Carrots, cabbages and potatoes were the only vegetables ever served up to Zina Zaya. Never as a child, but in the canteen of the factory where she worked as a seamstress in the 1970s. Vegetables were hard to come by in the Mongolian People’s Republic, she recalls, and work lunches were for decades the only time she saw vegetables, and only those three.
But now, aged 76, an impressively large greenhouse stands outside Zaya’s ger, a traditional Mongolian circular felt tent. She lives there with her daughter, Naranchimeg, and grows tomatoes and cucumbers, celery, a wide array of greens – including Naranchimeg’s favourite, broccoli – and more than 10 other varieties.
The women’s small farm, not far from Mongolia’s capital city, Ulaanbaatar, is surrounded by fields of cattle. Among their neighbours and for miles around, Zaya and Naranchimeg are the only ones growing vegetables.
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A common condition
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The human toll of non-communicable diseases (NCDs) is huge and rising. These illnesses end the lives of approximately 41 million of the 56 million people who die every year – and three quarters of them are in the developing world.
NCDs are simply that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types are cancers, chronic respiratory illnesses, diabetes and cardiovascular disease – heart attacks and stroke. Approximately 80% are preventable, and all are on the rise, spreading inexorably around the world as ageing populations and lifestyles pushed by economic growth and urbanisation make being unhealthy a global phenomenon.
NCDs, once seen as illnesses of the wealthy, now have a grip on the poor. Disease, disability and death are perfectly designed to create and widen inequality – and being poor makes it less likely you will be diagnosed accurately or treated.
Investment in tackling these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and communities is staggeringly high.
In low-income countries NCDs – typically slow and debilitating illnesses – are seeing a fraction of the money needed being invested or donated. Attention remains focused on the threats from communicable diseases, yet cancer death rates have long sped past the death toll from malaria, TB and HIV/Aids combined.
‘A common condition’ is a Guardian series reporting on NCDs in the developing world: their prevalence, the solutions, the causes and consequences, telling the stories of people living with these illnesses.
Tracy McVeigh, editor
Mongolia’s uniquely cold and dry climate does not easily lend itself to growing crops. Over thousands of years the people living in the region learned to thrive on the relatively infertile land by raising cattle, constantly moving their herds across the steppe in search of fresh grazing. Today, approximately 30% of Mongolians are nomadic herders and their diet is high in beef, flour and salt, and very low in vegetables.
The health consequences of Mongolia’s national diet and vegetable deprivation are becoming apparent. The country has the highest rate of liver and stomach cancer cases in the world. Cancers which, Erdenekhuu Nansalmaa, director of Mongolia’s National Cancer Centre says, are heavily influenced by environmental and lifestyle factors.
The scourge of cancer in the country is overshadowed only by cardiovascular diseases, also aggravated by poor diet, which are responsible for 44% of deaths annually in Mongolia.
But over the past two decades, vegetable gardens and greenhouses such as Zaya’s have begun to pop up around Ulaanbaatar, thanks in no small part to the Mongolian Women Farmers Association, headed by Byatshandaa Jargal.
Jargal, formerly an agriculture lecturer, received training when communist authorities were eager to increase vegetable production and consumption. In the 1990s, she watched as the collapse of the centrally planned economy led to mass closures of factories, casting great swathes of Mongolia’s population into poverty.
“Men and women were staying home. Out of work, incidence of alcoholism and domestic abuse skyrocketed,” she says. “I thought that by training women how to grow vegetable gardens, I could help families by giving the mums something productive to do while also providing the household with a source of food and income.”
The Women Farmers Association began collaborating with the Swiss Agency for Development and Cooperation to deliver training and equipment – such as greenhouses and irrigation, necessary for cultivation in Mongolia’s harsh climate – to interested women. It was at one of the sessions organised by the association that Naranchimeg learned about plants such as celery and spinach.
“I turned to growing vegetables after I had a car accident in 2006. The spine injury left me unable to walk or work, I felt I needed something to do that could supplement my income,” Naranchimeg says. “I set up my own greenhouse, but the only vegetables I was familiar with were carrots, potatoes and cabbages. Until I went to the training, these were the only vegetables I grew.”
Naranchimeg sells two-thirds of the vegetables she and her mother grow, mostly to neighbours. This is her main source of income, along with a meagre disability allowance. In the summer there is no shortage of buyers for fresh tomatoes and cucumbers, Naranchimeg says, but other vegetables such as celery are less popular.
“People are not familiar with it. They don’t know how to cook it or the health benefits. It’s the same for other vegetables, like sweet potato for example,” she says. “It’s a shame. They’re missing out on many nutrients.”
“My grandchildren love vegetables, especially pumpkin soup. They prefer it to traditional meat stews,” says Atarjargal, sitting on a bench outside her greenhouse while her grandsons whiz around on bicycles. “My husband doesn’t though. He only likes Mongolian meat dishes. I cook him separate meals.”
Atarjargal used to live in the southern district of Gobi Altai where she worked in a factory while her husband was a bus driver. But after the regime change, life became difficult. She and her husband lost their jobs and by 2008, they made the decision to pack up and move to Ulaanbaatar in search of work.
Like thousands of other families pushed out of rural areas by unemployment, they settled in the city’s unplanned ger district. The unofficial settlement has been growing in recent years, as cattle herders find the livelihood that had kept their families afloat for centuries is becoming untenable because of the climate crisis. Dzuds, as Mongolians call exceptionally severe winters, used to be a rarity – but are becoming increasingly common. More than 5 million livestock (8% of all Mongolia’s cattle) died in this year’s dzud; their carcasses can still be seen strewn across the steppe.
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As the settlement grew, Jargal became eager to plant her programme there. In 2016 she established a “model street” in the district, with the help of donors. A water pipe was extended along eight households who volunteered. Participants, Atarjargal among them, were provided with seedlings, irrigation, training, and money towards greenhouses.
“When we moved in here it was just empty land. Now we grow pumpkins, tomatoes, broccoli, herbs – everything,” Atarjargal says. “My grandchildren are growing up with vegetables and vitamins. If we weren’t growing the veggies ourselves we wouldn’t be able to afford to eat many.
“We have become like family. We look after each other’s crops. Our street is safer now,” she adds.
Mongolia’s population is young: more than 30% are under 18. Introducing children to vegetables is the best way to establish lifelong healthy eating habits, says Nomin Batsukh, a paediatrician working with Save the Children Mongolia.
“Nearly a third of Mongolian under-fives are anaemic and 70% have vitamin A deficiency,” Batsukh says. “This could be addressed by eating veg such as carrots.”
Nursery 71, on the outskirts of Ulaanbaatar, serves children from the ger district and makes sure all its pupils not only eat vegetables but grow them.
Thanks to the Women Farmers Association, the nursery has its own greenhouse and a field. Children, staff and parents are all involved in growing and harvesting and the vegetables are incorporated into school meals. At least three times a week the children are served creamy vegetable soups – a big improvement, the nursery cook says, from when only meat and potatoes were on the menu.
“For some of our kids, the school meals are the only times they eat vegetables,” says Khud Erdenechimeg, the nursery’s director.
“The children grow seedlings in classrooms then learn to seed them in the ground – we have classes outside where they can learn about different fruit and vegetables. It’s part of our curriculum,” she says. “I really hope we can plant a love of Mother Earth in our pupils’ hearts. These skills will stay with them for life.”