Workshops and Meetings and Trainings, Oh My! Part 4: Nutrition Workshop

To give you a perfect example of how the culture works here and how work gets done, I wanted to document these next couple of months of workshops and meetings and trainings.

I have mentioned it once and I will mention it a thousand times: that we, as PCVs, cannot just come and make a change. We need to fulfill the needs. We are here to make slow change, over time. We don't burst in the door and say "HERE IS HOW TO MAKE IT ALL DIFFERENT."

Lately, there have been so many workshops and meetings and trainings that I wanted to give you an inside look at what is discussed at these meetings, who attends them, and how they run.


September 7th, 2018
Workshop Planning

On September 7th, I talked to the canteen cook, Susan, about having a community nutrition workshop. She told me there's a community nutrition committee, of which I was completely unaware (I'm not a health volunteer, so that's not on my radar). Leisale, the chief's wife, is the head of the committee, and I can talk to her. Susan, on the other hand, manages the community women's club building, so she is whom I talk to regarding getting a venue. Susan told me to talk to Leisale, and once I had a date, I could check with Susan and set it all up.

That afternoon, I talked to Leisale. She was all about having a nutrition workshop. She explained the committee was formed after Cyclone Pam in 2015, when Save the Children (an NGO) came and set it up for them, and gave them seeds to regrow their gardens after the damage. STC also encouraged them to sell healthy snacks, which is why there are people in the village who now sell freshly grown peanuts (that was previously not a thing). 

She told me to put together a program, and then we could set a date. 

On Sept 10th, I brought to her a plan for several workshops, and asked when would be best, as I didn't know the community happenings ever since I moved to school grounds. She said Mondays and Wednesdays were best, and let's set the first one up for Wednesday, September 19th. 

On Sunday, September 16th, I heard through the grapevine that I would have to make the workshop on Monday the 17th, because apparently the 19th, there was a church fundraiser at the same time that all the mamas were attending. We decided to host it on Monday instead. Then it got moved back to Wednesday. I knew that no one would be able to attend if we kept it on Wednesday, so we moved it instead to Monday, Sept 24th. I showed Leisale my more detailed outline for the first workshop. She loved it, and we worked together to plan for her to bring certain packaged foods (with nutrition labels for an activity) with some mamas. Then, I sat in her house as her husband, the chief, looked at his community calendar and wrote it on the blank page for Monday. 

All weekend before the 24th, I ran through my activities and revised my guidebook. I was making the entire presentation from scratch, not based on any previous workshop or template. I used Kids Health as a resource, as well as countless nutrition facts resources online.

In the morning of Monday, Sept. 24th, I heard from Susan that Leisale was cancelling and that I should talk to her. I went to Leisale and she informed me that some doctors came to the village and everyone wanted to go see them. Leisale tried to push people to still come, but she knew that people would prefer to see the doctor than to come to a nutrition workshop. I was confused as to why no one knew these doctors were coming prior to 9am the day of the visit. If it were the Ministry of Health or an NGO, they should (hopefully) give previous warning to their arrival.

We couldn't move the workshop to Wednesday of this week because Friday is a wedding in a neighboring village, so lots of families are heading off to prepare and celebrate. I sighed in defeat and agreed that yes, we can move the workshop to next Monday, October 1st. I asked again, "are you sure there is not an event next Monday?" and Leisale ensured me that no, there is not...just a community meeting at 8am that won't affect our afternoon activity.

On October 1st, it was finally time to do the workshop.


Mamas (Leisale in the middle) play a nutrition vocabulary matching game

October 1st, 2018
Nutrition Workshop

After lunch, I walked over to the mamas' community building in the village, which Susan had unlocked and had some women in the village tidy for me before my arrival. This is essentially a large house with an indoor (gas stove and oven) and outdoor kitchen. It has a couple bedrooms and a large living room area, all of which can be rented out to tourists or visiting groups. Today we'll be using the living room to host the workshop.

Though everyone knew the workshop would begin at 1pm, only Leisale and a couple mamas were present right at the starting time. I started around 1:45pm, when about 6 mamas were present, and for the next half hour, others trickled in. I had them fill out a sign-in sheet to get an idea of the demographics of their families. In total, 19 mamas attended, who cook for a total of 52 adults and 54 children. These mamas ranged in age from young (20s) to elderly.

Overall, I feel that the workshop was a good balance of lecture and activity. Not having practiced it beforehand, I was impressed with how well-timed the activities popped up after my lectures, right when interest was waning.

I knew I had other workshops wherein I could give more detail, so today was just an overview of a little bit of everything.

As with all meetings, we started with an opening prayer, led by Leisale, and an apology, led by me. The apology is usually just to apologize for taking people's time and for interrupting their day with a meeting. It's a standard in the culture.

I started with the Healthy Foods poster that the villagers are quite familiar with. I asked them to tell me the three kinds of food. Here in Vanuatu, the food groups designated by the Ministry of Health are in three categories:



There's "Kakae blong blokem sik," or, "illness-fighting foods" which include vitamin-rich foods like fruits and vegetables.
There's "Kakae blong givim powa" or, "power-giving foods" which includes carbohydrates.
And finally, there's "Kakae blong bildimap bodi" or, "body-building foods" which include proteins.

But, since vitamins, carbs and proteins aren't explicitly listed, I went through those foods and what they meant.

I started with calories, explaining how cars and boats need fuel to run, and our bodies need fuel to run. Any fuel we don't use turns to fat. Something that frustrates me here is that the rice everyone buys at the store advertises that it's "CALORIE RICH!"  and I tell people how that isn't necessarily a good thing. We discuss "empty calories." We also talk about how we all know that daily intake requirements for a child who runs around all day and a meal for a newborn and a meal for a sedentary adult will all be different because they use different amounts of calories.


We then discuss carbohydrates, and I explain simple vs. complex carbs. Diabetes is a major issue in Vanuatu, and our village is well aware of how it's caused. The word for it in Bislama is "siksuka" or, sick sugar. Our pastor recently had both of his legs amputated because of diabetes, so like I said, our village is well aware of the consequences.

I explain how even if they don't put sugar in their tea, their heavy rice intake will cause their blood sugar to spike. I ask them about their personal experiences with eating mounds of rice. Do they ever notice how they are full, but then a few hours later they're exhausted and hungry? The mamas all nod their heads. It's because of that spike in blood sugar, the same kind caused by eating candy.

We talk about complex carbs and how they are found in all the island foods grown in the garden: taro, cassava, plantains, bananas, sweet potatoes, etc. I talk about how these are healthier, using my hands to gesture waves of energy caused by simple carbs and the slowly building wave of complex carbs, and how they sustain you.

We talk about proteins and how they build muscle. We list out all the foods we know go in this category. Local examples include peanuts, various tree nuts, powdered milk, eggs, fish, chicken, seafood, pork and beef.

We talk about fats and how there is both good and bad fat. Based on their reactions, it appeared as though they were unaware of good and bad fats. "Sugar is bad" and "don't cook with oil" are common phrases used in the village when it comes to eating nutritiously. But I explain that avocados and coconuts are both very fatty foods, yet they are "good fats" because they have fiber and other nutrients. We discuss how fats are necessary to build brain tissue, create hormones, and help us absorb vitamins.


At this point I wanted to test their comprehension of my Bislama lecture on nutrition, so we play a vocabulary matching game.




I printed out small cards with vocabulary in Bislama and English and their definitions in Bislama and English. The words included were: calories, "bildimap bodi, blokem sik and givem pawa," carbohydrates, carbs, simple carbohydrates, complex carbohydrates, fiber, "proteins, fats and carbohydrates," fats, and empty calories. The mamas enjoyed the activity, and it was good for them to do in groups and compare their answers/discuss with their neighbors. Our village is fortunate enough to have a higher literacy rate in adults, as many had access to a good education or they currently work in Port Vila in careers that require literacy. I know other volunteers may face challenges with these reading activities.



We move onto more lectures. I explain vitamins and we talk about what each one does. I don't go into too much detail, but we cover the basics. Everyone is very knowledgeable on what foods can help with what, which helped the discussion questions afterward, wherein we talked about which foods have which vitamins, like which probably contain iron ("which food do we eat because we know it's good for the blood? Island cabbage!")  We also talked about what nutrients are in breast milk and why those are so important for a baby.

Something I learned from them was the treatment for diarrhea. My Western culture tells me to drink oral rehydration salts or sports drinks, but our PC doctors told us the local treatment is coconut water. When I ask the mamas what they eat when they have diarrhea, they say "dry foods." I am confused by what that means, especially since I associate eating lots of watery and juicy things to replenish what I've lost. They explain that they roast local food, like taro, cassava, or sweet potatoes instead of boiling them. They also eat plain rice. While at first I was confused by the roasting-versus-boiling, I share that the good part of that is the nutrients are not lost. Sometimes over-boiling food will pull out all the nutrients, but roasting it ensures they stay intact, and it's good your body is getting vitamins when it's sick. I then re-iterate that consuming lots of oil and eating fruits and leafy greens is "taboo" while you have diarrhea because it can be hard on your stomach.



We then do another activity which delves into nutrition labels. There's been many discussions I've had one-on-one with people in the village about how I rarely eat rice and if I do, I eat brown rice. Sometimes they'll ask if one food is better than another and I tell them to look at the nutrition label. But think about it...nutrition labels are a mess of information and numbers and percents, and it requires some translating and training to know what you're looking for.

I had large cards printed with blank nutrition cards so we could go over each category and what it meant. I also created laminated cards with nutrition labels for local foods that wouldn't otherwise have nutrition labels, like coconuts, tomatoes, breast milk, parrot fish, etc. I gave groups related items and had them compare.

One group had locally baked bread and breakfast crackers. One had powdered milk and breast milk. One had tin tuna and fresh fish. One had candied fruit slices "omai" and mangoes. They compared sodium and protein and how packaged foods often have lots of additives and unnecessary "stuff."

We also talked about portion sizes. This was especially important for starches. The PC doctor Elodie sent me an excellent digital book titled Pasifika Plates which has a section on measuring using your hand if you don't have measuring cups.



We talked about how the bag of white rice says one portion is 1/3 cup of cooked rice...but how many times is your plate overflowing with four cups? And breakfast crackers' portion is two, but how many times do you eat ten at breakfast? The mamas all look at each other and laugh. They know they over-portion.



We do another activity in groups wherein we calculate a meal with local foods. I give a "recipe" to each group of a common meal I've seen in the village. A few weeks prior, Susan helped me write the recipes of all the local foods/meals. There's one group with simboro, one group with a chicken stew and rice, one group with laplap, and one group with a breakfast of fried bananas and breakfast crackers. They use their nutrition label cards, calculators on their phones and some pads and paper to figure out particular categories that I assign them, like the fats or protein. I pre-calculated it all in case it was difficult, but for the most part, all the women were fine calculating it themselves. After all, most of them are treasurers of various community groups.

We calculated the amounts for the portion sizes and saw the astronomical sodium or carb measurements for the chicken soup, or the fat content of the fried bananas. Then, I offered subtle changes to the meals by either adding or subtracting items to make them healthier. The simboro and laplap groups simply got the portion size cut down, the chicken stew and rice had the ramen noodles removed and rice replaced with boiled taro, and the breakfast group got a whole rehab with their meal replaced with fresh fruit and raw bananas.  I pre-calculated the nutrition of the new meals, so I could quickly share the drastic changes that these meal swaps made.

The mamas calculate the calories in their meal.

Mamas use the nutrition cards to find the nutrition in their meal.


The final discussion was a recap of what we learned, and I asked them to do some homework, not for me, but for themselves. I asked them to write, for either a couple days or a week, a food journal of what they eat and when, and how they felt about the meal: how long until they were hungry, how long until they were needing an energy boost.

I opened the floor to questions and comments. My host mom asked if it was bad when people don't rinse their rice before cooking it. I said it was probably fine, since any germs would be boiled away. Another mama asks why "mix" or "three-in-one" coffee is bad. This is a packet of instant coffee available in the store that is sugar, instant coffee and powdered milk that you simply add to water. Of course, the main ingredient is sugar. I explain that plain Nescafe instant coffee is the best, since there's no calories or too much sugar. You have control over the sugar content in those. I also stress that it's important not to add huge spoonfuls of sugar (I often will see mamas add 5-6 tablespoons of sugar to a single mug of coffee) to a cup for themselves or their children.

After all the questions were asked, Leisale thanked me and gave a short speech. She told me before the group that everything I did in the workshop was stuff they all already know, it is just they simply don't practice it. They know lots of rice is bad, they know island food is good, and they know lots of sugar is bad. They just don't practice good cooking habits. While it wasn't meant maliciously, this was a bit of a blow to hear, especially before the entire audience, and especially after I'd showed Leisale the agenda for the meeting weeks before, so she knew everything that I was planning to discuss and never gave feedback. Oh well.

She closed with a prayer, and the women trickled out, but not before shaking my hand and thanking me.

As I cleaned up my cards and papers, one of the mamas asked me to do a cooking class, specifically, "teach us how to make cake!" This is often an interest of mamas, as I've seen in my village and heard from other PCVs in their villages. One of my future workshops will cover a cooking class, but I wanted a base for future workshops so I wasn't talking about vocabulary that went over everyone's heads. I also don't plan to make cake. People here know how to make cake, but they often omit or use sparse sugar because of the fear of diabetes. When they eat my cakes, they are overwhelmed by the sweetness and often tell me "Melissa! You know we can't have sugar!" yet load their tea with scoops of the white stuff. I explain that I eat cake maybe once every couple weeks, which is far less damaging than a daily dose of 12 tablespoons in my tea. It can feel repetitive and frustrating, but it's something.

For my future workshops in nutrition, I plan to use some kits I received from World Vision called "Ademap Kala" or, Add-em-up Color, explaining the food groups in color categories and how to properly portion your meals. I also will have some cooking courses, most of which I will focus on using spices instead of salt/sugar, since we're fortunately close to Port Vila and have access to a variety of ingredients.




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