This past week we had milk day for the kids in Manna’s Child Sponsorship program. Once a month, the children come to the clinic in Villa Guadalupe and have their height and weight checked and receive a can of milk, a bag of food, and a bottle of liquid vitamins. Through this program the children also receive hemoglobin testing, regular deparasiting, and consultations with a nutritionist. Even with these resources, many children still struggle nutritionally.

The nearest grocery store to Villa Guadalupe is around 2-3 kilometers away and there are only a handful of residents that own cars. Most people get their groceries from carts that come through the neighborhood selling a variety of foods. There are many small ventas run out of homes that sell processed snack foods and sodas. Residents usually eat meat about once a week. White rice and beans are the main staple of their diet.

I was was able to shadow the nutritionist at the Villa Guadalupe clinic this past week, which was an incredible experience. I sat in while she talked with moms of young children and pregnant women about their diets and cooking methods. Although the conversations were sometimes hard for me to follow, I understood that she was making recommendations for foods to include in the diet and food safety practices. The majority of children are anemic, so protein was a big topic as well. Rice and beans together make a complete protein, but the white rice that is readily available is stripped of many nutrients such as iron and magnesium, which are incredibly important for someone with anemia. I have never seen brown rice, which includes the nutritious bran and germ, in Nicaragua. The easiest way to combat anemia is to eat more red meat, but most residents in Villa Guadalupe cannot afford to do so. So the job of the nutritionist is doubly hard.

How do you help someone improve their nutritional status if they can’t afford to eat the foods that will make them better? This is a question I also struggled with in the States. I spent many hours working with Second Harvest Food Bank of Middle Tennessee during my time in college, helping sort food donations that would be distributed all over the state. The most commonly donated foods were processed snacks and cereals. The people who needed nutritious foods the most were only able to get foods of low nutritive quality. But calories are calories, and something is better than nothing.

The difference, of course, is that here in Villa Guadalupe there is no food bank. The food assistance comes from NGOs like Manna Project that rely on overseas sponsors. People make do with what they can get in their communities, and are largely a products of their environment. Problems like widespread anemia, which causes weakness and fatigue, are difficult to alleviate in a community like Villa Guadalupe that has limited access to high quality proteins like red meat. Environment is a huge influence in health, so long term change will probably have to start outside of the home and work its way in.