Selling Death: The real cost of tobacco to Malawi

First published in the Nation of 21 January, 2009. www.nationmw.net

Selling death:
The high price of
tobacco to Malawi

by Kondwani Munthali

Former UNICEF resident representative Idah Girma said Malawi within a short period has transformed its own story from that of perpetual hunger to self sufficient, reducing maternal deaths, increased access to safe water and meeting some of the acclaimed millennium development goals including access to education.

Girma said the onus was on Malawians to identify the remaining challenges “especially in health” and work had to find solutions. Girma left but her words ring louder as cholera outbreak is reported in the capital city claiming 19 lives and attacking more than 300.

Day before 2008 Christmas, Ministry of Health principal secretary Chris Kang’ombe made a chilling admission when he spoke of 7,000 lives that the country loses to malaria with close to 6 million incidences recorded in a year.

“I would say yes it is a difficult choice, either we forgo all the foreign exchange that the country depends on tobacco or we accept to continue sacrificing 7,000 lives that we lose due to malaria,” said Kang’ombe is trying to make sense over the resistance to the adoption of use of Dichloro-Diphenyl-Trichloroethane (DDT) spraying which is proven to eradicate the fatal disease.

Cases of Malaria are well complemented as public health systems crumble in the face of growing HIV and Aids, Tuberculosis and even cancers. Child death arising from respiratory failure is also on the increase.

Tobacco is the name of the crop, introduced in Malawi ages ago and slowly it has enslaved the country that the risks of speaking against it are huge and have political, social and political ramifications.

The crop which contributes to a third of the countries gross domestic product continues to undermine economic diversification that a few interventions by Government have ended up increasing production instead of decreasing the product.

Ned Khalapula, 55, is a farmer in Kasungu’s Chinkhoma area, where production of burley and flue cured tobacco is high that Government opened an auction floors, the only one in a rural setting. He has been growing it for 30 years as a subsistence farmer.

“I always have a cough, so too my family but I have never related it to fumes from curing he crop. Neither do I have intentions to quit growing it now that you have told me about the dangers of tobacco, after all what will I do next. There is more money in tobacco now,” said Khalapula whose prizes for a 30 year hard labour is a bicycle, a four roomed house with iron sheets and a mobile phone worth US$15.

He is among thousands of small scale farmers who grow the crop, but normally re-sale before the opening of auction floors open to intermediate buyers who sale at higher prices. They sale fast to repay fertiliser and other input loans they get at the beginning of the season.

A father of six honest to admit, “It is a labour intensive work and with few returns. I do this because I have nothing else to do. I grow maize for food and rear a few goats. My life is tobacco.”

Processing of burley tobacco which is the main type grown in Malawi followed by flue cured uses many trees for creating drying sheds, curing and processing which has led to massive deforestation as one of the traditional leaders in the district agrees.

“The environment in Malawi has been greatly affected, rainfall patterns in agricultural belts of Kasungu, Dowa, Ntchisi and Mzimba indicate the huge disparity the environmental degradation has caused leaving people more poor than before,” stated Senior Chief Lukwa during a recent stakeholders meeting on situational analysis on tobacco control.

Tobacco control has been gaining momentum across the world, culminating into the Framework Convention on Tobacco Control (FCTC), ban in advertising and marketing and more recently in November 2008 adoption of more stringent measures to curb cheating among the tobacco countries.

Malawi has refused to sign the framework, irking public health workers who have to deal with huge cases of TB, cancer and malaria with inadequate tools, most of them can be directly related to tobacco.

For Malaria calls by the Ministry of Health to be allowed to use DDT residual spraying which has proven effective have met rebuttals from their Agriculture counterparts who contend that any trace of the chemical will make the country’s tobacco unattractive.

“But the truth is that the quantities we will be using are very small than that used in tobacco. More important we can devise a way to use the residual spraying and ask tobacco farmers not to keep the crop in the house,” said Dr. Storn Kabuluzi director of preventive health in the Ministry who still has hope that soon the country will come to its senses and allow the use of DDT.

Apart from Malawi there has never been research to establish the reasons for increased respiratory infections among children, effects on pregnant mothers and coughs including TB in major growing districts.

“Only six percent of people are able to access cancer treatment in the country,” says a veteran politician Aleke Banda who has retired from politics to fight cancer which is increasing at an alarming rate. Nobody has yet to link it with tobacco.

The truth however is still haunting many public health professionals, tobacco has enslaved Malawians plunging many into debts, causing sickness and iced up by a Government that is willing to sacrifice 7,000 lives to malaria, hundreds more to TB and many more to cancer.

“The real cost of tobacco to Malawi in terms of health is very huge. Malaria eats up 40 percent of the health service budget. We have tried to make an economic case of it and we hope it will change in due course,” adds Kabuluzi.

Tobacco smoking unfortunately for Malawi is on the increase according to a recent WHO study placing the country among the top free in 12 African Tobacco Control Situational Analysis (ATSA) programme.

Activists have accused tobacco companies of deliberately targeting young people that a recent Phungwe in Mzuzu where one won one million made it to a BBC documentary which showed BAT Malawi dishing free packs to guests at the hotel.

The documentary producer also filmed several children in Zomba and Mulanje either selling or buying cigarettes at ease and more importantly allowing sellers to sell single cigarettes than full packets.

“Unfortunately while in Europe and developed nations they do not allow to sale single cigarettes, if Malawi BAT produces posters which categorises price of one. Use famaous musicians to host phungwe’s and exploit on young ones,” states a narrator on the documentary.

The burden on smoking families has not been clearly spelt out among Malawians as each addicted smoker can go between 10 to 30 cigarettes a day which translates to an expenditure of K300 a day and almost K100,000 a year for a poor family.

“Tobacco makes one poor. Whether in smoking or growing, the only people that have been rich are tobacco companies who continue to register huge profits and the expense of the life of young Africans,” says a youth officer with the National Youth Council of Malawi.

The officer says absence of organised civil society to push for signing of the FCTC and control access to tobacco by young people and promote alternative and diversified economy continues to undermine the public health concerns of tobacco.

The Council is launching a ten month secondary school project with Youth Alliance in Social and Economic Development (YASED) and Bunda college’s Centre for Agriculture Research and Development (CARD) to educate young people on the dangers of smoking.

Smoking according to scientific evidence causes many types of cancers, inflammatory skin infection, causes or worsens several eye conditions, skin wrinkling, hearing loss, tooth decay, heart diseases, stomach ulcers, discoloured fingers, miscarriages and cervical cancers, deformed sperm and many more.

“Actually some diseases or body disorders such as infertility have ended up being heaped on poor old people as witches when the truth is that they have been exposed to smoking. Secondary smoking is as dangerous as first hand smoking, Government needs to work up to the same reality,” says Edward Phiri, Executive Director of YASED.

In Malawi, more lives especially children and women continue to be exposed to secondary smoke at public places as there is no specific law stopping smokers from smoking in public.

According to Phiri, 7,000 lives added up to cancer, TB and child infections, pregnant mothers and myriad of diseases caused by tobacco does not compensate its arguments against the FCTC.

“The tobacco companies know they are selling death. US courts have made them pay billions of dollars and accused them of mafia type of behaviour-hiding the truth. President Bingu wa Mutharika actually accused them of exploiting Malawians, that is the truth. He knows the truth let his Government act on it,” says Phiri.

Forty five years after independence, Malawi knows how it can stop Malaria but it is still not free enough to act. It continues to be enslaved by a crop that has been grown and aggravated poverty and diseases among its citizenry and it has no idea when to stop it!

Ends.