A. Ariffin
Dr Anuar bin Ariffin is Assistant Director of Health in the Food Quality Control Unit of the Malaysian Ministry of Health.1
1 The author wishes to acknowledge the advice given by Mrs S. Sitaba,
Head of Sub-Directorate of Food Legislation, Ministry of Health, Indonesia;
Mr K. Bounlonh, Senior Officer, Food and Drug Administration Office, Ministry
of Health, Laos; Dr Dai Yin, Institute of Food Safety Control and Inspection,
Ministry of Public Health, China; and Dr Pakdee Pothisiri, Ministry of Public
Health, Thailand.
Modernization and food safety
Food control officials' view of consumer participation
Barriers to consumer participation
Resources and training
Enhancing consumer participation
Malaysia's experience
Conclusion
References
Records on safety and wholesomeness of food date as far back as 3400 BC in Egypt and 2900 BC in China; thus consumer problems related to food are not new (Wolgamot and Fincher, 1954). Food poisoning is still a major problem in developing countries (see Table), with serious public health, trade and economic implications. Very often this reflects poor handling, preparation, storage and transportation of food. However, it is only when countries have relatively adequate food supplies that food safety and quality become major concerns. Furthermore, it is only in this century that consumer concern and actions have become relatively organized and firmly established. For instance, the first international congress of consumer organizations was held in 1960 (IOCU, 1974).
Influenced by international consumer organizations, local consumer groups address the following overall rights; the right to safety; the right to information; the right to basic services, fair practices and choice; the right to representation; the right to redress; the right to consumer education; and the right to a healthy and safe environment. However, the issues raised by consumer organizations may or may not directly address the concerns of the average consumer who occupies a low socio-political position in developing countries.
Each year, the world's population grows by about 90 million people; most of this increase occurs in the poor developing countries (Unklesbay, 1992). Population growth is attended by many socio-economic problems in these countries, and many people view industrialization as a solution. Food production and processing are among the industries that are growing, limited only by the countries' infrastructure.
Some recent food poisoning outbreaks - Foyers récents d'intoxication alimentaire - Focos recientes de intoxicación alimentaria
|
Location |
Year |
Disease |
Cases |
Deaths |
Reference |
|
Cairo |
1991 |
Botulism |
91 |
18 |
Rakha, 1992 |
|
China |
1988 |
Hepatitis A |
292 000 |
32 |
Christian, 1990 |
|
India |
1974 |
Aflatoxic hepatitis |
n.a. |
100 |
Krishnamachari et al., 1982 |
|
Latin America (10 countries) |
1991 |
Cholera |
300 000 |
3 170 |
Dawson & Costarrica, 1992 |
As these countries develop, small-scale food producers and cottage industries usually outnumber large-scale commercial producers and processors. Depending on their stage of development, small-scale producers and cottage industries have at times been sources of environmental pollution and unsafe food, (It should be noted that the large-scale food producers and processors are not exceptions to this problem.) Small-scale producers often lack adequate facilities and knowledge to produce foods that are safe and of acceptable quality. Traditional practices passed down through generations are often the only guidelines for food preparation. In many Asian countries, for example, dangerous chemicals such as boric acid are used in noodle preparation. As can be expected, the major driving forces for these industries are consumer demands and profit.
With development and modernization, lifestyles and eating habits are rapidly changing and becoming more "Westernized". In rich and poor areas, the demand for street food is mushrooming at such a rate that water supplies and waste disposal are not sufficient. Poor hygiene and food handling practices can be observed at street-food stands and restaurants where many city dwellers regularly take their meals.
Tourism is growing rapidly in many developing countries, and this can have a profound impact on the domestic food industry and consumer demands for food. About 7 million tourists visited Malaysia in 1990 and tourism has become the country's third biggest earner of foreign exchange (Malaysia Tourism Promotion Board, 1990). There are rising concerns about the hygiene and safety of food served at locations where travellers eat for convenience and recreation.
Many consumers are not happy with "factory food" because they believe it is "unnatural" and has a high sugar and salt content and low vitamin and mineral content. This dislike is further compounded when they discover impurities, infestations and foreign matter in food, indicating a high possibility of poor handling and preparation. These discoveries form the basis of many complaints directed to food control organizations and very often highlighted in local media.
Consumer groups are concerned and disturbed about technological advances in food production in which the products seem artificial. They are generally opposed to the introduction and proliferation of new and more complex products, sophisticated marketing techniques and increasing technological complexity. The positive concern of the International Organization of Consumers Unions (IOCU) in the 1970s about the safety of the kerosene stove created an awareness of safety issues with strong public and government support in Asia and the Pacific. Irradiation technology for food preservation and the use of microwave ovens, though scientifically proven safe, are still not fully acceptable to many consumers. In addition, the use of biotechnology or genetically engineered products is high on the list of consumer worries (Frewer, 1992).
The use of advertising to influence consumer preferences is becoming popular as an effective approach to product marketing. It is a very powerful tool in shaping the perception and behaviour of consumers towards a specific product. Although it can be argued that advertisements are advantageous to consumers, in many instances the messages transmitted in commercial food advertisements have been unacceptable, confusing and untruthful.
In some developing countries, groups are actively creating consumer awareness through independent monitoring reports of local and international issues regarding food safety. The concern over radionuclide contamination of foods following the Chernobyl nuclear reactor accident in 1986 caused considerable alarm in developing countries, stimulating rapid government action to monitor the safety of food imported from the affected countries. The use of pesticides in agriculture and the detection of pesticide residues in food frequently attract the attention of consumers in their quest for a chemical-free environment and safe food to eat. Other concerns include the fear of possible migration of chemical leachates from food packages, stimulated by isolated research findings on the subject. Although most of these concerns are genuine, consumers may misinterpret and generalize about specific scientific findings and anticipate that an ideal solution to the problem can be found when, in fact, this is not possible.
The rudimentary food control regulations in some developing countries, or their complete absence, generally reflects a poor national commitment to food safety, usually associated with a weak national food control organization. In these situations, consumer participation is expected to be lacking. Even when comprehensive regulations exist, the food control organizations tend to put more effort into regulatory enforcement than into obtaining maximum participation of the consumer. In Asia and the Pacific, for example, about 42 to 89 percent of overall resource allocations for food safety have been focused on regulatory enforcement, while only 10 percent or less have gone to health and consumer education (Codex Coordinating Committee for Asia, 1990).
In developing countries formal channels of communication between food control organizations and consumers are generally lacking or exist only through consumer complaints. As countries develop, consumer participation is generally more acceptable and structured channels of communication in the form of advisory committees, consumer councils or even a specific ministry for consumer affairs are established.
As some consumer organizations tend to be viewed as pressure groups which are antagonistic to government agencies, their direct participation in formulating food control regulations is not well accepted and is avoided. At most, comments are sought indirectly or openly through an established government gazette mechanism where active consumer feedback is minimized.
Although a food control organization may officially acknowledge the importance of consumer participation, food inspectors and other staff may not be fully committed to the organization's goal. This may be due to a lack of emphasis on consumer education and participation in the staff's initial training. In addition, the harmful beliefs and attitudes held by consumers may be shared by the staff. This can be a broader problem and needs to be addressed by the organization.
Many authors have observed that consumer perceptions of risk do not usually coincide with actual food hazards as seen from the scientific angle or as envisaged by food control organizations (Senauer, 1992; Wolf, 1992). The communication gap must be reduced to ensure consumer acceptance of food safety messages.
The relatively low levels of education and low literacy rates in developing countries are among the most important barriers to effective consumer participation (see Figure 1). General knowledge of the need for safe food handling and preparation would stimulate interest of the consumer in food safety issues.
Source: Asiaweek, 1993
While some strong cultural beliefs can promote food safety, others can be harmful (Foster, 1985). Examples of harmful beliefs include taboos against hand washing, precooking of large quantities of food and preference for uncooked meat and fish. These beliefs are part of a way of life and are difficult to change.
Consumers can fail to show concern about harmful food handling practices. For example, it is not uncommon to see consumers continue to patronize street-food vendors after witnessing the washing of utensils in dirty water. It may be that such practices are accepted because they have become a norm, or there may be very little choice for consumers.
Weaknesses in infrastructure, such as poor transportation, are a barrier to communication. Low access to radio and television has a considerable impact on transmission and acceptance of educational messages that need to reach the consumers. In many developing countries, very few people have telephones, reflecting the inadequacies of communication facilities (see Figure 2).
Source: Asiaweek, 1993.
An effective consumer affairs programme must be managed by a food control agency that has a clear mandate to ensure safe food for the public and the necessary human resources to operate the programme. When the programme is initiated, individuals or groups within the national organization need to be trained on the basic aspects and operation of a consumer education programme so they can impart new knowledge, attitudes and skills. This training must be shared with other officers at the level where the actual education and participation are expected to occur.
Organizations in developing countries usually face many constraints in relation to human resources, especially lack of expertise and frequent transfers and movement of officers within and out of the organization. Sometimes, staff members have an unenthusiastic attitude towards the introduction of any new programme Hence, in addition to a long-term personnel plan, staff training is necessary at regular intervals.
Materials must be available to support an educational programme; they may include magazines, newsletters, booklets, pamphlets, posters, calendars, audio and video cassettes, training manuals and syllabi. The suitability and quality of the materials, their appeal to the target groups, and quantities and distribution needed for the desired coverage and impact should be considered. It may be more cost effective to produce these materials centrally, but where diverse local conditions are expected, local production which accounts for local needs will be more acceptable to consumers.
Adequate funds needed to obtain all of the above can come from the agency's budget or be shared with other sectors. On a long-term note, some selected functions may be privatized to increase the efficiency and acceptability of the programme. In many situations financial resources are lacking or the organization tends to overstretch those that are available. During the wait for more adequate resources, the existing ones should be used optimally so that time is not wasted in starting the desired change.
Government's role
Consumer education and participation programmes within food control agencies must have a specific plan (with short-, medium- or long-term objectives) and set a priority of actions based on available local data, especially on food handling practices and food contamination. Target groups should be identified; they may include the general public, policy- or decision-makers, local authorities or other relevant agencies and special groups such as teachers, schoolchildren, mothers, women, food handlers, hawkers, caterers, homemakers, manufacturers, sellers, importers and exporters. The media for transmission of information must be chosen (e.g. television, radio, printed materials, magazines, booklets, calendars, toys, audio or video cassettes, seminars, dialogues, classroom activities, training modules and syllabi) and the relevant messages to put across to the target groups must be identified. An important consideration is the intersectoral nature of the actions, which calls for strong cooperation, coordination and leadership and an understanding of the many effective ways to do the job, e.g. through campaigns, competitions, awards or other innovative approaches suitable for the local situation.
Consumer participation must be encouraged at all stages of planning and implementation. Consumers' responses must be analysed and used to evaluate the effectiveness of the programme. Their views may be received through correspondence, consumer complaint boxes or consumer advice centres, or through the conduct of regular and well-planned consumer surveys.
National agencies must promote specific behavioural and epidemiological studies and health system research in order to provide a strong basis and direction for the existing and future consumer education programmes on food safety and quality.
Private sector's role
The food industry has a social responsibility to produce safe food and can play an important part in educating consumers. Its relatively large resources can be shared directly in dissémination of food safety information, in providing necessary expertise in education and communication and in training of industry personnel on food safety. Indirectly, the food industry or its associations can contribute through active participation in some of the national programmes on consumer education and/or sponsorship of such efforts.
Consumer organizations' role
Consumer organizations have been very active in creating awareness of food safety issues among the public. They can play a positive role by motivating and guiding consumers on important issues with regard to specific foods, making appropriate dietary choices and demanding safe food. Many organizations educate consumers through special consumer projects and reports, magazines and newsletters.
More integration and cooperation with the government and industry are needed to achieve the broader objectives of safe food for all people. A good network of consumer organizations at the national and local levels would enhance rapid and effective transfer of information on food safety issues to the consumer. With the availability of education, communication and other technical capabilities these organizations can design and conduct training sessions, develop educational materials and influence consumer perception and participation.
Non-governmental organizations' role
Non-governmental organizations (NGOs) can develop special programmes and at the same time cooperate actively with national agencies in the education of the consumer on food safety. Women's organizations and hawkers' associations are very active in many developing countries. Professional organizations in the fields of medicine and food science and technology as well as academic institutions have contributed tremendously to consumer awareness and participation through sharing of information on food safety and providing the necessary resources and expertise. There is much to be done to narrow the communication gap between technical knowledge and general consumer understanding.
International organizations' role
Special consideration of technical support to developing countries must be emphasized in view of their severe lack of technical resources for initiating and implementing their educational programmes, FAO has had a major role in the promotion of education as an important strategy in food control and food safety, especially in the food and agriculture sector. The World Health Organization (WHO) has had an equally important role in the health sector. In many instances international funding of special projects is needed to assist developing countries in this field.
With the growing importance of food safety in Malaysia, the Food Quality Control Unit (FQCU) was established in 1974 with the broad objective of ensuring that food sold to the public be safe and wholesome, free from health hazards and fraud. Initially, the development of adequate legislation and strong enforcement were emphasized. By 1983 the Food Act was established in addition to the Code of Practice of Food Hygiene. These were later supported by the introduction of regulations on food standards and contaminants (the Food Regulations, 1985) and other relevant codes of practice and enforcement guidelines. Very little organized consumer education on food safety was conducted during this period.
As in most developing countries, poor food hygiene and food handling practices were among the most disturbing problems faced by the food control authority. These practices had been seen among street hawkers as well as the numerous small-scale food processors or cottage industries throughout the country. Though they were improving, it was observed that the environmental conditions, manufacturing practices and standards of the food industry generally ranged from very good to very poor. Awareness of food hygiene and food protection was generally lacking among consumers and the food industry, and the objectives of FQCU were not well understood by most people.
The growth of the food industry in Malaysia outpaced the growth of FQCU. The organization needed strengthening to ensure effective implementation of its food control programme, and a project. Strengthening Food Control Services in Malaysia, was initiated in 1985, authorized by the United Nations Development Programme and the Government of Malaysia with FAO as the executing agency and the Malaysian Ministry of Health as the counterpart agency responsible for project implementation. The immediate objective was to strengthen FQCU's capacity for programme planning as well as infrastructure development in terms of developing efficient systems of food quality control, information dissémination, inspection, examination and certification and staff training.
Under the auspices of the project, educational materials on food safety were developed in 1991. A total of 12 booklets, posters and pamphlets were designed and later published and distributed locally. Around this time FQCU established mechanisms whereby materials produced were properly organized for quick reference and dissémination in spite of modest office automation support. These materials were used during a national seminar. The Role of Women in Food Hygiene and Food Safety, organized in 1992 by FQCU and the Department of Women's Affairs, in which 200 representatives from various women's organizations in the country participated.
Cottage industries
Having previously addressed its concerns on food safety to the general consumers, FQCU initiated activities to educate the cottage industries in 1992. The Consumer Education and Industry Advisory Services of the Food Quality Control Programme were upgraded and a plan of action was developed. The existing mechanisms were reviewed and updated, as were the curriculum and materials for education of food industry personnel in consumer protection and food quality assurance procedures. The new materials were used in training courses, and trained officials were instructed and supervised in the use of the materials to conduct training sessions in a selected food industry (FAO, 1992).
Cottage industries, with very few exceptions, do not meet the Malaysian and international recommendations for Good Manufacturing Practices, (Most large-scale and many medium-scale food industries, however, do follow Good Manufacturing Practices and meet or even surpass national and international standards and guidelines.) Although the products of cottage industries were traditionally sold locally, the situation is gradually changing. Now the industry is growing rapidly with increasing demand and better transport facilities, and the products are more widely distributed.
Once the decision was made to embark on the education of cottage industry, seven FQCU food technologists working at the state level were chosen as trainers. The skills needed were identified and several workshops were held to create the training manual, training module and training guidance to augment the FQCU industry education and training. The training manual and workshops were designed to enable the FQCU food technologists to plan, develop and conduct a broad range of education and training programmes.
Because of their scientific background and education experiences, the FQCU food technologists initially approached the preparation of materials and training from a highly technical rather than a trainer's perspective. To effect the desired changes, the FQCU food technologists had to overcome their scientific conditioning and their inclination to prepare more technical industry training programmes. The focus was on developing techniques and skills to influence change among non-scientific industry and consumer groups, to achieve training objectives and to raise the understanding of these groups on matters pertaining to food quality and safety. Training with the food industry was conducted for hands-on experience.
As the magnitude of the task of training the food industry is enormous, state and district inspectors were subsequently trained by the initial group of food technologists. These inspectors will expand their training role from one-to-one information transfer during plant inspections to more group training. As part of the follow-up to the project a group of 30 state and district inspectors was recently trained, and it is envisaged that such training will be carried out regularly to expand the existing coverage of the food industry.
This project has laid the foundation for future education programmes for FQCU, especially for small-scale industries. The trainers who were trained have demonstrated confidence in their ability to conduct similar training after the end of the project. Using food technologists as core trainers was an excellent strategy, not only because of their technical background but because these professionals have stable positions within the food control programmes of FQCU.
Consumer education
Malaysia's Ministry of Health has strengthened its health education efforts, and in 1992 a Health Education Communication Center (HECC) was established. Many education activities that were initially done on an ad hoc basis are more organized now. As part of the Ministry of
Health, FQCU must actively compete for the personnel and financial resources that are needed for full-fledged consumer education activities. The available resources within FQCU have not increased enough to meet the new challenges of food safety, much less consumer and industry education. As resources are always scarce, decision-makers should be aware of these needs. The organization must fully utilize its resources, and additional resources outside the organization may need to be employed.
The importance of consumer education and participation in food control is gaining recognition and acceptance worldwide. Many developing countries such as Malaysia have realized this and are taking positive steps to incorporate consumer education and participation in their programmes. The utilization and participation of consumer organizations, the food industry and NGOs could help to overcome the lack of resources needed to solve the many and expanding problems of food safety.
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