Pippin: But what about breakfast?
Aragorn: You’ve already had it.
Pippin: We’ve had one, yes. But what about second breakfast?
[Aragorn stares at him, then walks off.]
Merry: Don’t think he knows about second breakfast, Pip.
Pippin: What about elevenses? Luncheon? Afternoon tea? Dinner? Supper? He knows about them, doesn’t he?
Merry: I wouldn’t count on it.
Food Security. It’s a phrase thrown around international development and human rights circles, but one that many reading this have never heard. I guess because those of us who have it don’t need to think about it. Or do we?
The World Food Summit of 1996 defined food security as existing “when all people at all times have access to sufficient, safe, nutritious food to maintain a healthy and active life”.
Food security is built on three pillars:
- Food availability: sufficient quantities of food available on a consistent basis.
- Food access: having sufficient resources to obtain appropriate foods for a nutritious diet.
- Food use: appropriate use based on knowledge of basic nutrition and care, as well as adequate water and sanitation.
Fourteen times a week, the staff in Kigutu is presented with essentially the same meal: a giant pot of rice, a giant pot of stewed pink beans, and two other accoutrements: some type of potato or banana (boiled or fried skewers or slices), 
and a stewed vegetable concoction consisting of lenga lenga (amaranth, a healthier version of spinach), or tomatoes and cabbage.
Two meals a day, every day. The food is quite good – in fact I had the beans for the first time in a few days this past week and was struck by how delicious they were. But monotony is the point here.
The vast majority of Burundians (of the world, really) would be overwhelmed with gratitude at the prospect of such a nutritious meal of unlimited quantity every day, without worry. I try to keep this in perspective as I silently long for the freedoms and variety available to me at home.
After a couple of weeks of this, I realize I’m getting fat – a result of the combination of the carb-laden meals (including the fried bananas which I adore and can’t stop eating), the major reduction of fresh vegetables as compared with my stateside diet, my reduced activity level (refer to earlier post…), and the overeating that comes from the quest to satisfy an unnamed craving, despite being physically satiated ... you know the feeling – the constant unspecified hunt for whatever will shut down the “feed me” function.
Occasional supplemental treats grace the meals, such as slices of creamy and fresh local avocado (awesome),
a “salad,” which is shredded cabbage dressed in mayonnaise laid out on a platter and garnished with slices of tomato (way less awesome), and very occasionally meat – beef, goat, and the very rare fish (usually for special events), stewed in a savory tomato sauce. We mzungos have brought things with us like granola bars and dried fruit and almond butter. We supplement with oatmeal and the rare but coveted muesli purchased from the alimentation shops in Bujumbura. We work out how to get fresh fruit and vegetables (only those that can be eaten raw – non-kitchen staff have no way to cook), and I wonder what my colleagues are thinking at the meal table as we seem never satisfied with what’s offered to us. We hoard things like a bottle of coke zero, a can of ginger ale saved from a plane trip, a small packet of processed and artificial cookies left over from a small fete, the likes of which we would not be interested in at home. It takes me three days to eat the outrageously expensive European version of a Snickers bar as I carefully ration and savor the luscious chemically engineered delicacy.
I take it one step further and co-opt space in the preparation kitchen’s refrigerator at Kigutu, to ensure I have access to yogurt (locally made,
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| local strawberry yogurt |
strawberry or plain, full fat, runny, home printed labels), peanut butter (also locally made with homemade labels pasted crookedly onto the jars, fluffy and delicious), and orange juice (from concentrate, yes, but no added sugar – score).
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| locally made natural peanut butter |
Breakfast is chapatis. The budget is tight, so it’s just chapatis. No butter, no confiture, no fruit, no napkins. They are fried and heavy and greasy and I love them. But I exercise restraint. I have had a couple, but I typically retreat to my oatmeal (which I prepare with the tea served) or yogurt and muesli.
We Americans find solace in our weekend trips to Bujumbura where we are masters of own appetite domain. We eat lovely grilled brochettes (kebab) at local places (our Burundian friends sometimes generously bring us along), or find inexpensive delicious Chinese (frequented by mzungos and locals alike), various varieties of excellent East and West African food,
or occasionally visit the mzungo places and indulge in things like authentic pizza, solid Indian food, or really, anything with cheese.
Five weeks into my stay here, I have a trip planned to South Africa to visit a dear friend from when I lived in Sweden, now two decades ago. We haven’t seen each other in seven years, and it’s like no time has passed. She is married to a generous and warm South African, and lives in Cape Town with her beautiful family. They use words like “dah-ling” and “shame” and “hectic” (pronounced ”hayk-tic”) in ways that make me smile. Having (gorgeous) twin almost-six-year-olds means the lovely house is always stocked with goodies and treats.
Five weeks into my stay here, I have a trip planned to South Africa to visit a dear friend from when I lived in Sweden, now two decades ago. We haven’t seen each other in seven years, and it’s like no time has passed. She is married to a generous and warm South African, and lives in Cape Town with her beautiful family. They use words like “dah-ling” and “shame” and “hectic” (pronounced ”hayk-tic”) in ways that make me smile. Having (gorgeous) twin almost-six-year-olds means the lovely house is always stocked with goodies and treats.
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| Karin, Maya, Max, Michael - chill time before bed |
South Africa is an aberration in sub-saharan Africa; it might as well be in Europe. They have vast and bright grocery stores – of the super fun Marks & Spencer variety, called Woolworths or “Woolies” to the locals – and somehow, we find ourselves there every day.
I eat everything in sight. The Woolworth version of Oreos (dare I say they are better than the original), helping upon helping of green salad with baby tomatoes and fresh herbs, roasted cashews, delicious thick lowfat yogurts, crunchy sweet granola, easy-peel succulent mandarins, rusks (if you know of rusks, then you know the joy). We have fresh non-UHT milk, maybe the biggest treat of all. We go out for sushi, and macarons with cappuccinos, and order in Thai. Karin’s sister and California-born husband make nachos grande one night, and I bake a chocolate cake and with a chili-cinnamon chocolate glaze, served with freshly whipped cinnamon cream and fresh figs. We have caught-that-day fish from the harbor down the road and a lavish vegetable medley (always including “buttah-nut”) on the braai, South African for barbecue.
I eat everything in sight. The Woolworth version of Oreos (dare I say they are better than the original), helping upon helping of green salad with baby tomatoes and fresh herbs, roasted cashews, delicious thick lowfat yogurts, crunchy sweet granola, easy-peel succulent mandarins, rusks (if you know of rusks, then you know the joy). We have fresh non-UHT milk, maybe the biggest treat of all. We go out for sushi, and macarons with cappuccinos, and order in Thai. Karin’s sister and California-born husband make nachos grande one night, and I bake a chocolate cake and with a chili-cinnamon chocolate glaze, served with freshly whipped cinnamon cream and fresh figs. We have caught-that-day fish from the harbor down the road and a lavish vegetable medley (always including “buttah-nut”) on the braai, South African for barbecue.
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| Karin and me at a local wine farm. |
We drink gorgeous wine at home, and later visit the neighboring wine farms for some local varieties – a generous tasting each of six different wines for 30 Rand – about $4. In fact, I do all kinds of indulgent things, like wash my clothes with warm water in a washing machine, blow dry my hair ( ! ), heat my homemade hot chocolate in a microwave, and take a shower almost too hot to enjoy, just because I can. I use not one, but two mildew-free towels on exit.
I do all of these things because I feel I have been deprived these five weeks.
I find I have been subsisting on a diet primarily of rice, oatmeal, peanut butter, dried fruit, yogurt, and excellent Burundian coffee, peppered with the occasional indulgence from a market run or alimentation stop, and dreamy exotic produce: bananas, avocados, passion fruit, mango, papaya, mandarina (green and tart little delicious oranges laden with seeds). This is deprived. Hmmm. My friend Tim tells me no worries – I can survive on avocados – they have everything I need. Phew.
To really talk about deprived, let's talk about the staple of a rural Burundian’s diet - cassava. Common in south and central America, we also call it yuca. There is a popular and delicious restaurant in my East Village neighborhood named after this apparently controversial tuber.
I do all of these things because I feel I have been deprived these five weeks.
I find I have been subsisting on a diet primarily of rice, oatmeal, peanut butter, dried fruit, yogurt, and excellent Burundian coffee, peppered with the occasional indulgence from a market run or alimentation stop, and dreamy exotic produce: bananas, avocados, passion fruit, mango, papaya, mandarina (green and tart little delicious oranges laden with seeds). This is deprived. Hmmm. My friend Tim tells me no worries – I can survive on avocados – they have everything I need. Phew.
To really talk about deprived, let's talk about the staple of a rural Burundian’s diet - cassava. Common in south and central America, we also call it yuca. There is a popular and delicious restaurant in my East Village neighborhood named after this apparently controversial tuber.
It’s readily available in Burundi at little or no cost, and as a main supplement to the Burundian diet, is seen filling bicycle baskets all along the roadways. A common sight at the roadside markets is cassava ‘bread,’ a starchy, gummy white ball wrapped in a banana leaf. It has a texture like yeasty-bread-dough-meets-cookie-dough and a mildly bitter taste.
The leaves are also stewed and eaten. Cassava has debatable health implications. At best, there is no nutritional value but rather just empty carbs. At worst, cassava may be somewhat toxic when consumed in large quantities. According to the Food and Agriculture Organization of the UN (FAO UN): “Like other roots and tubers, cassava contains antinutritional factors and toxins.[5] It must be properly prepared before consumption. Improper preparation of cassava can leave enough residual cyanide to cause acute cyanide intoxication and goiters, and may even cause ataxia or partial paralysis.” The FAO UN has deemed cassava a ‘fall-back’ resource to be used as a food security crop in times of famine.
When walking up the road to Mugara the day we visited the baking co-op, Arnaud points out the cassava growing along the side of the road – he introduces it as the enemy.
For VHW, cassava is an enemy. Malnourishment and malnutrition are among the top challenges faced by the clinic staff. One of VHW’s four community programs focuses on Agriculture, Livestock, and Environment Protection, formerly known as Food Security; the program name was changed to accommodate the expanded focus. The major goal of this program is addressing the root cause of malnourishment and malnutrition: lack of food, lack of resources to grow food (seeds / land), and lack of education about nutrition and farming techniques.
The program aims to include participants from the community groups and schools. Women whose children have been admitted to the clinic’s malnutrition ward must participate in agricultural training, and it is available to those who volunteer for community hours at the clinic on Fridays (this is dozens of people from the catchment area who want to give back in thanks for what the clinic has done for the community).
When walking up the road to Mugara the day we visited the baking co-op, Arnaud points out the cassava growing along the side of the road – he introduces it as the enemy.
For VHW, cassava is an enemy. Malnourishment and malnutrition are among the top challenges faced by the clinic staff. One of VHW’s four community programs focuses on Agriculture, Livestock, and Environment Protection, formerly known as Food Security; the program name was changed to accommodate the expanded focus. The major goal of this program is addressing the root cause of malnourishment and malnutrition: lack of food, lack of resources to grow food (seeds / land), and lack of education about nutrition and farming techniques.
The program aims to include participants from the community groups and schools. Women whose children have been admitted to the clinic’s malnutrition ward must participate in agricultural training, and it is available to those who volunteer for community hours at the clinic on Fridays (this is dozens of people from the catchment area who want to give back in thanks for what the clinic has done for the community).
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| demonstrations gardens at Kigutu |
The program provides training, teaching farming skills (“if you can grow carrots, you can harvest them, and then you can have them in your home”) using the beautiful demonstrations gardens on site. The program also provides farming materials – seedlings, watering cans, organic fertilizer.
VHW also supports the formation of agricultural co-ops – community members working together to produce and sell a crop or a resource. The Economic Development Program provides business training and assists in getting these co-ops legitimized as legal entities. They provide on-going support as the co-ops grow and develop. For the co-ops that are working well together and showing potential, there are occasional perks, like a goat give-away. Twice since I’ve been here, I’ve had the privilege of witnessing a select number of co-ops received a windfall of 20 goats each from VHW. The purchase of these goats is funded by various donor organizations that support the growth opportunities provided to the community by VHW. During a recent give-away, Melchiade, our community organizer, admonished the recipients “don’t … eat … the goats.” It’s tempting, but these goats are here to provide fertilizer to help crops flourish, and to breed and be sold to the benefit of the co-op.
On a recent visit by a super cool and fun donor from Project Redwood, we had the opportunity to visit one of the co-ops that received goats.
They had built a nice little house for these new assets, and we were able to ask questions like, how have the goats helped you? (fertilizer), what do you grow? (various vegetables for subsistence and to sell at market), where is the garden? (not close by), how do you get the fertilizer to the garden? (on our heads). Wait – what? On their heads. Some of these women I see on the roadways, carrying baskets on their heads, are carrying baskets full of goat poop. The smell was as you might imagine. I tried to envision walking along a hot and dusty roadway, kids in tow and tied to my sweaty back, cars and buses racing by, hot sun beating down on me, with poop on my head.
VHW also supports the formation of agricultural co-ops – community members working together to produce and sell a crop or a resource. The Economic Development Program provides business training and assists in getting these co-ops legitimized as legal entities. They provide on-going support as the co-ops grow and develop. For the co-ops that are working well together and showing potential, there are occasional perks, like a goat give-away. Twice since I’ve been here, I’ve had the privilege of witnessing a select number of co-ops received a windfall of 20 goats each from VHW. The purchase of these goats is funded by various donor organizations that support the growth opportunities provided to the community by VHW. During a recent give-away, Melchiade, our community organizer, admonished the recipients “don’t … eat … the goats.” It’s tempting, but these goats are here to provide fertilizer to help crops flourish, and to breed and be sold to the benefit of the co-op.
On a recent visit by a super cool and fun donor from Project Redwood, we had the opportunity to visit one of the co-ops that received goats.
In the US, our biggest health concerns are heart disease, cancer, and stroke. By-products of an indulgent, sedentary lifestyle. In Burundi, the biggest health concerns are malaria (treatable, yet thousands die from it on a regular basis), tuberculosis (for which there is an immunization, but not accessible for the majority here), and malnourishment.
Malnourishment. People are dying in this country on a daily basis because they simply do not have enough food to eat. I have an image clearly ingrained my memory of World Vision t-shirts, printed for their 30-hour famine campaign, that announced that 32,000 children a day die of hunger. I had a giant bowl of oatmeal this morning, into which I mixed almond butter, then added raisins and peanuts, topped it with a perfectly ripe banana, and then drizzled it with a ginger honey I bought in South Africa. The minute I finished I declared that I was starving (refer to early reference to second breakfast). This is a word we throw around when we’re feeling maybe a bit peckish, or maybe even truly hungry. But we don’t know hunger the way much of the world knows hunger.
My office in Kigutu butts up against the triage area for the clinic. The doctors, nurses, and technicians here see upwards of 150 patients a day. There are screaming babies most of the morning every morning. Sometimes we muse that they are trying to outscream each other. I wonder how many of them are screaming because of empty bellies.
The six contributory factors to malnourishment in the VHW clinic catchment area are:
Malnourishment. People are dying in this country on a daily basis because they simply do not have enough food to eat. I have an image clearly ingrained my memory of World Vision t-shirts, printed for their 30-hour famine campaign, that announced that 32,000 children a day die of hunger. I had a giant bowl of oatmeal this morning, into which I mixed almond butter, then added raisins and peanuts, topped it with a perfectly ripe banana, and then drizzled it with a ginger honey I bought in South Africa. The minute I finished I declared that I was starving (refer to early reference to second breakfast). This is a word we throw around when we’re feeling maybe a bit peckish, or maybe even truly hungry. But we don’t know hunger the way much of the world knows hunger.
My office in Kigutu butts up against the triage area for the clinic. The doctors, nurses, and technicians here see upwards of 150 patients a day. There are screaming babies most of the morning every morning. Sometimes we muse that they are trying to outscream each other. I wonder how many of them are screaming because of empty bellies.
The six contributory factors to malnourishment in the VHW clinic catchment area are:
- Culture
- Lack of education of parents
- Family size
- Poverty
- The Child Health system (the health centers are not educated on the issue)
- Population density, leading to lack of land capacity for subsistence farming
As to family size, I was struck early in my stay here about how often the word ‘family planning’ is thrown around in conversation among my young, mid-20s to early-30s male Burundian colleagues. They ask how many siblings I have – one (super awesome) sister. Wow – they are impressed. Americans know about family planning. They have 6, 7, 8+ siblings. How many young professional guys do you know in the states who have ever even thought about family planning, let alone discuss it over breakfast? I don’t know any. They are talking about Tim Tebow and JP Morgan Chase today. But when I look at the chart below, I understand. These guys work here because they are passionate about the cause – about health and its ability to augment their society and their country. They know far too well the adverse effects of a too-large family.
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| The chart above shows the number of VHW cases of malnutrition, analyzed against family size, in 2011. |
An intersection of the effects of these two issues – culture and family size – unfortunately happens within the church. As I've written, this is a deeply faith-based society. Many are devout worshipers. I am learning that some denominations within the larger “church” here (I have heard different things about different denominations – Catholic and Pentecostal alike – so I won’t single out any one denomination) have very strong teachings. In some parishes, people have apparently been told they will be excommunicated if they practice family planning. I have heard of people being kicked out of churches because they were not producing enough children fast enough so foul play was suspected. This brings great conflict on these people who are not educated on the issue, think they are doing right by following the teachings of the church, and end up putting their children and themselves in danger as their families grow and they cannot support them.
In addition, a recent change in laws now allows children under the age of five and maternal health cases to be treated in state hospitals without cost to the patient. While this is ostensibly good for the general health of women and children, it does nothing to discourage the growth of family size.
While some of the causes of malnourishment and malnutrition have solutions (education), the issues of poverty and population density persist. Burundi is a country of about 8 million people, most of who are living in extreme poverty. I put this into perspective by imagining the vast majority of the denizens of the five boroughs of New York City living below the poverty line. Seems hard to get my head around.
So what are the solutions? While the international development and relief community consistently works on strategy and approaches to address this colossal need, the rest of us have the ability to make smaller choices – we can continue to amass things and experiences and space and dividends. Or we can use some of the resources and the blessings we have been given to support the efforts of so many – with our time, with exposure, with education, with funds. There is work being done and it is making a difference. Change can come – buke buke, yes, but it’s not impossible.
In addition, a recent change in laws now allows children under the age of five and maternal health cases to be treated in state hospitals without cost to the patient. While this is ostensibly good for the general health of women and children, it does nothing to discourage the growth of family size.
While some of the causes of malnourishment and malnutrition have solutions (education), the issues of poverty and population density persist. Burundi is a country of about 8 million people, most of who are living in extreme poverty. I put this into perspective by imagining the vast majority of the denizens of the five boroughs of New York City living below the poverty line. Seems hard to get my head around.
So what are the solutions? While the international development and relief community consistently works on strategy and approaches to address this colossal need, the rest of us have the ability to make smaller choices – we can continue to amass things and experiences and space and dividends. Or we can use some of the resources and the blessings we have been given to support the efforts of so many – with our time, with exposure, with education, with funds. There is work being done and it is making a difference. Change can come – buke buke, yes, but it’s not impossible.
As our world continues to globalize in ways that were unthinkable just a handful of years ago even, has our responsibility grown? How has our response changed? Does knowing more translate necessarily into doing more? Reading more? Giving more? Thinking more? Feeling more? Have we a responsibility to give of ourselves to help those in great need? The parable of the faithful servant would suggest so: "From everyone to whom much has been given, much will be required; and from the one to whom much has been entrusted, even more will be demanded." It's a personal topic - one that cannot be dictated, but must be felt. I'll close this (very long) post with these thoughts and questions. While my version of food security is getting grumpy if I don't get second breakfast, can I keep the perspective of my global neighbors, and stand in solidarity with those who don't even get first breakfast? We can find ways to accept this responsibility if we choose. It's up to us to decide if we will.
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