English - IFAD

80
Rural Poverty Report 2011
whole local economies, because after the initial shock there may be an associated
collapse in local agricultural employment and wages, non-farm income and asset
prices. 79 In addition, in many societies traditional social solidarity has weakened and
has not been replaced by new social contracts between the state and citizens.
For example, during the food shortages in the Niger in 2005, it was reported that in
many villages those who were less badly hit showed little willingness to provide food
to neighbours who had suffered more acutely. 80
Some of the key risks for poor rural people today
Personal and household-level risks: ill-health and ceremonial costs
Ill health represents a major risk factor for poor individuals and households in all
areas. This is because of lack of adequate health services in many rural areas, the
direct and indirect costs of accessing them, the loss of the ill person’s contribution
to the household economy and the diversion of time – particularly of women in
poor rural households – from productive activities
to caring for the ill. These costs may have a
particularly severe impact in case of chronic ill
Soon after marrying, Shazia became ill
with a blocked heart valve and remained
in hospital for three years. Her
continuing medical needs have resulted
in considerable debts, yet to be paid off.
“Illness didn’t give us a break so that
we might be able to save something.
Every week I had to be taken to
hospital. Every week we used to go
and spend 1,500 rupees. And also from
here the fare to Rawalpindi… So we
used up so much money. The loan we
have, it has to be returned.”
Shazia Bibi,
female, 37 years, Pakistan
health due, for instance, to HIV/AIDS or
tuberculosis; respiratory illnesses from continuous
exposure to the fumes of household stoves
(particularly affecting women and children); chronic
exhaustion from insufficient nutrient intake and
continuous physically taxing labour (such as
collecting and carrying fuelwood and water – again
particularly affecting women and children); poor
access to safe water and sanitation; and genderbased
violence. Malaria too can take a very heavy
toll on poor rural households, and it is spreading to
new areas as a result of warming climates. In the
future, climate change is expected to multiply risks
of exposure to illness in many parts of the
developing world as well as elsewhere. In conflict or
post-conflict areas, ill health can also result from exposure to violence, displacement
and loss, often with particularly heavy, long-term costs for youth and children.
A large proportion of people affected by HIV/AIDS depend on agriculture, and
since 1990 the effects of the epidemic on rural health and impoverishment have
been dramatic in many countries, especially in sub-Saharan Africa. The productive
capacity of HIV-positive people is substantially reduced, while AIDS-related deaths