Case study 1 Benin

In 2016 and 2018 PAN UK and Organisation Béninoise pour la Promotion de l’Agriculture Biologique (OBEPAB) undertook surveys of cotton farmers and a series of consultations with farmers, clinicians and epidemiologists. The purpose was to understand the scale of the problem of pesticide poisoning among cotton farmers and to determine how much information on incidents of pesticide poisoning reaches national authorities and decision makers. The questionnaire was developed in close collaboration between PAN UK and OBEPAB and in consultation with four cotton farmers from Glazoué area (who helped to refine the questions). In addition to the questionnaire, the team used group discussions and semi-structured interviews with a variety of stakeholders in order to elicit more information and verify survey results. Country: Benin Partner Organisation: OBEPAB Years conducted: 2016 and 2018 Number of participants: 493 (2016) and 507 (2018)

Description of participants:

6 6 6 6

6 Aged over 18 Smallholder farmers growing cotton Working on their own family’s land (not paid farm workers) 41% selected farmers were organic and the remainder were conventional cotton farmers in both surveys 36% participants were women in both surveys

Location: Two locations in the North of Benin (Kandi and Sinende) and two further South (Glazoué and Djidja).

Protective equipment

During a group discussion, cotton farmers reported that they usually have training on the use of pesticides and protective equipment, but the protective equipment is not provided and farmers struggle to find Personal Protective Equipment (PPE) in local shops or other outlets.

Results for conventional farmers only

6

6 6

6 % pesticide users reporting acute pesticide poisoning (APP) in previous 12 months: 42% in 2016 and 51% in 2018. % farmers missing days’ work due to APP: 21% in 2016 and 9% in 2018.

Number of incidents in previous 12 months:

In 2016, 32% of farmers experienced multiple APP. 17% farmers reported six or more incidents in the previous 12 months. In 2018, 20% conventional farmers reported suffering six or more incidents in the previous 12 months. Signs and symptoms reported by farmers reporting APP: The types of symptoms experienced by farmers included localised reactions such as eye irritation/inflammation (93% of farmers suffering symptoms) and skin (91%) irritation. A high proportion of farmers

6 also experienced systemic reactions such as blurred vision (51%), general weakness (46%), tremors (34%), insomnia (34%), vomiting (9%), memory loss (3%) and convulsions (2%). Doctors and farmers consulted in interviews and group discussions (not the survey) also reported severe rashes and skin lesions and sexual dysfunction, which they associated with pesticide exposure. The rashes and lesions commonly seemed to be associated with leaking backpack sprayers resulting in heavy exposure of skin on the back and groin. % seeking medical attention: in the 2016 survey 13% of affected farmers said they went to medical facilities for treatment by qualified practitioners, while 48% bought medication from an unqualified person.

Photo: Cotton farmer, Aziadougan Tadogbe Calixte, reports a deformity of his little finger that occurred after repeated exposure to a pesticide he uses in cotton farming. Credit PAN UK

Pesticides reported by farmers in 2018

Group discussions with conventional cotton farmers in 2018 were used to identify common pesticides in use. The trade names were investigated afterwards to determine the active ingredients and other attributes.

TABLE 2. PESTICIDES USED BY COTTON FARMERS, REPORTED IN GROUP DISCUSSIONS IN 2018

PESTICIDE (ACTIVE INGREDIENT)

Chlorpyrifos Cypermethrin Emamectin benzoate Endosulfan Glyphosate Lambda-cyhalothrin Profenofos Acetamiprid Fluometuron Prometrine

PESTICIDE FAMILY

organophosphate pyrethroid emamectin organochlorine Phosphanoglycine (OP) pyrethroid organophosphate neonicotinoid Phenylurea herbicide Triazine herbicide

Post-registration monitoring (information from results of surveys and consultations)

Doctors and farmers told us that most incidents of pesticide poisoning are not reported to medical services. When people suffering from acute pesticide poisoning do seek medical attention, the health facilities are not equipped to analyse human samples and it is usually impossible to determine which pesticide has caused the problem. Incidents may be recorded in hand-written hospital case notes but there is no way of collating these incidents for monitoring purposes. Generally, the incidents that are reported to a higher level within the health service are limited to incidents of mass poisoning by ingestion. This sometimes occurs in families where bottles of pesticides are mistaken for cooking oil and there have been similar incidents in restaurants too. Fatalities due to pesticide poisoning do occur, but there is no system of collating information of this type. Consultations revealed a lack of awareness among higher level decision makers of the serious health impacts being suffered by cotton growing communities in Benin. A lack of monitoring systems likely contributes to this.

Conclusion, Benin studies

The results of all the studies and consultations indicate that conventional cotton farmers in Benin are frequently exposed to HHPs under poor conditions of use. They are using HHPs without protective equipment and a high proportion of farmers are suffering signs and symptoms of pesticide poisoning. Many farmers suffering multiple incidents every year. The impacts of acute pesticide poisoning can be severe. The scale of the problem also suggests a large and unquantified problem of chronic exposure. The majority of such incidents are invisible to health services and decision makers, although there is a high level of concern among medical practitioners with direct experience in the cotton-growing areas.