A buzzword that captured a lot of media attention a few years ago was the idea of a “food desert.” Defined by the CDC as “areas that lack access to affordable fruits, vegetables, whole grains, low-fat milk, and other foods that make up the full range of a healthy diet,” food deserts are traditionally discussed in the context of developed countries like the U.K. or U.S. whereby communities (often distinguished by geographic location, racial/ethnic background, and/or socioeconomic status) are unable to reasonably access healthy foods [1,2].
Food deserts aren’t something we talk about in the developing world context, but as I think of my situation in Malawi, we’re facing a similar issue; it is systematically impossible for certain communities to access a variety of “healthy” foods, which combined with other factors like culture, education, and food security, can significantly impact one’s diet. In particular, foods like low-fat milk, yogurt, or whole grain anything, are expensive and often physically difficult to obtain here. A single-serving of yogurt can cost as much as 220 Malawian kwacha, which is almost enough to purchase a large meal of nsima, meat, stew, and vegetables that would fill you for several hours. Healthy foods are here but for the masses, they are inaccessible, like a mirage in the middle of a desert.
Food deserts are also characterized by lack of access to fresh fruits and vegetables, such as was all too common in cities adjacent to my undergraduate institution of Michigan State University. In certain communities, the only accessible places were often convenience stores, which carried non-perishable, non-nutritive foods. Here in Malawi, this is not a primary issue. Fruits and vegetables are available in large quantities and relatively inexpensive prices, even by living standards here. But these healthy foods present other unique challenges, creating an obstacle to a nutritious and fulfilling diet. First, to eat them in their most nutritive states (raw), you need to clean them. This assumes the availability of clean water, which is not always a reality. Second, once you’ve purchased fruits and vegetables, you need to store them. And this is something that I’ve found to be a challenge. Electricity is not consistent, thus refrigerator storage is not a long-term option. Those who can afford a freezer often store things there, but of course this isn’t an ideal way to store fresh fruits and vegetables. And leaving many of these items on a shelf or in a storeroom drastically decreases their shelf-lives.
When I informally asked friends and colleagues here – “how are you able to keep food?” – the responses I got were interesting. In addition to storing food in deep freezers, many keep large quantities of maize meal, Irish potatoes, and eggs but buy fresh foods like fruits, vegetables, and bread on an almost daily basis. Even if we’re on the main road coming back from a field visit, a co-worker may pull over and within three minutes, purchase enough fresh veggies for that evening’s dinner. And while this makes a lot of sense, it presents additional challenges.
- You must be able to get to a place that sells these fresh foods at an affordable price. I walk 30 minutes to get to the open-air market (as opposed to buying things at almost quadruple the price in a grocery store near work), which is ill-advised to do after work hours when the sun is already setting. Even driving or taking a taxi is challenging with the fuel crisis that has peaked at my three-month mark.
- Fruits and veggies aren’t sold individually; they’re sold in bundles. Thus, what I call inexpensive – one bundle of tomatoes for a one-person household once a week – becomes more expensive for a woman who has, on average, 5 – 6 children and a husband to feed.
- If you buy fruits and vegetables, and they start to spoil, you have to cook them, and cook the nutrition out of them to make sure that you’ve killed all the bacteria. For example, if I have tomatoes that I’ve tried to save for three days, I usually end up making a stew or pasta sauce, and I usually add spices and salt. And while I do these things modestly, ask any Malawian, the meal accompanies the pile of salt used for seasoning, not the other way around.
So, here in Lilongwe, when you look at the facts – the high costs, the far geographic proximity, the unavailable safe food storage – I am, by definition, in a situation where I cannot access healthy foods. And while I know many expats here whose situations are different – fuel reserves provided by their governments, generators in the homes to ensure 24/7 power, higher incomes to warrant paying 800 kwacha for 5 apples (the same price of buying a Malawian meal for three or four) – it becomes almost impossible to expect the local community to have access to these nutritious foods. By definition, I’d say that here in Malawi (and throughout the African continent), we are most certainly in a food desert.
And once we understand that, we see that the solution to improving diet is not just based on changing individual preferences but reshaping a greater system and set of policies .
What do you think?
 Cummins, S., and Macintyre, S.(24 Aug. 2002). Food deserts” – evidence and assumption in health policy making. BMJ, 325, 7361, 436-438. Retrieved 27 Oct 2011 from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123946/pdf/436.pdf>
 Pearson, T., Russell, J., Campbell, M. J., and Barker, M. E. (2005). Do ‘food deserts’ influence fruit and vegetable consumption?—a cross-sectional study. Appetite, 45, 195-197. Retrieved 27 Oct 2011 from <http://gis.sheffield.ac.uk/Library/Downloads/Publications/2005_FoodDeserts.pdf>
 Caraher, M., and Coveney, J. (2003). Public health nutrition and food policy. Public Health Nutrition, 7, 5, 591-598. Retrieved 27 Oct 2011 from <http://journals.cambridge.org/download.php?file=%2FPHN%2FPHN7_05%2FS1368980004000710a.pdf&code=d2ed946c9be9c1f95695a37a3d8fa71f>