Last week, I had the opportunity to shadow a very smart man at a clinic in Cite Soleil. Two weeks ago, one of the kids at Grace Village told me about his English teacher (and the piano player at our church) who was teaching them a bit about nutrition in school. Turns out the part-time English teacher also works at a clinic teaching nutrition education and talking with individuals about their health problems. When I heard about this, I couldn't resist the opportunity to introduce myself to the teacher at worship the following Sunday. We exchanged contact information-- I got a hold of his people and my people. Before I knew it, plans were arranged. Tuesday afternoon I headed to Port-au-prince for the night, where I anxiously awaited to get to the clinic the next morning.
My view in PAP. Tent cites...
Ready to roll!
The Healing Haiti team was heading to Cite Soleil Wednesday morning to deliver water to the people living in the slums --so I hitched a ride with them. I had some idea where we were headed, based on the directions that I was given from my contacts at the clinic. I had been to Cite Soleil many times before, so I could pretty much picture the location in my head. Not long after entering Cite Soleil, our taptap pulled over to the side of the curb and our driver ran-up to the compound across from a market to see if it was my final destination. Soon enough, I was out of the taptap and making my way into the compound.
Upon arriving at the doors of the clinic, the escort asked for our contacts and we were on our way! I was so excited to be there-- to meet all the Haitian workers and to tour the clinic. We were informed that about 150-200 people are seen at the clinic everyday and that they often have to turn people away. People of all ages come to the clinic with all sorts of aliments. Many clients have things like TB, anemia, Type 2 diabetes, high blood pressure, heart burn.... conditions that can be prevented.
Famasi
Lab tests
After our tour, we made our way to a building across from the main clinic. People of all ages were starting to gather on the benches. Once the crowd settled in, my friend that works at the clinic started to talk to them about health/ wellness and nutrition. He followed-up with answering individual questions. He asked me if I wanted to talk, but I just wanted to stand back and observe him at work. He did awesome! I was impressed with how much information he knew and how personal and engaged he was with each individual. My favorite thing he said to them was, "Medicine can't do everything for you." He talked to the people about reading food labels, eating natural and wholesome foods, using less salt/ oil/butter, drinking less energy drinks and pop. After I while, I started to engage with the people in the space. I talked with them about physical activity and how it is important to get your body moving. I showed them a few things they could do without a lot of space-- jogging in place, push-ups, jumping jacks... etc. I also talked with a few people who had individual questions and concerns. I think the escort with me was enjoying his time with me at the clinic too. Soon enough he was answering people's questions. I asked what he was saying to them, and he was spot on. Hmm... I might have a nutrition team in the works. I am scouting.
The nutrition Team!
A great teacher!
Educating
Later on, my friend that works at the clinic said to me, "People can't believe in medicine, people need to believe in food." Amen, amen!!! what you put in your body (or don't put in your body) could be killing you slowly. For people with limited income, it is especially important that they choose some of the most nutritiously dense foods to invest their money in so that they can maximize their daily nutrient intake. In my opinion, if you have little money---there isn't wiggle room to buy sweets and desserts all the time. Most days, you better be investing in the foods that are going to ward of disease. Unfortunately, I find that many people in Haiti are choosing to spend their money on less nutritiously dense foods (nutritiously dense in terms of micronutrient content) and place higher emphasis on quick-convenient, sugar loaded, and highly salted foods. I just want to sit down with people and have them SEE that if they didn't buy sugar for their juice, ate the fresh/natural fruit instead of juicing--they would ultimately save money and could buy something more nutritious than sugar (ie. avocados, spinach leaves, bulgur). That's what we did at our feeding center. By cutting out the juice, we have saved money by not needing to buy ice and as much sugar, which has allowed us to have more money to increase our purchase of produce. It's all about perspective, planning, analyzing, and education.
medication... after medication... after medication. Eat well, now and prevent this from happening.
Now this is my kind of medication.
My new friend informed me that many people in Port-au-prince (PAP) eat more convenient and processed foods, unlike the people on the country-side. I have observed this too. When I had asked a few people in PAP if they knew how to make Tchaka (a traditional Haitian soup), many of them didn't know about it. I was surprised. The traditional Haitian foods and "slow-cooking" foods have been lost with the transition to city life.
At about 11:30 AM, I had the chance to sit in an all-staff meeting at the clinic where the staff was discussing diabetes. The Haitian doctor at the clinic did an awesome job explaining to the staff about what diabetes is and how diabetes impacts all parts of the body. My friend gave a talk about nutrition-- how nutrition can help in the prevention of diabetes and how it is important in the management of diabetes. He was spot on with his talk and did an excellent job explaining to everyone the importance of good nutrition. Later on I was informed that many of the staff at the clinic had blood glucose tests done earlier that week, and many of the staff were at risk for diabetes. Again, this wasn't overly surprising to me based on the nutrition-transition I have observed here in Haiti.
Throughout the day, my friend at the clinic was handing out Oldway's African Heritage brochures to all of his co-workers. Unfortunately, all the brochures are in English (at this time), but I think it is helpful for people to see pictures of what their daily dietary intakes should like. The wonderful thing about the pyramid is that it has pictures of foods that are native to Haiti! My mission in Haiti is NOT to Americanize the Haitian people--many American resources and books are well, American. I am so thankful for the Oldway's materials because they have been a great asset to my mission here in Haiti: helping people to have good health through their native and cultural foods.
In the afternoon, we made our way to the pharmacy area to meet with people as they picked-up their medications. My friend meets with people as they picks-up their medications and asks them about what they should be doing with their dietary intakes in addition to taking the medications. I joined him. It was a very informal way of "counseling" people on their nutritional needs, but it works. Any opportunity to engage individually with people is better than none at all. We found three ladies sitting on a bench near the pharmacy, and we started to talk with them about their medical conditions. I let my friend engage with the clients first, and then I helped him to "dive-deeper" by asking them more questions about what they were eating and how they were preparing their foods.
This is where we would talk with people individually.
My friend started out the conversation by asking them, "What are you supposed to limit in your diet?" and one lady said, " salt, not a lot of Maggi, reduce the amount of fat." ... okay, good. She learned something. I asked her if she cooks for herself and if she does, is she preparing her food with a lot of Maggi. She informed me she does cook for herself and that she doesn't use Maggi or a lot of salt (even though later in the conversation, I found out she does use Maggi). Throughout the course of the conversation, one of the ladies talked about her acid-reflex (this is another common problem in Haiti). She told us that when she gets acid, she purges in order to minimize the acid-reflux problem. My ears perked-up, she what!? A quick fix to a problem that also cause more damage to the esophageal tract, the teeth, and even the weakening of the sphincter (the flap between the mouth and the esophagus). I couldn't imagine that purging would be a good long term solution to her problem. We talked about foods that cause acid, and how to better control the acid-reflux. We continued on to talk about her dietary patterns. "So what is the first thing you typically eat each day....", I asked her. (at this moment a quick memory of my professor at St. Ben's popped in my head. She said this frequently in her lectures about nutrition counseling). The lady responded, "Soup--carrot soup" and then she added (in creole of course).." with spinach and olive." Okay, great... but what else is she not telling me. I pressed-harder. "What else do you put in your soup? Do you add any salt, Maggi, butter, oil?" She told me that she doesn't use a lot of oil, she does use Maggi. We continued on to the next meal. Naturally, rice and beans. I knew what things to ask her about with this one. We dove deeper into how her rice and beans were being made. Maggi, salt, butter, oil.. and from what I can assume (based on what I have learned from many people here) these ingredients were probably being used in excess. These are the things that add "flavor" and "enhance" the foods, and most people don't know that serving sizes exist for them. I talked with her about just using the oil, and not buying the butter. She can still use fat in her diet, but with limited nutrition-education everything becomes an all or nothing principle. So I say buy one and don't buy the other-- it not only reduces the amount of fat they are using, but it saves them money too. We talked about this in our session. I showed the ladies what a serving size of oil looks like with my thumb. A small amount of oil contains about as much energy as a whole banana. We talked about the importance of fat in the diet, how foods have different components and energy.
Counseling session
Towards the end of the session, one of the ladies stood-up in the group. She pulled up her shirt, grabbed a roll of skin on her abdomen and shook it. She asked me how to get ride of it. The lady was pretty overweight, which puts her at risk for several chronic diseases and joint problems. We talked about energy balance: energy in must equal energy out, otherwise you either lose or gain weight. We talked about energy in food and about physical activity. The lady was pretty immobile, so I showed her some simple moves she could do to get her body moving. I told her moving any part of her body was going to be better than not moving at all.
educating
Showing the ladies the African Heritage Pyramids
During our counseling session, my friend and I have the ladies a brochure to show them the African Heritage Pyramid. It was a really useful tool. We talked about all the different foods in Haiti--avocados, spinach, squash, sorghum, cornmeal, beans, tubers, yams, cassava, peanuts, coconuts.... and we talked about using fresh foods to flavor meals. Focusing on plants, eating fish about 2 times a week, and using oil/sugar/salt within reason. At the end of the session, one of the ladies looked at the pyramid and said to me, "when I was little, we never used Maggi." Boooom. I lit-up inside. She was getting it. The whole talk about heritage and the past was resonating with her. My hope is that she actually took that message to heart and thought about the "Oldways" people used to cook, eat, and live in Haiti... before the western and inner-city influence.
The rest of the day, I spent with the escort. We got our blood pressure taken for fun, talked with some of the other staff, and I even taught him how to read a food label. We talked about some ideas bouncing around in my head with nutrition education in Haiti, community outreach and cooking class, and helping people get access to fresh "fast-food" at an affordable price. It's one thing to get the message out there, but it is another thing to make the suggestions and advice available to them. I am still praying about connecting the dots to my bigger visions. In a country full of opposing forces, my messages, my marketing, and my strategies must be BOLD, STRONG, AND LOUD.
I have good blood pressure!
My experience at the clinic was amazing. It gave me reassurance that everything I am doing in Haiti with the children, especially, is important and needed. Hearing people talk about what they eat, about their chronic (but preventable and maybe even reversible) health conditions has given me courage to keep on being BOLD and STRONG in my mission. People in Haiti need nutrition education. While it is important at any age, starting with the youth and the young adults is critical. "Catch" them while they are still learning and acquiring new taste. Teaching kids to like their fruits, vegetables, and whole grains is a great place to start. If they acquire a taste for whole, fresh, and natural food young, the hope is that they will continue to seek these foods as they age. We have noticed that our children no longer complain about the meals. For a while, we did have "food wars" with the kids and yes--they still stick their nose up in the air at new foods, but they are getting used to trying new things. The kids are learning to enjoy trying new things and expanding their taste-buds beyond rice and pasta. The kids are also learning not to be food perfectionist. For example, the other day at breakfast we were unable to "blend" their bulgur smoothies like they usually prefer because the blender was broken. The kids had to eat the bulgur whole with milk and spice, but they didn't complain like I would have expected them to several months ago. That same morning, I brought out a big bag of flax seed and asked the kids if they wanted to mix it into their bowl of food. I was surprised by how many said yes! I had kids swarming around me-- hands reaching out for me like I had a big bag of candy. I was shocked. They were eager to try the flax seed. I guess that's what happens when you are persistent with the kids and you allow them to participate in meals... they learn to adapt, to appreciate, and even seek-out "new experiences" with food.
The adventurous kids.
The need for PREVENTION of disease is present here in Haiti. There is elevated cases of chronic disease existing in the same context of malnutrition. When people have access to food, my concern is that they are choosing to eat what they know and like, but not necessarily what their body needs in order to ward of disease, increase immunity, and potentially save money.
No Maggi in the food for almost two weeks!! I am happy! No more Maggi!
My daily medicine.
Nutrition EDUCATION is the "food" for the people. Knowledge is power and it can help individuals make informed decisions about their life. Without knowledge, especially as it relates to survival skills (which include eating and eating behaviors/ patterns), an individuals' quality of life will greatly suffer. Malnutrition has a cyclic effects--- lack of a well-balanced diet decreases immunity and increases risk of disease, which can further cause an increase in expenses for medical visits and medications, and inability to work or go to school......which further drives the cycle of poverty.
I love Haiti.
Now watch this--- A TED talk by Jamie Oliver. He places a lot of emphasis on obesity, however, anyone (regardless of weight or size) is at risk for chronic health problems with poor lifestyle choices. The video is worth watching. His most important message: TEACH KIDS ABOUT HEALTHY FOODS AND TEACH THEM GOOD "OLD" HOME COOKING.
There is always so much happening in Haiti that it becomes hard to find time to blog and share the news of what we are working on in Haiti. I encourage you to check out the "For I was Hungry" facebook page for more frequent updates: https://www.facebook.com/foriwashungry
I made it to Haiti last Tuesday morning after a little hiccup in travel plans. The 1.5 weeks that I have been back to my second home have been wonderful, but extremely fast. The staff seemed to maintain a lot of the changes while I was gone, but there is still work to do.
Market day
Unfortunately, the staff was still using Maggi when I returned to Haiti. This past week, however, I took away Maggi and challenged them to use the herbs and spice we have in the cupboards and can find at the market. The first day of the challenge was great! I actually thought they did a fabulous job making a tasty creation. The kids managed to find out there was no Maggi in the lunch. They grumbled as they walked in (mentally setting themselves up for not liking the food). Many children gave me a face like "this is going to be so gross" Seriously. I was getting pretty heated. Thankfully, my friend was in the cafeteria with me. I had her educate the kids about why there was no Maggi going to be used at the feeding center anymore. Might I add, I was very impressed with the amount of information she had retained from me (more on this later). She made her points and asked the kids if they had any questions. No one seemed to have them so they all started eating.
Everyone was eating just fine, except the older boys at the table next to me. I got up from the table I was sitting at and asked them what the problem was. They commented about needing Maggi. A little irritated, I asked them if they even know what Maggi was. "It makes my food taste good." said one of the boys in Creole. I pressed-on, "okay, well do you even know what is IN Maggi?" and one of them responds, "spice!" ... I chuckled a little and informed them that Maggi is a packet of artificial flavor that is composed of salt, rice flour, MSG, sugar, vegetable and animal fat, "flavor identical to natural and artificial spices" (garlic, onion, and parsley), and coloring. Sooo basically there really isn't that much flavor to Maggi besides sodium, salt, fat, and fake seasonings. There is no REAL added nutritional benefits. I told them they need to learn to enjoy the fresh flavor of foods. They will learn to like them, and that sometimes we just eat things because we know they are good for us EVEN if we know we don't like or LOVE them. I have no time for FOOD PERFECTIONISM here, folks.
Bulgur and beans WITHOUT Maggi
After my little talk, the boys ate their meal and didn't complain again. We have been pushing forward with this action of NO Maggi and several people (including medical staff) have complained about the food not tasting good. My response is always GIVE IT A FEW WEEKS. YOUR TASTE-BUDS WILL ADAPT. It just drives me CRAZY how much people rely on Maggi... you see it everywhere here in Haiti. The cute little foil packet with chickens all over it--- cute on the outside, "tasty" on the palate, but contributing to chronic health problems on the inside. Instead of being addicted to drugs and smoking, I am convinced people are addicted to Maggi. Maybe it is not so much the "addiction" but it is the LEARNED BEHAVIOR OF USING MAGGI (for cooking) and THE LEARNED BEHAVIOR FOR TASTING MAGGI. Well, we are in the "unlearning" and "untraining" process... once we are past the "hump" hopefully there will be new flavors and tastes that "stick"... and the enjoyment of actually tasting real, natural food will be strong enough that they won't regress.
Meet Maggi.
I might need to make this a research project and entitle it: The effects of removing Maggi from your diet. Track physiological changes, brain chemistry changes, lab values and their changes, perception, behavioral changes.....
Enough with "Maggi" We've got all kinds of NATURAL FLAVORS we can find in Haiti...and this is only just a few of them. People in Haiti are already using them. THE MESSAGE: SAVE YOUR MONEY---AND JUST DON'T BUY MAGGI.
Last week, I really started diving deeper into my experience here in Haiti. I am trying to learn more from the Haitian people themselves, and to allow them to be my teachers too. You really can learn a lot by just asking questions...lots of questions. My friends aren't shy and most are willing to share with me about their lives. I am enjoying asking lots of questions, and hope to ask more over the course of the next few weeks. It helps me to better "assess" the psycho-social status of the population, the barriers I might face in my work, and ways I can better get the message across.... BUT even more than that, it is helping me to REALLY get to know some of the staff, and understand what their lives are like. I'd have to say that I do genuinely care and love the people I work with. The Haitians that I have come to know and that have been teachers to me along the way are incredible people. Many of them have passions and visions, have withstood some pretty traumatic and devastating situations, and continue to be resilient....to press on. Many of the younger generations are open to change--- open to exploring ideas and inspiring creativity. I like that. Most people that see Haiti on the news and in the media don't see this side of Haiti.
He gave me free ble (bulgur) in the market, so I made him some bread with it!
Education
Earlier in this blog, I mentioned how my friend is learning and retaining a lot. Well, last week I had a chance to sit one -on-one with her outside of our busy work day to just chat. We were working on questions for an interview for another blogger and organization. I really learned a lot about my student during that conversation. She shared with me some information about her mom, and her recent health troubles. Back in January, I learned that my friend's mother was diagnosed with Type 2 diabetes. I saw this as a "golden" opportunity to motivate my friend and drive this message of PREVENTION AND GOOD NUTRITION HOME. I gave her some resources about diabetes in creole and told her that she should really teach her mom about what we are doing at Grace Cafe. Well, my afriend took that message home, and shared with me some exciting news about what she did for her mom. Since her mom was diagnosed with diabetes, she has been cooking food for her mom and making her eat more balanced (more vegetables, whole grains, less meat, and a moderate amount of oil). When her mom went to the doctor after several months of eating better, her blood pressure and blood glucose levels went done. She even had lost some weight. Supposedly friends were commenting on how healthy her mother looks now. After the appointment, my friend received a phone call from her mother's doctor. He had said that the mother told him her daughter had been cooking for her and helping her eat better--- he wanted to know what she did! As my friend told me the story, she was grinning from ear-to-ear and giggling a bit. The excitement in her eyes and in her face told me that she was proud of how she was able to help her mother and how the doctors were even contacting her for advice! She continued to share with me that her message has gone farther than just to her mother. She has also talked to her brother a lot about good nutrition, and he and his co-workers call her to ask questions. When her nephew comes over to eat, she makes him more than just rice and makes him eat a variety of foods. EVEN if he doesn't like them, she is persistent with him and makes him try. It is exciting to hear her talk about the messages and theories we use at Grace Village and how she has applied them into her personal life. While I was sitting there with my friend, I realized there was so much I still didn't know about her and how much I still want to know about her. I am actually planning a weekend to go visit her home and to see what her life is like outside of work. Maybe go to her English school and meet some of the people that are important in her life.
Last week, I also started talking with one of the staff members at our village. He is a 21 year old male that is finishing his high school education. He shared with me about his life, and I asked him about his cultural food patterns. I uncovered a whole host of information that made a more "clear" picture for me about his generation, his family, and the food environment in Haiti. My friend is the oldest of 6 children and his mother is widowed. While growing-up, his mother sold things in the market. When I asked what kinds of things she sold, he said like clothes and shoes. His mom didn't always make enough money to send him to school each year. When he was only 6 years old, he learned how to cook and prepare food for him and his family. He said he made things like: rice and beans, spaghetti, and sweet potatoes with milk. When he was 9 or 10 years old, his mother started working at a mission near his house as a cook (she still works there today). At that time, he learned how to wash his own clothes and to prepare his own uniform for school. He grew up a very independent child--- able to care and provide for himself. Today, he is finishing school and would someday like to go to a university to become a general mechanic. During our conversation, we continued to talk about other things in Haiti and about nutrition. He told me his grandparents have a farm on the countryside. They grow things like pitimi (sorghum in English), beans, and peanuts! I told him I want to visit them sometime. When I asked him what kinds of foods his grandparents ate, he told me--pitimi (sorghum), corn, cassava. They make soups like Tchaka, and they make a bread called "Casav" out of the cassava. He told me they don't eat rice and beans everyday. It sounds a lot like his grandparents have retained their true African Roots. My friend also told me her grandma doesn't eat a lot of rice either and that she doesn't cook with Maggi (the artificial flavored seasoning packet I am fighting with). These conversations make me wonder what happened to these last few generations..... how has the nutrition transitioned? How has the food aid programs and missionary influence changed the cultural food patterns? Furthermore, how are these transitions and influence impacting the environment, malnutrition, and poverty in Haiti? This is a big investigation.
When I asked more questions to my friend, he continued to answer me with honesty. "You know Kristina. When I first came to try your experiments at Grace Village, I would always tell myself before I took my first bite that I wasn't going to like them." He continued on, "But then I would taste them, and I was surprised that I liked them! I like eating at Grace Village because we don't eat the same thing everyday." .... He continued on, "A lot of Haitians like rice and beans. I prefer pitimi and corn for my body. A lot of people like rice and beans because they are "cheaper" and easier to prepare/ cook." He went on to tell me about how people need to make a sauce when they eat pitimi and corn, they can't just eat it plain. Where as with rice, people don't need to add anything. I sensed some food perfectionism through the conversation and a lack of knowledge (for the general population here) about how to prepare these foods in quick, tasty ways. He told me that if I asked people here about what haitian food is, they would tell me, " Rice, beans, and chicken." He continued to tell me that in the mornings people eat pasta or corn, they have rice and beans for lunch, and flour milk for dinner. Shocking? Nope, not for me. This was not much different than what I observed when I first came to Grace Village. He also informed me that if people have money, they will eat meat everyday. If they don't have money, they only eat it on Sundays. (class system: diet is related to a class system and status). I learned from him that PEOPLE ARE FOCUSED ON WHAT THEY KNOW THEY LIKE. THEY DON'T LIKE TO TRY NEW THINGS, BUT HE THINKS PEOPLE NEED TO TRY AND LEARN. (As do I. What people don't know is killing them slowly). After our insightful conversation, I sent him home with a few packets of information about sodium and hypertension (since he mentioned symtoms his mother was currently having. It sounded like high blood pressure), information about a sustainable food supply, and overall general nutrition. I told him to read the information and come back with questions. We spent a whole afternoon answering questions, talking about nutrition, and the different foods available in Haiti and the nutrition they provide. He told me he was so blessed to have this knowledge about nutrition and that he wants to work hard to make changes in his life.... putting in his body what is going to be good for it. I have continued to provide him with resources (how to use fresh seasonings and produce in Haiti to make tasty dishes), as well as followed up with him about what he is learning. It is incredible how much EDUCATION CAN REALLY CHANGE THE WAY SOMEONE THINKS ABOUT SOMETHING...and how much it GIVES THEM THE TOOLS AND THE POWER TO MAKE INFORMED DECISIONS.
Yesterday, I had an incredible opportunity to go to a clinic in Cite Soleil to shadow a Haitian man at work. This Haitian man, now a friend of mine, works at a clinic 3 days a week and provides nutrition education for the 150-200 people that come the clinic each day. He works with some of them individually and helps them to over come their chronic health conditions (more on this in my NEXT blog). The opportunity came about through a conversation with one of the teenagers at Grace Village. One day at lunch, he told me that his teacher taught him about Maggi and that his message was similar to mine. I asked who his teacher was and he said it was his English teacher and the man that plays the piano at our church on Sundays. I told the teenager that I wanted to meet his teacher, and he said that I can. Sunday morning after church, I went and introduced myself to the teacher/piano player. I told him my profession is in Nutrition and that I am a registered dietitian. I told him that his student told me that he has learned about nutrition in English class. The teacher/piano player told me what nutrition information he teaches and knows about, especially in Haiti, and I was blown-away. His message is the same message I have been promoting all year at the feeding center. He mentioned that plant food is cheaper and better for you, and talked about the association between diet, lifestyle and disease. I was so excited to hear him talk! During our conversation, He invited me to visit him at work on Wednesday in Cite Soliel. I couldn't refuse the offer-- I took contact numbers and e-mails and started figuring out how I could get myself to the clinic to shadow. Now I am going to put a pause on the rest of this story because it needs to be a blog of its own. SO TO BE CONTINUED.....
The nutrition team for the day!
It's amazing how many "puzzle" pieces are starting to come together for my nutrition mission in Haiti. For a while, I was feeling "stuck" in my ministry here. Feeling like the meesage was being under-minded and that it was unimportant. It is hard to be the SMALL VOICE SPEAKING OUT AGAINST THE CULTURAL FOOD PATTERNS, LEARNED BEHAVIORS, AND CONSTANT REINFORCEMENT OF THE OPPOSING MESSAGES. I have been hit with a lot of blows, which have really tested my self-confidence, my self-esteem, my hope, and sometimes even my passion for education and good nutrition. There have been times on this journey where I have felt like packing-up and never coming back again. The opposing forces are so strong, and they come from everywhere--- expat/ missionary influence, food-aid, advertisement, social pressures, lack of education (poor education), folklore and anecdotal experiences, misinformation, poor labeling (etc). It is a constant feeling of FIGHTING, which becomes distasteful and unpleasant after you have been beat-up so many times. Sometimes these forces make me feel weak, exhausted, and powerless. Feelings that are so strong to overcome and ignore.
Over the course of the past few weeks, however, I have felt empowered again. I have been reminded that the MESSAGE IS IMPORTANT AND IT IS NEEDED. ...and small glimpses of HOPE (the puzzle pieces) keep peaking up along this journey. It is going to be a long tough road to convince a whole population of people TO CHANGE THEIR DIETARY BEHAVIORS AND PATTERNS of eating, but I BELIEVE IN EDUCATION.... and I have been given and have acquired gifts to share, to inspire, and to teach. As I continue to gain confident against the opposing forces, I am learning skills and ways to make my SMALL voice into a LOUD, SCREAMING VOICE. I am gaining confidence... and I am keeping my mind focused on that small glimpse of HOPE.
"No one can make you feel inferior without your consent." - Elanor Roosevelt
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).
Tchaka!
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!!
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!
"Maggi"
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!
