World Health Day, sponsored by the World Health Organization, is an opportunity to raise awareness of global health issues. It is celebrated every April 7. This year, we are pleased to have a guest post from Katy Ajer. Katy program director of health and sustainable development for the ELCA’s Global Mission unit.

“Why should health be a priority within ELCA World Hunger programs?”

This was a question raised during the interview process for the position I currently hold as Program Director of Health and Sustainable Development within ELCA Global Mission. However, as we celebrate World Health Day – acknowledging all the efforts that are made throughout the world to improve the health of individuals and communities and the work that still needs to be done – I think the more important question is HOW are we a church called to respond to health inequalities in the United States and around the world.

We are called as a church to respond to health inequalities because those health inequalities are frequently not the result of biological chance but the result of other systemic injustices and power dynamics. We know that health is not in a silo but is deeply interconnected with hunger and poverty. The graphic below provides a visual of all the aspects of our lives that affect our health.

We know that health injustice is in direct relation to economic justice. We know that those who are poorest are least likely to be able to access health services, medicine, or even the clean water and nutritional food that would help prevent some of the diseases. We know that they oftentimes have a cyclical relationship – once sick, people miss work, resulting in less money for the necessary treatment and continued worsening health.

All of which brings us back to the question above: HOW are we as a church called to respond to health inequalities in the United States and around the world. When looking at the graphic to the right and all the areas that influence our health, it can often be overwhelming to decide where and how to start implementing efforts to improve health. In my short time at the ELCA, I’ve had the pleasure of learning how many of our companions around the world, with support from ELCA World Hunger, work to alleviate the short-term suffering of individuals while taking multi-pronged approaches to improve the long-term health of the communities. Below are some examples of this important work.

Educación Popular en Salud (EPES)

EPES in Chile provides nutritional courses with a twist through its Promotion of Nutrition project. It looks at the issue with a focus on rights and with attention to gender, in addition to nutrition value. What this means in practice is that in addition to education about nutritional foods and recipes, they examine the food production chain and how that can affect the nutrition of the food and the health of the surrounding environment, which in turn affects the health of the people. The participants then decide on actions to take to share this information and encourage healthy food choices and changes in food production or availability so that all may have access to nutritious food. Most recently, they have created a cookbook filled with nutritious recipes as well as a mural on a street advocating for decreased production pollution that can impact the ability to cultivate crops and the quality of the food.

Artists with EPES celebrate in front of the completed mural

Lutheran Communion in Southern Africa (LUCSA)

LUCSA InfoHuts projects in Namibia, Zimbabwe, and Malawi work to contribute to a generation free of HIV and AIDS by combining life skills and sexual and reproductive health education with computer use training. At first it may seem like an odd mixture of topics for a project; however, as with many of the projects that combine health education with livelihood training, students leave more knowledgeable about how to prevent and/or treat HIV and AIDS and have a new employable skill that allows them to earn money for nutritious food, medications and other needs to maintain good health or treat any future health concerns early on. By addressing both health and poverty, the impact is often greater and more transformative.

Students learn computer maintenance at the Vashandiri InfoHut Zimbabwe

A life skills facilitator teaches students in Zimbabwe.

Lutheran Health Care Bangladesh (LHCB)

LHCB provides quality clinic care as a hospital and mobile clinic but also operates activities focusing on other aspects that impact the health of their patients and community. They provide livelihood training in agriculture development, vegetable gardening, poultry and livestock, and tree planting. They organize the installation of safer stoves that are less harmful for the lungs of the women who cook over them. LHCB also works on raising awareness and mobilizing their community through workshops on gender and human rights, advocacy meetings, and community dialogues. Recently, they arranged a space in the hospital for breastfeeding to encourage the practice while providing mothers with privacy should they desire.

How are we as a church called to respond to health inequalities in the United States and around the world this World Health Day?

I had been in this position for little over a month when we recognized World HIV Day here. One of the most impactful parts of the day was a reflection read aloud by Kim Serry, who attended the US Conference on AIDS in 2016 with a delegation from the ELCA. Throughout the reflection, she came back time and again to the proclamation of African theologians, “The Body of Christ has AIDS.” She also paraphrased Melissa Harris Perry who made a similar claim:

“Our collective HIV status matters. It is not to say that our individual status does not matter, it certainly does. It means that our communal life suffers when individuals in our community suffer. It means that our communities are gravely sick when power and privilege determine who is shielded from harm and who will suffer it… and a pharmaceutical will not fix that.”

An aspect that is present within each of these projects that positively impacts health (although we often don’t think about it in these terms) is the sense of community that arises. These and many other ELCA World Hunger-supported projects work with groups over time, and these groups become social support systems that can help participants maintain good health physically, emotional, and spiritually. This support can arise through sharing knowledge between neighbors, helping one another recognize health symptoms that may not be noticed otherwise, lending money through Village Savings and Loan Groups for medication or transportation to a hospital, and, importantly, listening to one another and praying together during difficult times.

We are part of that Body of Christ. While some of us receive the burden of poor health unfairly, we all suffer. We are part of the social support system that is so important in creating equality that all may have the best health possible – that there is justice in who has access to health care and medication, to clean water and nutritious foods, to environments free from violence, and to opportunities to learn.

So, this World Health Day I give thanks to our partners, companions, and missionaries around the world and in the United States, striving to alleviate short-term pains and illnesses and to address root causes of health inequalities to ensure that all can live a healthy and joyful life. Thank you for your work and thank you for teaching us how to address health injustices with a Christian heart.

Photos above are courtesy of: EPES (Chile), Evangelical Lutheran Church in Zimbabwe, and Lutheran Health Care Bangladesh.

(A version of this post previously appeared on the Huffington Post Impact blog – http://goo.gl/L3MtiH.)

New reports suggest climate change could push more than 100 million people into poverty in just the next 15 years.  “Climate change hits the poorest the hardest,” says World Bank Group President Jim Yong Kim, “and our challenge now is to protect tens of millions of people from falling into extreme poverty because of a changing climate.”

The impact is a “two-way street.” Climate change makes it harder for farmers to grow crops, on the one hand, and some farming practices, on the other hand, damage soil, pollute water supplies, and create harmful emissions. But change is happening in small farming communities around the world, especially in communities of faith.  Here are three ways poor communities around the globe are adapting to climate change with the support of ELCA World Hunger.

Cleaner Cooking

Ramoni Rani and her husband, Nor Uttam Hawlader, live in the village of Rajakhali in Bangladesh with their two sons. Like many Bangladeshi farmers, Ramoni and Nor use wood-burning stoves to cook food in their homes. The cost for fuel is steep, and the continued need for it threatens the country’s already-depleted forests. Ramoni, Nor and their children suffered from respiratory illnesses and eye problems because of the carbon emissions and smoke in their homes. In fact, a 2009 profile of Bangladesh from the World Health Organization found that indoor air pollution contributes to nearly 50,000 deaths every year.

“Bondhu chula,” a more efficient cookstove, was developed to combat some of these problems.  But many Bangladeshis have been reluctant to use them, mostly because they don’t know how.  Lutheran Health Care Bangladesh has stepped in by working with over 250 women to help them get familiar with the cookstoves and the positive impact they can have.  For Bangladeshis like Ramoni and Nor, efficient cooking in the home means better health and more money for themselves and a path away from deforestation for their rural community.

In this picture, a man holds biomass pellets similar to those that will be used in the project in Padhar.

Cleaner cooking also makes good economic sense for families in Padhar, India.  To address some of the problems older cookstoves create, Padhar Hospital is helping households get access to smokeless stoves that use biomass pellets. The program will not only train the people to use the stoves but will also help them turn their biomass into profit by providing it to a processing plant.  Since no such plant currently exists in Padhar, one will be built.  Thus the program will provide cleaner stoves, help residents earn income, and create jobs for people in Padhar, all while protecting the environment.

“Green-er” Coffee

Farmers in the Rachuonyo District of Homa Bay County in western Kenya know the daily realities of climate change.  They see it in the shortened periods of rainfall, prolonged dry seasons, and increased flooding that washes away valuable crops and seeds.

Most of the farmers in this region focus their attention and limited investment on subsistence farming, trying to grow enough food to feed their families but often not producing crops that they can use for income.  This leaves them with little savings to weather the kind of volatility that comes with climate change.  One bad season can mean a year of hunger for a smallholder farmer.

One group is working to change that.  Members of the smallholder famers’ collective group, APOKO, partnered with Lutheran World Relief (LWR) in 2014 to launch the Kinda Coffee project.  Farmers in the project learn how to maintain the nutrient levels in soil, prevent erosion and increase water retention at model demonstration plots.  This will not only help them increase their resilience to the droughts and flooding but will also help them protect the environment while earning a sustainable income.  Support for this project from ELCA World Hunger will continue into 2016 and will improve the quality of life for hundreds of households.

Smarter Farming

Thanks to the collective efforts of the last decade, over 90 percent of the world now has access to clean water.  Unfortunately, climate change threatens to undermine much of that progress. Longer, more intense droughts for farmers affect everything from what kinds of crops or animals they can raise to the yield they get from their fields.  When families are already teetering on the edge of poverty, these are serious risks.

But communities in Nicaragua and Bangladesh aren’t just waiting around for something to change.  They are adapting to the changes already sweeping their regions and doing what they can to steward their resources sustainably.

In Bangladesh, air pollution and deforestation aren’t the only problems.  The country faces huge disparities in access to safe water, and more work is needed to provide irrigation to the agriculture industry that employs nearly half of the labor force.  RDRS, a locally-run associate program of the Lutheran World Federation, is helping train farmers in Alternate Wetting and Drying (AWD), a technique that can reduce by up to 30% the amount of water needed to grow rice.  As a result, they are able to preserve groundwater and reduce risk of contaminating their crops with unsafe water.  And some studies indicate that AWD can actually increase the yields from rice fields, so the process is a win-win.

With an abundance of water on the ground and under the ground, Nicaragua seems like a place where there is enough to go around.  But a 2014 drought – the worst in the country in 40 years – reduced crop yields by more than 70%.  In the area of Somotillo, most of the wells ran dry, and the people worry about another drought down the road.  “In this place,” Pastor Gerzan Alvarez of the Lutheran Church of Faith and Hope (ILFE) in Nicaragua says, “we’re only able to survive.”

With support from LWF and ELCA World Hunger, ILFE is taking steps to manage the crisis.  Since the drought, the community has improved wells in the area, led trainings in proper water usage and management, set up irrigation systems, and planted yard gardens.  Pastor Emperatriz Velasques of ILFE says now, “Each day we’re learning about nature’s behavior, and we need to keep on working and teaching so we can grow our crops with the little water we have and keep home gardens with water from our wells.  This way, we can provide food for the households.”

Policy changes that reduce emissions and change the way we relate to the environment are necessary, long-range solutions to a changing climate, and the recent agreements about climate change and hunger give some hope.  But there is also a lot we can learn from those on the margins, in local communities throughout the world.  In Bangladesh, India, Kenya, and Nicaragua, families are doing what they can to protect their environment and make themselves less vulnerable to the changes that are still to come.

Ryan P. Cumming, Ph.D., is program director of Hunger Education with ELCA World Hunger.  He can be reached at Ryan.Cumming@ELCA.org.

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I’ve decided to go out on a limb today. I’m writing about something I probably have no business writing about. I apologize in advance to all whom I offend with my ignorance, and I welcome your comments and corrections. But I’m curious about something: How should businesses (globally) respond to the food crisis? And what should we ask and expect of them?

My question arises from an article I read today on the BBC International web site about garment factory owners in Bangladesh. Factory owners there have started to distribute subsidized rice to their lowest paid workers as food prices force people to skip meals and some food groups. The government is doing something similar, but government purchasing locations are only open during working hours, so factory employees haven’t been able to participate.

I also learned that the garment industry accounts for 3/4 of Bangladesh’s export income. In my mind, that ranks the importance of the garment industry close to that of the government’s in some ways.

At this point you may be thinking, “Why don’t the factory owners just pay their employees a living wage and give them the time off work they need?” Certainly the thought crossed my mind, too, and certainly the companies aren’t acting from pure altruism when they subsidize rice for their employees. People who don’t get enough to eat, and who need to wait in government lines during the day, will be less productive and have increased absenteeism. That’s bad for business, especially when you’re competing with China, India, Vietnam, and other low-cost locations. What’s more, since the garment industry is such a huge part of Bangladesh’s economy, slowing its production and growth would cause even more problems, at least in the short term (though there’s certainly an argument to be made for longer-term diversification). And it won’t help a factory worker to lose his job in order to stand in line for cheaper rice. So even if these garment factories are not doing all they could do, and even if their motives are displeasing, they are bringing relief that’s not otherwise available.

So I ask myself, if businesses and industry have power and resources, and also have an interest in keeping people healthy, working, and buying their products, why are they not a larger part of the conversation about addressing the food crisis? At a minimum, people spending more of their income on food will have less to spend on other products and services. At worst, people who are starving will not be coming to work, and the business or industry will falter. Yet most of the reporting I hear involves the responses of government, globabl political bodies like the UN and WTO, and not-for-profits. That’s why today’s BBC article caught my eye – it seemed unusual. Buy why? Where are the voices of business and industry? Perhaps they are there, and I just haven’t been reading or listening to the right things (entirely possible!). But I also wonder if we don’t somewhat overlook the business sector when we look for solutions. Perhaps our initial reaction to a crisis should be not only “What are governments doing?” but rather, “What are governments doing and how are businesses assisting or complementing those efforts?” And then we should expect a real answer.