As the seatbelt sign turned off, I sat with one hand on my heart and one cradling my stomach. We had just touched down in Honiara after a 2 hour and 45-minute flight through tropical winds and torrential rain. The plane was a small 16 seater with no cabin pressure or seatbelt signs. Although the thought of falling gets the heart pumping, what was even scarier was the fact that it was raining inside the plane. That’s right, there were droplets inside the plane (no, not condensation), rain from the thunder clouds outside the plane, were clearly making their way through the small cracks. Now if that doesn’t get the heart pumping, and the mind wandering… I do not know what will.
So what does this death-defying flight have to do with nutrition?
Surrounded by dense jungle, stunning natural waterholes and picturesque coconut trees, the job was to run a series of educational sessions on nutrition and facilitate stakeholder meetings with the local hospital, school, and health promotion office. The aim of the mission – to determine the health and nutrition needs of the Kirakira community (a small island community four hours north of Brisbane in the Pacific Ocean) .
First things first! The countries demographics show that 40% of the population is under the age of 15 years old and 80% of people live in rural and remote areas. Solomon Islands Government Meterological Services Division. Climate Information 2015 [Available from: http://www.met.gov.sb/solomon-islands-climate-in-brief. Andersen A, Thilsted S, Schwarz A. Food and nutrition security in Solomon Islands. Australian Government, Australian Centre for International Agricultural Research, 2013 Contract No.: AAS-2013-06. Government of Solomon Islands. National Food Security, Food Safety and Nutrition Policy 2010-2015. Honiara: Solomon Islands: 2010. Due a lack of nutrition education, food insecurity, inadequate water sanitation and poor access to fresh colourful vegetables, plus the high availability and cultural acceptance of processed foods means that 46% of the Solomon Island population is at high risk for non-communicable diseases (NCD’s). These include diseases like hypertension, type II diabetes, cancers, obesity and heart disease Andersen A, Thilsted S, Schwarz A. Food and nutrition security in Solomon Islands. Australian Government, Australian Centre for International Agricultural Research, 2013 Contract No.: AAS-2013-06 Government of Solomon Islands. National Food Security, Food Safety and Nutrition Policy 2010-2015. Honiara: Solomon Islands: 2010. Although this sounds like a dismal situation, the Solomon Islands is not an isolated case. Many developing and developed countries, including Australia, suffer from the burden of NCD’s. Just in Australia alone, diabetes solely costs our Government $14.6 million per year. The saddest part about type II diabetes and other non-communicable diseases both here in Australia and abroad, is that they are all preventable.
Yes, they are all preventable.
To highlight that food is the biggest factor in preventing these diseases is no understatement. Nutrition is the foundation of good health but is also the cause of serious life changing conditions that can appear later in life. The reason for this is NCD’s are silent plus in the Solomon Islands, medications to treat conditions such as hypertension are few and far between. Unlike cultures that have access to local general practitioners and incentives such as medicare, these people severely suffer from the consequences of chronic disease.
Take Fred for example. He was bedridden, unable to get up to do daily tasks because of a debilitating headache. The main culprit? Salt.
Although salt assists with food preservation, Fred (like many others) had been exposed to the mineral since he was a boy, notably due to a high intake of processed food. Even though Fred did not add extra salt to his meals, his consumption of processed packaged foods on a daily basis, at all meals, resulted in Fred getting more than his adequate intake of sodium. Resulting from this is uncontrolled hypertension and many consistent headaches.
This sad story highlights not only the importance of food in disease prevention and management but also how public health nutritionists can play a key role in working with communities. Kirakira is a unique place, where the Health Promotion Office and other key persons in the village know and want to make a difference to their community.
This is what they expressed:
‘We need to come from many directions and the attidues of the locals needs to be changed’ – The Primary School Head Master of FM Campbell School
Coming from a multi-dimensional approach is something that the small community of Kirakira has already started to implement. Currently, The Health Promotion Office has proposed to the Government for Kirakira to become a Healthy Settings Village. A Healthy Settings Village is an initiative set up by the Solomon Islands Government to encourage local Health Promotion Officers to determine the environmental and health priorities of each community. A great initiative has also been started in the local school where a Healthy Market Committee provides school children with healthy and local snacks. Additionally, nurses are extremely receptive to knowing more about health and diet, and the school teachers requested more information to teach the children about good food choices.
Based on the nutritional needs assessment of Kirkira, the following strategies were proposed in order to address food insecurity:
- A nutrition food policy for the local school
- Nutrition training and resource development for teachers
- Develop procedures and protocols around malnutrition screening and treatment at the local hospital
- Provide support and ongoing educational seminars to Health Promotion Officers
- Assist in the collection, management and interpretation of health data specific to Kirakira
- Provide ongoing nutrition and NCD education sessions to students, nurses and the greater community where appropriate, each year.
From this experience, a solid foundation is nutrition knowledge helps but the real skill is in being able to consult with stakeholders, develop trust and rapport with locals, liaise with teachers and students, develop resources that are culturally appropriate and use nutrition knowledge to assist the community is combating their health priorities. Most importantly, sustainable change cannot occur overnight and instead knowing how to guide a community to use a multi-dimensional approach to achieve their own change, in their own time, is much more effective.
References [ + ]
|1.||⇪||Solomon Islands Government Meterological Services Division. Climate Information 2015 [Available from: http://www.met.gov.sb/solomon-islands-climate-in-brief.|
|2.||⇪||Andersen A, Thilsted S, Schwarz A. Food and nutrition security in Solomon Islands. Australian Government, Australian Centre for International Agricultural Research, 2013 Contract No.: AAS-2013-06.|
|3.||⇪ab||Government of Solomon Islands. National Food Security, Food Safety and Nutrition Policy 2010-2015. Honiara: Solomon Islands: 2010.|
|4.||⇪||Andersen A, Thilsted S, Schwarz A. Food and nutrition security in Solomon Islands. Australian Government, Australian Centre for International Agricultural Research, 2013 Contract No.: AAS-2013-06|