Few people are out turning over the soil, even in small gardens.
The famine keeps the rural population inside and sickly. Tuberculosis is running rampant in the AIDS population as well as the general population, i.e., the AIDS victims are likely to be killed by something else before a prolonged mycosis like Cryptococcosis can claim them. The paradoxical effect is environmental. This is true world-wide. Instead they lean to a life-style explanation.