An Interview With A Global Health Research Scientist
Susanna is a Ph.D. student teaching undergraduates on the topic of Global Health. After finding the Healthy Eating Progam Guanajuato on Instagram, she used it as an example on how to create a sustainable and supportive nutrition program. But she had some questions about it first, so we answered all of them below. We wanted to make it available to our donors to be completely transparent on the evolution and efforts that are being put into this project and the long way we have to go to continue to make this possible, ethical, and sustainable.
Pitfalls of Community-Driven Projects And How Healthy Eating Project Combats Them
Susanna (S): Hi Kiona! I’m prepping my lecture for next week and the topic is on Nutrition in Global Health. I thought of using your project with Saya as an example of a community-driven project. I’m pulling a lot of the info you have available on your website already, but I just wanted to check in with you and ask if there was anything you’d prefer for me to share/not share with the class.
Kiona (K): Hi! That’s so awesome! Omg I should probably update the website. But important things to highlight are:
- It requires a community liaison to communicate the community’s needs
- The community has to request your presence there (not necessarily the lessons but just an invitation)
- It’s fine to start and fund the project, but ultimately to make it sustainable, instruction should be majority from people who look and speak like them
- It has to be replicable in their own homes and not just during class
Ok, I think I just spoke in stream of consciousness so I don’t know if that even made sense.
But basically don’t fall into the pitballs of applying Global North issues to communities you’re not a part of. For example: we had a Mexican-American man want to come and do a lesson on obesity. Even though he’s Mexican, he’s American and did not grasp the community’s needs. This community is undernourished and doesn’t deal with obesity at all.
All of our recipes are created around culturally relevant foods. We are simply revising their ingredients on dishes they would already cook. And they should be telling you what they cook, not the other way around.
And then our funding goes towards providing them with food AND supplies like spoons, ladles, pans, and cutting boards to facilitate this at home and encourage them to replicate it at least once on their own. The more you repeat the recipe the less scary it becomes. I’ll go home and update the website and I can send you the link.
Another example is Mexico is the number one consumer of Coke. So we created a recipe around that to replicate Coke with tea (apparently it was good, we get requests for it all the time). We do not try to switch them to water.
S: Yasssss I love all of this! That’s such a good example of an alternative that is sensitive to the local diet instead of just being like “coke=bad, water=good.”
K: These people have bigger problems then trying to eliminate coke from their diet. They’re just trying to survive. And Coke is cheaper than bottles water. But boiling leaves is even cheaper and even free if we are giving them a box of it.
Funding For The Healthy Eating Project
S: Ahh so cool. Where does most of the funding come from and what would you say had made this project sustainable?
K: The funding is 100% crowd sourced from How Not To Travel Like A Basic Bitch.
The most important part of this project is finding dieticians and chefs and doctors ON THE GROUND. Our volunteers that just come in are OK, but really people familiar with language and culture makes everyone feel safe.
Keep in mind $25 used to fund an entire workshop. It’s so cheap for us. Because attendance has gotten larger, we now struggle to spend $100, which is our goal every workshop. So we’ve only taken donations twice and TURN AWAY donations. We don’t feel comfortable holding onto that much money without having an avenue to spend it.
S: I’m so excited to share this with my students! Soooo amazing!
K: Saya would probably tell you that she doesn’t pay the chefs and dieticians. She has paid volunteers before, but for this project it’s important we do not assume that just because university professors are from Mexico that they need the money. We do pay for transport and a bit extra, but our volunteers love doing community work. It really just depends. We are willing to keep that convo open as we move forward, but she says it’s important that the privileged within country have the opportunity to volunteer their time. It makes them feel good, too. I’m not on the ground so she knows the community best.
S: Wowwwwww. You have no idea how excited this makes me. Like it’s so cool that it’s community-driven, culturally sensitive, sustainable, and conceptually simple. I feel like I’m angry 80% of the time because there are so many organizations in global health that don’t take this into account, but coming across organizations like yours and Saya’s makes me happy.
K: I hope we’re doing it right. Saya does not disclose to them where the money comes from. They don’t really ask, but it’s important to us to not concentrate on the out-of-country donations.
S: Huh, so interesting. If they do ask what would y’all say?
K: I’m not sure. She’ll probably just keep it vague and say from a donor. But she basically wants to stress less the donations and where it’s coming from, but rather what they’re provided and what they’re going to do with it. We do not want them to feel like charity.
I mean even for me it’s kinda hard to present on. But we know the importance of updating people on their donations. So whenever I present, I try to present that it’s their participation that makes this project go. Not the donations. And that without donations, they’d still be OK. Because really, if no one showed up or wanted to learn, then there would be no project.
Critiques of The Healthy Eating Project
S: Do you have any critiques for improvement on this project?
K: YES. We are at the mercy of QUALIFIED volunteers. We don’t let just anyone come and volunteer. Saya calls their references and makes sure they’re OK to be around children. When our last volunteer moved, our project stopped for a few months until we could find another quality person. And when we did, she lives 40 minutes away. Saya had been scouring the city for people who were qualified to teach.
S: Oh wow. And I’m assuming this woman was the one running the workshops and stuff?
K: Most of them, yes. So having a back-up volunteer or one in training is important. Whatever it is, we need two. Even a back-up Saya! Someone with a big car that can transport the groceries and do the shopping.
With the new lady, she’s bringing her students and teaching them how to teach while also teaching. That was our solution. We also thought about having a summer program of teaching the older kids basic nutrition and then paying them with the funds to give classes to the younger kids. Things like ‘What’s a fruit? What’s a vegetable? What do the colors mean? What’s the difference between soda, juice, and aguas frescas?’ Small lessons like that.
We’d “pay” them by funding their school tuition, which I think is $100/year. But we haven’t implemented that, yet. It’s just an idea we’ve been playing with. We’ve also been thinking of having an 9-day intensive of training moms on nutrition and basically giving them the creative freedom to come up with new recipes based on the things we’ve learned. But I don’t know. It requires more thought. We don’t know if that is realistic.
But YES, major critique. We know we need to do better here.
S: Haha I’m glad to hear that you see places for improvement, though. Community projects take time and requires an extensive amount of planning and relationship building.
K: Yesssss and Saya and I are both just volunteering so like we barely have time.
S: I think it’s important for me to show real examples of people who are involved in projects that empower the local communities. And give specific examples of HOW that’s done. They told me last week that they want more real life examples of global health work so I truly appreciate you taking the time to tell me more about this.
Data Collection Of The Healthy Eating Project
K: Oh another critique is that we don’t take any data. So normal community projects would probably track food consumption. And see if they’re actually implementing the change in their homes. And also probably anthropometrics and blood pressure.
S: Ooo that’s interesting because the academic inside me immediately goes, “ what about M&E”
K: The only way we measure it is in attendance and attendance of NEW faces. As long as we keep getting a larger and larger crowd, we deem it a “success”. And the women have expressed to Saya how the workshops make them feel. Things like, “I felt close to people in my community that I had a previous problem with.”
S: Interesting– so this I imagine aligns with your objects of the project.
K: We don’t want them to be viewed as science objects. This is based on creating a community and providing relevant education on nutrition.
The Healthy Eating Project Redefines Outcomes
S: What would be your response to someone that says you need a way to measure health outcomes for this to be an effective nutrition project/org?
- I think you’d have to define “effective”. Like for us, people coming out and having the DESIRE, asking questions, bringing notepads to take notes, putting in requests, means that we’ve been effective in peaking their interest on the importance of the food they are consuming. BUT if your project is looking to eradicate or improve a specific co-morbidity, then yes you would absolutely need that.
- It depends on your funding source. Because our funding is community-based, our donors expect consistency and a positive contribution to the community with relevant education. They don’t require us to make them lose weight or improve disease outcomes. Our project is solely education. In academia, that’s usually not enough.
Like for us, we rejoiced when the men started coming out. And wanting to cook. That was huge for us. That probably wouldn’t matter if your aim is for the lessons to transpire in a physical manner.
S: I love this– it’s a shift in perspective on how global health work can be done. Academia definitely focuses on the “hard data” outcomes to measure success, and even larger orgs need that to get larger donors to buy into their projects. And like you said, it’s about what the original vision and goals are, and how these are expected to transpire as an outcome.
K: Yes! Exactly. For example, we did a lesson on the cost of food and basically physically demonstrated how many fruits and vegetables you can buy for one bottle of Coke (this was to kids, not adults). It was a very simple exercise. At the end, we had a table of fruits and vegetables and a table of Coke and chips. And we gave them a bag and was like you can fill it with whatever you want on this table. OR you have one Coke and one bag of chips. All the kids, like about twelve, ran to fill their bags except one. And then I think the one kid felt peer-pressured and was like fine I’ll fill my bag. But we saw the kids fill the bags and give it straight to their moms and went to go play again. So it kinda showed how they were thinking about their families. And to us that was a “success” in objective.
S: You can’t get that just from numbers. That’s valuable information that you can use to further improve your workshops!
So they’re building a country portfolio the whole term (my students) and each week they learn the basics of a filed in global health. Since you are an expert in nutrition, what would you say are the essential pieces of info that people should look for when they’re looking to implement a project?
I’d say 1. Know the local diet, 2. Understand the cultural and economic context of the diet, and 3. Come up with alternatives that maintain the needs and voices of the community. Oh and sustainability.
K: Yesssss all of those. And especially sustainability. Like once the project is developed and deemed valuable, you need to train community leaders so this can run without you. Like notice how I started it, but the program does not rely on my presence. We have sourced local volunteers, but training would be our next step.
Another thing I would say is IF you’re having out-of-country community volunteers, make sure they can speak the language at the level the community can understand. times. We have been faked out by someone who said they could speak Spanish and they just weren’t fluent enough to lead a class without losing the audience. All of our volunteers are accompanied with a translator though, just in case, so that the lesson can still go on. But like what if there was no bilingual person? That lesson would have died and then probably low turn out on the next workshop.
Also a way to advertise the workshops. We started out by printing flyers. But now it’s solely word-of-mouth. Saya tells one lady and the news travels and they show up and the groups get bigger and bigger every time. But a way to transmit the information on time and place.
S: Wow! Does Saya go to every workshop?
K: Yep! She also transports like pounds and pounds of groceries with her husband. We pay for the transport because it’s at the top of a mountain, literally. Without Saya, this workshop would not go. I can’t express enough how little the donating part has to do with this project. It is one part and it wouldn’t function without it. But it also wouldn’t function without Saya on the ground acting as a bridge, without the qualified volunteers showing up and volunteering their time and skills, and without the community eager to learn and show up every time we put together something.
S: Thanks so much for all this information. This will go on to be transmitted to my class.
K: Thanks for having us, Susanna!
The Healthy Eating Project Implemented In A Classroom Setting