Katie Sutton (ANutr) is a Public Health Nutritionist who lives in the EBPP volunteer house in Tianyar, East Bali and works in the health field team, training local health team staff in nutrition programme delivery and monitoring. She has been volunteering with EBPP since February 2014 and has recently signed on for a further 12 months to continue building staff capacity for future sustainability.
Why did you decide to volunteer with EBPP?
I was drawn to the focus on sustainability the organisation promoted through its website. I have always known that in development work I would be working to eliminate my own job, which is something I am comfortable with.
How have you adjusted to living in the village?
The volunteer house is in Tianyar, around 5km from the Ban office. It is beautiful, with beautiful people. We live right next to the beach, which is lovely. The food is great, and always fresh – great for a Nutritionist!
How does sanitation relate to malnutrition and stunting?
If a young child gets sick with infection, they generally lose weight. We see it often in the monthly health posts we attend, where the growth chart line goes down rapidly. The sickness can be a direct result of exposure to pathogens in the child’s environment. These pathogens could be from open defecation for example – they are present in the faeces and then spread via hands, tools, animals, or water, for example, and are then inadvertently ingested. As previously mentioned, this sickness can result in weight loss, which if dramatic and/or prolonged, can lead to malnutrition. When a child is malnourished, their immune system is compromised, and doesn’t function as well. This means they are likely to get more infections, and lose more weight, and so the cycle continues. Links are now being drawn between stunting (a result of chronic malnutrition) and sanitation, with suggestions that stunting could be reduced by 17-27% with the use of sanitation interventions.
How much does a person’s environment impact their health?
The environment in which we live, and the hygiene and sanitation practices we employ have a huge impact on our health. We know that children frequently put their fingers, and other things, in their mouths – it’s natural. In more developed countries with good hygiene practices, ‘germs’ are often considered good for building the immune system, and subsequent resistance to the pathogens. However, in places where open defecation is practiced, hygiene practices are lacking, and where access to health care is limited, the pathogens in question are much more dangerous, and have more severe consequences. Therefore introducing good hygiene practices, in particular through the introduction of toilet and bathroom facilities, to these areas can dramatically improve the health of those living there.
What changes to people’s health have you seen since you first started working in Ban?
Last month 2 of our severely malnourished children aged below 5 years moved up a bracket from SD-3 to SD-2, which is really great. We have been working with these families to improve the nutritional intake of the children, and also to improve the family’s sanitation practices. We have done this through education sessions, supplemental feeding, and home visiting. The families were really happy when we showed them their child’s growth chart, and explained what it means to move up. There are also noticeable changes in the children’s behaviour; they are much more engaged, happy, and active. There is still a little way to go to get them into the healthy range, but the families are committed and so are we. Development work can be slow, and patience is an important quality for our team!