Background and Analysis
Historically, Bolivia was considered to have contained inhabitants for over 20,000 years. In the XV century, the Incas took over what is now known today as Bolivia and incorporated them into their then empire. Thus, today, many of Bolivia’s main foods and methods of preparation are similar to that of other countries who had also been taken over by the Incan empire. Over 200 different kinds of potatoes are cultivated in the country, as well as massive amounts of corn and quinoa.
However, because of the world’s recent fascination with Quinoa and with Bolivia being the world’s largest exporter of quinoa in the world, local market prices are soaring and making it difficult for the general public to obtain this nutritious food. Almost all of the quinoa goes to exportation, and the little bit that is left is heavily overpriced.
Quinoa, however, is not the only crop that is experiencing a surge in prices. In early 2011 a string of violent protests took place in response to the rising food prices. As a result of the economic struggle families are facing to feed their children, many have ceased to farm their traditional, nutritionally dense crops in favor of feeding their children on cheaper, nutritionally lacking, foreign products.
As such, there has been a shift in food culture in Bolivia. It is becoming more common for children to prefer nutritionally deficient white bread over toasted quinoa or coca cola instead of quinoa based drinks. The shift of the younger population to preferring cheap junk foods is doing nothing to help raise their younger population, where malnutrition and obesity abound. The results of these diseases is appalling, with 1 in 3 children in Bolivia under the age of five suffering from stunting. Bolivia has the second highest rates of stunting in Latin America and the Carribean.
Aside from poverty, a broken health system, which is unable to provide the correct supplements to its people, is also to cite for this crisis. In addition, the general lack of awareness and education on children’s behavioral issues with respects to diet are also to blame. Finally, mother’s characteristics, household assets as well as public services are strong determinants of a child’s health. There is no general public educational system in place about physical nor sexual hygiene, much less nutrition. There is barely any standardized information as to how different foods affect the bodies of adults, much less that of children. It has come down to the point where children will just eat whatever is at hand and readily available for consumption.
Moreover, Bolivian cuisine is traditionally devoid of vegetables and fruits. The main foods in their everyday meals consist of corn, potatoes, beans, rice, wheat, beef, pork and chicken. While these foods tend to be relatively healthy in nature, they do not encompass all the requirements of a healthy diet.
What this means for my project in Bolivia is that I will have to take multiple approaches to reach as much of the population as possible. Education for parents and children will be indispensible. That is, education about basic nutrition for the parents will be a basic demand of the program. A good part of my time should be dedicated to creating courses for mothers, and potentially fathers, about the importance of fruits and vegetables in raising healthy children. As of now, I have started considering creating a pamphlet which can be mass distributed with condensed information about different fruits and vegetables and how they promote healthy growth and weight maintenance. The issue with this is that I am not well aware as to how literate the general population that I will be working with will be, nor do I know much about the availability of different fruits and vegetables in Bolivia throughout the seasons. In addition, in my approach I will also need to expose children to healthy foods and teaching them to like eating fruits and vegetables. Frankly, I believe this will actually be more difficult than find an effective form of mass education, because convincing someone to do something they do not want to do, specifically convincing children to do things that they do not want to do, is incredibly difficult and sometimes next to impossible. Perhaps in the beginning it will come down to a matter of conditioning and exposure treatment, masking vegetables into their favorite foods until they are more consciously willing to try foods they are not entirely used to eating..
But these two will only be some of the several approaches I will have to take. That is, I will have to account for the effects of socioeconomic status on food availability for families. Affordability and accessibility will have to be major concerns in my mind at all times to ensure that I am being realistic rather than idealistic in my approaches to aid. Moreover, food culture and norms are essential laws to consider, because even I can find ways to incorporate vegetables into their traditional dishes, that doesn’t mean that my approach will be taken seriously or that people will be willing to even try my new and “weird” approach to dishes they have been eating to centuries. Perhaps it will come down to introducing new and non offensive recipes to families which are easy and quick to cook but also incredibly cheap, or at least affordable, as well.
Breaking News
There have been several movements to help alleviate the issue, with good success. For example, the Inter-American Development Bank worked with families in El Alto, and achieved wonderful results. Specifically, their initiative targeted families with children under two years of age displaying signs of malnutrition. It was found that while nutritious foods such as Andean grains, fruits, and vegetables were available and affordable to the people, many families were opting for cheap carbohydrates such as rice and high fat foods with poor nutritional content. The result of consuming these foods for the Bolivian children was an increased prevalence in both obesity and malnutrition of the children who took part of the initiative. The mothers were taught about basic nutrition as well as domestic hygiene and were provided with nutritional supplements for their children. Group cooking classes using fruits and vegetables were also provided to the mothers.
One thing that was particularly interesting about this program was that the volunteers specifically went to the homes of the mothers and observed the eating habits and culture of the family at hand. This approach provided specific information about the eating practices of the family going on behind their doors which would have otherwise been unattainable. Moreover, much of the training of mothers was done inside of their own homes in their personal environment, on a one on one basis.
The project was a success. Before the program took place, only 39% of the children in the program received their recommended minimum of daily food. After the program, 77% of the children in the program did. This is proof that education can make a significant impact on issues of malnutrition in children. That is, behavioral change is closely linked with relative awareness.
In terms of my personal project, many of these things are things I should consider incorporating into my personal practice. I especially like the idea of going out and reaching into the community to mothers, creating a personal connection with them so as to better understand their situation, and then using that personal connection as a means for education. I believe it’s through strong interpersonal connections that I will be most able to move people to make lifestyle changes, and this seems like the most realistic and organic way of creating them.
A similar program was installed in Somalia, in which women and children are often victims of malnutrition. In 2013, during the country’s record high rates of malnutrition, informal courses started to be taught about foods and their effects on people’s health as well as the importance of consuming clean water. Moreover, education was also provided in regards to best breastfeeding practices as well as how to effectively wash dishes. The program held a strong belief in that education was indispensible, even superior to just giving the women supplements. That is, supplements were only a short-term solution to the chronic issue that was plaguing the country. It was found that this hypothesis was correct. Within 18 months of the program’s beginning, the rates of malnutrition in Somalia’s capital decreased dramatically, from a devastating 45% to 16%. In urban areas, this plummeted even further, to levels even less than 10%.
In relation to my project, this is again another reminder of how education is indispensible. The power of education cannot be understated when talking about malnutrition, but also the power of community and unity. It is one thing to have a small handful of individuals come in for individual nutritional counseling in their own time, but it’s another thing entirely when you can convince an entire community to value a certain social issue. That is, if an entire community invests time and energy into change, bigger changes will result than if the cause is not a common communal value. In my project, if I can bring a community together to rally for the cause, I believe I will be able to make a more significant impact than if I periodically work with individual families.
A study was done on geography and culture as a matter for malnutrition in Bolivia. Mother’s characteristics, household assets and access to public services were assessed and studied for trends and indicators of children’s risk of malnutrition. It was deduced that altitude and Quechua culture both had significant influences over a child’s chances of suffering from malnutrition. In particular, high altitude had a negative impact on children’s height and weight (where altitude was defined as being higher than 3000 feet).
With respects to my project, all I can say is that I should probably take these factors into account when deciding which areas I would like to target for in-house dietary evaluations. I should probably pay special attention to families from high altitudes in order to more likely get in contact with the population that, statistically, needs help the most.
My final article explores capitalism and malnutrition and how the two are invariably tied. It is a common misconception that obese individuals do not suffer from malnutrition, but the fact of the matter is that often these two conditions appear hand in hand. Capitalism has pushed for over-consumption, valuing quantity over quality. This has resulted in the trends that we see of malnutrition and obesity coming in hand in hand.
This information leads me to ponder over the idea of creating an anti-capitalist anarchic society of people to bypass capitalism and ensure that both quality and quantity are assured. The theory is interesting, but I am lacking in an understanding of how the whole concept would be feasible. It would take a significant amount of brainstorming to create a realistic materialization of this theory, and even so I am not sure if there will be enough time and resources or even interested people’s to partake in the project. But it is interesting none the less.
Faculty/Community Connection
My faculty sponsor was Daniel Prudencio, a graduate student in the department of economics. His tie to my project is that he is from Bolivia himself. From our conversation, I learned quite a bit about the country but also about my Hispanic identity as well. I don’t usually consider myself to be white, but occasionally I’ll mention it for a political reason. However, Daniel has much darker skin than I do, and much more indigenous features than I do, but he said that, in Bolivia, both him and I are basically white. It begged to me the question of what it means to be white in Bolivia. In Venezuela, being white is tied to privilege and socioeconomic status, but not necessarily to race itself. I wonder now if in Bolivia being white means. He did however say that it will work to my advantage as people will take me more seriously due to not only being a foreigner but also due to the color of my skin. He did warn me about the people working in the markets being not very friendly unless you were going to buy from them, that many people have lost hope in volunteers as many of the projects they work on are not sustainable, and that the government is too busy to every care to meet with a volunteer such as myself. He did inform me that most of the people should be fluent in Spanish, and that I should not worry about learning anything from the indigenous languages as they will not serve much use to me.
In terms of integrating the information he gave me into my service project, I will simply keep his advice in mind when going by my day to day activities. I will take advantage of people’s perception of me to make sure that I am listened to when I have something important to say, I will be less disappointed when the market people shoo me away when I first try to talk to them about recycling their food, and I will press harder to and more strategically to get in contact with the mayor in the chance that I decide to get political.
In terms of community organization, I talked with several people from Texas Children’s Hospital, in particular their nutritionist. Many of the children who come to see the nutritionist at Texas Children’s suffer similarly to the children I described above from Bolivia: malnourished and obese. The parents of these children come in for consultations and advice to help their children lose weight and have happy lives. One thing that I was told was to expect patients to lie to you. Not that all patients will, but many will not give you the full picture of their situation, at which point it comes upon you to go to their homes and conduct an in depth observation as to what their living situation is and how it’s impacting how the child is fed. Many times the issue comes down to food not even being the main factor of concern their everyday lives as is their general sense of safety. Many times, in the sense of nutrition, there are extenuating factors that aren’t even necessarily related to ignorance that act as determining factors in what gets consumed. I was especially cautioned that whenever I was not seeing progress, there were probably going to be extenuating factors that would have to be overcome before I could expect to see improvement.
Texas Children’s nutrition wing is somewhat similar to the Nutrition Project, but it is different in that children who take part of the nutrition project are left there for an extended period of time without their parents while the children who are taken to Texas Children’s are only there for the span of a consultation and are not fed during their time there. I am yet to decide which approach I think is more appropriate, but I think that parents are an essential part of the equation and separating the children from their families instead of directly teaching the parents about how to feed their children might not be the best idea. But that is yet to be determined as I have yet to actually go and see the situation for myself.
In a sense, a lot of the cases I will see in Bolivia are similar to the ones they are experiencing here, where the children are given cheap, nutritionally-deficient foods rather than whole foods for their diets. Much of it is a result of ignorance and as they underlined, education is indispensible to solving that problem. However, here children are being fed meals off of McDonald’s $1 menu while children in Bolivia are being fed white rice, meat and white bread. That is, the effects on the bodies of these two different food cultures will be different and that will be apparent in the physical manifestations of their malnutrition.
Once I return from abroad, I am not sure what I plan to do, frankly. It will depend on my experience in Bolivia. I will definitely try to spread awareness of what I encountered there, but since I am not a licensed nutritionist I do not believe I will be able to partake in working with malnutrition issues here in Texas
Reflection
The reason I originally chose to go to Bolivia was because I knew nothing about the country. Whenever a conversation about countries in South America comes up, at least in my experience, the two countries that are most commonly left out of the conversation are Venezuela and Bolivia. I decided to go to Bolivia because I wanted to learn more about a country that is constantly passed under the radar and ignored in everyday conversations about South America. In particular, I want to learn everything I can about Bolivia, their history, politics, culture, traditions, everything, so that I can raise awareness about not only their existence in the world but also about the projects going on there for other people so inclined as I to participate in it.
In respects to my personal connection to my project, I knew I wanted to do something related to nutrition because that is something I am well versed in. I have taken two nutrition courses at Rice as part of my major, am currently teaching one about plant-based diets, and also read articles and books about nutrition on my spare time. Food as medicine is something I firmly believe in, as well as something I am well accustomed to working with. I believe the profile of this project is congruent to my strengths and experience background. Moreover, I feel that in participating in this project I will actually be making use of real skills rather than, as is the case in many other international service projects, being an unproductive burden to the project.
Through this ISP I have yet been able to answer more detailed yet obscure questions regarding this project. For example, how open would market people be willing to donate the unsold produce that they did not sell at the end of the day? How do the people in Cochabamba view service? Will I be taken seriously as a woman? All of these are questions I will not know the answer to until I have actually been in the country and worked on my service project for several weeks. I don’t think that these are questions that it is essential for me to get the answer to however, as I am flexible and hard working, and capable of trouble shooting whatever comes my way with respects to the answers of these questions. I am confident that nomatter what the answers to these questions are I will still be able to do a good job and make a legitimate and significant impact on the project, eventually at least.
Going further from what I have studied here, I would like to take more time to study the food politics of Bolivia as well as the current standing government of the nation. I believe grassroots change cannot occur without an understanding of how the government works as well as the personalities of the individuals in office. I believe part of the solution to malnutrition in the nation will come from having a political revolution addressing food prices and farming for the people. A large political shift is often key to actually experiencing a change at the market level. Perhaps having government subsidies to incentives farmers to lower their food prices could lead to greater accessibility of traditional foods that have become too expensive for consumption.
Appendix
Bolivian Food History and Interesting Important Facts. (n.d.). Retrieved February 25, 2016, from http://www.boliviansfood.com/bolivia-history-important-facts.htm
Romero, S., & Shahriari, S. (2011). Quinoa’s Global Success Creates Quandary at Home. Retrieved February 25, 2016, from http://www.nytimes.com/2011/03/20/world/americas/20bolivia.html
Finding Ways to Change Eating Habits in Bolivia. (n.d.). Retrieved February 25, 2016, from http://www.iadb.org/en/news/webstories/2013-03-04/bolivia-fights-malnutrition,10320.html
Finding Ways to Change Eating Habits in Bolivia. (n.d.). Retrieved February 25, 2016, from http://www.iadb.org/en/news/webstories/2013-03-04/bolivia-fights-malnutrition,10320.html
Finding Ways to Change Eating Habits in Bolivia. (n.d.). Retrieved February 25, 2016, from http://www.iadb.org/en/news/webstories/2013-03-04/bolivia-fights-malnutrition,10320.html
Result Filters. (n.d.). Retrieved February 25, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/15576244
Global food crisis: Combating malnutrition in Bolivia. (n.d.). Retrieved February 25, 2016, from http://www.soschildrensvillages.org.uk/news/archive/2011/06/global-food-crisis-combating-malnutrition-in-bolivia
UN World Food Programme. (n.d.). Retrieved February 25, 2016, from https://www.wfp.org/stories/education-key-reducing-malnutrition-rates-somalia
W. (n.d.). Result Filters. Retrieved February 25, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/22383142
M. (n.d.). Geography and culture matter for malnutrition in Bolivia. Retrieved February 25, 2016, from http://www.sciencedirect.com/science/article/pii/S1570677X04000589