Tuesday, February 19, 2013

Ventures away

This week, I have the opportunity to step away from my nutrition mission here in Haiti to engage in some of the other ministries of Healing Haiti (the organization I volunteer through). My mom is in Haiti this week leading a Healing Haiti mission team, so I am spending the week with them. So far this has been a nice little break from my "normal" routine.

Today, we visited the home for sick and dying. I have been here before on many occasions, as my volunteer work initially started through mission team activities. Since my last visit here, there had been some dramatic changes with the facility. Open, bright, clean... beautiful! They actually had a playground for the kids to play on. Swings, a slide, matted floors. I was impressed. Upon walking in, I was greeted by babies laying on a mat (their bedroom was being cleaned). Instantly, the sweetest little boy clung to me. He was so full of smiles and giggles... it was great. I just love these little nuggets. It is fun knowing some creole now to actually communicate with the people. I found myself really enjoying that throughout my visit, and I could tell some of the people did too. One of the 10 year old girls with malnutrition really liked hanging around me. She would always end-up finding me.. in the hallway, on the swings. She would pick up some of the little babies there and sit with them on the swing with me. It was sweet. The slightly older kids and toddlers just seemed to flock. I guess I was kind of used to hanging out with this age group since they resembled the kids at Grace Village. Towards the end of the visit, the kids were given a packet of Medika Mamba, the supplement I had many of the kids on at Grace Village. It just kept tugging at my heart thinking about the fact that these babies, toddlers, and children shouldn't even have to be here for malnutrition. It is such a preventable condition.

Our afternoon was filled with pleasant surprises at the home for sick and dying adults. When we arrived, there were little faces sticking there heads out of the deck on the second floor of the building. It was prayer time for the ladies, and all of the ones that were feeling well enough to leave their beds were gathered in the hallways on the second floor. The ladies on my team made our way up the stairs to start our mission: comforting the sick and the dying with basic human touch. We rubbed lotion on their arms and legs. I only got through two ladies during my time there. I was able to communicate with them a bit, which was delightful. After my second lady, I had to chase down my mom for lotion and eventually got caught-up talking to a woman in the hallway. I just stood back from the large hospital rooms (literally 3 rooms filled with small beds lined up in rows...like a war movie) to observe the action around me. All of a sudden, I noticed a few little girls peaking their heads in the room were I was. They were just hanging out....watching the missionaries, the nurses, and the activities here. I was so intrigued by them. They were so cute in their matching outfits. Their cuteness definitely attracted me, and I made my way over to where they were gathered. I started speaking to them in my broken creole and asked if they were friends. They giggled (probably because this young white girl spoke their language) and responded yes. So I continued on.. asking them if they had family here and were visiting. A valid question since this wasn't a children's hospital. When they told me no, I continued on. I asked if they were sick, and they said yes. My heart melted, but I continued on again and asked what they were sick with. A few responses were that they had trouble eating (malnutrition) and another said anemia. I told them what I do, that I work with kids about their age, and know all kinds of things about nutrition. They seemed to like to hear that. We continued conversing for a bit and one little girl boldly told me she wanted lotion on her body too... just like the adults were getting. I hunted down the lotion, and started a little spa session with the little girls. They all wanted lotion on their arms, legs, and necks. Putting lotion on their extended bellies made my heart melt even more... malnutrition. They lined up, and when I had to track down the other missionaries for more lotion....they trailed right behind me..giggling. They were absolutely loving the attention and the "spa day." It reminded me of when I was a little girl and loved getting my toe nails painted with my mom. They were so sweet. While I was rubbing lotion on the girls, there was one girl that seemed to be distant from the rest of the group. She had a blue dress on...different than everyone else. Her eyes were yellow, hair pretty dry and brittle, and her skin covered in little bumps. She was absolutely adorable even with her disheveled appearance. She wasn't working overly working hard for attention, but followed along. After putting lotion on all the other girls, I bent down to the little girl in blue and asked her in creole if she had medication on her arms and legs. I told her I wouldn't be able to put lotion on her, but rubbed her belly and her hair to make sure she knew she was just as loved. Soon enough, I was called into the girls room where the bunks were lined up. They were all sitting there with my mom singing songs, and sure enough they wanted me to sing Justin Beiber's Baby. So we did! It was cute. In the corner of my eye, I saw the little girl in blue sitting a kiddy-corner in the bed row behind.. watching us all from afar. It broke my heart knowing she just wanted to be better, to be able to play with the others.

When it was time to go, I told the girls I would pray for them all.. and then I quickly snuck off to find the nun that spoke English. I wanted to know what they were doing for nutrition here. I wanted to know about these little girls. The little girls were mainly there due to malnutrition, HIV, and TB. She showed me a few of her nutritional supplements (both were ones have used at our orphanage). They also had a plumpy-nut program, which was nice to see. I told her about the Medika Mamba product in Haiti-- she wasn't familiar with it. I enjoyed getting to converse with her. I wish I had done so sooner to dig deeper, ask more questions, and possibly get more involved.

As we gathered in our tap-tap outside of the facility, the little girls we had just been playing with were peaking their heads out from the cracks on the deck of the second floor. They watched us pack-up, and as they noticed that we could see them... they smiled and waved. It was one of those picture-perfect moments---a scene you would see in an old war movie. Little malnourished kids in their hospital gowns, peaking out of an old wooden deck with draps hanging from the banester above them.

It is moments like this make my life here in Haiti feel so surreal... I constantly feel like I am in some sort of movie with fake scenery, fake conditions, and really good actors/actresses. If only that were the case. Unfortunately, this is real life.. someone's reality in 2013.

This picture isn't from today, but  captures that "movie" type scene.

Monday, February 18, 2013

Food Wars

It has been weeks since I have written a more formal update about my life in Haiti. I am often amazed by how time can fly by so quickly, but feel like forever all at the same time.  So much happens in the weeks span, and it is often times hard to find the time, energy, or words…and lately, internet connection.. to even express the emotions, the frustrations, the struggles, the joys, and the activities that take place on a day-to- day and weekly basis.

My work extends beyond just the kitchen, meal planning, and the kids’ nutritional needs. I find myself often times taking on the role of a coach, a mentor, and a psychologist. We are constantly dealing with arising issues amongst the children/staff, the community, a system of activities, educational/communication/cultural barriers, and (in my case) rodents/ pests. Problem solving does not stop. Brainstorming, collaborating, and team-work are a continuous activity amongst myself, the other missionaries, and the Haitian staff (and children). I am learning how to prioritize my work to fit with the “outside” factors of life (ex. Is it a good time for nutrition education, where are the staff/ children’s minds at, what activities are taking place that might impact the success of an event). I am finding that setting aside my personal agenda is oftentimes difficult and frustrating, but teaching me a great deal of patience and understanding.

The rapport I have established with the children, the Haitian staff, and, above all, my  Haitian apprentice  (our Operations and Feeding Center Director) are vital in my nutritional work. It has taken some time for them all to trust me with what I say and do. It has taken many failed experiences, trials-and-errors, and mini educational or pep-talk sessions to help them understand that I am not “feeding” them information that is going to hurt them, but the dietary changes I am asking for will directly impact their overall wellbeing and quality of life (even if they don’t see the dramatic effects within a day… or even a week) and furthermore, are based on research, science, and education.

Taking an adventure!

A picture hasn’t been able to capture the depth of my nutritional work here in Haiti. I am constantly fighting a “Food War” (whether you want to believe it or not). First and foremost, kids are kids anywhere you live. We battle with certain foods or certain meals. ... and the fact that they wont have rice and beans everyday. (That's right, we are a "non-traditional" Haitian-run Feeding Center. Rice and beans are only provided 1-2 times per week). Sometimes I think the Feeding Center Director has learned more from me than I have learned from myself because after any “unsuccessful” meal ( unsuccessful meaning that there is a 50 to 50 of likes to no likes), she doesn’t let me give-up. When I come to her discouraged and upset by the behaviors/ the reactions at a meal she will tell me… “Kristina, we will try again. They will like it.” Evidently, she has learned something from me---try a meal once, try it again, and eventually, they will learn to like it.  We have found this to be true with the kids...and even the staff.  Sometimes slightly adjusting flavor, ingredients, or style of the meal helps to make it more accepted, and we learn these things through simple trial and error. Overtime, the "new" foods or meals just become a familiar menu item. The "Food Wars" with the kids have gotten better with the implementation of a few systems: 1. Menu Planning 2. Division of responsibility 3. Modeling of healthy eating.

This morning the boys decided not to eat... 
So the girls ate the boys food..

 Every week, the feeding center director and I meet to menu plan. The first time we did this, it took us a good hour or two to plan-out 3 meals a day for 9 days. The second and third time planning were a lot easier since we had a running list of menu items, new meals to add to the bucket list, and a few new food ideas to implement. Planning the menu ahead of time helps the staff to be prepared for market days,  have variety in their weekly-work flow (instead of making cornmeal and beans every Monday, they have a new combination of foods to work with), and keeps everyone out of a rut. A changing menu also helps to balance out the financial costs, as well as the kinds of nutrients the kids are getting on a daily basis. If we did rice and beans everyday, we would be "cheating" the kids out of a variety of vitamins, minerals, and macronutrients (carbohydrates, proteins, fats) found in different grains, starchy vegetables, vegetables, and fruits. Providing a variety of foods is an easy "insurance" that the kids are getting a balance of nutrients. I have often been asked if we add any special powders to the kids meals (vitamin or mineral packets), and my response is always no. The kids currently take a multivitamin, but with the set up of the menu and the variety of foods served at the Feeding Center the kids should be getting an adequate amount of vital nutrients from their daily intake. I place emphasis on EATING your vitamins and minerals through lean proteins, whole grains, vegetables, fruits, and heart-healthy fats rather than taking a supplement or using special powders (unless you have no other option or you have special needs--such as our kids needing to gain weight).


Zesty pasta salad with black beans and vegetables
Homemade veggie burgers with a side of pineapple and aquaponic lettuce!

Our menu and education board in the Feeding Center. 

We have found that posting the menu also helps the kids to have a visual of what to expect to eat for the week. Furthermore, helping them psychologically prepare for new experiences and their favorite and/or least favorite meals. If they have to eat something they don't like one day for breakfast, they can look at the menu and see that the rest of the day are things they do like. And what happens if they like nothing on the menu besides rice and beans? Well, good question. That is for them to decide. This is where the second system comes into place: The division of responsibility (Ellyn Satter's Division of Responsibility in Feeding).

The division of responsibility is between the parent and the child. It is the parent's (in our case: myself and the feeding center director) responsibility to decide what will be served and when it will be served. We know what is best for the kids and what they should be having for proper growth and development. It is the child's responsibility to decide if 1. they are going to eat and 2. how much they are going to eat. More recently, our meals have also become more engaging with the kids having participation in serving of some of the lunch meals, as well as helping prepare some of the dinner meals. The participation allows the kids to learn about the food and to feel some control in the division of responsibility. For example, on saturday night I helped the night staff prepare a black bean salsa for dinner. A few teenagers were in the cafeteria and kitchen either watching and/or helping me prepare the salsa. They helped chopped onions, tomatoes, green peppers and mixed them in with the beans. Not only were they learning how to wash/cut the foods, they were also getting the opportunity to see how simple and easy it is to prepare the salsa. When I told them to add mango to the salsa, they all gasped in surprise/shock that I would even suggest such a thing. Their expressions where laughs of "you have to be crazy!" So I cut a mango and mixed a few slices in a small bowl of the mixture we had already created. I made them sample it...and to their surprise, they actually liked it!! So we all decided as a group that we would prepare 2 batches of salsa--one with the mango and the other without. We would make all the kids try both. Having a few kids already accepting of the new creation made it easier for others to be willing to  try it when it came to dinner time. Through this experience, we learned that allowing the kids to participate in the meal preparation helps them to 1. develop skills to prepare meals for themselves 2. learn how to create new food combinations 3. be more accepting of new foods/ combinations because they were able to participate in the creation of it.
Serving up some delicious, healthy foods!

The monitors (children's caretakers) help with serving the meals.
The older kids are allowed to serve themselves sometimes too!!

Serving up some carrot and ginger soup! 

Now on to the third system being implemented: Modeling Healthy Eating. This system also fits nicely in with the division of responsibility. The parents' responsibility is to model healthy eating. If you want your kids to eat healthy and balanced, well you better eat healthy and balanced too!! For many meals (especially new menu items and dinners) served at Grace Village, I like to eat with the kids. I like to show them that I wouldn't feed them anything I wouldn't eat. Some days I even make my own creations, and mix it in with the food being served to show the kids what else we can do. For example, the other day I lightly sautéed tomatoes, eggplant, onions, and spinach, and I mixed the combination in with the bulgur and beans being served for lunch. I showed the kids what I did and just ate it infront of them. I wanted to showing them that 1. I love eating a lot of vegetables 2. the combination tastes great. I want them to want to eat what I eat.. so I might as well "brag" about it infront of them until they ask for me to make that for them too. If they can see me enjoying eating healthy, I am sure they will want to participate in the same enjoyment. You can make vegetables look as desirable as a big piece of chocolate cake... and if you really feel like you can't, just pretend that you can!

Eating with the kids! 

My second battle with the "Food Wars" is not just with the kids. I also find that I am challenged with folklore and ideologies about food here in Haiti. Hearing the misinformation about food and/or food groups helps explain WHY the kids/ staff are initially resistent to my menu changes and ideas. Two examples of nutritional misinformation I have uncovered through conversation: 1. Protein makes you fat 2. Iron in vegetables and whole grains causes hypertension. These two things MIGHT (not proven to be fact) explain why there is a high rate of anemia and protein-malnutrition in this developing country. People place a high emphasis on rice... rice....rice (and when it comes to imported white rice, this brings a whole set of other food wars). These little nutritional misinformations might explain why the kids/staff are resistent to eating so many beans... they think I am going to make them fat. So part of my "Food War" is education.. education.. education. I have to help the children and the staff understand that too many calories (of any kind) makes you gain weight and that lean, quality protein is vital for normal maintenance, repair, and growth. I have also had to work with the staff to re-educate them on the fact that the iron in plants does not contribute to hypertension. The high amount of salt, butter, and oil that are used in the cooking process are contributing factors to chronic disease risk, not the high amount of whole grains, fruits, and vegetables. Trying to explain all this through a language, cultural, and educational barrier is not easy.

Bean plants in Haiti!

An additional pestering "Food War" I face on a daily basis is the use of SALT and "Maggi" in the kitchen. The cooks and I often "battle" about “Maggi."-- she is a hot topic in the kitchen. "Maggi" is a little seasoning packet that is used in EVERY dish around here. Through experience and observation, I have come to learn that the staff uses "Maggi" as a crutch seasoning. One day I "caught" a staff trying to sneak "Maggi" into the vegetable dish without me seeing. When I called her out on it, she told me she didn't know how to cook without it. I was shocked. They already use so many flavors in their cooking...  why would they want to drown them-out with a packet of "Maggi". This battle drives me nuts.  I taste "Maggi" in everything and some days it makes me NOT want to even eat with the kids as a way to "protest" to the staff that she HAS to go. She is ruining our relationship (ha). Why am I so mad about "Maggi"? The staff has become dependent on it, and it is not a helpful ingredient in the kitchen--- 1. "Maggi" costs money 2. Her ingredients: salt, rice flour, flavor enhancer (monosodium glutamate), vegetable fat, sugar, animal fat, dehydrated chicken meat, flavor identical to natural and artificial spices (garlic, onion, parsley), coloring (carmel color, turmeric).  3. They ALREADY use a wide variety of natural flavors  in their cooking (garlic, spinach, coconut, cinnamon, hot peppers.... and we are working on using others like: cilantro, ginger, paprika  lemon pepper, lime, basil, and italian blends....). The battle with "Maggi" has been getting better, as the staff is learning that too much salt is not good for the body. I have noticed that some of the cooks have cutdown on the use of "Maggi" and salt in their cooking... but I can't wait for the day when I can actually taste my vegetables and taste the real flavors of the foods they are making. Change and learning take some time... we will get there eventually!!!

Sampling a few different kinds of hummus with homemade "pita" chips. 

My fourth "Food War" that I tend to face with all Haitians is determining what "Haitian" really means--especially as it relates to food. I like to challenge them on this. How is rice and beans, pasta with hot dogs and ketchup, corn flakes and condensed milk "Haitian"? Furthermore, how is it all "Haitian" when most of it is imported from the D.R. or U.S. anyways?  Majority of Haitians that I have met have this obsession with rice and beans.... I haven't quiet figured it out yet. I have one Haitian friend that has admitted to me that he actually doesn't care for rice and beans. I was shocked.. and delighted to hear so! Don't get me wrong, rice and beans can fit in a normal eating pattern, but when it becomes this obsession and that's all you desire to eat .. and that IS all you eat.. EVERYDAY. I can't imagine you are getting much of a balance of nutrients, that you are fully enjoying the many wonderful foods and flavors available locally in Haiti. The country is rich in tropical fruits, vegetables, starchy vegetables, whole grains... to limit yourself to just rice and beans would mean you are not taking full advantage of the goldmine of nutritiously dense foods, naturally available on this island. Several weeks ago, I came across a resource from Old Ways--- African Heritage and Health Program and Food Pyramid. I discovered the resource at the most perfect timing--- when my challenging needed more support. The food pyramid fit perfectly with the approach I was already trying to take at the feeding center--- a plant based diet using more whole grains, root vegetables, tropical fruits, nuts, beans, and using minimal amount of sweets, fats, animal proteins. Since the Haitians' decent is African, I have been emphasizing this in our feeding center. Reclaiming TRUE Haitian roots through the use of REAL Haitian foods. We are uncovering traditional Haitian meals (Tchaka, pumpkin soup, bean soup, millet and beans), as well as enjoying natural resources in colorful, creative, and healthy ways.

Rice day..
A trip to one of the places were a lot of the imported foods comes in.... this was an insightful market trip.
This is my kind of market! PRODUCE GALORE! 

Not lacking in fruits and vegetables here....

We always have an ample supply of produce. 

Teaching the kids about the African Heritage Pyramid. 

Showing the kids and staff that "pitimi" is served at Hotels in Haiti!! 

Corsol-- one of my favorite tropical fruits!

Tchaka-- a traditional Haitian soup! We make it vegetarian style! One of my new favorite dishes!

Mango Salsa 

Letting the kids be involved!

My fifth "Food War" here is with the rodents and the pests. Yes, bugs in the food are inevitable.  We have bugs in our feeding center and in our dry food. We have been fighting the cockroach battle for a while now. We have had to clean the feeding center from top to bottom, throw-out a bunch of food, and even after all that, we were STILL finding cockroaches. We have taken several new procedures and tried several poisons to kill them.. and the number of them has declined. Preventative actions are our best armor in this battle to be sure we dont have the problem this bad EVER again.
Cleaning the kitchen/storage from top to bottom! Scrubbing with toothbrushes! 

This little buddy wanted to help wash-out buckets for the feeding center. Can't blame him... cold water on a hot day!

My sixth "Food War" is the next battle I feel compelled to take-on. How can I bring what we are doing at Grace Village Cafe to the community, to other orphanages, to other schools? How can we reach more people and "target" them in all the right places? Through conversation with several Haitian men, I am learning that 1. they like other foods than rice and beans 2. they dont have the time or space to prepare foods so this leads to... 3. they buy what is available to them and that leads to... 4. rice and beans is what everyone is selling in their "fast food" stores across Haiti. In local street vendors you find rice and beans, fried foods, hot dogs, sugary-juice, pop.....it's fast, convenient food that comes with unwarranted health problems. Some thing that has been weighing heavy on my heart is figuring-out how I can bring recipes and health promotion to these "fast food" venues, how can I support local cooks in the communities to prepare a variety of foods in healthy ways, and how I can get people "to buy on" to the need for eating a variety of foods and eating balanced. My eyes and hears are open... I am just waiting for the right time to make that next move. It will happen.

Food Vendors at the market
Bulgur and Black Beans!

So that basically sums it all up.... these past few weeks... months have been a "war". While describing it as a "war" comes off in a very negative way, it is just what it is.. a war. I will have to say that most of the battles we face here in Haiti, we all (Haitians and myself) eventually end-up winning. Through trial and error, as well as research and education... the staff, the children, the community and myself continue to CONQUER these battles TOGETHER. We both come out as the winners of the "food wars". While it seems that we both feel attacked in the mist of the conflict/ the problems, we find ways to come together, to see eye-to-eye, to understand, and to change. The staff, especially, has taken many strides in the kitchen since the first day I started working with them. They are learning and taking pride in their learning. I can see them glowing when they try something new (cooking a new meal, using vegetables/fruits in a new combination, preparing a whole grain in a new way, and/or taking "Maggi" or salt out of food). I see them growing when they start to understand what I am challenging/ requesting/ teaching.... and I see them shining when they do these things INDEPENDENTLY without my presence in the kitchen!!! I couldn't be more proud of the kitchen staff, the feeding center director, and the kids...
Trying new things! 
Learning to like new things! 

If you wash pitimi after cooking it, the grain gets like a rice/ quinoa texture. 
Vegetables! Gotta love them!!
Getting creative with our resources!!!

It's a goldmine here!

Markets in Haiti are so fun!

Visited a waterfall in Haiti with my friends!

My friend Gretchen and I toured Titanyen. My friend Josue and Jeres made this house!
Josue's house!

Running the mountains with the kids!

Getting the kids active!
The kids on a hike!