Nutrition Counselling
Last Thursday October 3rd the three day Train the Trainer Nutrition Counselling Seminar got underway. The seminar sessions were preceded by several months of research and planning efforts by Lydia who managed to put together a several hundred page training guide last summer in Nova Scotia, the whole time remaining in close( e-mail) consultation with Madame Oussematou in Cameroon. Among her many other activities the last month here in Bamenda, she spent further time fine tuning the training document, preparing it for printing and coordinating many other activities required for the workshop presentations. The workshop participants at this stage were the five IDF staff members who in turn will become trainers as the program eventually is rolled out to the intended target audience, namely a category of IDF client known as a Promoter.
When our Cameroon assignment in Bamenda was being defined, Oussematou described these client Promoters as HIV AIDS +ve persons (mostly women) who they’ve worked with to qualify for a small loan from a microcredit program (operated by a Women’s Cooperative Credit Union). IDF apparently helped to create this small credit union with a small amount of funding from the International Labour Organisation (ILO). ‘Matou’ certainly is adept at leveraging extremely limited funds so as to get the largest possible impact from the smallest amount of available dollars.
The women entrepreneurs with whom IDF works are very low-income women with limited or no educational background. On average these women are between the age of 30 and 40, have had 5 children and only a primary schooling background. They earn between $40 and $100 dollars (Can) each month and generally run small convenience stands selling food and household items like rice, oil, spices and toilet paper. Many of these women’s first language is Pidgin and they have difficulty understanding and speaking English. For this reason it’s more effective if community volunteers can be empowered indirectly through the development of training modules and training them as trainers, rather than working directly with the Promoters.
Earlier in the year, Oussematou told Lydia of two topics that would not only benefit the women entrepreneurs but also single adolescent mothers, community volunteers and other beneficiaries (people living with HIV, and orphans and vulnerable children). The topics mentioned were nutrition and nutrition counselling and she said that "Lydia’s background is greatly suited to helping us in those areas". She also indicated that it would be of great use to them if training modules could be developed on these topics and then used to train IDF staff who in turn would give training to community volunteers and beneficiaries.
The assignment with CESO and IDF was defined last June. Lydia spent the intervening months leading up to it working with a nutrition manual that had been developed by a previous CESO volunteer. This base manual was developed by the Regional Centre for Quality of Health Care, Makerere University, School of Public Health, Kampala, Uganda.
The Rotary Club of Truro sponsored the Nutrition workshop, paying for the printing of the Manuals (five of them) as well as other related expenses. These manuals will be kept in the IDF office and used for training of the trainers who then will train the community volunteers to go out into homes in the various villages to counsel HIV persons in nutrition. Because the people in the villages speak Pidgin and many are illiterate, Oussematou herself will rewrite the program and bring it down to a very simple level using mostly graphics and pictorials to make it more easily understood. 2
The manuals in action:
The Food Groups used here are different than we are used to. One reason is most of the population does not drink milk. So, there are three food groups: Energy Foods, Immunity or Protective Foods and Body Builders plus Extras. Using the internet, Lydia found single pictures of some 50 foods to use as Food Models. You can see the Food Pyramids the Trainees built up on the wall.
Fortunately Lydia had saved a set of bar graphs from her years of teaching (no longer for sale through the Ontario Milk Marketing Board). They served as graphic teaching tools and are included in the manual in small version.
As well, $600 Can. of Rotary funding paid for transport and accommodation to visit the field office at Wum. Two people from the Wum office took the Nutrition workshop. That trip gave us insight into the living conditions of the persons who are dealing with HIV AIDS. We were able to meet a number of Promoters in the village who operate businesses and being HIV positive were able to qualify for microcredit loans from the credit union. Going to Wum required a driver/car for two days and hotel accommodations (this being a story for another time) for the driver and three of us. Oussematou kept meticulous records of this trip as she and her staff do of all their activities. Funds are extremely short and so Rotary assistance was much appreciated by IDF. When we brought the cash from Rotary for the trip to Wum ($300 US dollars), Oussematou said, "Rotary will not be disappointed in our use of these funds."
There was some money from Rotary left over for lunch time food ingredients and preparation over the three days and was thoroughly enjoyed by all. First, we had to get the stove going. This facility has great potential and a few years back had been used for programs such as one for Teen Age Adolescent Mothers. Everything was very dusty. We shopped at the market and managed to prepare two great meals. The first was a pasta salad (they had never eaten cold pasta before) served with soya chocolate milk in tetrapacs with lovely snacks-apples from South Africa, ground nuts and bananas. Because of concern about whether or not the stove would work, Lydia cooked the pasta in advance at the apartment. They mixed up three batches of the salad and there were no problems, neither in preparing it or eating it.
At lunch time on day two they worked on getting the stove going (and with his trusty knife, Allan included) and we made a healthy pot of corn chowder, multi-pizzas, and cinnamon buns along with lemon/lime bottled water, soya supplement (used as a liquid supplement mix for infants, the
elderly, and starving persons; in short, anyone who needs a nutritional, highly digestible and easy to swallow liquid based food.
Another interesting thing that happened is we had canned corn for the chowder and canned tomatoes for the pizza. Lydia discovered one of the trainees attacking the top of the can with a knife so as to open it, not to mention a can opener was sitting there on the table beside him. He had never seen or used a can opener before. Virtually all of the people here normally do not eat anything in the way of processed food. To them it’s costly and not part of their cultural tastes!
This picture shows Terrance Ndikum, Jean Baptiste and Amah Julius hooking up the gas range.
We managed a bowl of corn chowder for everyone, including the secretaries and office personal.
The day two and day three seminars focused on Community Volunteer training to counsel persons with HIV AIDS as a Nutrition based treatment for improving immunity to prevent infection and treatment for nutrition related problems resulting from HIV AIDS (diarrhoea, vomiting, mouth sores, weight loss, depression, isolation, rejection). Here are pictures of role playing the patient being interviewed by the community volunteer for counselling:
The wrap up focused on developing a plan of action to implement a pilot project in ‘Nutritional Counselling for HIV AIDS’ to reach the community of persons challenged by HIV AIDS.
Thanks to the Rotary Club of Truro for helping out here.
Allan and Lydia Sorflaten
November 6, 2011.
PS "Even the people from Wum are able to go the the rotarycluboftruro.ca web site and can view what Lydia’s efforts have produced here." (AGS).
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