Life - A-OK?
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Vitamin A is essential for the functioning of the human immune system. In industrialized countries, foods like flour or sugar have been fortified with it for decades. But it's not the same picture in some developing countries, where children with Vitamin A deficiency run the risk of dying from common childhood illnesses like measles. The cost of ensuring all children receive enough Vitamin A is peanuts: capsules cost just 2 cents each, but improve children's chances of survival by as much as 25%.
This episode of Life looks at the prospects for two very different Vitamin A distribution programs in Ghana and Guatemala, and asks whether the best way to ensure all children have access to the nutrients that can help them lead healthy, fulfilled lives isn't new, genetically-modified crops -- like the experimental Vitamin-A modified 'golden rice' currently being developed in Professor Ingo Potrykus' lab in Switzerland, as part of an initiative supported by the Rockefeller Foundation.
'Eleven million children under age 5 die worldwide each year from preventable diseases, yet only a few nonfiction films take on child mortality and its solutions...A-OK? Shows efforts to widely distribute vitamin A capsules to improve children's health in Ghana and Guatemala.' Sojourners Magazine
Tatham, Di (film director)
Tatham, Di (film producer)
Gawin, Luke (film producer)
Richards, Jenny (film producer)
Lamb, Robert (editor of moving image work)
Briers, Lucy (narrator)
Executive producer, Jenny Richards; series producer, Luke Gawin; series editor, Robert Lamb.
Distributor subjectsAfrican Studies; Anthropology; At-risk Youth; Biotechnology; Central America/The Caribbean; Death And Dying; Developing World; Economics; Food And Nutrition; Geography; Global Issues; Globalization; Health; History; Human Rights; Humanities; Hunger; Latin American Studies; Population; Social Justice; Sociology; United Nations
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Previously in Life…
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We can develop (inaudible) society economically,
financially if don\'t have good health.
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There\'s a real danger that we are
actually undermining the next generation.
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There are still 32,000
children under the age of five
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dying every day across the world from totally
preventable causes, totally preventable.
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Blindness and eye disease have long
been linked with lack of Vitamin A,
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far less well known is the road it plays in
children\'s resistance to common childhood illnesses.
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Without enough Vitamin A in their bodies,
children can\'t fight off respiratory infections,
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diarrhea, or measles. Two million
die every year as a result.
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In northern Uganda, before the
introduction of routine immunization,
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and Vitamin A distribution schemes,
children regularly ended up in hospital.
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At one stage, I was keeping the children\'s ward
and routinely daily we sign the certificates
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for children dying from measles, from…
from malaria, from diarrhea regularly.
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And I felt that well, and… and half of the
ward was full of nothing but measles cases.
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And we took up the challenge
into going to public health,
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and within five years of concerted effort,
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we\'re able to reduce the
incidence of measles annually
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from what 25 to 30,000 in
the northern region alone
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to less than 5,000 a year. In public health,
our concern is preventing these diseases.
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And Vitamin A provides
us with that opportunity
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in strengthening their
resistance to disease.
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Since 1996, the Canadian government has provided a
billion Vitamin A capsules through a UNICEF program.
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National Polio Immunization
and Child Health Days
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provide a vital thread in the Vitamin A distribution network
which now reaches nine out of ten children in the country.
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In the northern region, volunteers
distribute capsules to under fives
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and mothers of newborn babies.
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You know farming depends on the rain. So once
the rain start, I start work on the farm,
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but when it ends, I can
do this volunteer work.
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It is role as vital, while the donation of capsules
is key to the Vitamin A distribution program.
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It\'s continuing success relies heavily
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on the goodwill of Iddi and volunteers like him.
As he a mirthful believes that it will continue.
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These village volunteers were
already given health services.
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They were involved in the Guinea
Worm Eradication Programme.
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And, of course, the health uh… workers are part
of the health delivery system. And therefore,
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I already going into the communities
and I interact with these children.
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Teachers are also part of the Guinea education
service. So it is existent structures
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couple with an intensive information,
communication, and education programme
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to ensure that our target of
population also constantly
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reminded of the importance to go
for capsules by not only that,
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but also eat Vitamin enriched foods.
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Vitamin A is found in variety of sources,
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dairy foods, fish and liver,
dark green leafy vegetables,
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fruits like mango and
papaya, and red palm oil.
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But the price of some of these foods, as well as their
availability make changing traditional diets a slow process.
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The challenge after the supplementation. They had challenge is
to find out whether it can become a regular part of their diet.
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And that comes with a
change in uh… the cultural
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habit of what they eat, and
how they prepare their food.
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You remember the last time we came, and one
with prepared porridge we added palm oil,
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and we made it in the chief\'s house. This is palm
oil. And we bought some fish and meat as well.
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We bought some vegetables so
you could use that as well.
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You can choose either.
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And we try to teach them to use food we\'re
cooking. And one of these was preparing porridge
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and then adding red palm oil.
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And this a new turn to both
of the (inaudible) because
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under (inaudible) they think
porridge goes with sugar.
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But because I wanted to encourage the (inaudible)
to give more or vitamin enriched things
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to get children, we introduced the
foliage with red palm oil to them
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We try to encourage the (inaudible) to also
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eat more green leafy vegetables.
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we find out that these leaves are available in
the village. They normally dry these leaves,
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not eating them very phrase. So we encourage
them to prepare the leaves in their green form
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which I mean, will help to
improve upon their Vitamin A.
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In another part of the world, in Guatemala,
they\'ve come up with a different solution.
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They use sugar to deliver
synthetic Vitamin A.
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It was the fight to save children\'s eyes that drove doctors
to embark on a rocky road to government legislation,
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and get the sugar industry to agree.
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It came to points sometimes like they…
some… some guy came to me and said,
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\"Listen, how many cases you have
now?\" Okay, how much does it cost
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to get corneas and to transportation?
Okay, how much?
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Well, right now about $260,000 I mean can sell
us which that time was dollars in the one way.
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And he says, \"Okay, when we\'re
going to give it to you? But stop
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trying to fortify sugar. That\'s much
more expensive.\" Well, I got you.
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There people can to that point
in… in fighting back one single
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and chip measure of public health.
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And uh… of course, you know, what
we did was just to announce it
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because it was terrible.
And it was a change
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that what I mean I was going to be pioneer.
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Although fortification of sugar
started in 1974, it was sporadic.
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It wasn\'t until the 1990s that the sugar
industry had finally accepted that they too
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had a responsibility to public
health across the country.
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I went to all the sugar mills. And I took
samples from the children that live there,
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and I showed them the result
with their own children.
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It was like the… the children in the family. And
they knew that they were (inaudible), they knew uh…
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that they were improving on that. And then
there was a big fight after that because
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money was concerning. And another one we\'re
talking about $30 million worth of Vitamin A,
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it was a large amount of money.
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And umm… Just by chance
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uh… I saw the figures on how much
they were selling, and what amount?
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It was a huge amount of money.
And we thought and look
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if you sell this much, this is nothing for you. It\'s a
fraction of one percent of what you\'re going to spend there
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and the benefit will be so large
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that you may as well be nice and often
do it. And they bought the idea
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that I never thought that I was
going to be so much impact.
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Even though I believed in
fortification, and I thought that
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the eyes were going to be the ones
that really would get uh… healthier.
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But to know what you see
statistics in Child Survival.
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Unfortunately, we see now, also around
the world where it has been used
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that this is the main wall
that we get from Vitamin A.
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These preventive missions
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which can reach a very large
population with children
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definitely will save money because… because
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when you see a child like
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just looking into blindness,
a child that goes blind.
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How much does it cost to the state
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if they are going to have
40, 45, 60 years of life
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that would be really very
expensive for the society?
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There is some western criticism
of sugar as a Vitamin A carrier.
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But Guatemalans claim fortifying sugar
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is the best way of reaching the maximum number of people
because it\'s such a basic part of the national diet.
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But it doesn\'t reach everyone.
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With such a scattered population
in rural areas in particular,
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one in five Guatemalans miss out and they\'re
usually those living in the poorest conditions.
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The most usual problems we have with the
children here are respiratory problems,
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diarrhea and intestinal parasitic infections.
These are the most frequent problems we see.
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The longer time goal is food.
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Just improve the quality of food
of the people, to improve the diet
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with the… with that they shouldn\'t
have any problems or anything.
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You know, but this is a big order, eventually,
may happen, but it is a big… big order
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because you may go to places where you see that
the people are so poor and they cannot do much,
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and the conditions of soil are
so extremely poor so that
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only very few things that they can grow. The steel
if they could improve on that they could work.
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The Charity Action Aid
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works with many people in developing countries. And it agrees
that food is the long term solution to Vitamin A deficiency.
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No single micronutrient
deficiency exists in isolation.
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Most of the people who suffer from Vitamin
A deficiency, also suffer from all other
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types of deficiencies say in lodine, etc. So a
food based strategy is a much more integrated way
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of tackling the problem. In addition, I think uh…
if you\'re talking about food based strategies,
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you\'re also dealing with locally available
foods, and you can… you can uh…
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make it appropriate to local
dietary habits, and patterns.
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Bangladesh\'s a celebrated example of where this is seems to
be working at a very large scale, almost three million people
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covered with uh… small scale kitchen
gardens, and not just for people with land,
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but even for landless people using embankments
uh… you know, common… common land,
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as well as uh… poultry, for example.
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Plant Bio-technologist Emeritus Ingo Potrykus doesn\'t
believe the existing Vitamin A programs are enough.
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He\'s devoted the last 10 years of his professional career to
developing genetically modified rice that contains Vitamin A.
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In 1999, he grew the first
successful golden rice.
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The beauty of umm… genetic
engineering is that the
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entire technology is built into the seed.
And if the farmer gets one seed,
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he can go up to seed,
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one plant produces about thousand seeds.
It can go thousands plants.
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And then you can produce fields and
fields and fields. This is technology.
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This is (inaudible) anybody, any license
or feeling responsible to anybody.
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Today, the technology has
cost $2.6 million dollars.
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The Rockefeller Foundation which funds many sustainable
agriculture programs in developing countries
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also funded the initial
research into golden rice.
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I don\'t understand it\'s still the best one it\'s one
of a whole range of things that we have to do.
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We have to uh… supplement
as I\'ve said already.
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We have to increase the range
of foods that people eat.
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Uh… Those are the kinds of things we have
to do. But I think that the Vitamin A rise
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will in particular get to poor families uh…
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in more remote places.
How will that happen?
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Well, lot of them grow it themselves or they\'ll be able to purchase it, but
uh… in the… in the most remote places, we would expect that they would…
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the rice that they grow would be the Vitamin A rice. And
then anyway, they would grow that rice for their children.
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Our biggest concern is umm… the extent
to which people themselves are involved
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in the process of deciding whether or not,
you know, it should go ahead. Umm… and
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we have… we have… we\'re also dealing with a
great deal of uncertainty about the health,
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and social, and environmental effects of uh…
golden rice. We don\'t really know enough about it.
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And of course, there\'s this very
practical question of, you know, as to
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where the people would be, you know, particularly in South
Asian, Southeast Asia which are the big rice consuming bears
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as to where the people would want to go in for a sort of yellow tainted
rice when they way used to dealing with, you know, polish rice.
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Now which is very white
and colors, you know.
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My possibilities do not go
beyond offering for free
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is our (inaudible) what we have produced.
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If uh… Some people decide as they
want blind children and white rice,
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it\'s their decision. I\'m offering
a possibility of yellow rice
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and uh… no blind children.
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What\'s the decision about
people want, it is \"yes\".
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Seventy patterns owned by some 32 companies, and
institutions have been used in developing golden rice.
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But Ingo Potrykus is confident after
a difficult year of negotiations
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that farmers won\'t have to
pay for this technology.
00:16:05.000 --> 00:16:09.999
Now as we have regional state where we have
(inaudible) agreement of all important
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pattern told us to give free
license as for this purpose.
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I\'m (inaudible) so that uh… the farmers will get
this material free of charge and free of uh…
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any kind of obligations, uh…
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any uh… dependencies from anybody.
00:16:30.000 --> 00:16:34.999
Astra Zeneca is going to do all the bio-safety
testing. And he\'s going to get the pattern sorted out.
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And it was promised that the uh… Vitamin
A rise, and the Vitamin A technology
00:16:40.000 --> 00:16:44.999
will be available for uh… plant breeding
institutes in developing countries,
00:16:45.000 --> 00:16:49.999
in the Philippines, and in
Durham, Bangladesh, and so on.
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Uh… And I believe it will do that. And that\'s what it said
it will do. But of course, we have to keep the pressure on.
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Uh… There should be a spotlight shown on
those companies, and uh… that\'s where
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I think activists are particularly important role to play is
to make sure that multinational developed their promises.
00:17:05.000 --> 00:17:09.999
Ultimately, the whole debate on umm… GM uh…
00:17:10.000 --> 00:17:14.999
and Vitamin A rise is not any different in that
sense, is… is a debate about control, and dependency.
00:17:15.000 --> 00:17:19.999
And uh… you know, for example, we
understand that a lot of the uh… rice
00:17:20.000 --> 00:17:24.999
which has been year marked for Vitamin
A uh… sort of modification are ones
00:17:25.000 --> 00:17:29.999
which are also dependent on Agro-chemicals,
and irrigation. So the whole, you know,
00:17:30.000 --> 00:17:34.999
the… the problem of shifting control from poor
farmers to larger corporations, and forces
00:17:35.000 --> 00:17:39.999
beyond their control is a big concern. And uh… and
it\'s… it\'s almost like a vertical chain of dependency
00:17:40.000 --> 00:17:44.999
that\'s created every time the whole
new technologies introduced.
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I want to say that we are not at all against
technology in… in an absolute sense,
00:17:50.000 --> 00:17:54.999
obviously, not I mean, technology has brought many benefits. But
at the same time, you know, we are very concerned as to, you know,
00:17:55.000 --> 00:17:59.999
where the poor farmers will
keep losing control over time.
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During cleaning, poor farmers themselves in the
global debate on genetically modified crops,
00:18:05.000 --> 00:18:09.999
actually set up an unprecedented meeting in southern
India this year. Scientists, government officials,
00:18:10.000 --> 00:18:14.999
NGOs and biotech corporations
sat down with the farmers
00:18:15.000 --> 00:18:19.999
to discuss a full range of
issues on food security.
00:18:20.000 --> 00:18:24.999
So what we are saying is probably we\'re selecting the very elite
plants and multiplying by this kind of methods of tissue culture.
00:18:25.000 --> 00:18:29.999
Maybe, you can… farmer can have
plantations which are of better quality.
00:18:30.000 --> 00:18:34.999
So this… our experimentation shows there\'s
a great potential in this technology.
00:18:35.000 --> 00:18:39.999
On the key part of traditional
seeds in my village
00:18:40.000 --> 00:18:44.999
when people need them, they come to me because
I have varieties of seed no one else has.
00:18:45.000 --> 00:18:49.999
In the future, I want to conserve
even more varieties of seed.
00:18:50.000 --> 00:18:54.999
Now a stage has been reached when the
farmers will have either to spray
00:18:55.000 --> 00:18:59.999
or they will have to pray. So we
have reached such a situation today.
00:19:00.000 --> 00:19:04.999
Now it is during this situation
00:19:05.000 --> 00:19:09.999
that the transgenic technology seems to
have come for the rescue of the farmers.
00:19:10.000 --> 00:19:14.999
When the Green Revolution came, you
said it was a safe technology,
00:19:15.000 --> 00:19:19.999
but soon we had a lot of problems with the
pollution. Now you say biotechnology is best.
00:19:20.000 --> 00:19:24.999
How can we be sure that after 10 years,
00:19:25.000 --> 00:19:29.999
it will not backfire in a similar way,
and we will again be the victims?
00:19:30.000 --> 00:19:34.999
We are not people who are saying that let\'s go
back to nature. Let\'s not use modern technology.
00:19:35.000 --> 00:19:39.999
We\'re saying that use
technology very carefully
00:19:40.000 --> 00:19:44.999
in line with principles which
maintain the ecology of the region,
00:19:45.000 --> 00:19:49.999
and also technology in
control of the people.
00:19:50.000 --> 00:19:54.999
Most of the jury wanted
to stop, put to GM crops
00:19:55.000 --> 00:19:59.999
until extensive field trials have been
carried out for at least five or ten years.
00:20:00.000 --> 00:20:04.999
Since we have the real practical knowledge, farmers like
me should be made active participants in these trials,
00:20:05.000 --> 00:20:09.999
not only in yield
assessments, but in safety
00:20:10.000 --> 00:20:14.999
environmental and other aspects.
00:20:15.000 --> 00:20:19.999
We think that in relation to Vitamin A rice, it\'s very
important that we go through these kinds of processes
00:20:20.000 --> 00:20:24.999
at… at a reasonably large scale where people
themselves can give their views on it.
00:20:25.000 --> 00:20:29.999
And that\'s why, you know, increasing the awareness
of people who themselves of their own rights,
00:20:30.000 --> 00:20:34.999
I mean in… in this context, I mean the rights we\'re talking
about uh… for example, the right to have a choice,
00:20:35.000 --> 00:20:39.999
a real choice, not monopolis in
agricultural markets, is a… is a real right
00:20:40.000 --> 00:20:44.999
which… which gradually people are losing
out on uh… a right to uh… you know,
00:20:45.000 --> 00:20:49.999
have uh… self-reliance, you know, to depend on themselves,
rather than depending on… to depend on other people,
00:20:50.000 --> 00:20:54.999
the right to access to land. These are the types of rights
which people have to be aware of and start claiming.
00:20:55.000 --> 00:20:59.999
Uh… There\'s no shortcut, I don\'t think.
00:21:00.000 --> 00:21:04.999
Another very key factor in relation to Vitamin A deficiency, as
you know, is whole question of water, sanitation and hygiene
00:21:05.000 --> 00:21:09.999
because uh… if we introduce Vitamin A
00:21:10.000 --> 00:21:14.999
and people are unable to absorb it because of
poor water, sanitation, and diarrheal conditions.
00:21:15.000 --> 00:21:19.999
Umm… There… there cannot be a solution
which is, you know, in isolation.
00:21:20.000 --> 00:21:24.999
We are going to have to do umm…
00:21:25.000 --> 00:21:29.999
the right kinds of tests, health tests, environmental
tests. And that\'s what will now be done
00:21:30.000 --> 00:21:34.999
to ensure that this is going to be
as safe as one could make it. Uh…
00:21:35.000 --> 00:21:39.999
I think it will come out uh…
pretty sights what I can make out.
00:21:40.000 --> 00:21:44.999
Do you have any concerns about the uptake of Vitamin
A from the golden rice, five people only make rice?
00:21:45.000 --> 00:21:49.999
Well, I\'m not sure about that. I mean, I think that\'s
the kind of health tests that have to be made.
00:21:50.000 --> 00:21:54.999
But umm… the health experts have looked out
at the moment, don\'t seem to be concerned,
00:21:55.000 --> 00:21:59.999
but we… we need to look at that more.
00:22:00.000 --> 00:22:04.999
Ingo Potrykus is aiming to distribute the golden rice
to plant breeders, and farmers in the next three years,
00:22:05.000 --> 00:22:09.999
and he\'s not content with just rice.
00:22:10.000 --> 00:22:14.999
We got that patent producing uh… poor
Vitamin A containing cold plans,
00:22:15.000 --> 00:22:19.999
not only rice. Beyond
(inaudible) helping to
00:22:20.000 --> 00:22:24.999
transfer the same type and to reap until
African white males depend on them,
00:22:25.000 --> 00:22:29.999
say potato, cassava, avocados.
In 10 years from now,
00:22:30.000 --> 00:22:34.999
say maybe, uh…
00:22:35.000 --> 00:22:39.999
how\'s it made us stay (inaudible) and
poor if disregard to (inaudible) applied.
00:22:40.000 --> 00:22:44.999
If it took him about let\'s say the next five to ten
years, umm… they\'re very concern that, you know, the…
00:22:45.000 --> 00:22:49.999
the other technologies for dealing with Vitamin A deficiency,
or for dealing with nutritional deficiency generally,
00:22:50.000 --> 00:22:54.999
is…are not lost in the meantime.
00:22:55.000 --> 00:22:59.999
And that adequate investments which are made uh… in…
in the whole question of sustainable agriculture,
00:23:00.000 --> 00:23:04.999
public health, water, and sanitation, you know, all of
which affect the nutritional status of poor households.
00:23:05.000 --> 00:23:09.999
Gordon Conway agrees
there\'s no magic solution.
00:23:10.000 --> 00:23:14.999
He believes that all avenues
have to be explored.
00:23:15.000 --> 00:23:19.999
Phenomena is by farther most
important to the deficiencies.
00:23:20.000 --> 00:23:24.999
We\'re talking about millions of children a year
are dying because of Vitamin A deficiency.
00:23:25.000 --> 00:23:29.999
It\'s not just the fact that many of them go blind, it\'s
a fact that they die because they don\'t have resistance
00:23:30.000 --> 00:23:34.999
to umm… disease it. What we discovered, I mean,
discovered this only about 10 years ago,
00:23:35.000 --> 00:23:39.999
is that children who get uh…
a diarrhea or infection
00:23:40.000 --> 00:23:44.999
tend to die, if they don\'t have
a good supply of Vitamin A.
00:23:45.000 --> 00:23:49.999
And that was the discovery that made
everybody concentrate on Vitamin A.
00:23:50.000 --> 00:23:58.000