Freedom from tobacco production in Kenya for healthier lives

For a very long time, farmers in Kenya’s Migori county and other tobacco growing areas have suffered health risks and illness emanating from growing, nurturing and curing tobacco. This is because tobacco growing exposes farmers and individuals to noncommunicable diseases such as cancer and cardiovascular and respiratory diseases. In addition, people in communities are also exposed to a form of nicotine poisoning known as green tobacco sickness (GTS). Through the Tobacco-Free Farms project, the World Health Organization (WHO), in partnership with the World Food Programme (WFP), Food and Agricultural Organization of the United Nations (FAO), and in collaboration with the Kenyan Government, influenced and facilitated farmers’ transition towards producing profitable, less labourintensive, sustainable crops and eliminating the negative health effects of tobacco farming. The initiative was piloted in June 2021 and formally launched in March 2022. WHO Kenya trained 80 community health volunteers in Migori county to sensitize farmers about the harmful effects of tobacco and the benefits of switching to sustainable, healthier alternatives such as highiron beans. This has resulted in relief from the health effects associated with tobacco farming along with health improvements due to the regular consumption of high-iron beans.

How did Kenya, with the support of the WHO Secretariat, achieve this?

Tobacco farming accounts for less than one percent of Kenya’s economy: although many are unaware of the connection, studies have shown the harmful effects of the practice on farmers. In Migori county, tobacco cultivators have long complained of upper respiratory illnesses and symptoms consistent with green tobacco sickness (GTS) due to nicotine absorption through the skin when handling wet tobacco leaves, as well as to exposure to heavy use of pesticides and tobacco dust. Nicotine contained in tobacco is highly addictive and tobacco a major risk factor for cardiovascular and respiratory diseases, and for over 20 different types or subtypes of cancers and other debilitating health conditions.

Kenya was one of the first countries to ratify the legally binding WHO Framework Convention on Tobacco Control (FCTC) and subsequently adopted the Kenya Tobacco Control Act 2007. Both documents stipulate a need for an alternative to tobacco production that protects those whose livelihoods depend on growing it.

As part of its ongoing collaboration with other partners and the Kenyan Government, WHO Kenya trained 80 community health workers in Migori county to conduct outreach among the many tobacco farmers in the country about the dangers of tobacco farming and inform them about the available alternatives. Using WHO Kenya’s network, these community health workers were recruited from within the county so that they could better relate to the community members, increasing their acceptability and trust. Once identified, they were trained about GTS and other diseases related to tobacco growing and how to identify tobacco industry interference in the community in order to better sensitize the community regarding the dangers of tobacco farming on their health.

In a complementary move, using local procurement initiatives WFP and partners provided a long-term market for high-iron beans in the county, allowing farmers a steady, reliable source of income, as well as providing seeds and other materials for cultivation. County-based agricultural officers with technical support from FAO were instrumental in training farmers on good agricultural practices, and post-harvest handling of harvested crops.

This market gives Migori’s tobacco farmers a new way to earn a living with none of the negative health effects that come from growing the high-labour intensive and toxic tobacco plant. This is a new way to fight the tobacco epidemic that has stolen so many lives.” - Dr Abdourahmane Diallo, WHO Representative in Kenya.

More and more farmers are now making the switch after realizing the benefits of ceasing to grow tobacco and the alternatives available. Personal experiences shared from farmers have highlighted the positive changes on their health and wellbeing, as well as those of their families.

There are many diseases associated with tobacco farming that affect the environment and people. There were sudden deaths. When we stopped tobacco farming in this region, we saw development in children. The rate of students joining secondary schools has gone up.” - Reginald Omulo, a farmer in Migori County, Kenya.

While the Tobacco-Free Farms project is relatively new, the switch to farming alternatives has reaped the anticipated benefits for health and well-being. The initiative is laying a basis for healthy living and eliminating risks associated with tobacco products. Some challenges have however been identified. Due to the high demand for ironbean seeds, seed insecurity has been observed in certain areas. To combat this, WHO Kenya together with partners is engaging with seed providers to ensure a steady supply. Equally, WFP is working with the government to train farmers on quality grain production and seed selection for subsequent seasons. Furthermore, champion farmers are being identified: they will be trained on the production of high-quality grain which can be used as seeds by other farmers, thereby limiting any effects due to climate change.

Despite the challenges, WHO Kenya, together with partners, aims to expand the initiative to other counties in Kenya. From January 2023, Meru, Bungoma and Busia counties are next in line for rollout of this initiative, targeting a total of 2800 farmers in the coming seasons. WHO Kenya continues to reinforce the stipulations of WHO FCTC and the Kenya Tobacco Control Act (2007).

Knowledge

WHO country stories: delivering for all

“This impact story was published as part of the WHO country stories: delivering for all report, which presents a snapshot of how WHO has delivered on its mission in countries and contributed to health outcomes across a wide range of issues during 2022-2023.”