Wednesday, October 31, 2012

Summary of the past few months.


This is a long overdue recap of all that has happened over the past month! On September 24, I boarded the plane for my two month long mission trip to Haiti. Upon arriving at Grace Village, I was greeted with screams and cheers... The kids even sang me a welcome song (one that they used to sing at their old orphanage when greeting teams!!). I just about cried as I stood there looking at how great all the kids looked, especially the ones that had been so disheveled when I had worked with them in June. It amazes me how much a clean environment, supportive atmosphere, safe ( and ultra clean) drinking water, and a few meals a day can do to this kids!! Their whole being is directly impacted... Personality, physical appearance, health..

After being welcomed, I made my way to what would be my new room for the next few months and started to unpack. It was already dark in Haiti and the kids would have been getting close to preparing for bed. I was just anticipating the next few days to catch up with the kids, the staff, and get busy with work!!

Within the first week, my skills as a dietitian were greatly used. I followed up on the assessments of all the kids at Grace Village, even those that are not on supplements. Our new Haitian nurse helped me with this.. Which was awesome!! She gathered the weights, while I measured the kids' heights and arm circumferences. It was fun to see the exciting transformations some of these kids have made. There was a few things in the discovery of the supplements and the growths that challenged my patience.. Finding some issues with supplements getting out, not being prepared correctly, and some kids not taking their supplement. This discovery called for immediate attention, and I had to work with the staff to clarify instructions and to restructure the supplements into the daily routine. I found that sharing the growth charts and physical changes in the kids was helpful for them to understand the importance. I also thought it would be important to share with the kids what exactly the supplements are for and how they are benefiting them. one day, I showed the boys the famous picture and growth chart I typically use to show the dramatic changes nutrition can have on children. The boy in the picture was blown away by the images and the amount of progress he has made. while sitting with the boys, I taught them about the growth charts and the significance of the supplements. The educational moment was in favor of everyone's benefit. That evening... (and evenings to come) many of the boys would intentionally show me their mamba packets and tell me they were eating them. It was amazing to see their compliance with the program.

Another major project that I started diving into while I was there was the meals at the feeding center, as well as budget issues. Each day I tracked the meals served at the feeding center, and couldn't figure out why a fruit nor vegetable was showing up on these kids plates everyday. For several days in a row, the meals were all white and brown, lacking little variety, and little protein. I felt completely disheartened realizing something must not have stuck from June. However, it wasn't a total shock to me considering I had my attention in all different places in June trying to help new kids adjust to eating regular meals. And time constraints.. It's hard to see behavioral change within just two weeks. So I knew for sure I was going to have my work cutout for me over the course of the next few months...

After analyzing the budget and the meals served at the feeding center, I made nutritional recommendations on food (or food ingredients) we can minimize/ maximize in our budget in order to be more cost-effect, in other words getting the most nutritiously dense diet for our bucks. The recommendations would mean some major shifts for the feeding center. After analyzing the children's plates and the amount of money we were spending on meat, I decided that it would be best to switch focus of the feeding center from a meat, oil/butter, white grain diet towards a diet rich in plant based proteins, whole grains, fruits and vegetables. Haiti, despite popular belief, has a wonderful variety of fruits and vegetables... And our feeding center really needs to start taking advantage of the wide variety of produce available to us.

Don't worry the kids will be eating lots of beans, eggs, and peanut butter to meet their protein needs... I projected that the kids could have 1 egg per day for the cost of having 1 oz of red meat ten times a month. Using a lot of beans with whole grains, will provide these kids more protein than they were getting from their small portion of meat anyways (some kids were just getting the piece of a bone..that doesnt count for much). We are also cutting down on our use of juice in order to cut down on sugar expenses. I would rather see the money being used to by whole fruits (which provide natural sugars, vitamins, and fiber compared to refined sugar). Don't worry, I am allowing them to have juice once per week... And meat a couple times per month. We have created a new menu plan that has kept the use of traditional meals for lunch (rice and beans, pitimi and beans, black bean soup, corn meal and vegetables), but have added "new" foods or new meal patterns to allow for more nutrition throughout the day. My goal isn't to introduce American meals, but to show the staff new ways to use foods already available to them.. And to put them together to create well balanced meal. One meal in particular is the bean burgers the kids have been eating at night. I have shown the staff how they can use beans and different carbohydrate foods to make the bean burgers, as well as different ways to serve them (on a bun, with avocado, using tomato sauce). The beans are an excellent sources of protein, fiber, carbohydrate...and provide more nutrients per serving than some of their grains they had previously been serving the kids at night. This is something I thoroughly enjoy about my mission here in haiti... Discovering ways to use local resources to make nutritiously dense and cost-effective meals. I enjoy experimenting with foods and finding ways to make foods in new ways... And teaching the staff and children about well balanced meals.

This shift in focus isn't as easy as one would think; it requires some behavioral changes amongst the staff, as well as educating the children and staff about the importance of the switch, the importance of balance, and the bigger picture this has to their overall health. our children eat three to four times a day from our feeding center.. what they were eating day after day would heighten risk for chronic diseases later in life (hypertension, cardiovascular disease, diabetes). Introducing new foods will require some "taste bud training" , but the way the food is presented (both appearance  of the food and the environmental context in which it is presented) can provide a fun and positive atmosphere that will make the foods more acceptable.

After changing the menu, the Haitian feeding center director and I looked it over together to see if everything I suggested would be feasible. We adjusted a few things and then planed a staff meeting to discuss the changes with the staff. At the staff meeting, I also did a little nutrition education to help the staff understand why I was asking for changes in the menu. The key player in change, the orphan director, was invited to the meeting... And he seemed to really enjoy learning about the importance of a well balanced diet. Getting him on board would help him to encourage the kids to accept the new foods, as well as the staff.

At the meeting, I showed the staff pictures I had taken over the past few days. Many of the days were the same.. lacking little variety, and using very little produce. Then I showed them a really good day were they incorporated fruits and vegetables and how this changed the whole nutrition profile of the meals! This seemed to be pretty effective.
After the meeting, the staff was really good about keeping the kitchen clean and following the new menu.

In addition to all this, we also started a school breakfast program with the new school that opened in October at Grace Village. The program can only afford to do sandwiches at the current time, so we provide each student a peanut butter sandwich 3 times a week and an egg sandwich 2 times per week. It is important that we can target some of the kids coming from town with a good nutrition while they are under our mission. I am hoping that some day we will be able to expand our program to provide more for the 300 + children that come to Grace Village everyday to learn... And to become the future of Haiti.

During my third week in Haiti, I received a message from my mom that my grandma, who was on hospice at the time was not doing well. I planned to book a flight back home so I could be with my family during the time. I made arrangements with the airlines and began to pack my things because I was heading home to MN the next day. While packing, the kitchen staff called me in to ask me what was for dinner. The menu was black bean burgers... Something I hadn't shown them how to make yet. I had done a taste test on the kids earlier that week and they liked it. However, due to my limited time I told them to just make peanut butter sandwiches. They didn't like that idea and demanded I teach them. I was impressed with their eagerness to work and to learn.  So I told them I would be back later to show them.

While packing my things, I got word that my grandmother had passed away. Immediately, I began to cry. The door to my room opened and one of our orphans, who had been crying earlier came in. She was also sad because she missed her family. We both hugged each other and stood there crying in the middle of the room. We just hugged each other for several minutes. Our bodies swayed to the sound of the music playing from my computer. It was a simple, yet beautiful moment shared between the two of us. Though we could not speak the same language, we knew we needed each other at that moment.

After having some time to cope, I went to the kitchen to help the staff prepare the evening meal. I was filled with great joy and satisfaction that the kids and the staff enjoyed the burgers. I had to tell them what it was before they ate it and asked them to tell me if they liked them. I also told them the news that I would be leaving the next morning, but would be returning in a few weeks. ...

 The results from the meal---the kids loved the burgers!!! Everyone kept saying, "again, Kristina!?" ... " tomorrow, Kristina!?" It was so pleasing to hear that the kids enjoyed the meal.. And for me to know that they were getting a well balanced nutritional intake from it.



I was nervous about leaving the staff with the new menu, but left a camera for our feeding center to use while I was gone. I figured this would be a good way for her to photo document the meals and for me to see what happened while In MN. I figured this would be a good test to see what they would be able to do without me there to oversee everything. I looked forward to my return home... I had been feeling a little homesick and was excited to see my family. I wanted to be with them during this time of grievance.

I am so grateful and blessed for all the unconditional love and support people have shown me and my family over the past few weeks with the loss of my grandmother. She was a very inspirational woman... Growing up in poverty herself and teaching her children, her grandchildren... And anyone that knew her what it means to be a humble, and grateful servant. My grandma wasn't one to boost about herself or her generous deeds. She never wanted praise, glory, or demanded extra attention. Even though she rose above her circumstance of poverty, she never ceased to forget those who were in need. She spent many years devoted to serving and supporting the poor in both MN and in Haiti. She just lived... And lived in the narrow way, following in the foot steps of Christ. She was a woman of great faith.. Dedicated to serving her family, her church, and her community.  She is a woman that I desire to be like... An inspiration and a role model. I am blessed to have known and loved this woman... And now have her by my side watching and guarding over me.

Be sure to follow along my daily activities here in Haiti by clicking the link to my Facebook page. If you have a Facebook account, like the page to get frequent updates on your news feed!! Merci anpil!! https://www.facebook.com/foriwashungry