Monday, September 26, 2011

Pampas Grande's Food Revolution Could Present Challenges

Jamie Oliver, a Food Network chef and vocal advocate for fresh, nutritional food, is dedicated to educating people on how food affects health, happiness, and finances. His Food Revolution project, created in response to the obesity epidemic throughout the United States, places life-saving power on cooking good, fresh, non-processed foods. In 2010, Jamie Oliver was given the TED Prize for his ideas about the significance of cooking skills in the effort to create a healthier nation. (You can find Jamie Oliver's TED talk here.) According to Jamie Oliver’s Food Revolution website,

“The [obesity] problem stems from the loss of cooking skills at home and the availability of processed foods at every turn, from the school cafeteria to church function halls, factories and offices. This Food Revolution is about saving lives by inspiring everyone: moms, dads, kids, teens and cafeteria workers to get back to basics and start cooking good food from scratch.”

Pampas Grande, Peru is a community that does not have a high prevalence of obesity or processed foods, but could most likely benefit from a food revolution of their own. In Pampas Grande, and in many rural Peruvian communities, food is obtained from subsistence agriculture. The climate and soil conditions in the Andes Mountain region, however, are not suited for the sustained growth of highly nutritious fruits and vegetables. Instead, high-starch and carbohydrate crops like potatoes, which can grow through the temperature changes and low moisture conditions, make up a large portion of Pampas Grande villagers’ diets. In general, meals in Pampas Grande (and in other similar communities in Peru) often consist of a potato, a meat (chicken, beef, pork, rabbit, or cuy…if you’re lucky), and a carbohydrate (such as rice, noodles, or bread). Most of the people in the community receive only a fraction of the USDA’s recommended nutrient intake during mealtimes.

Chicken noodle soup prepared for us in Pampas Grande. They have this stuff down to a science.



Along with Pan Peru, the Richmond Global Health Alliance is looking to combat the lack of available nutritious foods in Pampas Grande through building community greenhouses. The hope is to make more fruits and vegetables available to the people in the community so that they can cook with them throughout all seasons of the year. In accordance to Jamie Oliver’s Food Revolution, making good, nutritious food available can help people lead healthier lives. Jamie Oliver adds to this goal by empowering people to learn how to cook delicious meals with these foods—not just making healthy foods available, but teaching people how to cook them.

In Pampas Grande, implementing a cooking skills program to the greenhouse project could bring up some ethical and cultural challenges. When Jamie Oliver visits communities in the United States and teaches people how to cook, he is arguably teaching people how to put a healthy twist on the foods they already eat (even though he is technically a foreigner). For instance, instead of eating heated up, frozen, processed pizza, he might encourage someone to bake their own pizza, using natural crust, tomato sauce, and lots of veggies. Or, instead of a milkshake ordered from the fast food window, he might suggest a homemade fruit smoothie.

For us, though, teaching others how to cook with different ingredients might be a little bit more challenging. The people in Pampas Grande and similar communities have been eating these foods and dishes for generations and have strong cultural ties to them. When we visit Pampas Grande, all meals are prepared for us by women in the community. They use a tremendous amount of their resources making traditional Peruvian dishes for us, for which we are so grateful. They are proud of their food, and should be, since it tastes delicious and reflects a part of their daily lives. How could we, then, enter this community kitchen and say, “here, try cooking like this,” or “try adding this ingredient to your dish”?

It’s a difficult predicament to be in. We most definitely want people in the community to place healthy, nutritious foods into their diets for their health and wellbeing (which undoubtedly involves changes in or additions to recipes). However, we would never want to show them disrespect by conveying a message that a cultural staple in their lives (of which they are experts) isn’t good enough. It is possible to help people in Pampas Grande have more nutritious lives, but as we implement our greenhouse program, we must be aware of the cultural ties that are linked to food preparation and mealtimes and that we are but guests in the community.

Do you agree that efforts to promote nutrition could bring up some of these issues? What are your ideas for helping people have healthier diets in Pampas Grande? How is Pampas Grande similar and different to communities in which Jamie Oliver has worked with his Food Revolution, such as Huntington, WV? We’d love to hear your thoughts. Feel free to post and leave links to other sources about this topic.


Here's a picture of a dish we were served at lunch in Pampas Grande. Cuy with rice, alongside chicken noodle soup. Very tasty!



Jamie Oliver's Website: http://www.jamieoliver.com/
Jamie Oliver's TED Talk: http://www.ted.com/talks/jamie_oliver.html
Jamie Oliver's Food Revolution: http://www.jamieoliver.com/us/foundation/jamies-food-revolution/home
USDA's My Plate: http://www.choosemyplate.gov/

Wednesday, September 14, 2011

New Perspective from "NEJM": Linking HIV Global Health Efforts to those for Noncommunicable Disease

A recent article in the New England Journal of Medicine (see link below) provides a new perspective on noncommunicable diseases in the field of global health. Such diseases like cancer, cardiovascular disease, diabetes, physical disability, and psychological disorder are ubiquitous and costly, and affect populations and public administrations across the world. There is a clear public health threat presented by noncommunicable diseases, and something must be done to prevent and control them among the world’s population.

The authors suggest that the lessons learned from the multi-national effort to prevent and treat HIV/AIDS (initiated in 2001 during the United Nations General Assembly) could be applied to similar efforts to reduce the prevalence and prevent noncommunicable diseases throughout the world. They cite the increase in HIV surveillance from government organizations, the influx of research findings that supported biologically-based therapeutic and prevention efforts, the rising pressure to deliver programs in a short amount of time, and the large donations and vocal advocacy campaigns that came from powerful activist groups. The authors suggest that a similar approach could be used to approach noncommunicable disease treatment and prevention from a global perspective.

Like HIV, many noncommunicable diseases are rooted in behavioral risk factors. Therefore, like HIV, surveillance systems for these risk factors can be used to measure the problem’s scale, categorize the vulnerable populations, and evaluate interventions. The authors highlight the need to approach noncommunicable disease prevention and treatment from both a behavioral and biomedical standpoint, just as was done in past HIV efforts. They make the point that like HIV, many behavioral interventions for noncommunicable diseases are effective exclusively to people who are motivated to make significant lifestyle changes. “Therefore…,” the authors suggest, “it is critical to welcome and integrate the use of low-cost biomedical interventions into prevention efforts for noncommunicable diseases, viewing them as complementary and part of a holistic approach.”

Considering that the biology of an infection is totally different than that of many chronic, noninfectious diseases, it is interesting to see a possible linkage in the global health efforts for HIV/AIDS and diseases like cancer, diabetes, and physical disability. Indeed, attempting to implement the efforts used and lessons learned from HIV/AIDS global efforts is a daunting task, which would require international (political) support, billions of dollars from governments and private agencies, quick delivery of available resources, competitive environments to produce research supporting effective biolomedical therapies, as well as public awareness and enthusiasm for the problem at hand. Due to its infectivity and mortality, HIV/AIDS came into the world demanding immediate cooperation and use of resources. As a global community, we must recognize the need for similar cooperation and resources to be applied to prevention and treatment efforts for chronic, noncommunicable illness, which is quickly proving to be a serious public health issue throughout the world.

Narayan, K. V., M.D., Ali, M. K., M.B, Ch.B., del Rio, C., M.D., Koplan, J. P.,M.D., & Curran, J., M.D. (2011, September 8). Global Noncommunicable Diseases--Lessons from the HIV-AIDS Experience. The New England Journal of Medicine, 365, 876-878. Retrieved from http://healthpolicyandreform.nejm.org/?p=15249&query=TOC

Tuesday, September 6, 2011

Hurricane Irene: A Prompt to Evaluate our Role in the Face of Natural Disasters

Today’s RGHA blog post is inspired by last week’s series of natural disasters in the Richmond area, including last Tuesday’s 5.9 earthquake and last Saturday’s Hurricane Irene. Although the earthquake caused minimal damage, Irene left thousands of people in the Richmond area without adequate water and power supply. According to the Washington Post, Virginia Governor Bob McDonnell predicted that damages to the state would total millions of dollars. Before, during, and after the hurricane, the Virginia Department of health worked (and is still working) tirelessly to minimize the health risks to the public brought on by the disaster, including adequate shelter, food supply, clean water, and ability to communicate with emergency personnel (to name a few).

For all intents and purposes, last week’s natural disasters hit a population that possesses relatively organized public programs for health, safety, and communication. Still, it made a giant impact in thousands of lives and created wide-spread, multi-faceted public health concerns throughout the area. Throughout the world, even in communities with structured public influence— let alone those that are underserved—natural disasters have the ability to create sheer public health chaos.

How can and should we, as practitioners of global public health, work to minimize the risks and damages to populations throughout the world brought on by nature’s wrath? What is our role, in the private sector, to promote and uphold health and safety for communities affected by natural disasters? Certainly these questions present daunting challenges and tremendous tasks for any organization to take on. In fact, private organizations exist solely based on the premise of providing education, prevention, and relief to communities affected by natural disasters (WANDAA, Relief International, Global Education). But what can a general global health organization, like us, do to uphold public health in an effective and efficient way in the face of a natural disaster?

Share your opinion with us. Here are some articles about Hurricane Irene in our neck of the woods and the general effect of natural disasters on public health. Also, feel free to leave comments linking us to more articles that discuss this broad topic.

Washington Post: Obama grants request for federal aid in Virginia for Irene damage

The threat of communicable diseases following natural disasters: a public health response

Protecting the Public's Health

RGHA Medical Projects