Friday, December 02, 2005

International Nutrition & Me

Dear all,

I know what I want to be when I grow up!

A long ride from Bertuoa to Yaoundé gives the traveller plenty of time for thought (not so much sleep, unless you can tolerate having your head pounded against the windows and ceiling as you slumber), and requires that you take advantage of that thinking time as a form of distraction from the road. Our driver was ultra-cautious, lumbering along at no greater than 25 km per hour for most of the trip (perhaps also to protect our interesting cargo: two goats standing on the roof), so I even had extra time to figure out my life…

I would like to be an international nutritionist. I don’t mean that I want to help Romanian celebrities stay thin, or plan protein-rich diets for Thai Olympic athletes; rather, I want to travel the world’s poor and hungry and malnourished places, examine people’s food preparation methods and eating habits, and try to integrate programs/tools/systems that address health problems through food. In Cameroon, I have seen so many crippling medical issues that are the direct results of single vitamin and mineral deficiencies: goiter from lack of iodine, rickets from lack of calcium, anemia from lack of iron, etc. The causes and effects are often easy to define (and their relationships have been proven many times over), but practical solutions to the problems do not come as simply in this part of the world.

I am interested in international nutrition for so many reasons! First, the thing that frustrates me about medicine – the field of work where I have always imagined myself, but which still does not satisfy me – is that most of the practice today is expected to be formulaic and unoriginal. Like I lamented before in this blog, I do not want to practice an art that must be done just the same by my colleague across the street, by a doctor on the other side of the continent, or by the next medical student who buys the same textbook and memorizes the same dosage chart. When doctors try to experiment and work with new methods, there is usually little room or understanding for deviance and error. However, working to find creative solutions that make agricultural, sociological, anthropological, political, and economic sense in different world settings – as well as serving the original health aim – is a kind of medical problem-solving that would be eternally interesting and intellectually challenging. Second, this work would introduce me not only to people’s ulcers and sore toes and skin rashes, but also to their lives and cultures. I love travelling and living with different people, learning about their lifestyles and practices, then taking time to document, discuss, and think about my experiences in a progressive and scientific manner. Finally, it could make a big difference. The successful and widespread introduction of iodine into the local diet (by salt, or some other carrier) would eliminate goiter, and probably boost the depressed hormone levels of many adolescent and post-adolescent Cameroonians. I honestly don’t know why it hasn’t already been done. The development of a drying method or surface that adds value to otherwise nutrient-void dried foods (like manioc and corn), which are eaten every day to no nutritional advantage, could potentially have great impact – could the distribution of iron metal drying sheets, or some process involving the iron-rich red earth, somehow work toward this goal? Good communication about breast-feeding and its benefits might be all it takes to effectively combat rickets and calcium deficiencies…but my experiences in the maternity ward of Hopital Central tell me that there is a long way to go, when even urban mothers seeking professional medical services at delivery, receive piss-poor information on how to nourish their newborns.

Of course, along the way I would get to eat lots of cool and interesting foods; still, I’m thinking that a few bottles of multivitamins might not be a bad idea… Love,

Mara/Chlodes

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