Medicosnext
Jane Maxwell, 75, one of the writers of Where There Is No Doctor had been to Nepal two years ago and stayed with me for one month. She was very happy to have rice and vegetables and various lentils and other hot food morning and evening. She was surprised that food was cooked two to three times (including snacks) in my kitchen, and that most of the time we ate at home, contrary to the USA, where cooking at home is rare in many families.
She was also surprised that we did not consume junk food like white bread and noodles, and that we did not have cold drinks in our freeze. “You eat very healthy food, like we used to eat in the 1970s; I am surprised that you are not impressed by the misleading ads about food on television. I try to eat healthy and homemade food in the USA, but sadly, most of the new generation have forgotten how to cook. I am sad that even my daughter eats a lot of junk food. How did you manage that your daughters are not attracted to junk food?” I was of course happy with her compliment.
In 2010, I had worked with Jane in the USA for six weeks, and she stayed with us in our house in California, where we cooked simple rice and vegetables and made curd from milk. She had even learnt from me how to make vegetable curry and lentil soup. Although I am not a very good cook, I was able to make healthy food while I was there, and we did not have to spend money on expensive restaurant food. “I will save money, as I am now able to prepare these foods easily,” Jane said happily to me when I left California after ten weeks.
I and Jane used to discuss a lot about health and food at the time, as we were working on the new version of Where There Is No Doctor, and one special chapter was devoted to nutrition. I had contributed to that chapter through many ways. One of the points I had raised was that we need not put too much emphasis on micronutrients, but rather, needed to give information on local food, highlighting their health benefits. I also pointed out that food is also a part of the culture; I gave various examples of Nepali and South Asian cultural practices that were associated with food. As an example, I pointed out that, with changing seasons, food pattern also changes in our part of the world. During the cold season, we celebrate Maghi (third week of January), when sesame seeds, sweet potato, molasses (chaaku), and butter are consumed; these foods are full of calories and calcium that are needed for the body during the cold season.
Jane and her team were very happy that issues of local food and cultures were also incorporated in the nutrition chapter. “We never would have thought that food and culture could be a part of the nutrition chapter, as in the USA we do not have such practices,” they said to me. I told them, “I am sure that aboriginal Indians, who are now marginalized, must have many cultural practices with relation to food. One just needs to study them by staying with them and documenting them. Maybe someone will do that soon.”
After two years, when I again visited Jane in her office in Heperian Foundation in California, I met one lady whose parents were Red Indian, and she told us about how the Red Indians worshipped nature, ate healthy food, did not worry about vitamins, proteins, and micronutrients, and remained healthy till old age. She pointed out, though, “After the Red Indians started to follow American diets and drinks, their health deteriorated. They started to suffer from osteoporosis, high blood pressure, and diabetes, which were earlier unheard of among our community.”
When she was telling me all this, I was also thinking about our people in the villages of the Far- West and Karnali regions, where people had started to eat junk food instead of their locally available healthy food, and the result was diabetes and other health problems. And sadly, these problems have spread all over Nepal, and even the young generation is suffering from complications because of these problems.
Nepal’s Ministry of Health is putting a lot of emphasis on various micronutrients without even realizing that if people will only value and eat local food, there will be no deficiency of micronutrients. But sadly, all efforts are now on ‘nutrients’, and that too in packets like ‘Ball Vita’ and ‘Plumpy’Nut’ for children, and in the form of food supplements for adults. These are expensive, unhealthy, and unsustainable ways of bringing health to the community.
I am not a nutritionist, but I have learnt about nutrition and health from my experiences of 33 years, and I can challenge the Ministry of Health that malnutrition or under-nutrition cannot be solved by talking about and providing vitamins in tablet and capsule forms, we have to provide information about the local food to the communities, so that they will not be dependent on packaged foods to be healthy.
I wonder if there would be any one in the planning commission who would deign to disseminate booklets on food values published by the Ministry of Agriculture, so that local community leaders and health workers would know that people should consume what is available locally in their villages, and the community would not suffer from high blood pressure and other health problems. I wonder if there will be anyone who will understand that one has to eat food, not nutrients in capsule form, to be healthy and happy. If this were to happen, I will be able to write to Jane a happy note about how we in Nepal have started to reduce malnutrition using real food—local food!
