It’s the African
stereotype – malnourished children. And just like fulfilling the expat
stereotype of living in luxury and partying with all the other expats in town
every weekend, I am working right among the stereotype.
Childhood malnutrition in the Upper East
Region is 27%, present in close to a
third of all children under 5. The national
average of Ghana is 13.9%, the differences between the northern regions of the countryclearly showing the disparity. Remembering our own backyard, I found an old study in the Northern Territory that
indicated a 20% occurrence of
malnutrition in Aboriginal children aged 0-2 years, well above the criteria for
needing a nutrition intervention.
Studying malnutrition in Australia, I learnt
about ‘kwashiorkor’ – malnutrition
caused by a deficiency of protein. The lack of protein causes fluid shifts; odema,
or puffy feet, and, as it gets worse, face and body. It is a global term, but
here I have found it is a Ghanain word – from the Ga ethnic group. It means “the disease of the displaced child”, or
the curse of the second child, because it occurs when a baby is weaned off (high
protein) breast milk, to the local diet of maize and/or other low protein
starchy staples, often due to the arrival of a second child. They quickly
become malnourished, and swollen with painful fluid, because there is little
protein-containing food being fed to them. As the name suggests, it was, and
still is, considered a curse of the child, and this is often difficult to
overcome. Often preventing recovery.
To address the low protein diets, districts
have been holding food demonstrations. I attended Karaga district’s (northern
region), where a group of Mother to Mother Support Group (MtMSG) participants
and other community based volunteers had gathered to learn how to increase the
protein content of their local recipes for the children.
Are you thinking stainless steel
benchtops, ovens and stovetops for everyone, MasterChef style? We were in the
health facility compound, cooking Ghana style. Over charcoal cookers, with no tables,
there was much food being prepared.
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| The scene of the food demonstration in Karaga |
Maize is the staple in the Northern
Region, with some millet, sorghum and rice available, all fairly low in protein
(11%). To start with, the mother’s learnt how to make koko (porridge) with added soya flour (35% protein). The ratio of
4:1 was used so it wouldn’t affect taste, and be too costly. Soya is available to some households,
it is grown as a cash crop; it yields a lot of money at the markets. Which
brought about a problem: These people can’t afford to keep the soya for
themselves and their families. If you can get better money for soya, then you
sell it and buy a larger portion of maize as it will stretch further and fill
more people for longer. But it is low in protein. Soya flour was also added to banku (fermented maize/cassava), and
the making of soya milk was
demonstrated. If this is actually used, as some mothers described, by keeping small
amounts for themselves after selling at the markets, it could improve their
children’s health remarkably (and easily).
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| Making banku with added soya flour |
Dawa-dawa
is fermented locust beans. This is high in protein, and can be used as a stock
flavouring as well (instead of the dreadful Maggi/Onga stuff they sell here).
This was added to some soups and jollof rice.
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| Dawa dawa before it is ground |
Moringa
is a plant that is said to cure all! Sort of like Ghana’s version of
wheatgrass, or goji berries. The claims of ‘more calcium than milk’ have been
proven false (the calcium it contains is not available to the body), and no
actual human studies have been done, yet needless to say, Ghana really needs
greens, so adding moringa to the soups and stews is encouraged.
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| Groundnut soup with moringa added |
Alifu
is another green vegetable, as well as brau
that was added to traditional soups that generally has no vegetables at all.
These are readily available at markets, which made me happy because it seemed
like a solution that could be adapted by the villagers.
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| Alifu and brau cut up ready to be used - this man was one of the only men to participate, and did well, the women loved to have a friendly dig at him. Particularly when he made sorghum banku - sorghum is pink |
Tubani
is steamed bean cakes. These are a healthier version of kosee and served with a sesame seed paste that was delicious. Steaming them in
plastic bags made me slightly uneasy. They made both of these with added soya
flour to boost the protein.
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| Steaming the bean cakes |
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| Tubani and sesame paste |
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| Kose, with the 4 types of koko |
The aim of the demonstration was for the
attendees to take the training back to their groups and communities and in
turn, teach these people, to ensure the new methods are taken into the home. I
sincerely hope that some of these practices will continue, to help prevent the
occurrence of malnutrition. There is never one cause for malnutrition, with
many social and cultural factors involved that are difficult to address. It
does always seem to come down to money however, and simple sounding things to
us, such as giving your malnourished child an egg from your chickens rather
than selling it, is not always possible. But getting the food right in the
first place looks at preventing malnutrition, and hopefully bringing about
small changes in the overall food supply for the benefit of everyone.
The plan for 2012 includes starting demonstration
gardens, which is a fantastic integration, hopefully I will be involved in this
too.
