Fighting Fat: The Growth of Childhood Obesity in Africa

English: Fighting Obesity (Photo credit: Wikipedia)

In today’s globalized world, African children living in the cities are increasingly at risk of contracting middle class diseases. The lifestyle and eating habits in the urban areas in Africa has been undergoing transformations over the past few years. Factors such as food choice and social conditions have contributed to this increase, making obesity rates amongst middle class African children problematic. Childhood obesity is linked with serious health problems and increases risks of contracting premature illnesses later in life.

Obesity rates are reaching epic proportions in sub-Saharan Africa. In a World Health Organization study published by De Onis, Blossenr and Borghi (2010) in the American Journal of Clinical Nutrition, they estimate that the prevalence of childhood overweight and obesity in Africa in 2010 was 8.5% and is expected to reach 12.7%  by 2020. The situation has become so severe that in countries such as Mauritius, one third of children aged 6 to 19 are either overweight or obese. Similar patterns of obesity can be seen in the adult populations in Mauritius. Other countries are experiencing similar trends in their youth and adult populations.

The growth in obesity has been accompanied by an increase in lifestyle related to non-communicable diseases in children and adults in all countries such as diabetes, cancer, hypertension and heart disease. This is beginning to put a strain on the fragile health systems in Africa as new health related problems are rising.

The cause of this increase of obese African children is accredited to a variety of factors including food choices and social conditions. With the rise of the middle class, there has been an increase in sedentary behavior, purchasing power, high fat diets and consumption of low-cost imported foods in this group.

The African diet in urban areas is increasingly laden with high fat foods. There has been a growth in the presence of local, regional, and international fast food restaurants such as Kentucky Fried Chicken and Steers. This means many more people are relying on burgers, fries, fried chicken, and pizza as part of their regular diets. This has been accompanied by an increase in the availability and numbers of processed foods in supermarkets, many of which are cheap imports. In Luanda, Angola, these imported processed foods are at times less costly than buying healthier locally grown foods. Additionally, vendors in the city typically fry their street foods in high fat oils making fatty foods easily accessible to a range of middle class budgets. Furthermore, there has been more frequent consumption of alcohol and tobacco.

A breakfast very high in saturated fat (Photo credit: Just some dust)

The change in social conditions has also contributed to obesity. African children are becoming more sedentary in their lifestyle and engaging in less activity. Many African children are choosing to spend their days playing video games, surfing the internet or watching satellite television rather than engaging in physical activities. Although this appears to be the same issues faced by their middle class counterparts in the global north, there are a few social issues that further complicate Africa’s growing obesity problem. Unlike in the global north, labor in Africa is less costly, therefore more African middle class families have domestic workers, which means the children are less likely to perform chores or other work. Many of the affluent also rely on drivers and do not engage in much short-distance or long distance walking. The legal drinking age in African nations  is lower (typically eighteen) than in countries such as the U.S. where the drinking age is twenty-one. Additionally, those under the legal age are often still able to purchase alcohol at stores. Therefore, middle class African children have greater access to obesity causing alcoholic beverages than those in the global north. In many African countries, cultural attitudes have lead to overweight people being admired because large size signifies prosperity. Therefore you are less likely to find mass supporters for weight loss for young children.

The growing rate of obesity-related problems coupled by the lack of awareness of obesity related issues though is concerning and needs greater attention. Many programs by NGOs, governments and civil societies do not often target obesity problems for various reasons. Obesity is a new problem on the continent and data is few. Additionally, food security has been an on-going problem in many African nations and many people on the continent still face starvation. This means governments, international non-profits, and civil society are unlikely to focus on issues encouraging healthy diets in the middle class. The problem, however, needs to target both demographics since many of the lower income classes will move into the middle class.

A diet rich in soy and whey protein, found in products such as soy milk and low-fat yogurt, has been shown to reduce breast cancer incidence in rats. (Photo credit: Wikipedia)

There needs to be a greater focus on creating awareness and decreasing obesity amongst the middle class. When it comes to serving a balanced meal, nutritional education at the household level is needed. Some in the middle class are educated but may be ignorant when it comes to nutrition. Others may have the income to buy the food but may not have extensive formal or nutritional education. Therefore nutrition education is needed across the board. When people belong to the middle class, their diets sometimes change. In many countries, eating meat is seen as a sign of affluence as well, therefore it is common to find a household meal comprised of a starch and several meats. The over reliance on food like nsima (foo-foo) or rice during meals is also problematic since they are high in starch (and calories) but eaten in abundance with the main meal. In brief, nutrition awareness programs should be targeted to rich and poor alike as they are needed across demographics.

Obesity is a growing problem in Africa and needs to be addressed in the middle class and affluent urban areas. As Africa changes and adjusts to new lifestyle, there is a need to readjust so that we are not creating new health problems. We are already witnessing changes in the types of diseases being diagnosed and need to start to prevent them early. Middle class African children should be encouraged to engage in greater physical activity including chores, playing, and participating in sports at school. They should also decrease their video game, Facebook and television watching hours. Lastly, they should be taught good nutrition habits from a young age.

Although there are health-conscious parents on the continent who teach healthy eating habits to their children and encourage an active lifestyle in them, the increase in obesity among the youth signifies that there is a problem. Globalization for Africa has meant the acquisition of global health problems in addition to the ones already there. The government of the island-nation of Mauritius has already taken steps towards preventative measures by actively managing its obesity problem and encouraging healthy diets and lifestyles. This should be emulated in other Africa countries facing obesity related health problems.

-- This article appeared on Jan 25, 2013 on Africa on the Blog.

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‘Arab Spring, African Fall’: A Reawakening

Image via Wikipedia

Uganda's infamous dictator, Idi Amin

For some reason I thought it would be much easier to find a compiled list of African dictators online. Africa has been branded as the ‘continent of dictators’ along with Asia and Latin America since the waves of independence from foreign control. Even though the world’s dictators are spread across four continents (Europe’s dictators rarely ever get a nod), Africa is more often associated with dictatorial rule than its counter parts. Indeed, the continent has been home to its fair share of notorious dictators like Idi Amin, Kamuzu Banda, Al Bashir, Mengistu Mariam and Robert Mugabe. But African leadership is transforming. By looking online and trying to piece together a complete list of dictators, it looks like there are 17 dictators left out of the 48 countries on the continent:

• North Africa – Algeria, Chad, (North) Sudan, Morocco
• East Africa – Somalia, Rwanda, Ethiopia, Eritrea
• West Africa – Guniea, Cameroon, Equatorial Guinea, Gambia
• Southern Africa – Angola, Zimbabwe, Swaziland
• Central Africa- Congo, Central African Republic

It should be noted that the classification of who is considered a dictator varies by definition and list (one analyst, went as far as listing the number of African autocratic states as 39). Even though Africa is commonly seen as the continent that wrote the ‘dictator’s handbook’, the majority of autocratic leaders today, are largely in Asia. Across different lists of autocratic governance and across different indices that measure levels of freedom enjoyed by citizenry, Asia seems to currently bear the brunt of tyrannical rule. This is even more so since Africa lost four dictators this year. It’s not often that Africa is given credit for teaching and/or upholding the ideals of democracy. Dictatorships in Asia, which have already been inspired by events in North Africa as seen in the ‘Arab Spring’, can (and should) continue to draw parallels and learn from the long history of anti-dictatorial revolts in Africa by its citizenry.

Image by cactusbones via Flickr

Arab Spring in Egypt was a paramount event.

African dictators have been falling this year. This year, Africans have witnessed the fall of Moburak, Laurent Gbaghbo, Ben Ali and now, Ghadaffi. Although some African leaders tried to hold out a candle for Ghadaffi, even the African Union has now conceded that the he is no longer the leader of Libya. By examining the list, it appears within the continent, North, East, and West Africa have a lion’s share of countries led by dictators. It is clear that at the beginning of this year, the numbers of dictators within Africa, were disproportionally in North Africa. In fact, according to Judy Smith-Höhn, a senior southern Africa researcher at a Pretoria-based think-tank the ISS Sub Saharan (SSA) countries like Malawi and South Africa, experienced the events witnessed in North Africa this year, in the 1990s and yet people are constantly trying to use protests that occurred recently in countries like Malawi, as southern Africa’s `Arab Spring’ (Irin News). As an example, in southern Africa (consisting of nearly 14 countries), Zimbabwe, Angola, and Swaziland are the last remaining dictatorships. So it is also fair to say that North Africa too should have been able to draw parallels and learn lessons from the history of anti-dictatorial movements in southern Africa by its citizenry. When protest led to Kamuzu Banda and De Klerk’s National Party left power, we should have also looked to North Africa asking, “is North Africa next?”

The events in the Middle East that began in North Africa have to an extent been unfairly called the “Arab Spring”, “Arab Awakening” or “Arab Uprising” which by description alienates African countries. Many of the participants are both Arab and Africans or are Africans who are simply not Arab. This terminology marginalizes the millions of people and perpetrates the stereotype that all North Africans are Arabs or the even more problematic one – the claims that Arabs are not Africans even though they are physically on the continent. It also means that when the ‘Arab Spring’ started, a large part of the world initially looked towards the East (Syria, Bahrain etc...) and not at what was occurring in neighboring countries in the South. African presidents though saw the connection. They knew that their disgruntled citizens could once again take to the streets. African presidents’ continent wide, reflected on their own governance, began to panic and preemptively protect the status quo – even the ones that were not dictators! In democratic Malawi, a university professor was even investigated and fired for comparing the conditions in North Africa to conditions in Malawi. African presidents knew that their sleepy (but not asleep) citizens would rise.

In SSA this year, we have seen an African reawakening happening in Angola, Burkina Faso, Cameroon, Djibouti, Ivory Coast, Gabon, Malawi, Mozambique, Senegal, Swaziland and Uganda to name a few. It could have easily been termed the “African Fall”. In fact, the successful revolutions this year, so far have only been on the African continent. However, the power of media attention to sustain a revolt is important to a movement, and without much international support, SSA revolts didn’t turn in to televised revolutions. Instead, the western international media gaze was focused on what their governments have been holding their breaths a long time for - regime changes in much of the Middle East. Although this inspiration to overthrow current leadership has largely been viewed as an impact of the Arab Spring it’s also important to note that many countries in SSA had been ridding themselves of their dictators or other unpopular leaders for a long time. Fighting for democracy on the continent is not something new – it has been only 50 years since the struggles against the colonial rule (essentially, foreign dictatorships) and many of those freedom fighters still remember those battles. The recent struggle for independence seeping across the continent is about gaining independence from our own home bred leadership. We are witnessing, what I hope is the reawakening of Africans and the start of an ‘African Fall’.

--A version of this article was published on African on the Blog

The Tribalism Myth in Sudan: Why Can't Africans 'Just get Along'?

At the dawn of the newly independent South Sudan, some news reports on Sudan have explained that Sudan experienced ethnic cleansing and/or genocide resulting from 'tribal' warfare. It seems that this popular concept of 'tribal warfare' is widely understood by the viewing audience as well as widely accepted. However, it is important to remember that the word 'tribe' itself is problematic. 'Tribe' is a contested term due to its inconsistency in meaning [See definitions on dictionary.com or wikipedia], hegemonic affiliations, and stereotypical tendencies. As an example, the term 'tribe' presents inconsistencies in terms of location, numbers, and settlement types. Tribes are often restricted to select geographic areas like Africa (but not Eastern Europe) or amongst select nations within a geographic area like Native Americans (but not to Vikings). There is no consistency in number (aggregate) either but 'tribes' are traditionally thought of as a small group. Hence, this becomes problematic when 'tribes' can consist of millions of people or make up the majority of the nation. As an example, the Shona make up the majority of ethnic composition in Zimbabwe so do they numerically qualify as a tribe?. 'Tribes' are also often thought of as people that wander like the nomadic Khoi San or Masaai. In anthropology, social "evolution" is measured (in rank order) by how people live. The idea here is that people "evolve" from hunter-gathers, bands, tribes, Chiefdoms, Cities, to City-States (nations) [See:Franz Boaz ]. Again, the Shona live in permanent settlements in towns, cities and states so do they qualify as a tribe? Once the Khoi San or Masaai become sedentary (set up permanent settlements) are they too no longer 'tribes'? There are a plethora of other inconsistencies with the use of this term, but where it becomes most problematic is when a fictitious, human construct like 'tribe' is then used to describe another construct like 'tribalism' and 'tribal' warfare and when tribalism is used to explain conflict. 'Tribalism' is rarely unpacked when it is mentioned but the term carries meaning and implications. Notably, that these warring 'tribes' 'just-cant-get-along' due to differences inherent between those two groups. These explanation rob the audience of a critical analysis on the situation at hand and create an image of a continent whose conflicts bare no cultural or historical roots of significance - they just like to fight. Historically, Africa as a continent has bared the burden of the 'tirbalism' and 'tribal warfare' brand so once ethnic conflict or tensions arise within her borders, 'tribalism' is often given as the reason (and an acceptable one at that).

It is important that coverage that seeks to explain the birth of the new nation of South Sudan is inclusive of the former Sudan's historical roots. Some of the coverage that I have seen about the situation in Sudan dates the beginning of its troubles in the 1960's when the country gained its independence. It is vital though that we do not brand the balkanisation of Sudan as simply due to 'tribal' conflict between African ethnic groups that just cant get along. Citing 'triablism' prevents a situation from being analysed due to the real socio-economic dynamics that underlies 'tribalism'. Notably, economic policies or bread and butter issues. In most instances where ethnic conflict occurs on the continent, there is uneven access to wealth or the power institutions in the country (judicial system, private business, government, education, etc...). In the case of Sudan, the South was deprived access to the aforementioned institutions. This was also the case in Rwanda and Kenya as well where we recently saw ethnic cleansing that had its roots in economic woes dating back to colonialism. During colonialism, it was often the practice of the colonial rulers to select a single ethnic group (usually a minority group) and give them (limited) access to some of the power institutions. After the Independence movements, nation building became challenging because the suppressed ethnic group became the dominant groups and this often marginalized (socially and economically) the minority groups. Hence, economic issues often are at the center of 'tribalism'. But focusing on 'tribalism' prevents people from getting to the root of the problem - economics, privilege and discrimination in multi ethnic societies.

Bringing disparate people together through force and unification processes whose differences outweigh their similarities has always been problematic. This is particularly evident through the examples of countries like Germany, where we saw Hitler's unification process lead to the ethnic cleansing of German Jews. A proper and complete analysis leading up to the genocide would include the overwhelming economic conditions that led to antisemitism in post Wiemar Republic Germany as opposed to viewing it myopically as Aryan Germans simply hating Jewish Germans for their Jewishness or 'tribalism'. In which case, the subsequent World War is arguably the largest display of tribalism in 20th century Europe! In East Europe, the balkanisation of former Czechoslovakia and Yugoslavia provides us examples of multi ethnic nations that were forced together that led to continual conflicts. Czechoslovakia was founded in October of 1918 as part of the Treaty of Versailles. It consisted of areas that were once a part of the Austro-Hungarian Empire that were ethnically disparate. The ethnically disparate Czechs and Slovaks had been forced together into one country and this arrangement was problematic from the onset. This resulted in the creation of the Slovak and Chech Republics in 1993. Yugoslavia was formed as a result of unifying the Serbs, Croats and Slovenias into one kingdom amongst opposition. Forced arrangements brought about underdevelopment, war, and ethnic conflict. Eventually, Yugoslavia balkanised, and became the independent countries of Bosnia and Herzegovina, Croatia, Kosovo, Macedonia, Montenegro, Serbia , and Slovenia.
The current balkanisation of Sudan is hence a formula that we have seen repeated in other parts of the world in recent history. In the case of Sudan, like most African countries, it had been formed at a round table of European nations at the Berlin Conference where all African countries were formed at the stroke of ink. Hence dividing countries based on external forces as opposed to internal unification processes. The problems that arose in the former Sudan are not unique to Sudan nor is the ethnic cleansing that resulted there inherent in the Sudanese people. Similarly, "tribalism" is not isolated to select groups of peoples. The notion of 'tribal' wars seems to be an explanation that is often used to describe conflicts in Africa without fully unpacking the unique situations, conditions, or historical references of that country. This is done by both reporters and journalists from the west and from the continent. All Africans have been told that they have 'tribes', (and everyone belongs to one) and hence 'tribalism' (a natural conflict between ethnic groups for no particular reason) exists therefore it makes 'sense' that since Europe does not have tribes (they have ethnic groups) they cannot have tribalism. Therefore longstanding European conflicts like the plight of the armed movement for Basque independence from Spain and France is not seen as 'tribal' warfare. Few comparisons are made between the conflicts in Africa and other conflicts in the world.

The history of the Dinka's in South Sudan has been a history of domination -largely for control of resources. They have been dominated by Egypt, England (colonization) and lastly, the South Sudan was 'dominated' by Northern Sudan whom contributed to its underdevelopment. In spite of the presence of oil and fertile soil in the area, during these occupations, South Sudan was left underdeveloped. As a new nation, it will face the challenges of nation building amongst people that historically have had little control over their own society and economy. They will need to build a national identity and establish a "South Sudan brand" and reputation as an independent country. But already, tale tale signs can be seen of domination from someone from within its borders. The new money in the country is of the new president as opposed to a neutral national symbol or an apolitical symbol.This move marks the beginning of South Sudan iconography, where its politics are bound to be centered along the lines of individuals (national political icons) as opposed to shared symbols and ideologies. There national brand or identity is likely to be centered on the current President, Salva Kiir Mayardir. One can only hope that this is not a true sign of what is to come and that the new administration will proceed on a path that is inclusive of all the peoples of the new South Sudan.

Tribalism, with all its meanings and justifications is a disputed and problematic explanation for a multi-ethnic nation's ethnic tensions. Now that the Sedans have split, one wonders if any tensions that arise will continue to be called 'tribalism' or if it will evolve to a newer term like 'cross border tribalism' or if it will be considered a battle between two opposing nations with histories and dynamics that need to be unpacked to understand its roots.