Konzo Associated with War in Mozambique
Summary of published paper
Konzo (also known as cassava poisoning) is a medical condition associated with eating insufficiently processed cassava. This condition affects the central nervous system. Outbreaks of Konzo have been reported in a number of situations where populations have been extremely food insecure and have not been able to wait until their cassava crop has fully ripened before consuming it. Unripe cassava can contain high levels of cyanogenic glucosides which cause the symptoms of Konzo.
A group of investigators
have recently published a paper reporting their findings on a Konzo epidemic
in Mongicual district in Mozambique in 1993. Fighting was particularly
severe in the district in the months before the peace accord which was
signed in late 1992, as both sides fought to capture the maximum territory
possible. The research team found that the prevalence rate in the badly
affected area was 30/1000. Three hundred and eighty four patients were
treated in rehabilitation centres. Most of the patients were children over
3 and women. Patients complained of difficulty in seeing, hearing and talking.
Many had increased upper
limb reflexes. All complained of difficulty in walking and of those who
could walk many had a spastic gait. Some also had diminished sensitivity
to light touch and pinpricks. Agriculture in Mogincual is based on small
family holdings with cassava as the main food crop. There is normally a
two year period between cassava planting (August to October) and harvesting.
Women process harvested cassava by sun-drying for 1-3 weeks and then store
it in house attics for use throughout the year.
During the war most people
fled from the rural areas. For those who stayed agriculture was severely
disrupted as farmers could not spend long in their fields and monkeys managed
to decimate crops. Bitter cassava production increased and new varieties
were introduced. These types of cassava were favoured
by farmers as they were more productive, had a short reproductive cycle
and were resistant to predation by monkeys and wild pigs.
In 1992, returnees could only plant cassava when they returned home after October. As seed and tools were either non-existent or handed out too late they could not plant other crops. In 1993, they therefore had to harvest cassava earlier than usual and shorten its processing. They often used rapid sun-drying where the tuber is peeled, pounded, dried in the sun for a few hours, pounded into flour and then eaten on the same day. Owing to the on-going war, communities turned to bitter cassava as their staple and took shortcuts in the processing. When the war ended they continued to depend on inadequately processed bitter cassava. The Konzo epidemic lasted 2 years, the last year of the war and the first of peace, with peaks each year during the cassava harvest.
Conclusion
Earlier Konzo epidemics in Mozambique were associated with drought-provoked agricultural crises. This time war was the cause of the agricultural crisis rendering the population dependent on a diet of insufficiently processed bitter cassava. The food shortages forced families to eat bitter cassava after only one day of sun-drying, a method that probably does not adequately lower cyanohydrin concentrations. Increased use of cassava as a staple in war has been reported from other countries such as Vietnam and Rwanda. Although this is the only documented Konzo epidemic associated with war, anecdotal reports suggest that such epidemics have also occurred in Angola and Uganda.
Reference
Cliff. et al (1998): Konzo associated with War in Mozambique: Tropical Medicine and International Health, Vol. 2, No 11, pp 1068-1074
More like this
FEX: Innovation and success in prevention of konzo
By Dr Howard Bradbury1 This article was prepared by Dr Howard Bradbury, who is an Emeritus Fellow at the Australian National University. Since the mid-nineties he has been...
FEX: Suspected toxic ingestion outbreak in central Afghanistan
By Gerald Martone, International Rescue Committee (IRC) Gerald Martone is the Director of Emergency Response at the International Rescue Committee's Headquarters in New York....
FEX: Analysis of the 1996 Konzo outbreak in Democratic Republic of Congo
Summary of published paper1 A recently published article documents and analyses a Konzo outbreak in south west Democratic Republic of Congo (DRC) in 1996. Konzo is a distinct...
FEX: Impact of cross-sectoral approach to addressing konzo in DRC
By Marie-Morgane Delhoume, Julie Mayans, Muriel Calo and Camille Guyot-Bender Marie-Morgane Delhoume is an agricultural engineer specialising in agro-development of tropical...
FEX: A cross-sectoral approach to addressing Konzo in DRC
By Dr. Emery Kasongo and Muriel Calo Emery Kasongo is the ACFUSA Project Manager who led the study described. Previously he has worked as national consultant on several food...
FEX: Practical pointers for prevention of konzo in tropical Africa
By J.H Bradbury, J.P.Banea, C. Mandombi, D, Nahimana, I.C. Denton and N. Kuwa Dr J Howard Bradbury, Emeritus Fellow, Australian National University, developed the cassava...
FEX: Grass Pea Consumption and Neurolathyrism
Summary of published paper1 Field of green pea grown in Ethiopia Neurolathyrism is a neurodegenerative and irreversible spastic paraparesis2 that can be crippling and lead to...
FEX: NGOnut discussion summaries - cassava poisoning, and HIV and breastfeeding
The following are edited summaries of e-mail correspondence from the NGO Nutrition Association (NGO Nut) which may be of interest to readers. The NGO Nut was recently set up...
FEX: The link between tuberculosis and undernutrition
Research snapshot1 Undernutrition increases the frequency, severity and fatality of many infections, including tuberculosis (TB), while infections, in turn, worsen...
FEX: The Risks of Wet Feeding Programmes
The author of this article, Steve Collins is a medical doctor. During the autumn of 1996 he was Oxfam's health team leader in Liberia. This article is based upon his...
FEX: Food Preparation an Obstacle to Education
This article is written by Betty Kidan Muni who is a field officer working for SCF with women's groups in south Sudan*. Background Betty Kidan (author of the article)...
FEX: Recurrent pellagra in Angola
Summary of report* Since March 1999, successive waves of people have arrived in the town of Kuito, Angola, displaced by fighting in their native Bie province. As a result,...
FEX: Emmanuel International
By Andrew Mellen, Emmanuel International Andrew Mellen has been the relief programme manager with EI Malawi since 2003. With a background in agriculture, he previously worked...
FEX: Destocking to improve food security in drought - prone Ethiopia
By Dereje Adugna Tieke Dereje is an Emergency Response & Transition Program Officer for CARE Ethiopia, with sixteen years of field experience in development work and emergency...
FEX: Saving Lives through Tried and Trusted methods: Evaluation the Intervention of the International Committee of the Red Cross
Summary of published paper A retrospective study on the under five mortality of children was conducted in Meringue, a district of central Mozambique in October 1994. During...
FEX: From the editor
An aerial view of Darfur, Sudan The role of data and analytical tools in guiding and evaluating emergency programming figures strongly in this issue of Field Exchange. There...
FEX: Feeding young children during mandatory COVID-19 quarantine in Australia
View this article as a pdf Catharine Fleming is a Lecturer in Public Health at the School of Health Science, Western Sydney University Michelle Fitzmaurice is a Research...
FEX: Impact of drought and HIV/AIDS on child malnutrition
Summary of published research1 A too familiar sight in drought striken areas, here Red Sea State, Sudan There is growing interest in delineating the impact of drought and HIV...
FEX: From the editor
Group of women participating in a focus group discussion This is another bumper issue of Field Exchange, with eight field articles and just under 20 research summaries. On the...
FEX: Emerging cases of malnutrition amongst IDPs in Tal Abyad district, Syria
By Maartje Hoetjes, Wendy Rhymer, Lea Matasci-Phelippeau, Saskia van der Kam Maartje Hoetjes is a Medical member of the MSF emergency team, currently working in South Sudan....
Reference this page
Konzo Associated with War in Mozambique. Field Exchange 5, October 1998. p6. www.ennonline.net/fex/5/konzo
(ENN_3349)