This chapter focuses on how the marginalization of Bahaya women increases poverty, thus exacerbating issues of hunger and related disease in a region characterized by a history of environmental degradation, agricultural change and decline, rural poverty and disease. In the past several decades, diminishing sizes of banana farms, an overall decline in cattle, decreasing soil fertility, and an increase in food crop pathogens have posed challenges to achieving adequate agricultural yields in Buhaya of northwestern Tanzania. This situation has resulted in an increase in poverty, food insecurity, nutrition insecurity, and related disease. Culturally, women are the primary agriculturalists and producers and providers of food in Buhaya. However, Bahaya cultural practices hinder women from achieving equal representation in society, thus blocking their access to self advancement and resources such as money, land, education, and agricultural inputs. These constraints marginalize and hinder women from fulfilling their social role as primary farmers and provisioners of food, nutrition, and care. As patriarchal practices and ecological challenges work to constrain women's roles, poverty, food scarcity, and disease increase, affecting and weakening the foundation of Bahaya society and culture.