Choking off the supply / John Madeley

Choking off the supply Coca leaves have nutritious properties but all too often are converted into deadly cocaine. Bolivia is trying to discourage coca- growing and promote health-awareness John Madeley A the deadly drugs cocaine nd "crack" kill and maim growing numbers of people around the world (in the SA, 1,600 people died after using cocaine in 1987) attention has turned to how to reduce the supply of the raw material that make the drugs possible - the coca plant, Erythroxylum Coca. The plant is a native of South America where it has been cultivated since the Inca civilisation. Most of the world's coca grows in Bolivia, Colom- bia and Peru, and most is used for healthy purposes. Local people have a long tradition of chewing coca leaves, which are rich in nutrients, such as calcium and phosphorus, also Vitamins A and & . The leaves dull the appetite and act as a stimulant, enabling people to work long hours on little food. The leaves are also used to make a brand of tea which is very refreshing in high altitudes, and indeed is offered to new arrivals as preventive medicine against altitude sickness. Coca is used in hospitals as a local anaesthetic (in some Latin American hospitals it is the only anaesthetic available.) Some is bought by drinks companies. Coca- Cola once advertised its drink as "containing the tonic properties of the wonderful coca plant." A popular bottled drink in Peru is called Inca- Cola. But some of the coca harvest is treated locally and turned into the paste for cocaine and "crack," the designer drug derived from it, both of which threaten people's lives. In small aeroplanes, in lorries and in all kinds of innovative ways, the paste then goes to laboratories in Latin America and abroad, to be turned into cocaine and eventually find its way on to the streets of the world's big cities. To try to eliminate this trade, the United Nations Fund for Drug Abuse 28 Control (UNFDAC) is cooperating with governments of coca-producing coun- tries on a wide range of measures to reduce coca supply. In Bolivia, a US $65 million joint effort of the government, UNFDAC, and other agen- cies, is trying to persuade farmers who grow coca to switch to other crops, especially coffee, fruit and vegetables. The aim is to eliminate that percen- tage of coca growing which goes for drug production. Farmers in the Yungas region of the country - one of Bolivia's two main coca-growing areas - produce coca on small plots of land extending up the steep hillsides. They harvest the crop three times a year, but their income from it is erratic and prices have dropped sharply over the past three years. Farmers are paid $2,000 a hectare to stop growing coca, which is, in part, compensation for lost earnings. It takes three years for newly-planted coffee bushes, for example, to yield their first fruit. For every hectare that the farmers diversify, the project puts a further $4,000 into the Yungas region in an ambitious attempt to develop the infrastructure and improve the rural economy, · so raising overall living standards. For the crop which has brought riches to cocaine dealers has left the people of Yungas desperately poor. Most people are severely under- nourished. "Some survive on only a fifth of the minimum nutrition requirement," says Mr Oscar Miranda, head of the project's technical unit in Coroico, the region's main town. Poor health is acute. Some three-quarters of the population are estimated to suffer from tuberculosis. Few have access to clean water, most are illiterate. "The amount of land devoted to coca takes away a lot of land that could grow food," points out Oscar Miranda, "and partly accounts for the high level of malnutrition. The money earned from coca is often not enough for people to buy the food they need." The infrastructure money is there- fore devoted to a wide variety of purposes. A hospital and many health centres are being built, new roads are under construction, crop research is going on, and farmers are provided with seeds, bushes, advice, training and help with organizing cooperatives. Chickens, bees, fish and pigs are encouraged, safe water and electricity supplies are being laid on. The project's "social community and health development" arm is a joint effort between UNFDAC and the Italian organization, Centra ltaliano di Soli- darieta (CEIS), a non-governmental body with UN consultative status. On the outskirts of Coroico, a new $2.8 million hospital is under construc- tion and is due to open late this year. "There was no hospital here WORLD HEALTH, June 1989 Harvesting the coca plant on vertigi- nous terraces in the Andes. Facing page: Coca leaves on sale in Bolivia beneath an advert for a drink that borrowed the name. Photos L Sirman © and J . Madeley © before," says project coordinator Mr Erico Coza, with a smile: "this will serve the entire area." The area that the 36-bed hospital will serve ranges over 4,000 square miles and is home to 156,000 people. A team consisting of four doctors, three dentists, three nurses and a nutritionist is funded by the project. But the emphasis is firmly on the improvement of health at village level and the development of community organization. "We help people to organize into 'social priority groups' to improve health and education," says Erico Coza, "to help them to be more aware of what makes for good health, the role of water and sanitation, how they might prevent illness and so on." One of the first fruits of the project for many people in the region is the availability of drinking water. Attempts are being made to bring piped water from springs within reach of most of the population - a difficult task in vie..v of the scattered nature of settlements. WORLD HEALTH, June 1989 By the end of 1988 the ne..v system had brought piped drinking water to around 5,000 people. A religious order, the Sisters of St. Anne, will run the Coroico hospital's out-patient and maternity wings. A clinic for the prevention of drug abuse is intended to help people who are experimenting with cocaine, and will also have an important educational role. "Because they are usually very short of money, youths in the region are sometimes persuaded to collect coca for the illegal purpose of making paste for cocaine, and are dragged into the drug network," says Erico Coza. "Part of the clinic's work will be to help young people be aware of the dangers of coca when it is used for illegal purposes." The project has been given a strong boost from a ne..v government anti- narcotic law which makes it illegal for farmers to plant any ne..v coca. The law has not pleased all the coca farmers of the Yungas region, some of whom believe that their crop has been given a bad name by drug interests and defend their traditional right to grow it if they wish. Opposition to the law is especially vocal in the highly fertile Chapare district, to the south of the capital, where coca farmers reap four harvests a year. The project has now expanded into this area. Mr Prudencio Ticona of the Council for the Industrialisation of Coca (COINCOCA), which represents growers, says they want "to restore the dignity of this sacred and medicinal plant which has been blemished by drug traffickers and users." COINCOCA believes that coca can be used in ne..v ways and has applied to the country's Ministry of Health for licences to market ne..v health pro- ducts. This includes a coca syrup, claimed to counter physical weakness, sexual impotence and anaemia, an anti-diabetic preparation to reduce sugar level in the blood, and another preparation to prevent obesity. Project officials stress that the aim is not to eliminate all coca but only that part of production that goes for the manufacture of cocaine. They claim that the project is succeeding and that reduction in coca-growing, plus stricter law enforcement, has led to the closure of nearly all illegal cocaine factories in the Yungas region. Encouraging The project is clearly gaining support from many farmers. Officials say that when it started, in 1986, around 10,000 farmers in the region gre..v coca. Some 1,300 farmers in 53 communities have now switched to other crops - over ten per cent of the total. This is seen as encouraging in view of the physical difficulty of reaching farmers in the many isolated areas of the Yungas region. Mr Giovanni Quaglia, the project's Italian advisor, has no illusions about the difficulty of encouraging farmers to switch crops. But having done similar work in Pakistan for seven years, helping farmers to switch from growing the poppies that make opium and to grow other crops instead, he knows that it can be done. The price of coca is likely to be a major influence on whether farmers stay with the crop. Farmers sell their coca in a "cesto," a basket holding 30 pounds of the crop. In 1986, a cesto fetched the farmer $150. In mid- January this year it fetched only $12, and in late January $25. "But the price trend is firmly downwards," a project official insisted. Coca remains a tantalising crop - capable of being turned into one of the world's deadliest drugs or used as a health product. To grow coca at all is to risk that it may be turned into cocaine, but not to grow it means that useful products are lost. What most people in Bolivia are looking for are ways of growing it for healthy, not deadly, purposes. • 29