can be stored and then sold at an advantageous time.

Bo-Mphato Litsebeletsong tsa Bophelo, Lesotho

In Lesotho, PIH has launched nascent partnerships with Catholic Relief Services and World Vision to introduce families to high-yield gardening methods such as keyhole gardens and trench gardens.