Thursday, July 3, 2014

If You Could Eat Only One Food…

…for the next two years, what would it be?

Chances are you’ve never considered whether that hypothetical question could become a potential reality. And if you had, I highly doubt you’d have chosen daal bhaat. For travelers, sampling Nepal’s traditional rice and lentil dish is a novel experience. But after eating it twice a day for the past ten months, it’s become the bane of my existence.

Health-wise, the last few weeks have been a real struggle. In my four years at college, I was sick for a total of a week and a half; in the just past 7 months, I’ve been sick for over 30 days. And not with your run-of-the-mill coughs and colds. Most recently the culprit was giardia, a protozoan that causes loss of appetite, frothy diarrhea, sulfurous belching, and extreme flatulence. Let me just say, getting giardia in Nepal is a quick and sure way to get that beach body you’ve always wanted. You lose a bunch of weight all while getting a great glute workout from all the squatting over the latrine. My host mother was just diagnosed with typhoid for the third time in six months, so I really shouldn’t complain. And fortunately, I’m vaccinated against that one, although my 78-page Peace Corps-issued Health Handbook warns that “this vaccine is less effective than most of the other vaccines.” Here’s to you, dumb luck!

In the past month and a half, I’ve taken medicine for giardia, amoebas, and other intestinal parasites. Typically someone opposed to self-medicating for minor medical issues, I’ve popped about a hundred Pepto Bismols and antacids. I’ve gone entire days without an appetite for anything, which, for those unaware of my eating habits, is analogous to Nicolas Cage refusing any movie role put in front of him. I’ve now lost 20 pounds since arriving in Nepal, through a combination of gut-wrenching disease, hard work (by which I mean doing anything in this heat), and poor nutrition.

My counterpart at the health center loves to joke that if I’m going to continue counseling people on good nutritional practices, I need to start looking healthier. I don’t actually look underfed (Nepalis’ ideal body image is a bit meatier than that of Americans’), but he’s right about needing to improve my diet. For the past month, my eating schedule with my host family has been:

6:30am: milk tea
10am: steamed rice, thin lentil curry, and vegetables
4pm: toasted corn
8pm: steamed rice, thin lentil curry, and vegetables

Most American college students eat a more well-rounded diet than rural Nepalis (and, consequently, than Peace Corps Volunteers living with those rural Nepalis). Aside from fresh eggs, milk, meat, grains, legumes, and seasonal fruits and vegetables (about five at any given time), the only food items available in my village are crackers, chips, chow mien, donuts, soda, juice, and, of course, tea. Lately, the lack of ingredients and imagination in Nepali cuisine has really begun taking its toll. Eating has become a chore, an unpleasant but necessary task of everyday life. Faced with the monotony of an unfamiliar dish, we volunteers find ourselves craving all sorts of food—even things we never really liked in the states (for me, that thing is chocolate). My knees begin to weaken when I imagine that trepidatious moment when I’ll once again walk onto the linoleum floors and enter the endless maze of eatables that is the standard American supermarket. Nepalis often ask me just what American food is like, a conversation which, like most others here, varies little with each recurrence. In this case, they’re shocked to learn that Americans don’t eat rice every day, and I’m unable to convey the sheer variety of things that Americans put in their mouths.

These twice-a-day daal bhaat binges, aside from constituting an unhealthy dietary schedule, often fail to provide the protein, vitamins, and minerals I need to be healthy. I supplement some with fruit, peanuts, and other snacks whenever possible, but the distance to the nearest store (forty-five minutes by cramped taxi) and my budgetary restraints (thank you for giving almost all of our living allowance’ food allocation to our host families, Peace Corps Nepal) makes it impossible for me to balance my diet.

Why is eating healthy so difficult here? Well, as a food security volunteer, it’s pretty much my job to figure that out and work towards improving it. A big part of it is a production/supply problem—most local farmers are producing only a few crops at any given time using primitive agricultural methods, and foods imported from elsewhere are too expensive for most families. But equally important is rural Nepalis’ ignorance about nutrition and its importance in overall health.

I’ve given nearly 30 nutrition trainings in the past six months, each of which has involved a game in which I ask participants to match food items with their nutritive role: energy, growth, or protection from disease. Typically, groups correctly place fewer than half of the commonplace food items (things like meat, rice, tomatoes) with their appropriate group, and sometimes as few as a third. In other words, people have very little idea of what they need to eat to get the nutrients they need.

Misconceptions about nutrition are rampant in my community. The pervasive belief that foods are either “hot” or “cold” means that many villagers go half the year without eating certain nutritious foods—eating a mango or papaya in the cold season, for instance, might cause you to catch a cold. As another example, sons are traditionally are fed nothing but breast milk for their first six months (as is recommended), but daughters are only exclusively breastfed for five. One day, I tried to get a pandit (Hindu priest) and his wife (a female community health volunteer) to debate this discrepancy, but they settled on “that’s the way it is.”

Perhaps my most upsetting encounter with a nutritional fallacy occurred this past week, when a mother came into the health center complaining of weakness and fatigue. Her sixteen-day-old daughter had jaundice, a troubling but not uncommon phenomenon among newborns in my community. Because of her baby’s jaundice, the woman’s husband and his family had been forcing her to live on strict diet of only salt water. It should go without saying, but that’s extremely dangerous for the health of a lactating mother and her child. I sat down with the husband to explain the gravity of his actions and to set him straight. When I later recounted the story to the health center doctor, his draw dropped in horror.

Because of erroneous beliefs like those above, a lot of rural Nepalis have poor nutritional status and habits. Without marginalizing the severity of their situation, my sincere fear is that the longer I live here, the more my nutrition will suffer too.

You can make a huge impact on the food security of this volunteer by sending a box of goodies to:

Ben Wagner
Shreegaun Primary Health Center
Shreegaun 2, Bagar, Dang
Nepal

These days I’m craving protein bars and powder, dried seaweed/spirulina, and, naturally, peanut butter. Plus, tomorrow’s my birthday!

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