INFORMES DE LOS PAÍSES: Voluntarios Nutricionista

Nutrition in the Field. Or up the Mountain

Por Katie Sutton, EBPP Expert Volunteer, Julio 2014

Working in the health field is challenging anywhere in the world because there will always be things that are beyond your control – it is the nature of the job. A team that works in this particularly challenging profession, in a particularly challenging environment, and whose purpose is to help others achieve a better quality of life, is an incredible team to be part of.

As a Public Health Nutritionist working in the field, I am part of a programme that delivers monthly Posyandus (Health Posts) en 47 locations across East Bali. Many of the locations are in remote hamlets on the steep mountainous climbs to Mount Agung and Mount Abang. A large problem with the provision of healthcare and nutrition in East Bali is logistics. Access to most of the villages and sub-villages is via extremely basic roads, or tracks, accessible by us in 4x4s, on dirt bikes, and on foot (the views are dramatic, as is the skill involved in driving the 4x4s up there!). This remoteness means going to the market, health centre, or school is extremely difficult for residents. EBPP is effective in providing basic healthcare to the people in these hamlets, which would otherwise be unavailable, and/or, too costly.

(De izquierda a derecha) Katie taking the weights of children in Desa Ban; EBPP Nutritionist, Sinta delivers nutrition to mothers in Temakung Posyandu

At the Posyandu the team weigh the children, give immunisations and contraceptives, run a playgroup with games, stories, and hygiene sessions, provide the monthly nutritious ‘Bubur Kacang Ijo’ (Mung bean porridge), a bottle of mineral water for every infant and mother, and provide nutritional assessment and outreach. Over the last 15 años, EBPP has implemented an efficient set of health and nutrition systems. The people attending the Posyandus clearly value what is provided by EBPP, and the team has established valuable, solid, and trusting relationships with them, and subsequently, the incidence of malnutrition in East Bali, particularly severe malnutrition, has been dramatically reduced.

(De izquierda a derecha) EBPP Playgroup leader, Armiani reading to playgroup children in Pucang Atas Posyandu; EBPP Primary School students collect water for handwashing prior to lunch

My current work plan also includes auditing the EBPP school meals. Previous volunteer Nutritionist Berit conducted intensive training with the school cooks in order to ensure the meals are nutritionally balanced, saludable, and in sufficient amounts for the growing children – work that has clearly had a positive impact. The cooks are inventive with ingredients to ensure the children do not get bored, and have learned a lot about the need for high quality protein. It is great to see the children enjoying their lunch created by local hands, from local, fresh ingredients.

(De izquierda a derecha) A young girl eats “Bubur Kacang Ijo” (Mung bean porridge) at Darmaji Posyandu; A healthy snack of sweet potato, low GI coconut sugar and coconut given to EBPP school children by Jatituhu’s creative cook.

The nutritional problems experienced when EBPP was first established 16 years ago have been well addressed, and this is beautifully demonstrated through photographs, personal accounts, and statistics. Nutrition is a discipline that is subject to dramatic change over time, depending on things such as research, food politics, progressing scientific techniques, and relative changing tastes and demands. As is increasingly prevalent in both less, and more, economically developed countries, the increasing availability of relatively inexpensive processed snack foods, which have long shelf lives but little nutrition, is sadly beginning to form a similarly increasing part of Bali’s diet. An important role of any nutrition professional in the development field is to anticipate potential future nutritional problems and address them appropriately – work that EBPP is well positioned to do through its monthly Posyandu Outreach and School Health Education programmes.

So! Following the morning jeep rides, nutritional assessments, home visits, and afternoon office work, it is lovely to be able to go back to the beautiful volunteer house, situated 2 minutes walk from the ocean. There is a market at the top of the street, and buses running along the coastal road to Diver’s Paradise Tulamben and Amed in one direction, and to Singaraja and Lovina in the other. Or you can of course take out the house bicycle, if you’re feeling energetic!

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