1. Cover page

LARGE-SCALE DEVELOPMENT PROJECT

2. Application text

A. THE PARTNERS

A.1 The Danish organisation’s history, mission and experience

Dialogos was founded in 1994 and currently the number of members is 115. Dialogos is an organisation of volunteers with high professional standards and experience among its members from organisations in Denmark as well as from working experience with major Danish NGO’s, consultancy firms and Danida. The work carried out in Denmark is voluntary and unpaid, but when working abroad the consultants are paid a salary. Dialogos has a part time secretary, a home page and a mail system, where most communication among members takes place as they are spread all over the country. Dialogos has during the years proved to be able to work together with local as well as international NGOs, with local agencies and authorities (universities and ministries) and international organisations like the WHO. The projects in Bolivia and Nepal have got substantial budgets, which have been handled to the satisfaction of Danida and the Project Counselling Service. Dialogos has been working in developing countries since 1994, and has acquired experience within the fields of ‘Intercultural Medicine’ and ‘Pesticides, Health and Environment’, where the projects are seen as innovative in their fields.

Dialogos/ICOEPH has been working for the past 8 years on IPM and Pesticides, health and environment in Bolivia and through that gained experience on pesticide problems seen in most developing countries. The experts on pesticides, medical doctors and agronomists have been working with pesticides scientifically in Denmark and internationally, serving as advisors and Danish experts on the subject. This group has helped with the elaboration of adequate teaching materials, informative materials and programs, the revision of curricula in relevant training courses, educational programs, scientific studies documenting the magnitude of the problem and the effect of the interventions etc. The group has presented the results at international conferences and has seen studies documenting the same problem with pesticides in many developing countries, and noted the obvious need for activities to prevent poisonings of humans and pollution of the environment.

The current project proposal is Dialogos’ second proposal in Uganda, and members of the working group supporting the project do have experience from several African countries, including Uganda. The professional background of these people is health, agriculture and anthropology. Dialogos has for the last 2 years been running an intercultural medicine project in Uganda in Karamoja Region. The project is progressing as planned with the local NGO Kathes according to the latest evaluation from October 2009.

See annexes 1-4

A.2 Other Danish partners

Dialogos has agreed on technical collaboration with the following Danish organisations:

1. DASAM through its international committee ICOEPH.

The number of DASAM members is 165 specialists in environmental and occupational health. DASAM was founded in 1980 and ICOEPH as the international committee of DASAM was founded in 2004. ICOEPH has been working together with Dialogos in the Plagbol project and in pesticide research and education together with Danish, Bolivian and American universities in Cambodia, Bolivia, Uganda and Denmark. ICOEPH has also been involved in public awareness rising in Denmark about occupational health and environment in developing countries on conferences and in the media, e.g. pesticide production in India by Cheminova, ship scrapping at the Alang Beach in India, Maersk container factory in Goudong China and work environment on Ericsson and Telenor factories in Sri Lanka. ICOEPH has on request from the WHO been included in the group of international specialists on occupational medicine working to develop strategies and materials to improve the health of workers at a global level. This means that the experiences and materials developed in the Plagbol project and in future pesticide projects as the actual proposed might have a global impact through the WHO. Moreover ICOEPH is member of ICOH (International Comision on Occupational Health) and forming part of their group on agricultural health, where by our experiences also do have a substantial influence on ICOH policies regarding pesticides.

2. University of Copenhagen -

ISIM has a long experience with research and training aimed at reducing pesticide poisoning at community level, surveillance of pesticide poisonings and toxicology in Asia and Africa. 1/3 of the 380 employees at the department focus research and training on public health issues in low income countries. The department host the secretariat for the Copenhagen School of Global Health that it meant to coordinate activities in low income countries across all faculties at the University and partners at the State Serum Institute and Copenhagen University Hospital.

Department of Agriculture and Ecology, Faculty of Life Sciences has experiences from projects on plant protection in Latin-America and Africa, and a current cooperation with Makerere University in Uganda. The number of employees exceeds one hundred.

Letters of intent and collaboration has been signed between the above mentioned institutions and Dialogos, see annexes 6-8.

3. The project has been discussed with the University of Southern Denmark, Odense University Hospital and the international committee ‘Global Organic’ from ‘Organic Denmark’ (organisation of organic farmers), having expressed their support to the proposed project and willingness to collaborate with technical input where needed, e.g. in organic farming and guidance of students, works of documentation etc.

The project partners have a working agreement on the proposed project activities, where Dialogos will be responsible for the project and for administration of funds, while ICOEPH will deliver and coordinate the technical input concerning guidance of the local partner in the elaboration of teaching materials, documentation studies, evaluations, student supervision etc. The other partners will assist in focused activities like planning and guidance of documentation collection, inputs to elaboration of materials, supervision of students etc.

A.3 Counterpart organisation’s history, mission and experience

UNACOH were formed in 1987, it brings together health professionals, individuals and organizations interested or active in the improvement of health in Uganda. It was registered as a Non-Governmental Organisation in 1991. UNACOH enjoys a membership of about 1,000 from 80 Districts in the country and has 21 established District Branches: Bugiri, Iganga, Jinja, Kabarole, Kampala, Kamwenge*, Kasese, Kayunga, Kyenjojo, Masaka, Masindi, Mayuge, Mbale, Mbarara, Mpigi, Mukono, Pallisa, Rakai, Rukungiri, Sembabule, Wakiso. UNACOH targets to establish branches in all the districts of Uganda. The National Executive Committee is elected every two years at every second Annual General Meeting. Latest election was in 2009.

UNACOH is a local voluntary membership Ugandan NGO, with an elected 10 persons National Executive Committee (NEC), headed by the President. The General Meeting elects the NEC every two years. The day to day activities of UNACOH are carried out by a National Secretariat, headed by an appointed Executive Director, assisted by support staff. In addition there are 21 UNACOH District Branch Executive Committees which organise district specific activities.

UNACOH aims at promoting a positive health culture and influencing healthy public policies in Uganda through advocacy, education and research by involving public health professionals and other persons interested in public health such as policy makers, health media practitioners, social scientists and teachers, among others. The objectives includes Health Advocacy to decision makers; Exchange of Health information locally, nationally and internationally; Promoting a positive health culture among the public; Health Research including operational research; Implementing health projects.

UNACOH has been involved in several health activities during the years, se annex 10. As professionals in the field of occupational and environmental health they are used to work with different groups of working populations and in the districts, so working with farmers and farmers’ families is part of their professional experience. The president of UNACOH has professionally published about pesticides, and recently UNACOH has been involved in surveys on safe use of pesticides and review of health facility records on pesticide poisoning in three districts in Uganda, and on the health, environmental and socio-economic effects of tobacco growing in two districts in Uganda. UNACOH has worked on nutrition and early childhood development, HIV/AIDS, Occupational health of health care workers, community mobilisation and empowerment for health, among others. Besides, each year UNACOH organises an annual scientific conference where professionals and others interested in health research and health action present the results of their work.

(Further information about status, annual report, governing body members and CVs of core personnel can be forwarded on request.)

Contacts have been made with other Ugandan organisations that are positive and willing to collaborate in the project activities. The important collaborators will be:

Farmers organised in farmers groups at village level.

The Uganda National Farmers’ Federation (UNFFE) and more than 80 district Farmers’ Associations are essential for the contacts and for organising the educative and informative sessions at the local level. Moreover they have been giving training courses for their members to improve their technical agricultural skills and do have some informational materials that the project can benefit from.

The District Agricultural Offices and National Agricultural Advisory Services (NAADS), who are important for the education of farmers through local extension service.

The Uganda National Agro-inputs Dealer’s Association (UNADA) has experience in organizing and celebrating courses for their members to get them certified to sell agro-inputs.

Districts Health Care System with their curative and preventive health care workers.

Makerere University has several units interested in collaboration. The Faculty of Agriculture has a natural interest in IPM and student education; they have experience in scientific studies, education of farmers and have already some established partnership with Copenhagen University on research programs, student mobility and Phd projects. The College of Health Sciences through it’s School of Public Health is doing preventive health work, documenting studies and students education, and is interested in building stronger ties to the international health research environment at the University of Copenhagen and University of Southern Denmark. The Department of Chemistry, Faculty of Science Makerere University and the Government Chemist have both got experience in documenting the pesticide pollution/contamination of environment and crops, and will be able to provide information for awareness raising activities among consumers.

Ministry of Health and Ministry of Agriculture will participate in the development of materials for farmers, extension workers and health care workers at a superior level. Directly they can be involved in revision of laws and regulations concerning pesticides and in revision of curricula in the health and agricultural careers.

The Ministry of Gender, Labour and Social Development has its Occupational Safety and Health Department which also has an obligation to secure good working environment for farmers, and they express a desire to collaborate with project about this. Likewise the National Environment Management Authority, NEMA (operative branch of Ministry of Environment) is interested, as they also have an obligation of securing a good environment, and pesticides is one of the major environmental hazards.

UNACOH are signing letters of intent with the above mentioned institutions and more detailed working agreements will be signed when the project is funded.

Working agreement has been signed between Dialogos and UNACOH, see annex 9.

A.4 Experience of previous cooperation

Dialogos and ICOEPH members have been in personal contact with UNACOH members since 1992, several times they have been meeting in conferences and courses in Europe and Africa. The appraisal form and the actual application have been elaborated together. Several encounters have taken place during the last two years in Uganda. A survey was conducted together in 2008, documenting the pesticide situation in some of the districts in Uganda.

B. PROJECT ANALYSIS

B.1 In what context is the project placed?

The country

Uganda was one of the first Danish programme coordination countries identified in 1989 after the present leadership by the National Resistance Movement came to power in 1986. The current president has been democratically elected since then. The size of the country is 241.551 km2, and population density is 123 persons/km2. The BNI per capita is around 350 $ US and 31% live in extreme poverty. The population size is almost 28 million people and the fertility rate is 6.5. The life expectancy is 50 years; the HIV-prevalence is around 6%. The most prevalent diseases are diarrhoea, airway tract infections, malaria and HIV/AIDS. Half of the population has access to improved drinking water. There are more than 40 different ethnic groups and numerous of local languages are spoken apart from English. The illiteracy rate is 31% and women accounts for 75% of this.

Farming

Uganda is a nation of farmers, as 85% of the population lives in the countryside and is more or less dependent on farming and related activities. Of the arable 17 million hectares only 6 million is currently under cultivation. There are around 3 million smallholder households, and they produce the bulk of agricultural commodities. Plant products for home consumption cover about 65%, animal products 25% and the remaining 10% are cash crops like tea, coffee, cotton, sugar and horticultural crops. Agriculture is the backbone of the Ugandan economy and plays a vital part in the eradication of poverty. It contributes roughly 21% of Gross Domestic Products and 80% of the total employment.

Amounts of Pesticides used

With a growing cash-crop production, the imports of pesticides and fertilizers are increasing. Exact figures are difficult to get but the import of fertilizers has risen with a factor 47 from 1980 to 2004, and pesticides were imported in a number of around 4.000 tons in each of the years 2002-04. FAO only has erratic statistics on the value of pesticides imported to Uganda. On top of that it is estimated that at least another 25% of this amount is smuggled into the country over non-secured borders. A trip to Wakiso district as part of the appraisal mission clearly gave the impression of the seriousness of the matter, as we found pesticides not registered for use in Uganda. Several farmers used the herbicide paraquat to control weeds prior to soil preparation and planting of new crops. Paraquat is poisonous and not on the list of registered pesticides in Uganda. As to general pesticide load on arable land, one source claims that 17 kg pesticides are used per ha arable landUganda. As to general pesticide load on arable land, one source claims that 17 kg pesticides are used per ha arable landUganda. As to general pesticide load on arable land, one source claims that 17 kg pesticides are used per ha arable landUganda. As to general pesticide load on arable land, one source claims that 17 kg pesticides are used per ha arable landUganda. As to general pesticide load on arable land, one source claims that 17 kg pesticides are used per ha arable land

Figure 1 Import statistics in USD and quantity of pesticides. The use of total pesticides around 2004 is about 4000 ton per year.

The arable land of Uganda is about 36% of the total landmass of about 200,000 km2. Provided that the quantity of pesticides is only for crop protection the load of pesticide sprayed evenly would be not more than about 0,5 litre per ha. However, the intensive pesticide use in small areas growing vegetables, potato, tee and cotton will be high compared to the arable land at large. A rough guesstimate would be that if say 5% of the arable land is under these crops then the pesticide load of this smaller area would be 4 litre or kg per ha as the majority of the pesticides used are for these crops.

Problems with pesticide use

There are serious pesticide problems in the intensive cut rose industry in greenhouses, and also the intensive use of insecticides in cotton and fungicides in potatoes. However, this project focuses on the small scale farmers often with less than a hectare land to farm. These smallholders do not have the funds or knowledge to take action on unintended pesticide problems as does the industrial agriculture. A part of farmers supply the metropolis with fresh vegetables on a daily basis. The production is extremely intensive with crop duration of two or three months and with an average crop sequence of more than two per year, the pest infestation and infection on the vegetable land are massive and so is the spraying with pesticides. Spraying twice a week is common depending on whether it is the dry or wet season. The spraying is generally higher in the wet season due to higher pressure of insect pests, diseases and weeds. For example fresh tomatoes on the market is often sprayed post harvest in order to prevent the produce from rotting, and if the customer can see the residue on the tomato the price would be higher than when the sign of spray residues is not conspicuous.

Legislation

The pesticide legislation is primarily based on the 20 years old Statutory Instrument Supplement No. 23 of the Agricultural Chemical Regulation. The statute established the Agricultural Chemicals Board(ACB), consisting of 13 members

• Commissioner of Plant protection

• Head of National Agricultural Research Organisation

• Dean of Faculty of Agriculture, Makerere University

• Dean of Veterinary medicine, Makerere University

• Chairman of Agricultural Chemicals Technical Committee

• An Advocate

• Agricultural Chemical industry representative

• Farmers’ representative

• Government Chemist

• Commissioner for Veterinary Services

• Chief of Forestry Officer

• Commissioner of Medical Services

• Representative of the National Bureaus of Standards

• Representative of the National Environmental Management Authority

The board is responsible for the registration of agricultural chemicals of which pesticides are an important part. In order to be marketed in Uganda, a pesticide must be approved by the Board. The criteria for registration is that it, in regular use, has proved efficacious against the pest(s) it is supposed to control over three growing seasons, and that its profile of toxicity to humans and animals as well as its eco-toxicology, including degradation data and proof of its maximum residue limits in agricultural produce, are acceptable. Consequently, the registration criteria in Uganda follow the same lines as elsewhere, for example to comply with the Plant Protection Product Directive of EU, US Environmental agency, FAO code of conduct and international conventions on pesticide exports and restrictions.

Training in pesticide handling

Apparently there are several government institutions that are responsible for teaching in safe pesticide use. The Makerere University, Faculty of Agriculture takes care of the higher teaching and together with UNADA conduct training courses for a period of one week for dealers and other personnel supplying pesticides and sprayers used for distribution in the field. The course ends with an examination of the students. This initiative has produced some teaching materials, mostly for their own students.

The ministry of Agriculture, Department of Crop Protection is responsible for teaching all personnel within pesticide quarter, and also the end user, e.g. the farmers. The teaching of farmers is the responsibility of the districts and sub-counties, through NAADS and their extension staff.

Uganda National Farmers Federation (UNFFE) is an umbrella organization for farmers nation wide. As the structure of Uganda Agriculture is mostly small scale farmers of which the majority is subsistence farmers, the Federation provides demand driven teaching and training focused on the farming community. It organises agriculture management training at various levels that deals with all aspects of farming. Makerere University also uses UNFFE’s network when teaching extension personnel.

The National Environment Management Authority (NEMA) promotes training of farmers and extension workers in the safe use of agrochemicals and prepares environmental guidelines for management of hazardous chemicals and it also takes initiative to conduct Environmental Impact Assessments of regularly used practices in order to mitigate adverse environmental impact. NEMA, having a member on the Agricultural Chemicals Board provides guidelines on the effect of residues on human health and the environment, disposal of expired pesticides and restricting or banning extremely toxic and hazardous pesticides.

The umbrella organization for the dealers is The Uganda National Agro-input Dealer’s Association (UNADA) It is an umbrella organization of the private suppliers of agro-inputs of which a great part is pesticides. There are currently 35 members and they promote their products in the agricultural sector and also have a representative on the Agricultural Chemicals Board. Interestingly in an interview with the Executive Secretary the issue of paraquat was touched upon and apparently a UNADA company is dealing with this compound, although it is not allowed to import to Uganda.

Organic farming is promoted by the local NGO, NOGAMU, having an impressing number of 45.000 farmers as members.

Donors in agriculture

Foreign donors contribute to agriculture with annual donations in 1980 of almost 100 million $US, in 2002 the figure was 250 million $US and in 2003 75 million $US. These figures vary a lot. Several projects financed from e.g. Holland, the US (USAID, universities Ohio, Virginia, Tennessee, Florida), Sweden (SIDA) and Denmark (Økologisk Landsforening) among others have been dealing with the promotion of organic farming in Uganda, to minimize the risk when handling pesticides and at the same time strengthen the export of farm products to other countries. Information from these activities and surveys shows that a lot of training of farmers still needs to be done. Up till now little has been undertaken to strengthen diagnosis, treatment and registration of poisonings in the health care system, to improve effectiveness of the control with import and sale of pesticides, and to facilitate awareness rising among the public.

Danida is active with projects within the agricultural sector participating in the funding of the national agricultural extension service (NAADS) through a basket fund. Danida has set up 5 agricultural schools at country level for the young farmers, but this funding has now ended and the future of the schools is still not secured. An earlier project run by a Danish Workers Union dealt with pesticides and the organisation of workers in the tea plantations east of Kampala. Danida has also been funding activities concerning obsolete pesticides, and smaller activities through the pesticide dealers among others.

B.2 How has the project been prepared?

The project idea has been developed during the last couple of years where Dialogos/ICOEPH has been in contact with UNACOH during visits to Uganda, the latest being an appraisal mission funded by PRNGO in July-August 2009 (see report, annex 5).

The Dialogos/ICOEPH experience from Bolivia and the possibility for a project based on this experience has been discussed and encouraged by the positive evaluation of the Plagbol project done in the autumn of 2008, and the survey done by UNACOH and ICOEPH among Ugandan farmers and health professionals in 2008, showing a need and interest for working with a project like this.

ICOEPH participated in November 2008 in ‘The first African congress on pesticides and toxicology’, where papers presented from many African countries showed huge problems with contamination of environment due to pesticides and reports of poisonings, but very few with experience of interventions to minimize the problem were indentified. Various papers reporting on residues of pesticides in products for direct consumption like fish and vegetables were presented from Uganda, where a survey done by UNACOH and ICOEPH were presented. The Bolivian experience was discussed and the teaching materials brought about an enormous interest, because the materials give practical solutions to pesticide problems faced by many African countries.

In a field survey in three rural areas in Uganda the farmers did demonstrate little knowledge on toxicity of pesticides, how to protect them selves when spraying. Almost half of them had experienced symptoms of acute poisonings when spraying. The farmers (of whom 80% were men and 20% women) were very positive and open to participating in activities to improve their harvest and minimize health risks while using pesticides.

UNACOH has been working on environmental health issues for many years and has a good linkage to the health system that seems wiling to participate in courses for their staff in diagnosis, treatment, registration and prevention of pesticide poisonings among at risk groups.

Meetings have been conducted with authorities from the ministries (Health, Labour, Environment and Agriculture), Makerere University, Farmers Federation, Pesticide Dealers in Kampala and local authorities in the districts of Wakiso and Pallisa all expressing their interest in supporting an upcoming initiative and the need for such a project in this area.

The Danish Embassy and the Danida Health Sector and Agricultural sector programmes in Uganda have been informed about the planned activities and did find the pesticide problem compelling enough to deserve due attention in the Ugandan context.

B.3 Problem analysis

A general problem in Africa

African economies are heavily dependent on agriculture, in which, even under the most environment friendly approach to pest control (IPM), the use of pesticides is necessary in order to avoid crop failure. This is more so because climatic conditions favour the multiplication of insects, fungi and weeds. According to FAO, many pesticides that have been banned or whose use has been severely restricted in industrialized countries are still marketed and used in developing countries, especially Africa. The appraisal mission experienced it at two locations, where paraquat was used. FAO and WHO warned that approx. 30% of the pesticides marketed (>$300 million) in developing countries, including Africa are of poor-quality and do not meet international standards and hazard specifications. These chemicals pose serious risks to health of millions of farmers and the environment. Concurrently, the amount of toxic waste stemming from obsolete pesticides in developing countries has now been acknowledged to be much higher than previously estimated with Africa alone having about 120,000 tons (up from the previous estimate of 50,000 tons) of the estimated 500,000 tons worldwide. In many developing countries, the management of pesticides is often inadequate, due to lack of education in stewardship of pesticide hazards and resources. Consequently, many of these countries suffer from weak import controls, poor storage (both at retail and household level), poor stock management and a lack of training in proper pesticide use. Thus, even some products, which can be safely used in developed countries, may be impossible to use safely under developing country conditions.

Serious problems of pesticide adulteration, illicit trading and deliberate or uninformed misuse are widespread throughout Africa. Several pest management experts concur in their observations that trade liberalisation is now pushing pesticide supply into the hands of untrained, uninformed, unauthorized or fraudulent distributors and opportunists, with significant risks to human health. Whilst more effective control and regulatory mechanisms are obviously necessary, including stricter penalties for non-compliance, these mechanisms require adequate funding for training staff and for implementation. Of equal importance is the need to raise awareness amongst the general public, key stakeholders and decision makers to the costs of pesticide use, and to encourage the promotion of safer more sustainable alternatives to the dependency on chemical control of pests.

The situation in Uganda

In Uganda the number of farmers using pesticides is growing due to the evolution of the farming from mainly organic subsistence farming to a mix of cash crop and subsistence farming using increasing amounts of pesticide. This is also the result of many agricultural projects aiming at raising the production, thus inevitably leading to an increasing use of pesticides, often as part of the credit packet offered to the farmers. Surveys in cotton, groundnut, cowpea and vegetable producing areas shows that 40 - >90% of the small scale farmers use pesticides, meaning millions of farmers using an increasing amount of pesticides.

According to the National Union of Plantation and Agricultural Workers, the government of Uganda has passed a new agricultural protocol to protect farm workers but the law is not being enforced. Moreover Uganda has not ratified the International Labour Organization's Convention for the protection of farm workers, and there is one herbicide, paraquat, which in particular endangers Uganda's coffee, tea, sugar and cut-flower workers as well as the vegetable growers around the larger cities.

In Uganda a growing and not negligible number of poisonings is seen due to accidents, improper handling of pesticides during spraying operations and suicidal attempts. A study has shown that 50% of the number of poisonings reaching the hospitals for treatment is due to pesticides. This places Uganda way above the mean of 23% among African countries when comparing the reasons for poisonings. The actual number is difficult to know as registration is scarce and underreporting is common – but the number of intoxications, most of them never reaching hospital care, could probably be counted in tens of thousands and the number of dead in several hundreds.

Insufficient education or extension services are offered to the small holder farmers and thus they handle these highly toxic pesticides in improper ways, as shown by a survey conducted by UNACOH and ICOEPH in 2008 in the districts of Pallisa and Wakiso. In summary this study showed that more than 90% of the farmers interviewed did use pesticides in their agriculture, but very few had ever received any instructions on proper use. There was lack of knowledge about the toxicity of the pesticides, little knowledge of proper mixing and correct use of pesticides, virtually no use of personal protective devices, frequent symptoms of poisonings after spraying among the farmers (>60%). 50% of the interviewed told about suicidal attempts and 50% about accidents/occupational poisonings. Males, females and children all seems to be involved in the fieldwork with pesticides where poisoning can take place during mixing and spraying operations, but also during re-entry to newly sprayed fields, or on the consumption of newly sprayed crops. People most often do treat these symptoms at home, either because they know that acute symptoms often cease quickly or because hospital treatment is inadequate.

Numerous and maybe too many entities have the responsibility for training and evaluating farmers pesticide use, but still too little is done and educational and informative materials hardly exist in the districts among the farmers. The most effective training seems to be provided to the pesticide dealers by UNADA. The dealers are advising farmers about pesticide use, but their final goal is to sell as much pesticide as possible, so IPM strategies and reduced use is hardly promoted by the dealers. Safe us and protective equipment, gloves and masks should be sold together with the pesticides, but this apparently does not take place. The same survey showed that almost nothing is done to train health personnel in diagnostics, treatment and prevention of poisonings in areas with heavy use of pesticides, so the capacity of the health care system to manage poisoning cases is limited.

There is a great need of adapted and accessible educational materials on IPM, self protection, potential dangers of pesticides to farmers and agronomists; and general awareness rising in the public is necessary to put public pressure on the decision makers to take action on the pesticide problem.

Studies from the Makerere University have documented serious problems with pesticide residues in fish from Lake Victoria and in vegetables produced for human consumption. According to these researchers there is a lack of interventions to stop this pollution of environment and contamination of food. This is serious because pesticide poisoning might affect not only farmers and others directly dealing with pesticides, but also the general public consuming these products. Moreover it can and has to a certain extent already hampered exports of agricultural products, as products with a content of pesticides exceeding international limits cannot be exported.

B.4 Stakeholder analysis

Farmers in the districts are smallholders organized in farmer’s groups of 10-40 farmers pr. group. Both sexes are represented but with a majority of men. They are organized to be able to claim training from the agricultural extension services organised by the state and also extension workers from the Farmers Union in the district. Although these possibilities do exist, the groups we consulted had not had or had only had sporadic training the last years and had not received informative or educational materials. Obviously they have not had training on pesticide handling and use and how to prevent poisonings, nor on IPM. They have very scarce resources and are not able to finance their training by themselves, contrary to the cash-crop farming in the cotton, tea and flower industry. The small-holders are very motivated for participating in training as suggested by the project initiative. Women and men work on equal terms in agriculture, at times women might take the less exhausting jobs such as planting and weeding whilst the men do the harder work of clearing the bush to preparing the soil for planting. But many claims it is the same for both sexes, and women are present in the fields while spraying operations take places, although it might be the male who sprays, she is their to assist, and often also the children helping or playing around. The management of economy in the agriculture might be discussed in the family but is taken care of by the male.

The National Agricultural Advisory Services (NAADS) is an extension service basket funded among others by Danida, GTZ and USAID to build a national extension service in fishery, live stock and agriculture and is administered by the Ministry of Agriculture. In the Districts the District Agricultural Officer is responsible for the agricultural matters, and extension services for all farmers. The courses are demand driven, but relatively few courses are held, and materials are scarce.

The extension workers we spoke to welcome the initiative; they were, with support from their superiors, willing to receive training in safe handling, use of pesticides in order to prevent pesticide poisonings. Also they were interested in IPM and would like to collaborate in courses for farmers. The district agricultural officer promised support to the project initiative if realised, and she would see that vacant posts of extension workers in the sub counties the project would work in are filled.

The Uganda National Farmers Federation (UNFFE) is an umbrella organisation including district Farmers Unions, and some agro-input retailers. The members are small scale farmers, cash crop farmers and farm workers. The UNFFE is advocating for a good agricultural environment from field to marketing, are running agricultural shows and runs courses for the farmers to give them a Farm Management certificate. They have their own education materials elaborated some ten years ago. The material is good but has nothing about IPM farming or health and environment pesticide issues. The UNFFE is interested in collaboration with the project, and collaboration is foreseen in training, elaboration and distribution of materials and awareness raising campaigns.

UNADA – Ugandan National Agro-Input Dealers Association is lobbying for their members to give them the best business opportunities, and they have a seat on the National Agricultural Chemicals Board. They are conducting courses for their Agro Input dealers, which for most small holder farmers are the primary source for information about pesticides. They are conducting these courses for their members with support from the Faculty of Agriculture at the Makerere University and the Ministry of Agriculture. They have a budget of around 15.000 $ US per year for training. The education of a pesticide dealer costs 45 $ for a 5 days course, and so far 700 of the approximately 2300 registered dealers have participated in the course.

UNADA and the project could collaborate on in producing information materials both from the local companies and their multinational partners. The association was very interested in linking pesticide purchase to include personal protective equipments. The UNFFE, UNACOH and farmers groups should become able to advocate UNADA and its members to comply with Ugandan law and secure that the labelling of the pesticide containers are in a language understood by the farmers and covey relevant information for the formers to fully understand the implications of using a specific pesticide. There is of course a contradiction in the interests of the project as the goal of UNADA and its members is to sell as much pesticides as possible, while the project is promoting IPM, where the use of pesticides should be minimized. However, responsible stewardship of the pesticide products is imperative and in the interest of all parties

Makerere University – Faculty of Agriculture/Department of Plant Protection is educating agronomy students, doing research and also teaching of pesticide dealers together and with funds from UNADA and the Ministry of Agriculture. The Faculty is represented on the Agricultural Chemicals Board by the dean of the faculty who incidentally is an expert on pest management.

The project could collaborate with the Faculty in documenting studies carried out by students about IPM. The project must advocate for a strong IPM education at the Faculty. Collaboration does already exist between the KU-Life and the Faculty, a collaboration that will be further strengthened during the actual project.

The Ministry of Agriculture and its National Agricultural Chemicals Board has the responsibility for developing the Ugandan farming. The Chemicals Board approves the pesticides imported into Uganda. The Unit of Plant Protection has several inspectors among them 4 pesticide inspectors with the job to control import, distribution, sales, use and residues of pesticides in order to insure that national laws are complied with. They also have the obligation to teach these entities, but due to scarce resources this is barely done. The ministry could collaborate with the project through moral support in the elaboration of courses and materials for farmers and extension workers, and eventually adopt materials produced as part of their advisory materials for farmers. The project must advocate for the promotion of a secure a thorough control of import, sales, use and residues of pesticides.

The local health system can be divided into the curative system in the hospitals and health posts in the districts and the preventive system operating through village extension workers, educating people in health matters. The District Health Officers (DHOs) in the districts are interested in receiving courses and materials for their curative personnel about diagnosis, treatment and registration of pesticide poisonings. The same applies to extension workers that will receive courses and materials from the project about prevention of intoxications and first aid in case of intoxication.

Ministry of Health has the responsibility for the education of health workers, and the responsibility for curative and preventive work throughout the country. Moreover they are responsible for health statistics. The education of health care workers in the toxicology of pesticides – diagnosis, treatment and prevention of intoxications is insufficient both pre- and postgraduate, and no courses have been held in the health sector about this problem. They have the possibility to do outreach work through health extension workers in the Districts. The health of the general population is also a responsibility of the Ministry and initiatives to secure healthy foods without residues of pesticides exceeding the national limits is a responsibility. In spite of this vegetables and especially tomatoes are sprayed just before or even after harvest, so consumers find them with stains of poisonous pesticides mainly fungicides, on the markets. Outside agriculture, the same applies to the fish industry where the catch is treated with pesticides to prolong the period of freshness.

The Ministry could collaborate with the project through support to the production of information materials and courses for their health care workers. An eventual revision of the curricula in the health training institutions should be supervised by the ministry, as well as a revision of relevant laws and regulations.

Makerere University – School of Public Health is training students in Primary Health Care and prevention of diseases, moreover they are doing research in these fields.

Collaboration should be done in documentary studies about frequency and seriousness of intoxications, and in conducting awareness raising campaigns.

Ministry of Labour has the responsibility to inspect workplaces in Uganda, including the farms, to see that the work is done in a secure way. It has through its Unit of Occupational Health and Safety also the obligation to educate e.g. farmers in safe handling of pesticides. This is not done due to scarce resources.

The Ministry could collaborate with the project goals through strengthening the inspection of Agro Input Dealers and the labelling of the pesticide containers which for most small holder farmers are the primary source for information about pesticides.

NEMA is the operative branch of the Ministry of Environment. NEMA has to realise activities to promote a good environment including control with the use of pesticides educating users in safe and environmentally friendly handling.

Makerere University – Department of Chemistry and the Government Analytical Laboratory are both realising studies of residues of pesticides in soils, water and food, and have in some cases been able to document alarmingly high pesticide residues.

The project should collaborate with these institutions when documentary studies are needed to raise awareness of pesticide dangers in the population.

US-AID, NOGAMU and other NGOs are donating funds for various agricultural projects. The materials they produce should be collected and form part of an eventual elaboration of new materials in the project.

C. PROJECT DESCRIPTION

C.1 Target group and participants

The project will operate in the districts of Wakiso and Pallisa with a total population of around 1.500.000. These two districts has been selected to have experience with different crops as in Wakiso primarily vegetabes are grown and in Pallisa cotton. The training of farmers will take place in the sub counties of Nangabo, Agule and Apopong, while the training of health care workers will include people from the whole district. The awareness raising will reach the whole population of the districts and probably beyond. In a second phase the project will expand to other districts and apart from focusing on small scale farmers, will include cash crop farmers as production of coffee and tee, and productions in greenhouses to cover areas where large amounts of pesticides are used. Through changes of curricula in relevant teaching institutions and postgraduate courses students and professionals from all over Uganda will be included as target groups in a second phase of the project.

Objective 1:

Direct beneficiaries: The project will train 40 health workers (30 curative health care workers in the hospitals and health posts and 10 health education workers) in prevention, diagnosis and treatment of acute and chronic pesticide poisonings. Expected female-male ratio is 2-1.

Indirect beneficiaries: The health education workers will in turn pass their acquired knowledge on to the villagers in the districts in out-reach IEC activities, while the curative health care workers will share acquired knowledge with their colleagues. Expected female-male ratio is 1-1.

The materials and strategies for training of health care workers elaborated in the project might be of potential use in other health districts in Uganda, and through the WHO and ICOH at global level.

Objective 2:

Direct beneficiaries: The project will train 40 farmers in IPM strategies. Two farmers from each one of 20 farmers groups will be elected to participate in the training sessions. Expected female-male ratio is 1-2.

20 agricultural extension workers and pesticide dealers from each of the two districts will be trained in IPM strategies. Expected female-male ratio is 1-2.

Indirect beneficiaries: Trained farmers will be expected to pass their knowledge on to the other farmers in their farm groups and villages. Approximately 500 farmers will be reached this way. Expected female-male ratio is 1-2.

Extension workers and pesticide dealers will be trained to include IPM strategies in their daily advising and training of farmers, thus reaching a greater number of farmers, estimated 1000 farmers in the project period. Expected female-male ratio is 1-2.

The materials and strategies for training of farmers, NAADS extensionists and pesticide dealers elaborated in the project might be of potential use in other districts in Uganda, and through the WHO and ICOH at global level.

Objective 3:

Direct beneficiaries: Through seminars and meetings 20 local key stakeholders (farmers union, farmers groups, NAADS, pesticide dealers, health authorities and district administration) will form a district pesticide committee in each of the two districts.

Students at Makerere University will participate in education and studies done by the students in the field. The project can be expected to influence hundreds of students in teaching sessions at the university and 8 students will have benefitted from research. Expected female-male ratio is 1-1.

Two hundred professionals and farmers are participating in an annual conference on ‘pesticides, health and environment’ in Uganda. Expected female-male ratio is 1-1.

Indirect beneficiaries: Through improvement of control measures taken by the district pesticide committee regarding local import, sale, stocking and use of pesticides a larger population in the districts will benefit. Expected female-male ratio is 1-1, and expected adult-child ratio 1:1.

The project will reach a considerable number of people from the general population within and outside the districts by means of pamphlets, posters, radio and television with general information about the benefits and the toxic dangers of pesticides and how to use preventive measures. Expected female-male ratio is 1-1, and expected adult-child ratio 1:1.

The project partners UNACOH, UNFFE, farmers groups and the University will engage legislative and administrative authorities in the ‘National Agricultural and Chemicals Control Board’ to advocate for legislative and administrative measures in support of IPM and the Safe Use of Pesticides, being of potential benefit to the whole population of Uganda.

C.2 The project’s objectives and success criteria (indicators)

The General Objective is to reduce negative health effects of pesticides in humans and prevent pesticide pollution of the environment.

The specific objectives to be achieved at the end of the project period are:

1. Prevention, registration, diagnosis and treatment of pesticide poisonings is improved in the health clinics in 2 districts.

2. The number of cases of pesticide poisoning is lowered by promoting IPM strategies among farmers from 20 villages in 2 districts.

3. The civil society, especially emphasising Uganda National Farmers Federation and district village farmers groups, are aware of pesticide dangers and able to advocate for concrete actions in the ‘district pesticide committees’ and the National Agricultural Chemicals Board to ensure a sustainable food production

The indicators are:

C.3 Outputs and activities

C.4 Strategy: how will the project be carried out?

Introduction

Pesticide intoxication of humans and the environment is a growing problem to be addressed by farmers, technicians and politicians. The problematic has only been addressed by few projects, and there is a lack of knowledge of what is happening and how to give solutions, so the project can be seen as innovative in its field. Maybe that’s why we see a great interest to work with this problematic among the partners which is the most important prerequisite to be able to obtain sustainable changes. The pesticide use and associated problems is complex; on the one hand pesticides increase yields, and on the other pesticides lead to intoxications and environmental pollution. At the moment we do not believe that pesticide use can be avoided in the bulk of agricultural production or in vector control in Public Health Programmes, although the use can and must be minimized by the UN promoted IPM strategies and the exploration of new methods in organic farming. IPM is understood as an effective, economically sound and environmentally sensitive approach to pest management that relies on a combination of common-sense practices that enhances, rather than destroys, natural controls. In IPM pesticides are used sparingly and selectively always using the less toxic options and promoting the use of appropriate personal protection to minimize negative health effects.

The project is primarily a capacity building project raising awareness in the population, through sharing of knowledge among partners and target groups. The knowledge in the primary target groups is shared by working together, through seminars and courses, and it is expected that these groups will pass on their knowledge to colleagues and farmers, as a sort of ‘training of trainers’ principle. Broader more general information directed at secondary target groups is given by folders, pamphlets, radio and in newspapers. Based on our experience we assume that bringing new knowledge through teaching and information to farmers, health personnel and others will help them to alter their current practices and lead to a change in behaviour in relation to pesticides handling and the prevention and treatment of pesticide poisoning. It is our experience that this is a sound assumption if the new knowledge is understood and if it can help to improve performance and income of the target groups.

As advocacy towards decision makers and politicians is crucial, it is part of the project especially through the work with farmers groups and UNFFE who based on their newly acquired knowledge and experience will be given the possibility of promoting sustainable agricultural production through participation in District Pesticide Committees and National Agricultural Chemical Board, together with UNACOH and the University. Advocacy should be directed at more control with import and sale, better extension services especially on IPM, more focus on pesticide toxicity in foods and environment, and improved registration and treatment of intoxications.

Interdisciplinary collaboration

Many entities are involved in exports, imports, sale, use, legislation, information, teaching etc. Therefore efficient solutions have to be elaborated in a broad collaboration among authorities from various professional fields, farmers and consumers. The project is an interdisciplinary project, which will be reflected by coordination and mutual activities realised with the corresponding entities and by employing staff with the relevant skills. We can definitely take advantage of the experience accumulated by government and the private sector, where especially the university, the Ministry of Agriculture, NAADS, UNFFE and the pesticide dealers do have experience in training farmers, where as the Ministry of Health is having the experience of training their health care workers. As the pesticide dealers are the ones having almost a daily and direct contact with the farmers, when they come to buy pesticides, we want to include this group, as suggested by the Danish agricultural sector programme, in the training sessions for farmers. We know that there is a contradiction in the interest of the pesticide dealers and the IPM strategy, but on some points the project and the pesticide dealers could have the same interest e.g. minimizing intoxications due to promotion of personal protective equipment, the use of less toxic pesticides, a correct identification of the pest, to be able to choose and administer the pesticides effectively. The pesticide dealers are not seen as central actors in the project, but if good collaboration can be achieved then it might also lead to some valuable changes in their way of advising farmers and thus result in favour of the project objectives. Consumers groups are hardly seen in Uganda, but will certainly be created in the years to come, with knowledge, such groups might also be able to advocate for safer products and a cleaner environment.

The main responsibilities in the project are divided as follows: 1. UNACOH will be the coordinator and the direct counterpart of Dialogos. 2. The Uganda National Farmers Federation (UNFF) will participate as an organiser of the logistics around the courses for farmers, be part of the committees formed, and participate in courses and as trainers of their farmers, 3. Makerere University will engage students of agriculture, science and health in the project and participate in the elaboration of materials and documentation studies, 4. The local authorities and ministries will promote the project, participate in the committees formed and disseminate information, 5. NGO’s like NOGAMU will be invited to conduct courses in their area of expertise and educative and informative materials will be shared. All of them will be invited to participate in the steering committee of the project, thus enabling coordination and mutual activities to take place between these parties, which might even lead to activities not foreseen in the project plan.

It can be claimed that the number of collaborators seems to be unrealistically high. However this number clearly demonstrates that the pesticides safety problem is not a simple one, and therefore it should not be seen as having a quick fix solution. Instead for the first time many key stakeholders in Uganda will be brought together functionally, to address the single problem from the various angles. The project bear in mind not to set up parallel structures but is building on existing ones as can be seen from the description above.

Training, documentation and coverage

As a small project we do not expect to cover large areas with trained farmers or health care workers, although we expect that the strategy of ‘training of trainers’ will result in knowledge being passed on to more people than the projects direct beneficiaries. The project must be seen as a project having local areas where the work with farmers and health personnel will create strategies and materials that can be distributed to a larger number of people and other geographical areas, if there is an interest to do so. We have experienced our materials produced in Bolivia being sold to other projects and organisations (including Danida), photocopied and sold on the black market, adopted and distributed through ministries etc. Radio and television programs are also making it possible to get the information out to a much larger number of people, and through the WHO, these materials, strategies and experiences might be of world-wide interest. If the same is going to happen in Uganda only evaluations can show, but is common experience that to make a change, awareness has to be raised among people some way or the other and this includes the distribution of information, that in the long run if seen as vital will be taken seriously and contribute to a positive change.

In each of two districts 10 farmers groups from the villages will be selected to participate, and from each group two farmers will be elected by the farmers themselves to take part in 10-15 theoretical and practical courses about IPM, health and environment. The trained farmers will then be supported in passing their acquired knowledge on to their fellow farmers, and act as a kind of local consultants on pesticide matters in their villages. The agricultural extension workers in the districts from the farmers’ associations, ministry of agriculture and pesticide dealers will be trained them selves and later participate in the education of the farmers to strengthen their knowledge of IPM, making them able to continuously supervise and educate the farmers groups in the districts. The trained farmers are all directly attached to the local Farmers Union.

Likewise a group of health care workers will be selected by the health authorities for training in each district, and 5 courses will be conducted for each group on prevention, diagnose and treatment of pesticide poisonings. The training will be for both extension workers doing preventive work in the villages and curative personnel from the health care units, so each group get an idea of both areas treatment and prevention of poisonings.

The villages and health authorities will be required to secure an equal sex ratio to avoid male dominance in the courses and seminars. A female dominance can though be foreseen in the health education and maybe a male dominance in the farmers education.

The strength of the project will be an in-depth documentation of the actual situation concerning e.g. number of acute intoxications and severity, amount and types of pesticides involved, reasons for intoxications, handling and storage of pesticides among small scale farmers, residues of pesticides in food, soil and water. A knowledge that is useful not only to the project in its strategy and for evaluation purposes, but also of utmost importance for advocacy towards the entities and politicians that deals with pesticides, particularly the illegitimate use of non-registered compounds to make the responsible parties ware of the magnitude of the problem and take appropriate action to find sustainable solutions. An evaluation of the effects of the interventions performed and materials produced is valuable, if the experiences shall be of use for a wider range of institutions and farmers nationally and regionally, thus giving the project the possibility of a larger coverage than normally should be expected for the size of the project.

The outreach activity from Kampala to the districts means that the project employees will be 15-20 days in the field every month, which must be contemporised in the budget covering costs for per diem administered after the rules elaborated by a major Danish NGO in Uganda. The per diem is also used for collaborators when they go into the districts to collaborate in the project. A 4x4 vehicle for transport is necessary as no public transport is available and flexible enough to cover the transport needs.

Teaching materials and general information

Materials developed in Bolivia will be translated to English and serve as an example when producing materials for Uganda. It is foreseen to develop booklets for the farmers with themes like “The different classes of pests and how they attack different crops”, “The different classes of pesticides, proper mixing and spraying”, “Dangers to health and environment, how to protect man and nature, the use of personal preventive measures.”, “Organic methods and the preparation of natural pesticides.”, “Protection of non-cropping areas” etc. A common theme in the courses will be “How to pass on acquired knowledge on to others, - pedagogic methods!”, as many farmers do not have this knowledge and in the project are expected to give speeches to their fellow farmers in the villages to pass on their knowledge about IPM. For the health personnel a pocket book about symptoms of poisoning, classes of poisonings and their treatment will be produced and distributed, as well as educative materials about prevention of poisonings and first aid for teaching in the villages.

Awareness will be raised outside the primary target area with the help of various media. Radios will be used to get the messages out to a wide audience in talk shows, radio spots etc. This is a good media for mass communication as most Ugandans have a radio. Radios cater even for those who cannot read or write. TV and newspapers may also be used if the project is able to come up with interesting information or news in the interest of a wider audience. This has been shown to be possible by lobbying among the journalists. Lately free SMS messages of interest for the general public can be sent by the telephone companies, and the project will regularly use this methodology to reach great parts of the population. Danida’s agricultural sector program has offered the project space in their magazine ‘Farm Talk’, distributed to all schools in Uganda, thereby reaching lots children and their families. The contribution would be about IPM, poisoning of humans and nature, preventive measures etc. Establishing healthy communication facilities the project will open web pages in the adequate languages where distribution of articles and radio programs via the internet to all interested parties in Africa is possible. The cost of this added perspective is extremely low.

Materials produced and experiences will be systematised and disseminated at a national and international level through the collaborators in the project as also explained elsewhere in this paper. The means will be international and national conferences, publications, internet etc. – the key issue is to have an experience that has proven its worth and materials of high quality, the there is a big interest and ‘market for distribution’.

Students training and collaboration between universities and professionals North-South

Students in the medical and agricultural training institutions will be encouraged and supported by the project to write their final thesis in matters of interest for the project, e.g. it could be: a. documentation of the number of poisonings, b. document the causes for poisonings, c. show the value of preventive measures when spraying, d. do a comparison of the yields using conventional farming, IPM farming and organic farming etc. Studies like these have proven to be of value for promotion and dissemination of the strategy and ideas of the project. The results from studies can be disseminated at the UNACOH Annual Scientific Conferences and in other scientific and public circles.

The collaboration with Danish Universities and ICOEPH provides a platform for using the project experience in teaching, e.g. SDU Global Health, ISIM and Department of Agriculture and Ecology Life Sciences from KU provides input to Danish and international students each year in the field of public health, international health, global health, organic farming, IPM etc. A couple of Danish students will be given the possibility to participate in the project by doing research in Uganda collecting and analysing data from the project. An exchange of lessons learned will be possible as ISIM is responsible for several pesticide poisonings projects in India and Sri Lanka focusing on prevention through improved national registration process, improved safe sales practices and improved safe storage in households. Collaboration is expected to start between universities in the field of pesticide research promoted through this project and through ICOEPH linking it up to the WHO.

Administration

The project will be staffed with a coordinator specialised in occupational health, a health educator, an agronomist with knowledge of IPM and a part time secretary, employed by UNACOH. To support the core staff consultants will be hired for special tasks like elaboration of teaching and information materials, the carrying out of small research projects, revision of budgets etc. The project will be democratically conducted in the sense that a steering committee will be formed with the participation of the stakeholders in the project as described above.

In Denmark a steering committee will be formed to be responsible for the technical management and guidance of the project. The committee will consist of volunteers from Dialogos, ICOEPH and the universities. Dialogos will be responsible for managing the funds for the project. As can be seen from the CV’s that can be requested from Dialogos, the Danish partners will use experts with relevant knowledge and experience to guide the project whether it is in occupational safety and health, agriculture and pesticides, research, education, information or administration.

Sustainability

If the problem is big and serious enough as seen by decision makers, the health care workers experience an increasing number of cases of pesticide poisoning and the farmers see an economic advantage in IPM farming, then the activities started by the project will probably be sustainable.

As a health care worker your job is to prevent and cure and if given the knowledge and materials to do so, it is our experience that health care workers do it when requested. Actual discussions at the Ministry of Health promised an interest and thereby possible sustainability - “as the project is offering training of staff, improvement of registration, documentation of health problems and improvement in food safety all in the interest of the health system” as expressed by the senior health officer. The 50 trained health care workers will be supervised by the health care system.

Farmers are interested in methods to improve their production, and having learned beneficial production methods our experience shows that they continue to use them. In future more emphasis will be put on the production of agricultural products containing minimal residues of pesticides certainly to be able to export and also to sell on the home market, this will force the farmers to use pesticides in a proper way and to seek ecological alternatives. The Ugandan farmers are affiliated to Farmers’ Associations in the districts and by including these Associations, through the UNFF an organisational and technical link is established that should guarantee sustainability. A key strategy is to institutionalize the IPM concept and training in the UNFFE and the NAADS, thereby giving the farmers a possibility for continuous supervision and even training of new IPM farmers. This is done by describing a strategy of how it can be done, trying it out and facilitating adequate teaching materials as foreseen in this project. UNFF has already some older materials used in previous training sessions for farmers. UNFF sees the training of farmers as one of their core duties, so given the knowledge and materials training on pesticides safety might be continued by UNFFE in future. NAADS is already doing training and seems willing according to consultations to include IPM in their farmers training sessions.

By producing strategies and materials of high quality we have experienced other organisations (including farmer’s organisations), operative branches of ministries, teaching institutions and other NGO’s adopt the theme, our teaching materials and they themselves ask and pay for courses, which is a reflection of the necessity of the intervention and its sustainability. Through ICOEPH the strategies and materials produced might become useful worldwide as WHO wants to promote these materials and experiences on ‘pesticide, health and environment’ trough their channels.

If the capacity of awareness raising and advocacy in the civil society organisations is improved then some legal and institutional changes might be realised leading to sustainability of actions taken to full fill the objectives of the project. Some examples could in the long run be (probably in a second phase)

• Change/improvement of curricula in universities, technical schools and public schools.

• Changes in the control of imports and sales e.g. by promotion of a positive list of less toxic pesticides.

• Change in official policy and programs of farmers training in field schools through ministry of agriculure.

Changes like these have an effect beyond the local areas where the project will work and might influence the lives of hundreds of thousands of people.

The partners can be expected to continue coordination even after the project stops, due to having experienced working together, and the fact that their responsibilities within the field of pesticides will become easier to fulfil coordinating with each other. Regarding UNACOH given more knowledge at expert level will improve sustainability. Besides, UNACOH is the one Ugandan partner in this project whose core interest, and permanent mandate, is to promote the health and safety of persons in their living and working environment, wherever they may be living and whatever work they may be doing. Farmers, forming the majority of community members and the majority of workers in Uganda, are naturally UNACOH’s leading target beneficiary. And that is why they are the lead Ugandan counterpart for the project.

Economy

Although the budget is limited we might have various supplements to the existing budget financed from other donors. It is our experience that up to half of the activity costs might be covered by other sources interested in the project activities – e.g. by co-financing training and materials with ministry of health and agriculture, NGO’s, Farmers Union, pesticide dealers organisation among others, making the coverage increase beyond the expected. The universities can finance their student studies from other sources, and project funds are only meant as to stimulate at the beginning and preparation of such studies and collaborations. At the Plagbol project we have supported 15 local and 4 foreign students with external funds. Finally the Danish partners are financing quite a lot of the Danish expert’s time given to the project, estimated to be several man month/year.

If the project has to be phased out after this first phase, the last half year will see to that, donating the goods acquired in the project to the farmers union and UNACOH to strengthen their ability to continue operations. Personnel in the project must return to new or former jobs, ceasing salary and other economic relations at the end of phase one.

Time plan - activities

Future

If the first phase becomes successful, we expect to expand to a second phase of the activities, where the emphasis of the project will be more focused on changing policies at national level through the Agricultural Chemicals Board and seeking lasting changes by changing the curricula of health and agricultural training institutions. Actual curriculums in the health training institutions/courses will be evaluated, and the introduction of IPM and alternative organic methods can be supported in teaching at the technical agriculture schools and universities, likewise on the health schools and universities, where teaching in toxicology and prevention of pesticide poisonings will be offered. Post gradual teaching at a larger scale might be organised through the ministry of health and agriculture and their operative branches and through diploma courses offered in the University.

These interventions might be discussed and to a certain extent prepared in the first phase, but with a time limit of three years, they can not be dealt with sufficiently in this phase. Apart from this the project will expand to other areas of Uganda to gain more experience e.g. flower industry in green-houses and the big cash crop farms producing coffee and tee. We are only focusing on small scale farmers in this first phase of the project, as they are the underserved by extension services and do have very few possibilities to acquire new knowledge on agriculture by own means.

If we will not have a second phase then the knowledge acquired by the trained people, the new knowledge created by documentation and the materials produced in this first phase will be there as a sign of sustainability. 3 proposals for revised curriculums do exist.

C.5 Assumptions and risks

Main assumptions and risks

• The Government of Uganda and national authorities and organisations will support in the promotion and collaboration.

• The district local governments and their authorities will support in the promotion and collaborate in the proejct.

• The farmers are interested in training in IPM and they are ready to share acquired knowledge with other farmers.

• The private organisations are willing to cooperate and support the project.

• It is possible to make the different stakeholders work together.

• No major unrest in the country will hamper the activities of the project.

• The currency is more or less stable.

• Bringing new knowledge through teaching and information is assumed to promote changes in behaviour and practices, if the target groups can see a benefit.

• It is assumed that the funds for the project are administered in a sound way to avoid misuse and corruption.

The macro-level risk is clearly a change in either the Government, or a change in the direction of national policies. However, it is hoped that by effectively raising awareness, knowledge and understanding of project issues among the target groups, the project will foster an environment in which the public demand their rights and seek due accountability from governments and providers.

Before entering a phase two we want to see the above mentioned assumptions come through. It might turn out that some of the stakeholders are not interested in working together when it comes to reality, but the as the project is not relying on only one stakeholder, alternatives do exist within the group to take the project activities forward although one or two collaborators might fail.

D. PROJECT ORGANISATION AND FOLLOW-UP

D.1 Cooperation prospects: How does each partner contribute to implementing the project?

In Uganda: The day to day work is organised as seen in this table

In Denmark:

Dialogos has the project administration expertise and is the responsible organisation towards PR-NGO. Dialogos will handle the economic administration of the project.

DASAM/ICOEPH has the technical expertise and will provide the necessary technical ‘Occupational Health and Safety’ input to the project on a day to day basis through the internet and on an average visit to the project twice a year.

The University of Copenhagen through Department of Agriculture and Ecology and ISIM will provide specialised input on IPM and new knowledge creating studies involving students in Denmark and Uganda. The University will seek to strengthen collaboration with the University of Makerere.

D.2 Monitoring and evaluation of project implementation

The project will be monitored on a monthly basis by project personnel meetings within UNACOH. The project steering committee will meet quarterly and revise project plans, quarterly reports and accountability and provide technical input were needed.

The relevant administration procedures of MS-Uganda are adapted to fit this project. To help with this a local Danish consultant with administrative experience is hired some hours each month to guide the administration of UNACOH.

In Denmark a project group is formed that will meet quarterly to revise project plans, quarterly reports and accountability and provide technical input and supervision to the project where needed. A person from this group will have the direct day to day communication with the project personnel. Ad hoc meetings will be held when found necessary. From this technical project group expertise will be provided from Denmark or during visits in Uganda when needed.

At the beginning a baseline survey including health and agricultural matters of relevance to the project will be done. When reviewing and evaluating the project this baseline survey will be repeated to document expected positive changes in knowledge and behaviour as seen from indicators. After one and a half year and in the third year internal evaluations will take place to decide whether to stop the project after this phase 1 or prepare for phase 2. Information is gathered by means of questionnaires, interviews and statistics in the districts and at national level. Data will be analysed using sound statistical procedures and standard statistical programs.

E. POPULAR FOUNDATION AND INFORMATION WORK

E.1. The Danish organisation’s popular foundation

Foreningen består af medlemmer, der næsten alle har ulands erfaring indenfor sundhed og uddannelse og med nært kendskab til de lande vi arbejder i. Alle medlemmer har et vidtforgrenet professionelt netværk, som der trækkes på f.eks. ved projektformulering, specifikt fagligt input, monitorering m.v.

Foreningen har et nært samarbejde med unge. En ungdomshøjskole er medlem og sender hvert år et hold unge til Bolivia for at besøge projektaktiviteterne. Foreningens medlemmer deltager i disse unges forberedelse af rejsen. Ved hjemkomsten deltager de unge meget aktivt i en bred vifte af informationsaktiviteter (lokalaviser, lokalradioer og skolebesøg).

Foreningen har ladet producere oplysende film og radioprogrammer. Desuden har foreningen en hjemmeside, som retter sig mod medlemmerne, potentielle medlemmer og befolkningen generelt. Foreningen er i gang med en revision af hjemmesiden.

Ligesom planen er at sekretariatet skal forestå en mindre hvervekampagne med henblik på en udvidelse af medlemsskaren i de kommende år.

E.2 Information work in Denmark

During the project's life Dialogos will work to make its basic aim visible to the Danish population. We believe that since the project itself will not solve all problems, but rather be a beginning of a longer process, we'll go for visibility as soon as the project gets on the way. We need to tell the Danes about pesticides in Uganda, and what needs to be done to change things.

Based on a visit in Uganda we'll produce professional journalistic reportage for our own media (Dialogs Nyt and dialogos.dk). We'll also produce radio programs for a large number of Danish community radios, the online radio D2R as well as letting people listen from our web site. On top of that we'll write articles for u-landsnyt.dk, the leading Danish news media on third world affairs.

It is our intention to produce 1-2 spotlights, professional slide shows with high quality sound and many photos, to be published on YouTube for anyone to see and learn. The video will also be seen on dialogos.dk and other sites willing to link to our work. The same spotlight will become a DVD film for distribution to current and prospect members.

3. Budget summary

4. Contact information

5. ANNEXES

Supplementary annexes

Abbreviations used:

DASAM – Danish Society of Environmental and Occupational Medicine

DV-Curriculum Vitae

DKK – Danish Kroner

DAO – District agricultural officer

DHO – District Health Officer

DHE – District Health Educators

ICOEPH – International Center for Occupational, Environmental and Public Health

ISIM – Department of International Health, Immunology and Microbiology

IPM - Integrated Pest Management

MUSPH - Makerere University School of Public Health

MUAGRIC - Makerere University Agriculture

NAADS – National Agricultural Advisory Service

NGO Non governmental organisation

NEMA – National Environment Management Authority

NOGAMU – National Organic Farmers Union

PP - project personnel

PRNGO – Project Counselling Service for NGO’s in Denmark

UGX – Ugandan shilling

UNACOH – Ugandan National Association of Community and Occupational Health

UNFF – Uganda National Farmers’ Federation

UNADA – Uganda National Agro-input Dealers’ Association

US – United States

WHO – World Health Organisation