Challenges for animal health and meat safety
Tanzania has committed to a One Health agenda to acknowledge and act upon linkages between animal, human, and environmental health, and this includes recognition of foodborne and meat-borne disease [24, 55, 56]. This has resulted in greater support and collaboration for integrated research, including on the biosocial dimensions of zoonoses  but it is as yet unclear how this has affected frontline actors’ daily activities to promote livestock health and prevent foodborne illness. The veterinary sector in Tanzania, as in other sub-Saharan countries, lacks capacity for service provision and enforcement, and struggles with inadequate investment [20, 38, 49]. Only 20% of Tanzania’s rural livestock keepers utilise extension services  and only 6% of the country’s approximately 12 thousand registered villages have village-level LEOs. These low numbers result, in part, from recruitment cuts beginning in the mid-1990s, and in part, from bureaucratic reforms to privatise veterinary services in spite of livestock keepers’ inability to pay for them and poor rural infrastructure [49, 50]. Consequentially, state LEOs are often the only livestock professionals to which communities – and particularly rural ones – have access, although there may be other informal actors such as community animal health workers [25, 57, 58].
LEOs, and particularly those assigned to rural wards, are often charged with covering large geographical areas, and many lack official, or adequate transportation . This, along with few colleagues with whom to share responsibility, was the most frequently cited challenge from both urban and rural respondents in this study. It was seen as hindering LEOs from assisting livestock keepers, preventing zoonoses, and addressing meat safety risks. The Ministry of Livestock and Fisheries advocates a ratio of one LEO per village and recognises transport as a key ‘priority investment area’ for improving LEOs’ capacity [26, pers. comm. 7/11/2018]. One regional informant said the government tried to ensure all ward-level LEOs were issued motorbikes, although at the time of our interviews, only four of ten LEO respondents had them. The rest relied on their own motorbikes, hired transport, or walked. Access to a motorbike did not ensure effective performance however. Rural LEOs were often solely (or with only few colleagues) responsible for very large territories with poor roads that worsened during rainy seasons. Timeliness for slaughter inspection was a concern, and it was impossible to always be on site before slaughter occurred. Many LEOs had several distant sites to visit, most of which began operating before daybreak to ensure ‘warm’ meat was available for customers at the start of each day.
Shortage of material resources was another common concern for LEOs. In relation to inspection, uniforms and government ID cards were seen to provide LEOs and HOs with important symbolic authority. LEOs’ lack of uniforms was perceived as undercutting their ability to demand, as legislated, that butchers wear them - especially in urban areas. As one LEO put it, how could he insist on butchers wearing uniforms when he himself did not? Insufficient diagnostic tools also compromised LEOs’ field work. They perceived that when serious and/or unknown cases of animal disease were encountered, samples had to be sent for diagnosis to the district clinic in Moshi where they believed testing capacity was limited to anthrax or, more often, to the Veterinary Investigation Centre (VIC) in Arusha. This takes time and can lead to mistrust or at least, the danger that disease will spread in the meantime. And while trained in meat inspection techniques which make use of sight, smell, palpation, and incision (one claimed to ‘taste’ raw meat to detect medicine), they lacked technical equipment to support their inspections . This meant that they could not immediately identify many zoonotic enteric pathogens, such as Salmonella, which do not manifest as illness in live animals or cause overt visual symptoms in meat, and yet may have significant negative consequences for human health. Indeed, such pathogens were not mentioned by LEOs or others, suggesting that they were not perceived to be significant threats. This is a well-recognised limitation of visual post-mortem meat inspection which, in many other contexts, has resulted in the emphasis and adoption of risk-based approaches.
Lack of clarity over, and farmers’ reluctance to pay for services historically provided freely by the government, represents another substantial challenge. While LEOs’ remit does not explicitly mandate (nor prohibit) the sale of drugs, treatment and other services, this practice was universally reported among our LEO respondents. They rationalised their sale of drugs and vaccines – which they purchased wholesale from private animal drug shops – as saving farmers from having to travel to town and paying cost prices, often for much larger doses than required for their animals. LEOs’ fees for drugs were mediated by prices in the private drug market, which varied geographically and over time, and by the distance and travel necessary to reach farmers. They claimed not to profit from these sales. However, many LEOs and other frontline actors perceived that farmers believed they were being exploited, and one LEO referred to ‘other LEOs’ who profit unfairly from drug sales. Variance in LEOs’ fees – based partly on costs and partly on LEOs’ assessments of what different clients could afford  – further exacerbated tension, particularly in relation to mandatory (yet not always free) vaccination campaigns. That some free vaccines were, although very rarely, provided by district-level authorities or donor projects in response to localised outbreaks of anthrax or rabies, created further confusion and spurred resistance. As one LEO explained:
[…] last time we had rabies vaccines, we were asked to cover only villages bordering Kilimanjaro National Park [as these were considered most at risk]. We did as required, the rest paid. They complained but we showed them the letter from the District Council but they couldn’t understand. You know what that meant - others refused to vaccinate. (Rural LEO, F)
Compounding many challenges highlighted above are LEOs’ and other frontline actors’ low pay. In addition to meagre baseline salaries, three LEOs with meat inspection duties mentioned they were entitled to extra pay, as their responsibilities required starting work as early as 3 am, and overtime on weekends and holidays when more animals are slaughtered. They had not received this extra pay for years, and consequently expressed demotivation and frustration. While there is evidence of Tanzanian frontline actors supplementing their low salaries through abuse of the system , no respondents admitted to such activities, although three non-LEO interviewees suspected bribery or ‘collusion’ occurring occasionally between meat inspectors and butchers and two LEOs mentioned refusing bribes.
Despite the many challenges and obvious frustrations, many LEOs and HOs remained motivated by recognition of the seriousness and necessity of their work in preventing disease and supporting livelihoods. In seeking to implement policy in a context characterised by transport and other material resource deficits, challenges related to drug and vaccination provision, low morale and inadequate pay, these frontline actors employ a range of strategies and skills to ensure meat safety.
Strategies and skills for frontline action
Frontline actors’ main strategies to do their work included: using symbols of authority strategically; leveraging networks and teamwork; adapting to local contexts; and building local expertise. Each of these is discussed in turn below.
Symbols of authority: policy and officialdom
When asked about relevant legislation, most ward-level respondents made reference to ‘directives’ or local bylaws – which they explained provided them with guidance, legitimacy, and protection – rather than to national-level legislation. This corroborates previous government research that found little awareness among LEOs regarding specific laws such as the Animal Disease or Public Health Acts. Respondents indicated that ‘directives’ originated from ‘above’ – from authorities at ministry, regional or district level. In some cases, they may have been referring to regulations drawn up by ministries as directed in national Acts, while in others, they seemed to refer to ad-hoc measures or bylaws, the latter being developed at district, ward and village level . Thus, lack of awareness around national laws – copies of which were not readily available to most – did not necessarily mean respondents were wholly unaware of their responsibilities and several spoke of learning about and discussing directives and bylaws at district or ward-level meetings, or receiving letters about them.
Enforcement situations – such as condemning and destroying unstamped meat, or threatening to close butcheries or eateries for failing to meet hygiene standards – were often tense, contested and difficult. It was therefore important for frontline actors to assert their authority. HOs, LEOs and committee volunteers would, as shown below, cite from or, if they had them, physically show livestock keepers and meat handlers relevant provisions in print.
Before we destroy unsafe meat or food we have to read the sections of the bylaw covering food censure and destruction to the owner. (Rural HO, F)
Whenever we go to the site for inspection we normally take [the legislation] [ … ], we don’t scare business people. Before we take any action we educate and show them the section in the regulations [ … ]. You know many regulations are in English but we translate and explain some sections to the butchers and farmers. (Urban LEO, M)
This strategy of appealing to officialdom – through taking along, reading aloud and explaining legislation – was usually referenced in relation to inspection of sites where meat was sold. It was seen, as indicated in the quote above, as embodying the necessary diplomacy and respect not to ‘scare’ business people while still encouraging their compliance. One LEO had requested an additional, official letter from the district council to reinforce his authority:
We requested the district personnel to write the letter on our behalf to put more weight on it, as they respect and follow directives from higher levels more than from the ward. (Rural LEO, M)
Resistance was sometimes met with threats of legal action, although few concrete examples were offered, in part perhaps, because the courts were not seen as very effective . A more common strategy in such ‘complicated cases’ was to request additional support from district or municipal-level authorities.
They sometimes call us in to deal with someone who is not complying with the regulations, we go as a team to arrest the situation and make them comply. (Urban District Livestock Officer, M)
If they don’t respond and cooperate with me, recalling the previous incidents, then I will call for assistance from the municipal level. (Urban HO, F)
While such appeals to ‘officialdom’ were usually made in the context of regulatory duties, some LEOs sought to similarly smooth tensions with farmers regarding treatment fees. They innovated mechanisms to ‘officialise’ service and drug fee charges. For one rural LEO, this took the form of letters from district authorities, and a system of official receipts:
We asked the district council to write an official letter explaining to farmers they should pay for the services. The document will enable us to work smoothly with farmers. If an animal is suffering from say anaplasmosis, I will write a list of items to buy [ … ] and ask him or her to buy them from any veterinary shop. It’s always difficult for them to buy them. Then we negotiate the treatment price. Now we use special receipts from the district council. (Rural LEO, F)
The need to regulate LEOs’ fee structures has also been recognised by government research as necessary to ‘make the system of livestock services more effective’ . In the meantime, frontline actors make frequent appeals to ‘officialdom’ to legitimise their own authority and rely heavily on collaborative relationships.
Teamwork and leveraging networks
As illustrated above, meat condemnation can be difficult and contested as it involves destruction of property and income loss. Condemnation can happen at households where animals have died or been informally slaughtered; at slaughter sites (slabs or slaughterhouses); and at sites of meat sale. Although LEOs were sometimes invited by households or butchers to assess whether animals or carcasses were safe for consumption (in such instances, people were generally grateful, even if this resulted in condemnation), LEOs and HOs did at times discover or receive tip-offs from community members about suspicious animal deaths, slaughter, or meat sale. In such situations, and especially those in which human health was perceived to be clearly and/or immediately at risk, inspectors felt they had to act – but they often faced resistance or even, at times, personal danger. As such, frontline actors often drew on their professional networks to respond collectively:
I had to form a small team of four, including the HO and two other meat inspectors from nearby wards. We arrived at the butchery, we didn’t ask many questions, we just condemned the meat. (Urban LEO, F)
The above example involved a female LEO who subsequently worried the male butcher might ‘hire people to harm’ her. Another rural female LEO’s diagnosis of anthrax was initially met with disbelief. ‘Luckily’, she explained, a retired male LEO and other staff had accompanied her, otherwise ‘they would have harmed me or refused to bury [the carcass]’. She recounted another incident of condemnation when a male livestock owner threatened her with a knife. She called a senior male colleague for backup. Such fears were not only experienced by female inspectors. One rural, experienced, male LEO worried about being poisoned, while another expressed safety concerns when commuting in the dark. Furthermore, during informal follow-up conversations between the author (TH) and two female officers (one LEO and one HO), these experiences were not perceived as particular to their gender. Such examples, nevertheless, demonstrate the importance of both men and women officers being able to draw upon a team for support when undertaking contentious acts of enforcement.
Frontline actors have, as indicated in the following quotes, become skilled at sensing when to call-in their colleagues:
If I’m alone, it depends on the understanding of the butcher. If he accepts the truth we condemn it without problems but if he doesn’t, I call for assistance from other HOs from the municipal level and neighbouring wards to participate in the condemnation process. (Urban HO, F)
If I see an indication that the owner might bring problems later, I invite the District Vet Officer, HO and Solicitor, and fill in condemnation forms as required by law. (Urban LEO, M)
Professional networks were not only important for difficult enforcement situations. Two LEOs reported using mobile phone apps to participate in informal LEO networks, seeking advice in the absence of regular training. Photographing a carcass and getting confirmation of a diagnosis bolsters LEOs’ confidence and can project authority while also informally sharing information about disease patterns:
We have established an LEO group on smart phones. If one has a problem or needs clarification, we take photos and circulate them. (Rural LEO, M)
This network is very important as it provides opportunities to communicate to areas where [sick] animals are coming from [and tell them] to take control measures. (Rural LEO, M)
Many frontline actors also drew upon local community networks and power structures for practical and political support. Announcements about vaccination campaigns or disease outbreaks were frequently made through religious organisations, savings and micro-finance groups, farmers groups, at markets and even funerals. LEOs and HOs – especially those in rural settings – also relied on local elected leaders at sub-village and street (urban) level to disseminate information, and to accompany them during vaccination campaigns or community hygiene inspections.Footnote 7 In so doing, they relied on elected leaders’ good relationships with community members to encourage compliance.
I will seek support from the chairpersons of the sub-villages. They are very powerful. People listen to them as they are elected by community members. (Rural HO, F)
We usually move around with village and sub-village leaders during official vaccination. They are very important as they participate in sensitization and people trust them. (Rural LEO, M)
As indicated in these quotes, trust was central to accomplishing any work requiring the cooperation of residents, and local leaders were seen to be ‘very close to their village members’. They were capable of securing buy-in and participation beyond what officers could achieve given their inability to spend much time getting to know and delivering services in communities.
Adapting to local contexts
As frontline actors, LEOs and HOs were highly cognizant of the social and economic context in which they worked. They recognised that poverty affected people’s ability to pay for services, upgrade their premises, and comply with policy. Indeed, many respondents identified inability to afford services, drugs or upgrades as drivers of disease, and thus were sensitive to, and sought to accommodate, these local constraints. One rural LEO, quoted below, allowed poor livestock keepers to defer vaccination payments despite knowing reimbursement was unlikely. He and others also shared information about free vaccinations strategically:
We don’t announce free vaccines. We announce the campaign, and then during the process and in collaboration with sub-village leaders, we identify weak families unable to pay and give them free vaccinations. (Rural LEO, M)
Sensitivity to local conditions also helped LEOs and others recognise the difficulty of implementing certain regulatory recommendations – for instance that butchers have electric meat saws and deep freezers – leading them to overlook these when electricity was unavailable, unreliable, or unaffordable. Most focused instead on more context-appropriate regulations such as easily-cleanable tiled walls, glass windows, hand-washing facilities (running water hook-ups, or spigot-buckets) and plastic chopping boards, although the appropriateness of the latter was questioned by some.
LEOs’ and HOs’ sensitivity to poverty made them ‘careful’ and diplomatic in monitoring butcheries and meat handlers. One way of managing their relationships with butchers – which they were wary of damaging – was to selectively limit enforcement:
Meat inspection is a sensitive job. I must be careful, otherwise I may damage good relationships with the butchers. After meat inspection, the rest of the work is done by the HO and other staff. I don’t want to follow business people that much, although I have to make sure the meat is safe to eat. (Urban LEO, M)
This LEO emphasised making sure meat was inspected, choosing to leave ‘the rest of the work’ – such as ensuring hygiene and infrastructural compliance – to others. During meat inspection at slaughter, several LEOs reported trying to minimise butchers’ losses:
We feel very bad every time we discard animal livers. It’s a loss to butchers, but what can we do, we want consumers to eat safe meat. We may decide to trim the liver and remove affected areas to minimise loss. (Rural LEO, M)
When we find an animal with a disease that cannot affect other animals like dogs […], we call [the dog owners]. The owner of the cow would negotiate the price […] and can at least recover part of the loss incurred. (Urban LEO, M)
LEOs used a number of strategies that included: rationalising non-enforcement of certain regulations, leaving work to HOs, and/or negotiating with butchers and farmers to upgrade their facilities and change their behaviour. While inspectors may have had personal ‘red lines’ in terms of minimum standards, HOs and LEOs alike emphasised a combination of flexibility and insistence:
We explained to them the law requires all butcheries to meet hygiene standards. We had a tough time at first, but we sensitized them to the benefits and need for standards. We agreed on a deadline and all had to obey. I reminded them that if they didn’t make changes before the deadline we would not provide slaughtering services. (Rural LEO, M)
We have a lot to do, educating them to accept changes as a way of improving their business and safeguarding the health of their customers. We explain the possible consequences if slabs remains dirty allowing dogs and other animals scavenging on them. […] We educate them first, give them time to adopt the directed changes, if they don’t comply we finally use force. (Rural HO, M)
LEOs and HOs understood the financial impact upgrades, business closures and fines could have, and that business people often claimed to be, or were unaware of regulations. Thus, they issued a series of reminders, warnings and deadlines before taking punitive action. One LEO with over two decades’ experience repeatedly emphasised the importance of what he called the ‘extension approach,’ the core of which, he explained, is communicating sensitively and diplomatically with butchers and meat handlers to gain their trust, educate them and encourage their compliance. This combination of flexibility, patience and skilful communication reflects recognition of both local socio-economic realities and social-cultural understandings of respectful interpersonal interaction in both urban and rural settings. For these reasons, LEOs and HOs did not simply mete out fines for non-compliance. Instead they explained ‘the importance of implementing the law and the consequences of not complying’ (urban committee volunteer, F), confiscated unsafe meat, issued cautions and waited to see if improvements were implemented. When fines could no longer be delayed, frontline actors found ways to lessen the impact for those who could not afford to pay:
This ward is one of the poorest in the Municipal Council. We understand nobody can pay that amount of money at once. They do it by instalment, or we may even forgive them. (Urban HO, F)
In extreme cases of non-compliance, frontline actors did at times close businesses, but still they sought to limit associated financial burdens:
After I’m satisfied with the work done, I allow them to continue business again. We don’t ask them to pay a fine, because that would be double punishment. (Rural committee volunteer, F)
What is clear in the above examples is frontline actors’ use of discretion and diplomacy to carry out their duties in ways sensitive to local economic realities, social norms and expectations. This allows them to negotiate behaviour change in ways that preserve, in as far as possible given the nature of their work, relationships of trust with butchers and others.
Building local expertise and capacity
Our respondents emphasised the importance of education and awareness-raising about animal health, meat safety, and human disease. This ranged from advising consumers about safe meat consumption, to teaching farmers and butchers to recognise signs of animal illness and unsafe meat and explaining why certain protocols and standards existed. Such instruction happens through campaigns, meetings, training, media, and religious forums, and involve both independent and collaborative efforts. Clinical personnel for instance, described disease prevention efforts through in-clinic training.
Health education is done every day at the dispensary. It’s like prayers, we have fixed timetables showing that today we have health education on nutrition, on malaria, etc. If there is an outbreak of animal disease, we also include it in the sessions. (Urban nurse, F)
Community volunteers serving on ward and village or street-level health and environment committees, often in collaboration with HOs, taught local residents to protect themselves and others by buying only inspected meat, and encouraged its thorough cooking.
[At public gatherings] we tell them not to eat un-inspected meat and the government stamp on the meat means inspection was done and it is safe to eat. (Rural committee volunteer, F)
I talk a lot with mama lishe [food sellers] on proper ways of food preparation […] they have to make sure that food is cooked for a long-time in a clean environment. (Urban HO, F)
Certain frontline actors recognised the importance of ‘meeting’ people where they are. They therefore stressed their efforts, despite resource constraints, to visit far-flung corners of a ward, recognising they might, through education rather than timely inspection, prevent deaths from consuming infected meat. They also recognised that many people did not have capacity or inclination to attend public functions or meetings. In the words of one rural LEO referring to past government efforts to convene farmer groups for training purposes:
They have other issues to deal with, they cannot waste time listening to facilitators for several hours without getting anything tangible at the end of the day. ‘What shall we eat this evening, your words? We have families we need to feed, we cannot waste our time listening to you.’ (Rural LEO, M)
LEOs therefore also built training into their individual household visits.
We educate family members every time we visit for animal treatment. We tell them the symptoms of animal diseases, how they are transmitted and how to control them. (Rural LEO, M)
Indeed, LEOs’ mandated duties to support animal-based livelihoods include such instruction. However, they broadened the remit of their prescribed educational duties to include coaching butchers to identify unsafe meat and understand why particular standards were necessary.
We educate them on the consequences of butcheries without required infrastructure. [We explain that] meat which comes in contact with flies may harm their consumers. We demonstrate the difference between a wall covered with tiles and one not. If the blood splashes on a wall without tiles, how would they clean it? (Urban LEO, F)
This strategy – of training butchers so they might self-regulate – helped LEOs and others address their own limited capacity to serve and inspect all places punctually.
It may happen I am late to the slaughter site, I allow them to continue selling meat if no unusual symptoms have been seen on the animal carcass. I’m glad no one has ever betrayed my trust. They know how to examine the meat, I always show them …. (Rural LEO, M)
One LEO also linked butchers’ understandings of meat safety to the mitigation of conflict should he have to condemn meat:
So we have to educate [butchers] why the meat must be thrown away. Some understand. There must be obvious reasons and fortunately they can see this with their own eyes. So we do a lot of counselling and they sometimes do their own observation before I arrive. They know beforehand that today there will be no lungs or kidneys or heart etc. When I arrive they keep quiet to hear the final decision from me. (Rural LEO, M)
Education was thus, not only a way of ‘sensitising’ community members to ‘the benefits of complying with the laws and regulations on health issues’ (urban HO, M) and of raising general consciousness about human and animal health, it was also about being fair in a resource-strapped context. As shown above, punitive action for non-compliance was often treated as a last resort, meted out only after considerable effort to inform people of rules, standards and associated rationales.