Enhancing the economic viability of pastoralism: the need to balance interventions.

Extensive mobile pastoral systems do not follow conventional marketing optimisation models, since they must deal with the factors of mobility, erratic environments, dependency on natural resources, seasonality, and distance to markets. While pastoralist systems contribute substantially to national economies, government investment to support pastoralism remains limited or non-existent. Pastoralists are becoming increasingly integrated into larger market systems and therefore need investment and specially adapted policies to supply a growing demand for livestock products and to support their livelihoods. In this paper, the authors show that investment and technology can support and empower pastoralist marketing strategies in supplying higher-value and more stable livestock products. Furthermore, the authors demonstrate that pastoralists also supply services, broadening the marketing landscape within which they operate to include more players and trading options. Pastoralists are undeniably the custodians of rangelands and provide a wide range of ecosystem services. These new market prospects nevertheless require structuring (e.g. regulation, infrastructure) and adjustments in the trading environment of stakeholders all along the value chain. There is, however, an inherent risk in intervening in pastoral marketing and production processes. Too many or ill-adapted interventions can have severe effects on these systems, resulting in over-intensification and reduced mobility. Finding the right level of intervention to support extensive pastoral systems is important when developing policy, since it is about the only form of land use that can keep a third of the world's land surface in food production without additional inputs.

Les systèmes pastoraux nomades extensifs ne suivent pas les modèles classiques d'optimisation commerciale, dans la mesure où ils doivent faire face à des facteurs liés à la mobilité, aux fluctuations environnementales, à la dépendance à l'égard des ressources naturelles, à la saisonnalité et à l'éloignement des marchés. Malgré l'importance de la contribution des systèmes pastoraux aux économies nationales, les investissements consentis par les gouvernements pour soutenir le pastoralisme demeurent limités, voire inexistants. Les pasteurs s'intègrent de plus en plus dans des marchés plus vastes, ce qui nécessite des investissements et des politiques spécifiques afin de satisfaire la demande croissante en produits d'origine animale et de soutenir les sources de revenus pastoraux. Les auteurs de cet article montrent que les stratégies commerciales des pasteurs visant à proposer des produits d'origine animale mieux valorisés et plus stables peuvent être soutenues et rendues plus autonomes au moyen d'investissements et d'apports technologiques adaptés. En outre, les auteurs démontrent que les pasteurs sont également des prestataires de services, ce qui accroît la portée économique de leurs activités en intégrant davantage d'acteurs et d'ouvertures commerciales. Les pasteurs sont indéniablement les gardiens des prairies et fournissent d'importants services écosystémiques. Néanmoins, ces nouvelles perspectives commerciales exigent à la fois un cadre structuré (en termes notamment de réglementation et d'infrastructures) et certains ajustements du contexte commercial dans lequel opèrent les parties prenantes tout au long des chaînes de valeur. Toutefois, il y a un risque intrinsèque à intervenir dans les processus de commercialisation et de production du pastoralisme. Des interventions trop nombreuses ou inadaptées peuvent avoir de graves conséquences sur ces systèmes, se traduisant par une intensification excessive et une limitation de la mobilité. Il est important de trouver le niveau approprié d'intervention au moment de concevoir des politiques de soutien aux systèmes pastoraux extensifs, car cette modalité d'utilisation des terres est pratiquement la seule à permettre qu'un tiers de la surface agricole de la planète soit consacré à la production alimentaire sans recourir à un surplus d'intrants.

Los sistemas de pastoreo de carácter extensivo y nómada no se ajustan a los modelos convencionales de optimización de la comercialización, puesto que deben responder a factores como la movilidad, la variabilidad del medio, la dependencia de los recursos naturales, la estacionalidad o la distancia a los mercados. Pese a que los sistemas pastorales contribuyen sustancialmente a la economía de los países, la inversión pública en apoyo del pastoreo sigue siendo escasa o inexistente. Las sociedades pastorales, cada vez más integradas en sistemas de mercado de mayor tamaño, necesitan por ello mismo inversiones y políticas especialmente concebidas para satisfacer una demanda creciente de productos ganaderos y para respaldar sus medios de sustento. Los autores explican que la inversión y la tecnología pueden potenciar las estrategias de comercialización de las sociedades pastorales y favorecer su autonomía al propiciar una oferta más estable de productos ganaderos de mayor valor. Además, los autores demuestran que las sociedades de pastores también prestan servicios, ampliando el paisaje comercial en el que operan para integrar en él a un mayor número de agentes y vías de comercialización. Resulta indudable que los pastores son los custodios de los pastizales y prestan muy diversos servicios ecosistémicos. Sin embargo, para hacer realidad estas nuevas perspectivas de mercado es preciso estructurar (por ejemplo con reglamentos e infraestructuras) y adaptar el entorno comercial en el que intervienen los distintos agentes dentro de las cadenas de valor. Existe pese a todo un riesgo inherente a toda intervención en los procesos de comercialización y producción pastorales. Demasiadas intervenciones, o intervenciones inadaptadas, pueden perjudicar gravemente a estos sistemas y llevar a una excesiva intensificación y a una pérdida de movilidad. A la hora de formular políticas es importante dar con el nivel adecuado de intervención para respaldar a los sistemas pastorales extensivos, no en vano estos representan el único uso del suelo capaz de mantener la producción de alimentos en un tercio de la superficie terrestre del mundo sin ninguna aportación adicional.

Cost saving with ultrasonography in a developing country district hospital.

OBJECTIVE: To estimate the potential monetary reduction induced by the introduction of an ultrasound unit in a major district hospital in a developing country. DESIGN: Propective study. SUBJECTS: Patients referred with abnominal diseases and pregnancy. SETTING: Wad Medani Teaching Hospital, Central Sudan. RESULTS: Local specialists referring the patients stated that an estimated 792 radiologic procedures would have been carried out to obtain the same amount of information as achieved by ultrasound. Such procedures budgeted approximately 8100 US dollars, in terms of equipment, material and personnel by 1987 rates. Such savings have benefited all departments of the hospital. CONCLUSION: The authors consider this as evidence for the fact that despite its initial high investment (15,000 US dollars), availability of ultrasound virtually reduced expenditure on other radiological diagnostic procedures. This is of special benefit for the limited budgets of hospitals in non-industrialised countries.

Inter-observer variance in ultrasonographical assessment of Schistosoma mansoni-related morbidity in young schoolchildren.

49 Sudanese schoolchildren aged 6-9 years with Schistosoma mansoni infection were ultrasonographically examined by two independent observers in a double-blind fashion. The first observer recorded normal appearance of the liver in 23 cases, whereas the second observer recorded the appearance as normal in 33 cases. There were 23 concordant observations. For Grade I periportal fibrosis (PF), 13 observations were concordant. PF Grade II was rarely observed (2 versus 3 cases), and Grade III was not recorded at all. In total, 38 out of 49 observations were concordant (77.5%). These preliminary data from two ultrasound observers, from observations on a limited number of patients, can be seen as an indication of a potential inter-observer variation of around 20% for the distinction between the absence of PF and a low level of PF.

Smaller health areas for a better service.

An analysis of Sudan's health system revealed a lack of sound leadership for village-level providers. The district-based peripheral health system was failing to meet an increased demand for leadership and management support. Some of the principal factors explaining this state of affairs were population growth, increased numbers of health units, long distances and transport difficulties. With a view to solving these problems, the country was divided into smaller health areas around rural hospitals and similar physician-led facilities. A decentralized system based on the principles of primary care was established in these areas under health area management teams. Setbacks encountered in giving effect to the policy have led to proposals for a new implementation strategy.

PIP: Despite Sudan's commitment to primary health care, considerable health system weaknesses still existed in the late 1980s. For example, the health system was still operating under the organizational structure established by the former colonists and most of the allocated funds supported hospitals and salaries. The communities did not participate in primary health care activities and instead depended on official and outside funding. Lack of leadership and management support for health workers in the villages were perhaps the leading factors explaining the weaknesses. Its district-based system collapsed in the late 1970s due to population growth, transport problems in these large districts, creation of urban and rural councils to conduct administrative and decision making functions, separation of preventive and curative services (preventive services under local governments and curative services under the Ministry of Health [MOH]), decline in the national economy and in political commitment to health, increased numbers of physician specialists, and reduced numbers of physicians willing to go to rural areas. The MOH joined with Gezira University in Wad Medani, Sudan to develop a new health care policy. The National Council for Health adopted the new policy in December 1987. It decentralized the health system into 175 health areas around rural hospitals or health centers. Each area had a health area management team. The new policy was based on primary health care, community participation, and sound managerial processes. Since there was no clear national implementation plan, the regional health authorities tried to implement the new policy. Few regions did so successfully. Thus Sudan suggested that each region first implement the policy in 2-3 areas. Health workers would learn some lessons from this phase which they can apply to expand the system.

Field study of different oxamniquine dose for Schistosoma mansoni in Gezira, Sudan.

Two hundred and ninety-six individuals of whom 126 were children and 170 adults with positive stool for Schistosoma mansoni were randomly given oxamniquine treatment in a dose of either 20, 40 or 60 mg/kg body wt. They were followed in the field for ova excretion at 1, 3 and 6 months for adults and at 1, 3, 6 and 8 months for children. The cure rates in adults at 6 months are 93%, 87% and 73% for the 60, 40, 20 mg/kg-1 treatments in order. For children the cure rates at 6 months are 36%, 58% and 63% and at 8 months are 16%, 21% and 26% for corresponding doses. There is no difference in egg reduction for those not cured between the three treatments at 6 months. It is concluded that oxamniquine need not be given in the previously recommended 60 mg/kg body wt. A choice between 40 and 20 mg/kg body wt is suggested with the 40 mg/kg body wt to be reserved for individuals leaving the endemic area, and the 20 mg/kg body wt for those continuing to stay there with substantial exposure for reinfection. The overall proper cure rates for children with a possible advantage of the low treatment in the long term for this age group is noted.