Roesel K1,2, Grace D3, Dione MM2, Ouma EA2, Pezo D2, Kungu J4, Ejobi F4, Clausen PH1

Materials and Methods

Introduction

Results

Key message

Over the past 30 years, pig numbers in Uganda have increased by more than a tenfold (FAO, 2011; UBOS, 2009) and today’s estimated 3.2 million pigs are raised by 1.1 million households (UBOS, 2009). Up to 70% of all pork is estimated to be consumed in urban and periurban areas (ILRI, 2011) mainly through informal road-side butcheries and so-called ‘pork joints’. Pork consumption in Uganda currently ranks first in Africa at 3.4 kg per capita per year (FAO, 2011). Little is documented about the mechanisms under which this pork is produced, marketed and consumed and what implications this may have on public health. Small-scale pig production in Uganda was selected by the CGIAR Livestock and Fish research program as a value chain system with a high potential for poverty alleviation, through increased livestock productivity. Constraints and opportunities for improvement were assessed using a multidisciplinary approach from November 2012 to February 2013 various components from farm to fork were evaluated: feeds, breeds, markets, animal health, food safety and zoonoses. The present study was carried out with the financial support of the Federal Ministry for Economic Cooperation and Development, Germany through the Safe Food, Fair Food project and in collaboration with the Smallholder Pig Value Chain Development project funded by IFAD-EC.

Who eats pork, when and why? Eighty per cent (n=234/294) of the participating pig farmers eat pork with a slightly higher proportion of men (n=92/103, 89%) than women (n=142/191, 74%). Taste is one of the main reasons to eat pork; it is considered “so sweet” and ranks second behind chicken in terms of taste. For children, pork is considered to be a “body building” food and given for good growth. In rural sites, pork is believed to clear the skin, cure measles and make “strong bones” whereas in the urban areas pork is sometimes believed to cure HIV/Aids. Increased pork consumption is driven by festivals such as Easter, Christmas, Uganda Martyr’s Day (June 3) and Independence Day (October 9). It is also driven by cash availability; for example, more pork is consumed after the coffee harvest in June/July and less pork is consumed around the beginning of the new school terms (February, May and August) when pigs are sold to generate money for school fees (Figure 2). What are reasons not to eat pork? Followers of Islam, Seventh Day Adventists and Borne Again Christians are not allowed to eat pork in accordance with their religious code. However, in the study sites these rules were not observed by all followers. Also, some of the women who do not eat pork claimed that they were raised at times when women were denied pork because men believed that eating it makes women too energetic and rebellious. Moreover, according to local tradition, elderly women are not supposed to eat pork, chicken and red meat. Almost all (93%) of the mothers emphasized that nobody eats offal. Some stated it is because pigs eat anything including faeces and snakes. What is the role of pork in farmers’ diets? The closer to urban centres, the more frequently pork and other animal sourced food are eaten, e.g. weekly to daily (Figure 3). In the rural areas, animal sourced food is consumed less regularly. The biggest constraint for eating more pork in rural areas is low income as claimed during 25/27 (93%) focus group discussions with mothers. Other factors include religion or traditional beliefs. Are pig keepers pork eaters? Especially in the rural study sites, pig farmers rarely slaughter their own animals; they believe that “one pig has too much meat for one meal”. They prefer to use the money generated from sales for meeting family needs

• Pork is consumed by the majority of pig farmers, especially during seasonal festivities and when cash is available • Reasons for not eating pork are mainly religious and traditional beliefs, as well as taste preferences • Pig keepers are pork eaters. They are not consuming their own animals but buy pork at the informal butchery or pork joints. • Pig feed production does not compete with human food production. Some festivals when pork is consumed even coincide with

times when food is not abundant and hence can contribute to food security.

• Pork is accessible in all villages that were part of the study. • There are many misbeliefs around diseases transmitted from pigs and through eating pork. Pork is generally consumed hot and

well-cooked. Outside of the homes, raw vegetables are served with the pork which may lead to cross-contamination. • Tools from participatory epidemiology helped identify possible zoonotic diseases that have not been reported in Uganda before.

Grand-Bassam, Côte d'Ivoire from 1 to 3 October 2013

Figure 1: Codex Alimentarius Commission framework to assess food safety, adapted by Safe Food, Fair Food project (2008-2011)

Figure 3. The Venn diagramm helps visualizing the number of pork sources in Kitete village, Mukono district, and it provides information on the importance of the source (size of the circle) and distance from the home.

such as school fees and instead buy one kilogram of meat whenever they can afford it. The closer to urban centres, the more frequently pigs are kept both for sale and home consumption; one slaughtered pig is often shared between several groups of people. How accessible is pork? People have access to pork in all study sites either at road side butcheries or at ‘pork joints’ (Figure 4), which enjoy great popularity in Uganda. At the latter pork is consumed fried (Kamuli) or roasted (Mukono, Masaka and Kampala). In rural areas the consumers are mostly men, whereas in towns both men and women gather at pork joints for lunch and at night, to watch football or soap operas, play pool, or simply socialize over pork and drinks. Does pig feed production compete with human food production? Feed has been identified as one of the major pig production constraints for farmers who wish to improve production outputs (ILRI, 2013). Food for people, however, does not compete with pig feeds, as the animals are fed with leftovers such as peels from cassava, potatoes, bananas or maize porridge; or they are fattened during “times of plenty”, shortly after the seasonal rains, with tubers and fruits. Pork consumption on the occasion of Easter and Christmas often coincides with times when food is less plentiful. A safe product can therefore contribute to the protein supply of poor farmers and their families during seasons of food shortage. Knowledge, attitude and practices. Raw pork is considered unsafe for human consumption and a potential carrier of disease across all sites. In terms of safety, pork ranks fifth after chicken, fish, beef and eggs but still ahead of milk which ranks sixth. In all 34 villages, the pig farmers agreed that it is possible to contract diseases from eating pork. The most common problems reported are worms (26%), stomach pain (20%), diarrhoea (16%) and fever (13%). There is a general misbelief among pig farmers, pork consumers and technical staff that undercooked pork can cause madness or epilepsy in humans. This misperception results in inefficient management of the disease risks. Fifty per cent of the pig farmers have heard about food borne disease in their community, and 31% of them say that children are most affected. None of the respondents said that food borne disease can result in death but all agreed that it seriously weakens the person affected and hence his or her ability to work or concentrate at school. At home, pork is thoroughly cooked for at least one hour and attempts are made to preserve the shelf-life of raw pork, for instance by smoking and roasting. When eaten outside of the homes, fried or roasted meat is usually consumed with raw vegetables such as tomatoes, cabbage and onions the preparation of which might lead to cross-contamination. The main meat quality criteria for pork consumers are the cleanliness (rank 1), size of the fat layer (rank 2), freshness (rank 3), colour (rank 4), texture (rank 5) and smell of the meat (rank 6). Farmers across all sites, preferably in the rural sites, might eat meat from diseased pigs if they cannot find a market for their animals. The pathognomonic signs of diamond skin disease in pigs (caused by Erysipelothrix rhusiopathiae), have been reported in all villages in Kamuli district; indicating a risk to people handling raw pork like such as butchers and house wives preparing the meat.

Information on pork consumption habits as well as on knowledge, attitudes towards pork safety and pork preparation practices was collected from 295 pig farmers, 194 of whom were women. They represented producers from 34 villages throughout Masaka, Mukono and Kamuli districts in the Central and Eastern regions of Uganda. Tools from participatory epidemiology (PE) were used to assess the public health risks related to pork consumption. PE is an emerging branch of veterinary epidemiology based on the principles and methods of Participatory Rural Appraisal (PRA), a concept from social science where “stakeholders in a given community are discussing a problem”. It aims at collecting the ideas of the community rather than compiling quantitative data. PE has also proved to be effective in Veterinary Public Health. It provides a fast and relatively cheap way of identifying zoonotic and foodborne risks to public health (Safe Food Fair Food, 2008-2011). A wide range of PE methods are available and in the present survey we used focus group discussions, ranking and scoring methods, as well as Venn diagrams and seasonal calendars for visualization.

The present survey represents the views and habits of the community in the study area and will feed into an exposure assessment to help characterize the risk to public health (Figure 1). The results will be complemented with objective data from biological sampling (hazard identification), secondary literature (hazard characterization) as well as a questionnaire survey (exposure assessment and risk characterization). Our sessions aimed to answer the following questions: • Who eats pork, when and why? • What are reasons not to eat pork? • What is the role of pork in farmers’ diets? • Are pig keepers pork eaters? • How accessible is pork? • Does pig feed production compete with human food production? • Knowledge, attitudes and practices that could increase or reduce the risk of pork

borne disease?

Figure 4. In periurban and urban areas (Mukono district, top) animal source food is more frequently consumed than in the rural areas (Kamuli district, bottom).

1. Faculty of Veterinary Medicine, Freie Universität Berlin,

Germany, k.roesel@cgiar.org

2. International Livestock Research Institute, Kampala,

Uganda

3. International Livestock Research Institute, Nairobi, Kenya 4. College of Veterinary Medicine, Animal Resources and

Biosecurity, Makerere University, Kampala, Uganda

Assessment of knowledge, attitudes and

practices on pork safety among smallholder

pig farmers in Uganda

Figure 2. Seasonal calendar for pork consumption