Agrochemical Use in South Africa: The toxicological and sociological impacts of agrochemicals on susceptible populations in South Africa’s agricultural sector By: Sarah Marquis ENSC 501: 2013 Primary Supervisor: Dr. Louise Winn Secondary Examiner: Dr. Gary VanLoon March 22nd, 2013 2 Table of Content Abstract 4 Introduction 5 The South African Agricultural Sector 10 Historical Influences 11 Agrochemicals Used in the South African Agricultural Sector and Their Health Impacts 14 Acute and Chronic Toxicology 16 The Importance of Cholinesterase 17 Obsolete Pesticides 18 Susceptible Populations: The Low Income Farmer 20 The DOP System 20 The Perspective of the Farmer: General Awareness of Negative Impacts of Agrochemicals and Safety Practices 21 Personal Protective Wear 22 Pictograms as a Risk Communication Mechanism 23 Gender Differences and the Sexual Division of Labour in the South African Agricultural Sector 24 Reducing Agrochemical Poisoning: The Importance of Education 30 Sustainability in South African Agriculture - A Possibility? 32 Alternative Agricultural Systems and Integrated Pest Management (IPM) 33 3 Conclusion 34 Acknowledgements 38 References 39 4 Abstract The purpose of this paper is to explore the influences and impacts of South Africa’s use of agrochemicals in its agricultural sector. South Africa has a rich history, and some of those historical influences, such as apartheid and the subsequent capitalization and industrialization of the agricultural sector are relevant to the subject of agrochemical toxicity. The paper then explores the different types of agrochemicals used in South Africa. Different types of pesticides have differing levels of toxicity, and the adverse health impacts of high exposure are varied. Furthermore, I look at obsolete pesticides as a major problem in South Africa, and the need for a method of disposal of these chemicals. The paper explores susceptible populations who are harmed by the excessive use of agrochemicals. The low income farming population is at a high risk for agrochemical poisoning, due to a severe lack of knowledge and communication of the health risks involved with agrochemical use. Furthermore, I discuss the evolving roles of women in the South African agricultural context, including the fact that female farmers are often at a higher risk for unhealthy pesticide exposure, and are a population that is being marginalized through lack of proper safety education and training. The paper concludes by exploring different ways to reduce agrochemical poisoning, such as the implementation of education programs and pesticide safety programs. Alternatives to high input agriculture are also discussed in terms of sustainability. Integrated pest management (IPM) is a promising alternative as it stresses the need to use agrochemicals sparingly. Also, IPM is a proven method to educate and empower the farmer. The model of agriculture in South Africa is unsustainable, and the system needs to change. 5 Introduction South Africa’s unique and diverse environment is home to around 50 million people. Its agricultural system is complex since it has been impacted by the highly influential apartheid era, from which the entire country is still recovering. For a long time, the agricultural system was divided between large-scale white commercial farms and black smallholder farms (Rother et al. 2008). Commercial farms are profit-based, whereas smallholder farms are of a smaller size, and usually support a single family. But now, as the country emerges from the era of apartheid, a new class of emerging farmers is coming to light: black farmers who are entering into the commercial system. Meanwhile, pesticide use in South Africa is growing. Pesticide use in most developing countries is becoming an increasingly serious environmental problem due to factors such as water contamination, ecosystem disruption and habitat contamination. Agricultural pesticides, in particular, can be very harmful to the people who are interacting with them on a regular basis. The unsafe application and interaction with these agrochemicals can have negative health impacts upon emerging farmers, chemical applicators on commercial farms and on smallholder farms. South Africa’s increasing dependency on pesticides is alienating some of the most important people within the agricultural system. This situation is leaving various groups within South Africa’s population to be highly susceptible to the health impacts of pesticide use, most notably female farmers. Gender inequalities within the system are becoming increasingly apparent as the role of women within agricultural contexts is evolving. Women always played an important part in agriculture, yet recently, they are taking on more responsibilities that used to be considered exclusively male (Naidoo et al. 2011). 6 It is important to explore the reasons why pesticides are used to such a high degree in South Africa. Detailed data on the specific amounts of pesticides imported into the country or produced within the country are scarce. Yet, in 2002, statistics showed that 10 000 kl of liquid agrochemicals were produced within the country, of which 43% were organophosphates, a type of agrochemical that can be quite toxic. In addition to domestic production, South Africa has importation partnerships with countries including the United States, Australia, Germany and China (Quinn et al. 2011). Factors driving the country’s high-input agriculture are rooted in the political and socio-economic atmosphere in the country. The government is encouraging the commercialization of the emerging agricultural sector with the goal of economic growth. Furthermore, the government is the driving force behind the desire for higher agricultural yields and a generally higher level of production within all agricultural systems in the country. The consequence is that farmers are becoming increasingly dependent on pesticides, so as to transform their farms into profit and production-oriented businesses, rather than simply a subsistence farm, which are farms or gardens that exist to sustain single families (Rother et al 2008). The agricultural labour force has been shaped by both race and gender issues, which is why it is necessary to not only look at the residual impacts of the apartheid era on the agricultural sector in South Africa, but it is also necessary to fully deconstruct the gender differences that are ubiquitous in the agricultural labour system throughout the country. Rural women working on mainly commercial farms demonstrate these dualities of gender and race. Usually, female farmers are given informal work on commercial farms, resulting in a lack of health services and training (London 2001). This creates a 7 higher risk of occupational hazards for this population. This example is simply one way in which the risks involved with pesticide use are contributing to the marginalization of susceptible populations. The negative impacts of pesticides are exacerbated by the lack of training received by small scale and emerging farmers. The lack of education within this industry is especially apparent in some farm systems where agrochemical applicators cannot read the labels on the pesticide containers. High rates of illiteracy, especially in rural populations and within the population of female farmers, is seemingly not taken into consideration by pesticide companies, nor the South African government. This paper explores the different kinds of pesticides used in South Africa, and their specific toxicological impacts. Many different types of pesticides are used on emerging and commercial farms throughout the country. The chemicals may also be used on subsistence farms as well, but amounts used are usually dependent on access and affordability of the chemicals. On emerging and commercialized, profit-based, farm systems that grow crops intended for sale, however, diverse pesticides are used, which can have a variety of health impacts on farm labourers (Rother et al. 2008). The chemicals used include insecticides, herbicides, and fungicides. Insecticides are subcategorized into pyrethroids, organophosphates, organochlorines, and carbamates. Herbicides include the triazoles and the phosphonates. The fungicides include the dithiocarbamates, copper compounds and sulphur compounds. The diverse chemicals are used to varying degrees within agricultural systems, and they are categorized by the biological mechanisms by which they interact with the crop. They also differ in the way they interact with the human body, and thus levels of toxicity differ between each 8 chemical (Rother and Jacobs 2008). Furthermore, there remains the issue of obsolete pesticides that are banned by the government, but are still present throughout agricultural systems in South Africa (Dalvie et al. 2005). Toxic levels of exposure to most of these chemicals can result in a variety of adverse health effects. For example, the acute toxic effects of organophosphates have particularly severe consequences, including respiratory depression, slowed heartbeat, toxic psychosis and convulsions among many other symptoms (Rother and Jacobs 2008). The danger of these types of chemicals is only enhanced by the lack of protective measures that are used by farm workers and chemical applicators. Protective wear is often expensive and in some cases, farm labourers have not been trained and thus do not know the protective measures necessary for the use of these types of dangerous chemicals. It is becoming evident that pesticide regulations need to be enforced in all developing countries, not just South Africa (London and Bailie 2001). Regulations need to take into consideration the presence of dangerous pesticides. Evidence suggests that unhealthy human exposures are a result of the unregulated use of agricultural chemicals. Training programs also need to be looked into by the South African government as a valid option to protect its lower class farm labourers from agrochemical poisonings. A large study, spanning 24 countries examining the health impacts of pesticide use on over 6300 small-scale, non-commercial farm systems, produced some interesting research on the difference between pesticide poisoning in developed countries as opposed to developing countries (Tomenson et al. 2009). They found the incidence of adverse health effects due to pesticide exposure very low in most countries, yet African countries showed a "disproportionate number of incidents". The authors cite numerous reasons why 9 this might be the case, including the failure to use appropriate equipment, or lack of knowledge about the method of use of the pesticide. Evidently, the risk of pesticide exposure is a significant issue in developing countries, especially South Africa, one of the biggest importers of pesticides in Africa (Quinn et al. 2001). This risk is distinctly higher for female farmers, who are taking on more and more responsibility in the agricultural sector, especially in the rural areas of South Africa (Naidoo et al. 2008). It is estimated that, in South Africa, women make up 70% of the total labour used in farming activities. Throughout sub-Saharan Africa, women contribute to the food systems by producing 60%-80% of basic foodstuffs (London et al. 2002). This evidence not only suggests a dire need for more research into this area of study, but it indicates that agrochemicals are heavily depended upon in not only developed countries, but developing countries as well. The consequences, however, are more severe in developing countries as there is quantifiable evidence that pesticide exposure is having a negative impact upon susceptible populations throughout the developing world. A report by Jeyaratnam (1990) estimated 25 million occupational pesticide poisonings each year in developing countries. Regulations need to be formed upon this basis, and enforced efficiently and effectively. The evidence also suggests the need for access to education and new training programs within the sector. South Africa is one of the largest importers of agrochemicals in Africa, and this fact demonstrates the country’s growing dependency on pesticides (Quinn et al. 2011). The agricultural sector is contributing to the support of the domestic population, but attempting to increase yields so as to increase exportation. To increase yields, more pesticides are used. Furthermore, the increasing encouragement of the government to 10 produce more, and develop emerging farms into commercial farms is also a driving force behind the agricultural sector's dependency on pesticides. The sector’s reliance on agrochemicals is causing problems that arise when emerging farmers transition into developing commercial farms without the proper training, education and management skills (Quinn et al. 2011). The negative health impacts of agrochemical use in South Africa may be an indicator that the sector is becoming dependent on this new form of technology at the expense of marginalized populations, such as female farmers, and labourers without proper training. New agricultural systems should be researched such as conservation agriculture systems, which are agricultural systems that attempt to conserve both resources and the environment, and integrated pest management systems (IPM). These systems may be essential to avoid the many negative impacts of a dependency on a technology as hazardous as these dangerous agrochemicals. The South African Agricultural Sector South Africa does not have an abundance of arable land, and so it is important to be able to produce as much as possible with the little land available. 12% of the country is appropriate for the growth of rain-fed crops and only 3% of the total land in the country can be considered high-potential arable land (Goldblatt 2010). Production varies between different crops, but maize is one of the most important crops grown in the country, with a large portion of farmland being dedicated to the growth and harvest of this product. Exported products include a large variety of deciduous fruits, such as grapes 11 (and hence, wine), and other horticultural crops such as bananas, cotton, palm oil, pineapple, rubber, and sugar cane (McIntyre et al. 2009). Figure 1 shows the geographical areas in which specific crops are grown throughout the country of South Africa. Figure 1: This figure shows the different crops that are grown in South Africa and it also shows the geography of land use throughout the country. Historical Influences: The Apartheid Era One of the most important factors of the agricultural sector in South Africa is the impact of apartheid on land distribution in South Africa. During the apartheid era, which 12 lasted from 1948 to 1994, the government implemented policies that lead to the systematic racial segregation of the country. One such policy declared that black South Africans were to be forced to relocate to the homelands, also known as the bantusans. These homelands were overpopulated and the farmland that was available was degraded quickly. The apartheid era contributed to uneven development and unsustainable agriculture. Its legacy, among many other things, is severe environmental degradation (Mather 1996). During apartheid and in the years following its dismantlement in 1994, commercialization and industrialization of the agricultural sector was especially rapid. The shift towards intensification in agriculture has been increasingly apparent in recent years (Rother et al. 2008). The amount of chemical fertilizer used on maize farmland has increased dramatically in the last 50 years; statistics show that in 1966, agrochemical use on maize averaged approximately 20 kg per hectare, and by 1981, it had increased to 100 kg per hectare (Mather 1996). Intensification of agriculture has also lead to farmers using land that is not optimal for crop growth. This not only increases the amount of agrochemicals used on the crops, but also is inherently unsustainable. Such practices have lead to fluctuations in agricultural yields in the maize industry, for example, which is having an impact on the livelihoods of farmers (Mather 1996). Two decades after the official dismantlement of apartheid, South Africa is still struggling with the land question. The government has set about to reform land distribution so as to reverse the racialized land dispossession that occurred during apartheid. The goal was to redistribute 24.6 million hectares of white-owned agricultural land by 1999. However, by the end of 2011, less than 7.2% of this land had been re- 13 distributed (O’Laughlin et al. 2013). The agricultural sector is undergoing a radical reconstruction, yet the social issues of racial segregation linger. The land reform policies are, however, giving way to the emerging farmer. Both land reform policies, however unsuccessful they seem to be, and the commercialization of the agrarian sector resulted in the appearance of a category of black farmers, who work beyond the subsistence level, and are attempting to move up into a fully commercial business. These farmers are known as the “emerging farmers” (Rother et al. 2008). The government is pushing commercial farming, and as a result high input agriculture, to increase agricultural yields of the country and boost the economic status of the country. The duality between the intensive farming sector and the subsistence, smallscale farming sector is a primary feature of the South African agricultural system. The commercial sector, primarily owned by white farmers, is divided from the small-scale sector, which is made up of mostly black farmers. Emerging farmers are forming a middle ground between the two industries (Hall 2004). However, the clear division of race in South Africa’s agricultural sector influences the marginalization of the lowincome black farmer. Furthermore, the commercial agricultural industry is having a significant impact on the use of agrochemicals by farm labourers on both commercialized farms and on emerging farms. The industry is playing a key role in both the marketing of these agrochemicals and the training of emerging farmers. Dependence on agrochemicals is considered a necessity by the industry, as representatives of agribusinesses and the government emphasize that high agricultural yields would be impossible without the heavy use of agrochemicals. In fact, one of the only qualifications required for an 14 emerging farmer to upgrade to commercial status depends on their use of agrochemicals (Rother et al. 2008). Most training programs that are available to emerging farmers that concern agrochemical use are provided by the Department of Agriculture or large agribusinesses. These programs usually stress the necessity for agrochemicals, and underplay their safety risks (Rother et al. 2008). South Africa’s dependency on agrochemicals is becoming evident as they are spending more and more money on their importation. South Africa is investing its economic and environmental future in agrochemicals, spending $268 million in 1990, and increasing expenditure to over $600 million by the mid 1990’s (Dalvie et al. 2009). Researchers have also noted that the mass of pesticides being sold to the biggest crop sectors in South Africa has been steadily increasing. Particularly dangerous agrochemicals like aldicarb, endosulfan and chlorpyrifos are still being imported into the country (Dalvie et al. 2009). These agrochemicals have been linked to developmental and neurotoxic effects in humans. Agrochemicals Used in the South African Agricultural Sector and Their Health Impacts Agrochemicals are made up of an active ingredient and inert substances, which can be solvents or surfactants. The active ingredient is the portion of the compound that destroys, or repels the pest. They are classified into different categories called the organophosphates, organochlorines, carbamates, organobromides, inorganics, phenoxy herbicides, insect growth regulators, and pyrethroids. The active ingredients, however, 15 sometimes impact non-target organisms, humans included. This occurrence can result in the intoxication of the non-target organism (Rother and Jacobs 2008). Agrochemicals can be classified into different categories. These categories include insecticides, herbicides, fungicides, rodenticides, fumigants, plant growth regulators and a miscellaneous category (this category consists of arsenicals) (London 1992). The agrochemicals that are most likely to be involved in acute occupational intoxications are the insecticides: most notably organophosphorus and carbamate ester agrochemicals (Ecobichon 2001). High exposures to agrochemicals can cause both acute and chronic health problems. Acute intoxications occur after short-term, yet very high, levels of exposure. Chronic impacts, however, are the consequence of much more long-term exposure. Chronic intoxication from agrochemicals can result in reproductive issues, carcinogenesis, neurotoxicity, immunotoxicity and hepatotoxicity. Toxicity testing in the laboratory does not take into consideration various factors that would make an impact on toxicity in South African farming environments, and thus represents a limitation in research. For example, toxicity of chemcials can be enhanced by dry, dusty and hot weather, especially if they are not stored correctly (London 1992). In certain systems, more than one agrochemical may be used at one time. The toxicity of two or more agrochemicals mixed together can change the nature and the health effects of the chemicals. Other factors include the concentration of the agrochemical in solution. One of the most important factors, however, is the frequency and intensity of exposures (London 1992). The combination of a hot climate together with the frequency and 16 intensity of exposure makes South African farmers more vulnerable to agrochemical toxicity. Acute and Chronic Toxicology Acute pesticide-related toxicological symptoms include skin irritation, dermatitis, cough, conjunctivitis, metabolic symptoms, and in extreme cases, fatality (London 1992). The majority of research on the subject of agrochemical toxicity has been done on acute pesticide intoxication, as fatalities due to intoxication are a social, environmental and health crisis in developing countries. Continued research into the danger of acute toxicity of pesticides is ongoing. Researchers have been studying an acute toxicity symptom called organophosphate-induced delayed polyneuropathy (OPIDP). It is a rare symptom, and, as the name suggests, caused by high levels of exposure to organophosphates. Researchers characterize the symptom by "distal degeneration of some axons in both the peripheral and central nervous systems occurring 1-4 weeks after single or short-term exposures." (Lotti and Moretto 2005). Related symptoms include muscle cramping, muscle pain, numbness, weakness, and in extreme cases quadriplegia. OPIDP can be caused by agrochemicals like chlorpyrifos, which is still used in South Africa, yet severely restricted in other, more developed countries (Dalvie et al. 2009). Research on chronic health impacts of agrochemical use is much less extensive (Ecobichon 2001). Many different kinds of agrochemicals, however, are implicated in chronic health impacts including carcinogenic and mutagenic effects. Proving a direct link between these agrochemicals and their chronic health impacts is not easy, however, 17 and more research is definitely required (London 1992). Researchers looking at the link between pesticide use and respiratory illnesses found a positive correlation between the two. They found an association between pesticide use and chronic bronchitis and associated respiratory illnesses, such as asthma (Hoppin et al. 2007). In 2012, Starks et al. found a positive correlation between pesticide exposure and adverse peripheral neurological symptoms, like motor coordination effects, changes in deep tendon reflexes, and reduced muscle strength (Starks et al. 2012). The Importance of Cholinesterase Cholinesterase is an enzyme found in the blood and plasma that interacts with a neurotransmitter in the human brain. It is essential to neurological activity, and without it, humans would suffer from neuromuscular paralysis, possibly resulting in fatality. Some pesticides are cholinesterase-inhibiting compounds. A range of different types of agrochemicals, such as the organophosphates, carbamates, organochlorines, pyrethroids and bipyridals inhibit the production of cholinesterase in the human body. As such, levels of cholinesterase in susceptible populations can be measured and pesticide exposures can be estimated using this information (Rama and Jaga 1992). Cholinesterase testing has proven to be a standardized measure of agrochemical exposure, especially in developing countries (Naidoo et al. 2010). Furthermore, cholinesterase testing can be supplied through local health care providers, allowing agricultural workers to know their levels of exposure (London and Bailie 2001). This development could mitigate the occupational hazards of pesticide poisoning by acting as a prevention measure. 18 Obsolete Pesticides Obsolete pesticides are highly toxic agrochemicals that have been restricted from use due to their toxicity to humans and the environment. They can no longer be used for their original purpose and they require disposal. Some time after the end of the apartheid era, the government, big agribusinesses, and environmental and humanitarian NGOs formed a partnership in the hopes of eliminating the use of obsolete pesticides from the agricultural sector in South Africa. This was in the best interest of all parties involved because the government was trying to boost the agricultural sector so it would be competitive in the global market. To do this, South Africa's food exports would need to meet pesticide guidelines of the countries to which it wanted to export. Thus, the National Retrieval Project was undertaken (Dalvie et al. 2006). However, simply because the pesticides were banned from use, there was a problem in that farmers, especially smallscale farmers, did not have the technology or the means to dispose of these stores of agrochemicals (Dalvie et al. 2008). A study that was conducted in 2005 followed up with the National Retrieval Project's attempt to eliminate these pesticides from the agricultural sector. They found that the pesticides had not been disposed of properly and were, in most cases, being stored on the premises of the farm. These researchers studied an area called Stellenbosch in South Africa, and surveyed a total of 75 farms in the area. More than half of these farms were in possession of obsolete pesticides and furthermore, the farmer could not identify 30% of the obsolete agrochemicals that were found on the premises (Dalvie et al. 2006). 19 These conditions demonstrate the problems associated with obsolete pesticides. Farmers may not even be using these pesticides directly on their crops, but they are rarely stored in the proper manner and thus the risk of exposure is very high for the labourers working in close proximity to these stores. Furthermore, the containers can leak, making the entire storage space hazardous. Leakages could also affect water sources and the surrounding environment, both of which would increase the risk of high pesticide exposure to humans and the environment (Dalvie et al. 2008). This situation is the result of many different factors. First of all, obsolete pesticides are still imported into South Africa, and aggressively marketed by the chemical industry (Dalvie et al. 2009). Large agribusinesses are pressuring small-scale, emerging farmers, as well as commercials farmers to acquire large amount of agrochemicals that are sometimes obsolete and unusable. Farmers are not educated in the storage methods of these agrochemicals and, consequently, farmers are put at a higher risk for toxic exposure. The government needs to enforce regulations involving the presence of obsolete pesticides. Obsolete pesticides should not be imported into the country, and the government should provide safe disposal mechanisms. The presence of obsolete pesticides clearly demonstrates the ways in which low-income farm labourers are being taken advantage of by capitalist agribusinesses. The situation of obsolete pesticides in South Africa is contributing to the marginalization of this susceptible population, and this is a situation that desperately needs to be addressed. 20 Susceptible Populations: The Low Income Farmer The farming sector of South Africa includes some of the most poverty-stricken people in the country. This population is marginalized by the system in place now, and is at a severe socio-economic disadvantage. Farm labourers, both men and women, are among the least educated, least literate sub-populations in South Africa. They do not know the unregulated nature of the system in which they work; they have low awareness of their employee rights and have limited access to medical benefits (Naidoo et al. 2010). It must be noted that agrochemical poisoning is a result of not only the hazardous chemicals that are being used, but of underlying conditions as well. These conditions include poverty, alcohol dependency (which is alarmingly prevalent in South Africa’s population of low-income farm labourers), HIV, AIDS, and general attitudes towards agrochemicals and safety in the workplace. The ‘Dop’ System The ‘dop system is also an influential factor that is a significant part of the history of the South African farming labour force. ‘Dop’ is the Afrikaan word for “alcoholic drink”. The ‘dop’ System refers to the system in which South African farmers and employers have historically paid their labourers in alcohol rations. It is not technically legal today, but this rule is often not enforced. This system has simply contributed to the vicious cycle of poverty that is so prevalent in this population. Furthermore, alcoholism is extremely common within this group, and this actually increases the risks involved with 21 pesticide poisonings from a health perspective by weakening the immune system. The negative health impacts of exposure to dangerous chemicals are enhanced in someone who is dependent on alcohol (London 2001). Further evidence suggests that chronic alcohol dependence impacts learning skills. Since learning skills are necessary for safety in this type of industry, alcohol dependence clearly has a negative impact (London 1999). In terms of social behaviour, women are sometimes affected by alcohol-induced domestic violence. If they themselves are part of the ‘dop’ system, it may affect their reproductive systems – they may give birth to children with birth defects or learning disabilities. In some cases, people are affected more directly from the ‘dop’ system. In one case, 24 farm labourers (12 women and 12 men) were poisoned by alcohol rations that were contaminated by the agrochemical adicarb. This occurred in the Western Cape Province of South Africa in 2001 (Lodon and Bailie 2001). The ‘dop’ system is a contributor to the cycle of poverty in which the rural poor live. Although it is technically illegal today, the payment of farm labourers with alcohol rations has had immense consequences within the population (London 2001). The Perspective of the Farmer: General Awareness of Negative Impacts of Agrochemicals and Safety Practices Different studies that have been conducted throughout Africa have explored farmers’ perspectives on the dangers of agrochemicals. Different indicators of farmers’ relationships with agrochemicals are their use of personal protective wear, their hygienic and sanitation practices and their abilities to understand labels, colour codes and 22 pictograms on the sides of agrochemical containers. In one rural farm context, a researcher found that only 2% of the farmers that were interviewed agreed with the statement “pesticides have potential negative side effects on rivers and the environment” (Ajayi 2000). These results clearly demonstrate that the environmental toxicity risks involved with agrochemicals are not being properly communicated within agricultural systems in developing countries. Personal Protective Wear A study conducted in Ethiopia, found that farmers on commercial farms were provided with inadequate protective wear. The study showed that only 32% of pesticide sprayers in agricultural settings were using appropriate protective wear. Additionally, there was a general negative attitude towards specialized protective wear, such as goggles and gloves. There are many reasons that this could be happening. It is uncomfortable for farm labourers to be wearing protective wear because it is so hot and dry in their work environment. Furthermore, equipment could be expensive, and working without it is simply a cost-cutting strategy (Mekonnen and Agonafir 2002). A survey conducted in KwaZulu-Natal, South Africa found that rural farm labourers did not wear personal protective wear and often did not have the proper protective equipment while mixing, measuring or applying agrochemicals. They often used their hands for these jobs. This implies that there is a lack of pesticide safety knowledge in this context, and/or that there is a lack of accessible personal protective equipment. 23 Additionally, the use of hygienic and sanitation practices is almost always directly correlated with access to a clean water source (Mekonnen and Agonafir 2002). Hand washing and showering is sometimes not an option in extremely rural, water-scarce areas. Farming communities should have the right to clean water from an uncontaminated and accessible source. Unfortunately, this is not the case in many communities in developing countries. Additionally, in some cases the water that is accessible near agricultural areas may be contaminated with agrochemicals (Konradsen et al. 2003). Even in cases where farm labourers are aware of general toxicity issues associated with agrochemicals, waterscarcity presents a fundamental obstacle that prevents sanitation practices (Ajayi 2000). Pictograms as a Risk Communication Mechanism Studies have shown that pictograms on pesticide labels are not as effective as they should be. The United Nations Food and Agricultural Organisation recommended pictograms as a method to communicate environmental and toxicological risks associated with agrochemicals (Rother 2008). Pictograms represent instructions on the way agrochemicals should be used, stored and disposed of. If the pictograms do not communicate the idea clearly enough, then they are not working. A survey conducted on grape farms in the Western Cape Province of South Africa of 115 farm workers found that more than 50% of them had misleading, incorrect and confused interpretations of the pictograms provided to them on the labels of the agrochemicals that they were using (Rother 2008). 24 This information simply shows that the dangers of pesticides are not being fully communicated or understood in countries like South Africa. There is a clear need for the issue to be communicated more clearly, especially when the heavy use of pesticides is so enthusiastically encouraged within the South African agricultural sector (Rother et al. 2008). It is an example of how farm workers are not being provided with knowledge, and access to equipment that would prevent occupational hazards. Furthermore, it shows that intensive agricultural technology is not easily transferrable to developing countries, because of factors like the lack of access to clean water, the lack of access to supplementary safety equipment, and the lack of training and education. South Africa’s agricultural sector is becoming dependent on agrochemicals, a relatively new technology that it does not have the resources to support. The consequences include harmful side effects for agricultural labourers, and the subsequent marginalization of this population. Gender Differences and the Sexual Division of Labour in the South African Agricultural Sector. In order to explore the gender differences that impact farm workers in South Africa, it is necessary to illustrate the importance of gender roles, even in the agricultural sector. The majority of female farm workers are black, between the ages of 20 and 40 and married. In terms of levels of education, 47% of female farmers have seven years of schooling in total. 21% have four years or less, and 10% have had no education at all. Poverty, or circumstances caused by poverty, is the prevailing reason for the lack of education (Kritzinger and Vorster 1996). Women, with lower levels of education, and a 25 lower financial income than their male counterparts are even less likely to have the training and knowledge to use pesticides safely (Naidoo et al. 2008). Traditionally, the work of the rural female farmer was focused on cultivation, weeding, harvesting, processing and the storage of crops. Furthermore, they are in charge of getting clean water; this often requires walking long distances. They need to find firewood, and they are also involved in the preparation and marketing of food (Lado 1992). In the agricultural setting today, women's activities include plowing, planting, weeding, irrigation, and the harvesting of crops; in addition to these duties, they are increasingly involved with the spraying of crops (Naidoo et al. 2011). Female farmers have been taking on more responsibilities in the farm setting that, in the past, were traditionally part of the ‘man's role’ (Naidoo et al. 2008). Furthermore, the commercial farming industry in South Africa is becoming one of the biggest employers of women throughout South Africa. Because of gendered job-segregation, and the inequity of employee and occupational rights, women are given more casual, seasonal and informal employment. As a result, women are generally not provided access to unions, and large agribusinesses can avoid regulatory enforcement and not provide these women access to pesticide safety programs, and other measures to prevent the adverse health effects of the misuse of pesticides (London 2001). A study conducted in 1996 researched women working on deciduous fruit farms in South Africa showed that 82% of the female farm workers had not been offered any access to professional safety training (Kritzinger and Vorster 1996). Labour forces in South Africa are very transitory, with men migrating to urban centres and industrial areas to find higher paying employment. In the rural small-scale 26 farming context, the men leave their female counterparts to do most of the agricultural work in the community, in addition to their domestic responsibilities. The evolving role of women in the agricultural sector is putting them at a higher risk for unhealthy levels of pesticide exposure (Naidoo et al. 2008). At the end of the apartheid era and during the transition period afterwards, the government has tried to reform the agricultural sector to encourage equality between, most importantly, black and white farmers. Critics have suggested, however, that the government is so completely focused on the economic growth of the country that they are not reforming laws to lessen inequality, but they are simply re-writing power relations, gender inequalities, and racial inequalities to complement and drive the new commercialized industry, despite the fact that marginalized people may still be suffering (Orton et al. 2001). The marginalization of certain groups of people in South Africa, notably female farmers and low-income farmers in general, is important to understand because these are the people who are most negatively impacted by the occupational hazards of pesticide poisoning. Compared to South African men in the agricultural industry, female South African farmers have lower literacy levels and lower incomes. Evidently, this impacts their ability to read labels on pesticide containers, which is integral to the safe use of these chemicals (Naidoo et al. 2008). Taking into consideration their extensive domestic responsibilities, women work longer hours than men in agricultural settings (Lado 1992). These facts put female farmers at a higher risk for adverse occupational health outcomes. Since the dismantlement of apartheid in 1994, the government has attempted to redistribute farmland to the historically disadvantaged people of South Africa. Women 27 make up a significant portion of this population, as apartheid dictated that women could not own land. These developments paired with a migration of men to urban and industrial areas, left women to work on a significant amount of farmland in the rural areas of South Africa (Naidoo et al. 2008). Furthermore, research has found that women with a secondary school education are much less likely to work on a farm. They usually migrate to urban areas to find steady work. Thus, poorly educated women are concentrated within agricultural communities (Naidoo et al. 2008). As mentioned above, low education and low literacy rates put women at a higher risk for the occupational hazard of pesticide exposures. This research simply illustrates the need, not only for standardized and enforced regulations concerning agrochemical use, but the provision of basic training to every employee, no matter how under-educated they might be (Ecobichon 2001). Women who work on these farms are exposed to agrochemicals in many different ways. Their levels of exposure depend on their knowledge of safety measures, their use of hygienic practices and their use of personal protective wear. Even if there are males working on the farm, women are required to wash the clothes that the man has worn while spraying. This situation puts women at a high risk for exposure. If they are taking the appropriate preventative measures, they may be exposed to dangerous levels of agrochemicals (Naidoo et al. 2010). In 2008, a survey was conducted on women working on the Makhatini Flats in Nothern KwaZulu-Natal (Naidoo et al. 2008). This study was looking at the agricultural activities and occupational hazards facing female South African farmers living and working in poor, rural areas. The study found that almost half of the women who took 28 part in the survey had never attended school. The survey also found that only 30.6% of the women who regularly worked with agrochemicals knew the name of the pesticide that they were working with (Naidoo et al. 2008). It is significant to note that if the women owned the farm themselves, they were more likely to have a higher knowledge of the different types of agrochemicals. This pattern could signify that women in leadership positions are more educated and have higher literacy levels. However, this situation implies that if the women were working on farms that they did not own, they were not provided with the knowledge that they needed to identify different types of agrochemicals. They did not have the knowledge required to keep themselves safe from the adverse health impacts of pesticide exposure. The results of this survey demonstrated that women were being marginalized and taken advantage of by their employers. The majority of these women were found to be using highly hazardous agrochemicals and had no knowledge of the dangers involved (Naidoo et al. 2008). Female farmers are susceptible to the negative health impacts of pesticides for many reasons. They are prone to the acute effects of toxic pesticide exposures, including reproductive health impacts. A study conducted in KwaZulu Natal, South Africa, found that women were more likely to suffer from spontaneous miscarriage if they had been spraying pesticides during their pregnancy. This connection was found to be a result of post-conception exposure to specific agrochemicals: glyphosate and thiocarbamates, specifically (Naidoo et al. 2011). However, some of the women who were participants of the study did not know exactly which pesticides they were using. Situations like this result in increased difficulty in making direct scientific linkages between these agrochemicals and their adverse health effects. This research does, however, demonstrate 29 the need for more research on the topic of the relationship between pesticide exposure and reproductive health impacts (Naidoo et al. 2011). Naidoo et al. noted that there is, in fact, a desperate need for more research to be conducted on specifically female farmers involved in the South African agricultural sector. Most research that is available is focused on men (Naidoo et al. 2008). This lack of data means that the work that women contribute to the sector is marginally reflected in statistics. Furthermore, the adverse health effects that women have been subject too throughout the industry are poorly reflected in available data. According to one social scientist, women are "statistically invisible to policy makers and planners" (Lado 1992). There is a need to improve surveillance of pesticide poisonings, because the data that is available now may lead to inappropriate policy decisions. It is also important for this issue to be honestly portrayed through statistics, so that awareness can grow. Statistics that are available in South Africa now, concerning pesticide poisonings, suggest that occupational exposures are insignificant and that men are more affected than women (London and Bailie 2001). Researchers found that not only is occupational pesticide poisoning a significant problem in South Africa, but women are more prone to occupational pesticide poisonings than men. Furthermore, the numbers of people who were affected by pesticide poisonings was a severe underestimate (London and Bailie 2001). As a result, it is clear that the South African government should implement an effective and accessible surveillance system, because the statistics available are not representative of the real problem. 30 Reducing Agrochemical Poisoning: The Importance of Education The South African government is using high input agriculture as its main developmental tool. Increasing agricultural outputs is the fundamental goal, yet there is a significant missing link: education (Ecobichon 2001). The solution to this problem may lie in many different types of strategies and programs to improve the safety of pesticide use. The introduction of these programs could reduce pesticide poisonings, reduce contamination of water sources, and reduce ecosystem damage. Education programs and strategies would encourage meticulous adherence to safety instructions, rather than the excessive and unsafe use of agrochemicals (Ecobichon 2001). The use of education programs has been attempted in other developing countries, and the programs’ effectiveness was assessed. In a particular study in India, the occupational hazards of pesticide use were deemed to be a problem because farmers were often not very well educated in terms of the hygienic practices required for the safe use of agrochemicals. It is also expensive to use safety equipment; therefore it is rarely used in Indian agricultural communities. The goal of the education programs is to make using personal protective wear, and following safety instructions, a practical and rational option. Researchers implemented education programs in two villages in South India, hoping to encourage the safe use of pesticides in rural agricultural communities (Sam et al. 2007). In these two villages, before the implementation of the project, the occurrence of occupational related poisoning was 33% before education programs were implemented. Public education programs were found to increase the farmers' knowledge of severe health consequences of the misuse of agrochemicals. They stressed the 31 importance of personal protective wear, and encouraged farmers to use low toxicity pesticides, as opposed to high-toxicity pesticides. Participants were encouraged to read labels on the containers before application. The program taught participants to create awareness of this issue throughout the community. After the programs were finished, the researchers assessed the success of the program through questionnaires. They found that the program lead to a significant improvement of the system and awareness of fundamental safety measures (Sam et al. 2007). As well, researchers in Lebanon studied the effect of educational interventions on the knowledge and adherence to safety measures when interacting with pesticides in the Lebanese agricultural sector. They found that the use of precautionary measures was directly proportional to their knowledge. Essentially, when there was less knowledge, fewer safety measures were applied (Salameh et al. 2004). Indeed, around the world, researchers have found that the knowledge of pesticide safety measures is related to gender, geography, literacy levels, and, in the case of female farmers, the presence children (Sam et al. 2007). Pesticide safety education (and education in general) is required to close these gaps in safety knowledge. Education can also be used to reduce the inequality between female and male farmers and between rural and urban populations. Education programs and management strategies encapsulate a short-term solution to the reduction of the adverse health effects caused by the misuse of pesticides. The long-term strategy, however, is the restructuring of the South African agricultural system into a system that does not depend on pesticides not only to increase agricultural yields, but also to boost 32 the economy (Mather 1996). The goal of this new agricultural system would be sustainable development, with minimum pesticide input (Konradsen et al. 2003). Sustainability in South African Agriculture – A Possibility? The fact that South Africa is one of the largest importers of pesticides and other agrochemicals on the continent calls into question the cost-benefit ratio of the heavy use of chemicals in the agricultural sector. While pesticide use increases production rates and agricultural yields, it presents risks to human health and social capital, not to mention ecosystem health (Atreya et al. 2010). The agricultural sector does have an important role to play in the development of the country, yet this can only work if sustainable practices are implemented. Sustainability projects that have worked in South Africa's agricultural sector have stressed the importance of focusing on community needs in the short-term as well as the long-term. Additionally, the community needs to have confidence in the project's long-term sustainability, or they will most likely abandon it. There is evidence, however, that communities that implement sustainable management practices and projects in agriculture become profitable and self-sustaining (Mulder et al. 2006). However, these ideas for sustainable development are controversial, and there remains a population of skeptics. Policy makers and representatives of agribusinesses, in particular, do not believe that the methods available for ‘sustainable development’ will produce the same amounts of agricultural yields that are produced today (Mather 1996). Hopefully, however, this paper fully demonstrates the fact that an alternative is required in this context. Heavy, unsustainable pesticide use is degrading social and environmental 33 capital and the negative side effects of the heavy use of pesticides do not justify the economic returns of high yields (Atreya et al. 2010). Alternative Agricultural Systems and Integrated Pest Management (IPM) Conservation agriculture and organic agriculture are viable options in theory, yet researchers have determined that they are difficult to implement in areas where poverty is prevalent. Also, South Africa has an environment particularly vulnerable to drought and other climatic limitations. Studies have shown that yields have dropped in organic agriculture systems in South Africa (Nkala 2011). Biotechnology has, in some contexts, helped to reduce agricultural yields, yet export limitations on genetically modified food products do exist. Also, there is a worry that biotech crops will lead to the development of resistant pests. In a specific case in South Africa, researchers found that a species of African stem borer became resistant to insecticides after the introduction of genetically modified maize (Atreya 2010). Consequently, there is a high demand for further research within this field. Researchers have suggested that Integrated Pest Management (IPM) might be a suitable method to reduce unnecessary amounts of pesticide input into farming systems. IPM alters the focus of pesticide use from “pest control” to “crop and eco-health.” It does not emphasize the complete eradication of the pest, but encourages farmers to think about the system in a holistic sense, one that might not benefit from heavy pesticide input. In many instances, IPM not only reduces pesticide use, but contributes to higher agricultural yields (Atreya et al. 2010). IPM focuses on the education and empowerment of the 34 farmer, and it also results in a less risky workplace for the farmer. It is also better for the surrounding environment, as surrounding ecosystems are considered. IPM aims to transform farmers’ perspectives of the farming system: from an agricultural system to an ‘agro-ecosystem.’ IPM success stories can be found in countries like Bangladesh, Cambodia, China, India, Indonesia, Pakistan, Sri Lanka, Thailand and Vietnam (Atreya et al. 2010). For example, a study of IPM practices in Indonesia saved an average of about $1 200 per year for each farm system on which it was implemented. These savings are significant for low-income farmers. In India, there was a decreased use of conventional pesticides by an average of 50%. Furthermore, incomes increased and so did agricultural yields. IPM also has positive impacts on development, and this strategy could achieve sustainable development though improved livelihoods, more cost-effective production, collaboration between farmers, and improved education. Farmers can act on their own initiative, and they can identify and resolve pest-related problems. IPM contributes to empowerment throughout the agricultural community that can directly lead to sustainable development (Atreya et al. 2010). Conclusion There is clear evidence that the misuse of agrochemicals in the South African agricultural sector is putting agricultural workers at risk. Further data shows that, often, female agricultural workers are at a higher risk than their male counterparts (London and Bailie 2001). The agricultural yields to which pesticides contribute are a clear benefit, yet 35 these benefits do not justify the associated negative externalities. It is a social justice problem because a population of marginalized people continues to be ignored and mistreated by the system that is in place today (Artreya et al. 2010). Low-income farm workers are shouldering the acute problem of food security, and they are largely responsible for increasing food production in South Africa, which is no small task (Ecobichon 2001). The government is encouraging the increase of agricultural yields at any expense because it is determined to develop the country in a post-apartheid era. The government wants an agricultural business capable of being competitive on the global scale and views pesticides as the new technology that will allow this to happen. The evidence suggests that populations of Africa and other developing nations are more prone to the negative health impacts of agrochemicals due to many reasons, such as the lack of education, low literacy levels, and improper use or complete lack of personal protective wear (Tomenson et al. 2009). Pesticide legislation is also severely lacking in this context. In some situations farmers can only rely on the information provided to them by the agribusinesses that sold them the chemicals in the first place. Clearly this causes problems since there are no standardized methods of use of these agrochemicals, and the provided information sways towards the idea of the necessity of pesticides, rather than focusing strongly on the safety precautions that are necessary. This set of circumstances calls for the need for government legislation and regulation regarding pesticide use, stressing the safety factors involved (Ecobichon 2001). Instead of investing South Africa’s future in agrochemicals, the government needs to invest in its lower class farming communities. Their potential is being wasted when it could be geared towards 36 sustainable development in agricultural communities. This improvement of the system would contribute not only to the sustainable development of the country, but also improve food security issues by increasing agricultural yields (Atreya et al. 2010). The issue of obsolete pesticides in South Africa remains a intractable problem that is barely being dealt with by the government. The fact that obsolete pesticides are still being stored in the country, and on some occasions, still being imported into the country, represents a fundamental failure of the system (Dalvie et al 2009). Furthermore, the capitalization of the country and the growth of the presence of unregulated agribusinesses is also a cause for concern. Essentially, the power of these companies outweighs the power of the government in the agricultural context, making it very dangerous for the low-income farmer, who is more than likely to be marginalized in some way by large agribusinesses (Bernstein 2013; Atreya et al. 2010). This situation simply re-iterates the need for stringent governmental regulations and legislations regarding pesticide safety throughout the country. Additionally, the role of women in South Africa’s agricultural sector has been changing. They are taking on more responsibility in the farming communities, and being exposed to harmful levels of agrochemicals, affecting their health, and in some cases the health of their children (Heeren et al. 2003). Studies have shown that they are a definitive susceptible population when it comes to the harmful effects of over-exposure to agrochemicals. This situation is thought to be a result of lower literacy rates within populations of female farmers, lower levels of education and less access to basic social rights. Gender inequality has no place in the plan to develop South Africa and boost its economy. Women, female farmers specifically, are a source of social capital that cannot 37 be ignored. Given the right tools and educational resources, women can contribute favourably to the economy, enhancing the country’s global status. The impacts of pesticide exposure and poisoning can inhibit this source of social capital by contributing to health care costs and the cycle of poverty within the population of rural poor (Atreya et al. 2010). If this problem was prevented and mitigated, however, female farmers could be invaluable in the attempt to develop the country. A socially equitable and sustainable framework needs to be researched and implemented in these communities, because the marginalization of female farm workers is a social justice issue (London 2001). Women need access to education, to training programs and to occupational and employee rights. Sustainable and equitable development is possible through the means of education, legislation, government regulation and other major reconstructions of the agricultural system. The paradigm shift that is necessary in the agricultural sector could involve promising and sustainable options such as IPM systems. It is necessary to move away from a system that is so dependent on pesticides as a means to an end, and grow towards a system in which sustainable development is seen as the way forward. 38 Acknowledgements I would like to thank my supervisor, Dr. Louise Winn, for all of her feedback and support. I would also like to thank my secondary supervisor, Dr. Gary VanLoon, for his input. Thank you so much! 39 References Ajayi, O. O. D. (2000). Pesticide Use Practices , Productivity and Farmers’ Health : The Case of Cotton-Rice Systems in Cote d’Ivoire West Africa. Pesticide Policy Project Publication Series, (3), 1–172. Aqiel Dalvie, M., Africa, A., & London, L. (2006). Disposal of unwanted pesticides in Stellenbosch, South Africa. The Science of the Total Environment, 361(1-3), 8–17. doi:10.1016/j.scitotenv.2005.09.049 Atreya, K., Sitaula, B. K., Johnsen, F. H., & Bajracharya, R. M. (2010). Continuing Issues in the Limitations of Pesticide Use in Developing Countries. Journal of Agricultural and Environmental Ethics, 24(1), 49–62. Bernstein, H. (2013). Commercial Agriculture in South Africa since 1994: “Natural, Simply Capitalism”. Journal of Agrarian Change, 13(1), 23–46. Dalvie, M. A., Africa, A., Solomons, A., London, L., Brouwer, D., & Kromhout, H. (2009). Pesticide exposure and blood endosulfan levels after first season spray amongst farm workers in the Western Cape, South Africa. Journal of Environmental Science and Health, 44, 271–277. Dalvie, M. A., Africa, A., London, L. (2009). Change in the quantity and acute toxicity of pesticides sold in South African crop sectors, 1994 - 1999. Environment International, 35(4), 683–687. Hall, R. (2004). A Political Economy of Land Reform in South Africa. Review of African Political Economy, 31(100), 213–227. 40 Hart, G. P., & Sitas, A. (2004). Beyond the urban-rural divide: linking land, labour, and livelihoods. Transformation: Critical Perspectives on Southern Africa, 56, 31–38. Heeren, G. A., Tyler, J., & Mandeya, A. (2003). Agricultural chemical exposures and birth defects in the Eastern Cape Province , South Africa: A case–control study. Environmental Health: A Global Access Science Source, 2(11), 1–8. Hoppin, J. A., Valcin, Ã. M., Henneberger, P. K., Kullman, G. J., Umbach, D. M., London, S. J., Alavanja, M. C. R., et al. (2007). Pesticide Use and Chronic Bronchitis Among Farmers in the Agricultural Health Study. American Journal of Industrial Medecine, 50, 969–979. Ibedioh, S. O. (1991). Effects of agricultural pesticides on humans, animals, and higher plants in developing countries. Archives of Environmental Health, 46(4), 218–224. Jeyaratanam, J. 1990. Acute pesticide poisoning: a major global health problem. World Health Stat. Q. 43. 139-144. Johnson, S. E. (n.d.). Potential Contribution of Agriculture to Economic Growth in LessDeveloped Countries. The Annals of the American Academy, 52–57. Kishimba, M. a, Henry, L., Mwevura, H., Mmochi, a J., Mihale, M., & Hellar, H. (2004). The status of pesticide pollution in Tanzania. Talanta, 64, 48–53. Konradsen, F., Van der Hoek, W., Cole, D. C., Hutchinson, G., Daisley, H., Singh, S., & Eddleston, M. (2003). Reducing acute poisoning in developing countries—options for restricting the availability of pesticides. Toxicology, 192, 249–261. Kozawa, K., Aoyama, Y., Mashimo, S., & Kimura, H. (2009). Toxicity and actual regulation of organophosphate pesticides. Toxin Reviews, 28(4), 245–254. 41 Kritzinger, A., & Vorster, J. (1996). Women Farm Workers on South African Deciduous Fruit Farms.pdf. Journal of Rural Studies, 12(4), 339–351. Lado, C. (1992). Female labour participation in agricultural production and the implications for nutrition and health in rural Africa. Social Science & Medicine, 34(7), 789–807. London, L, Nell, V., Thompson, M. L., & Myers, J. E. (1998). Health status among farm workers in the Western Cape - collateral evidence from a study of occupational hazards. South Africa. South African Medical Journal, 88(9), 1–6. London, Leslie. (1992). Agrichemical hazards in the South African farming sector. South African Medical Journal, 81, 560–564. London, L. (1999). The ‘dop’ system, alcohol abuse and social control amongst farm workers in South Africa: a public health challenge. Social Science and Medicine, 48, 1407–1414. London, Leslie. (2001). Pesticides and women agricultural workers in South Africa : A question of social justice. Women & Environments International Magazine, 32–33. London, Leslie, & Bailie, R. (2001). Challenges for improving surveillance for pesticide poisoning: policy implications for developing countries. International Journal of Epidemiology, 30, 564–570. London, Leslie, De Grosbois, S., Wesseling, C., Kisting, S., Rother, H.-A., & Mergler, D. (2002). Pesticide Usage and Health Consequences for Women in Developing Countries: Out of Sight, Out of Mind? International Journal of Occupational and Environmental Health, 8(1), 46–59. 42 Lotti, M. & Moretto, A (2005). Organophosphate-induced delayed polyneuropathy. Toxicological Reviews, 24(1), p. 37. Mather, C. (1996). Towards sustainable agriculture in post-apartheid South Africa. GeoJournal, 39(1), 41–49. Mekonnen, Y., & Agonafir, T. (2002). Pesticide sprayers’ knowledge, attitude and practice of pesticide use on agricultural farms of Ethiopia. Occupational Medicine, 52(6), 311–315. Mokhele, T. a. (2011). Potential health effects of pesticide use on farmworkers in Lesotho. South African Journal of Science, 107(7/8), 1–7. Mulder, J., & Brent, A. C. (2006). Selection of Sustainable Rural Agriculture Projects in South Africa : Case Studies in the LandCare Programme. Journal of Sustainable Agriculture, 28(2), 55–84. Naidoo, S, London, L., Rother, H., Burdorf, A., Naidoo, R. N., & Kromhout, H. (2010). Pesticide safety training and practices in women working in small-scale agriculture in South Africa. Occupational and environmental medicine, 67(12), 823–828. Naidoo, Saloshni, London, L., Burdorf, A., Naidoo, R., & Kromhout, H. (2011a). Spontaneous miscarriages and infant deaths among female farmers in rural South Africa. Scandinavian Journal of Work, Environment & Health, 37(3), 227–36. Naidoo, Saloshni, London, L., Burdorf, A., Naidoo, R. N., & Kromhout, H. (2011b). Occupational activities associated with a reported history of malaria among women working in small-scale agriculture in South Africa. The American Journal of Tropical Medicine and Hygiene, 85(5), 805–10. 43 Naidoo, Saloshni, London, L., Burdork, A., Naidoo, R. N., & Kromhout, H. (2008). Agricultural Activities, Pesticide Use and Occupational Hazards among Women Working in Small Scale Farming in. International Journal of Occupational and Environmental Health, 14(3), 218–224. Nkala, P., Mango, N., Corbeels, M., Veldwisch, G. J., & Huising, J. (2011). The conundrum of conservation agriculture and livelihoods in Southern Africa. African Journal of Agricultural Reseearch, 6(24), 5520–5528. O’Laughlin, B., Bernstein, H., Cousins, B., & Peters, P. E. (2013). Introduction: Agrarian Change, Rural Poverty and Land Reform in South Africa since 1994. Journal of Agrarian Change, 13(1), 1–15. Orton, L., Barrientos, S., & McClenaghan, S. (2001). Paternalism and gender in South African fruit employment: change and continuity. Women’s Studies International Forum, 24(3-4), 469–478. Quinn, L. P., De Vos, B. J., Fernandes-Whaley, M., Roos, C., Bouwman, H., Kylin, H., Pieter, R., et al. (2011). Pesticide Use in South Africa : One of the Largest Importers of Pesticides in Africa. InTechOpen (p. 522). Rama, D. B., & Jaga, K. (1992). Pesticide exposure and cholinesterase levels among farm workers in the Republic of South Africa. The Science of the total environment, 122(3), 315–9. Rother, H.-A. (2008). South African farm workers’ interpretation of risk assessment data expressed as pictograms on pesticide labels. Environmental Research, 108(3), 419– 27. 44 Rother, H.-A., Hall, R., & London, L. (2008). Pesticide use among emerging farmers in South Africa: contributing factors and stakeholder perspectives. Development Southern Africa, 25(4), 399–424. Rother, H.-A., & Jacobs, R. (n.d.). Pesticide Health Risks for South African Emerging Farmers: Surplus People Project (pp. 1–23). Salameh, P., Baldi, I., Brochard, P., & Abi Saleh, B. (2004). Pesticides in Lebanon: a knowledge, attitude, and practice study. Environmental Research, 94(1), 1–6. Sam, K. G., Andrade, H. H., Pradhan, L., Pradhan, A., Sones, S. J., Rao, P. G. M., & Sudhakar, C. (2007). Effectiveness of an educational program to promote pesticide safety among pesticide handlers of South India. International Archives of Occupational and Environmental Health, 81(6), 787–795. Starks, S. E., Hoppin, J. a, Kamel, F., Lynch, C. F., Jones, M. P., Alavanja, M. C., Sandler, D. P., et al. (2012). Peripheral nervous system function and organophosphate pesticide use among licensed pesticide applicators in the Agricultural Health Study. Environmental health perspectives, 120(4), 515–20. Tomenson, J. a, & Matthews, G. a. (2009). Causes and types of health effects during the use of crop protection chemicals: data from a survey of over 6,300 smallholder applicators in 24 different countries. International archives of occupational and environmental health, 82(8), 935–49. Williamson, S. (2009). Understanding the Full Costs of Pesticides: Experience from the Field , with a Focus on Africa. Pesticide Action Network (PAN), (1990), 25–49. 45