Book Review: The Last Hunger Season

What Global Surgery can learn from Roger Thurow’s “The Last Hunger Season”

By Genevieve Barnard

In “The Last Hunger Season,” Thurow follows the lives of a handful of rural farmers in Western Kenya as they attempt to eliminate hunger from their communities with the assistance of an innovative NGO called One Acre Fund. Thurow follows the seven seasons of the farming year, telling the successes and struggles of individual African farmers, and highlighting the promise of One Acre Fund’s model. Founded by Andrew Youn while studying at Northwestern University’s Kellogg School of Management, One Acre Fund identifies groups of small-scale farmers, usually made up of primarily women. One Acre provides education on improved farming practices, planting materials and fertilizers, training on post-harvest storage, and crop insurance. One Acre Fund farmers are given seeds and fertilizers up front, but must pay back the cost of those supplies over the course of the year, before the next planting season begins.

“The Last Hunger Season” depicts a promising approach to breaking the cycle of poverty through improved agricultural methods and access to markets. In several instances, the reader shares in the excitement of One Acre farmers as they harvest bigger yields than ever expected and begin aspiring to move beyond subsistence farming and provide better futures for their children. “The Last Hunger Season” is a story of hope, hard work, and high aspirations. The characters in this story, from the organization’s founder, to political activists, to the farmers themselves, share a sense of pride in their successes and a daunting understanding that there is so much more to accomplish.

So how do the lessons learned through One Acre Fund’s success help those of us pondering the future of surgery in Africa? I will answer this question with one of my favorite quotes from the book, “How can we do this better?” Throughout the book, this question is asked several times; within One Acre Fund there is a constant drive to find a better way, whether it’s developing a more disease-resistant seed variety, improving storage containers for harvested maize, or teaching farmers about the importance of seed spacing. But more than just looking at how to be better, One Acre focuses on how to better serve. The banner across the home page of One Acre’s website reads, “Meet the Boss” next to a picture of a smiling Rwandan farmer. This imagery and phrasing sends a powerful message: One Acre Foundation is not just better; they better serve their boss, the smallholder African farmer.

Global surgery too is looking for better ways to address the surgical needs in sub-Saharan Africa, and it is important that we keep this fundamental question in mind. But it’s not enough for us just to be better; rather, like One Acre Fund and their farmers, we must better serve the surgeons with whom we work. All too often global health organizations care more about being better, focusing solely on improved outputs, instead of focusing on improved outcomes in line with local agendas.  Although the Office of Global Surgery works with surgeons, not farmers, the overarching philosophy is the same. The brilliance of the One Acre Fund model lies not in their ability to outperform and push harder, but in their underlying mission to embrace the missions of their farmers.


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