Health, agriculture, and rural poverty: Why seasons matter

This paper argues that in many tropical environments the wet season is the most critical time of year, especially for the poorer people, women and children. Commonly at that time malnutrition, morbidity and mortality peak; the costs of sickness—to society in lost agricultural production, and to families in food and income foregone — are at their highest; sickness is most liable to make poor people permanently poorer; and health services are likely to be at their least effective. But systematic biases prevent urban‐based professionals from adequately perceiving this seasonal deprivation; they tend to underestimate morbidity in wet seasons and not to recognise its social and agricultural impacts. More needs to be known about impoverishment through seasonal sickness, about micro‐level seasonal linkages, and about zones of adverse seasonalities; and priority is indicated for research on tropical diseases with seasonal impacts on agriculture. More immediately, seasonal analysis has practical implications for the management of health services, including the supply of medicaments, preventive and curative measures, crdches for working mothers, and the selection of community health workers able to provide care at the times of greatest need. Finally, decentralised seasonal analysis is proposed. This would bring rural health and agricultural staff together to identify local linkages between health, nutrition, agriculture and poverty, and then to plan and implement programmes geared to the seasonal needs of the poorer and more vulnerable people.