Monthly Archives: July 2012

Baseline: Day 6

Today was zoo-y in more than one way.

First, the house I visited this afternoon had water buffalo, cows, pigs, ducks, chickens, dogs, and cats. They were all roaming freely and came within a few feet of me. It was closer than I’ve ever been to most of these animals at a zoo or farm.

Second, the children in the afternoon village were extremely curious to see the foreigner (me). I dozed off for a minute in the van (we’d been in the field for 10 hours!) and woke up to see eight little faces looking at me. The girl whose house I was at went to all of her neighbours to tell them to come look at the strange girl at her house. As soon as my eyes opened they ran away. This time, instead of the animals, I was the main exhibit at the zoo!

They didn't smile for the camera, but they laughed when they saw their picture on my computer.

These three girls were afraid of me at first, but we ended up bonding. I took their picture and then uploaded it onto my computer right away. They were delighted and we did it a few more times. It was a fun game!

Baseline: Day 5

Today was a slightly more challenging day than yesterday for a few reasons:

  1. It was hot.
  2. A lot of the families that originally wanted to be part of our study had to move to other provinces because of a drought in the region that affected their crops.

I’m working on some more in-depth pieces about the project (methodology, materials, the survey modules, blood processing, etc.) so I’ll keep this brief. Those should be up over the course of the next week as we continue in the field.

Baseline: Day 4

More of the same today – which is a good thing. This means that everything is going according to plan. So instead of a long post, I’ll leave you with photos from the past few days.

Baseline: Day 3

Day 3 of baseline started out differently than the past two days. Instead of heading directly to a village to survey, we went to the Svay Antor Health Center to watch the first day of our blood collection. This part of the project is significant because it will provide us with quantifiable data (in the form of biochemical analyses) that will show whether or not our interventions have had the desired impact. I will write a special post about the more technical aspects of this process in a few days.

Several mothers and their children were waiting patiently at 7:30 am for us to set up. The village health volunteers were also there to make sure that everyone was accounted for, and to go back to their village to pick up women who hadn’t made it to the health center yet. There were a lot of familiar faces, as the women who were having their blood drawn today were women we have interviewed over the past two days.

A special team from the National Institute of Public Health (NIPH) came to collect and process the blood samples. They were extremely efficient, so the morning went by quickly. The only troubleshooting that had to be done was tracking down the right kind of tubes for one of the samples. Thankfully the problem was solved quickly.

This afternoon we went to a new village to watch more surveys, 24 hour recalls, anthropometric measurements and hemoglobin analyses. My favourite place to sit is with the anthropometrists and blood analysts. They are usually set up at the village chief’s house (or the village health volunteer’s house), and every mother and child that is part of our study has to come over to have their measurements taken and their fingers pricked. Usually news of our arrival spreads throughout the whole village, and a lot of children come just to see the foreigners. This afternoon went according to plan, so I don’t have many stories. I do, however, have a lot of pictures that I will be sharing soon.

Baseline: Day 2

Today we continued surveying villages in the Svay Antor district. Our enumerators acted like total pros, even though this was only their second day in the field.

I sat in on a 24 hour recall in the morning and a survey in the afternoon. The village where the recall took place was stunning. There was lush greenery everywhere, gorgeous views of rice fields, and a beautiful temple that we paused to admire.

Walking through a village in Svay Antor on our way to a 24 hour recall.

The path leading to a temple.

News of our arrival in the village spread quickly, and people kept coming into the house to look at us foreigners. We experienced a range of responses, from surprise, to fear (especially on behalf of the children who had probably never seen foreigners before), to warm smiles, to nosy grandmothers wanting to know if I was single or married!

This visit was the first time I stepped into a house, which was fascinating after only sitting under houses yesterday and in Kampong Chhnang. I finally saw what is under the roof of a typical (n=2) house: a big room with rolled up bamboo mats that are used as beds, and a TV. The TV surprised me given how few possessions people have, and how undeveloped the electrical infrastructure is in the region.

Being inside the house highlighted another way in which Cambodian culture differs from North American culture. In Cambodia, everyone sleeps together in the same room, which is also the living space during the day. This contrasts with the typical family dwelling in Vancouver (and probably most of the West) where almost everyone has their own bedroom, which is used mainly for sleeping.

We went to another village in the afternoon. I spent part of the time there sitting at the village chief’s house, which was the hub of a lot of action. Our anthropometry and hemoglobin analysis teams were set up at the chief’s house, so every mother and child that we surveyed came over. Today was the first day that I saw visible signs of malnutrition. The children we’ve seen in the past few days haven’t demonstrated any clinical symptoms of malnutrition. Today, however, we saw children with light, almost blond, hair. This is a sign that their diet is lacking in protein.

The supervisors also used the village chief’s house as a home base, so I observed them troubleshooting as problems arose (I will be writing a post about the types of problems we’ve encountered as baseline continues).

On top of all of that, a few people were bagging rice that had been harvested recently.

Bagging rice that is still in its husk.

But the kids were most excited about the arrival of the ice cream moto.

Trying to decide what to get from the ice cream moto!

Tomorrow we’ll be going to a health center to watch the first day of blood collection. This is a large, important (and expensive) undertaking, so hopefully it goes smoothly.

Baseline: Day 1

We left Phnom Penh early this morning and arrived in Prey Veng before lunch. Our task today was to interview women from a village in the district of Svay Antor. We stopped at the home of the village health volunteer to give the enumerators their list of houses to visit for the day, as well as directions.

Working with the village health volunteer to assign pre-selected houses to each enumerator.

The volunteer then took us into the village. where each enumerator managed to get one survey done before lunch, and one after. The goal is to for each enumerator to complete four surveys per day, which should be feasible since we won’t be traveling long distances every morning like we did today. Also, as baseline continues, the surveys will hopefully take less time to complete as the enumerators become more familiar with the questions and corresponding instructions.

Today was also the first time we tried our new and improved 24 hour recall. During the test survey, it was a series of questions incorporated into the survey. Today it was done as a separate event with a different team of enumerators. Bowls, spoons, and cups of varying sizes were purchased before our trip to help women measure their consumption. This turned out to be very helpful, as women could compare their own dishes with the sample ones to give us a better idea of how much they ate in the past 24 hours.

A woman compares her dishes to those provided by the enumerator during the 24 hour recall.

Though it is only 8:30 pm, it’s bedtime. The days are going to be long and hot, and with a 6:30 am departure time, I’m anticipating many early nights. I’ll leave you with the following picture:

A handful of the 20+ cattle that walked by the houses this afternoon.

Watching these cattle being herded down the village road definitely provided my first surreal “where am I?” moment. I’m sure there will be many more to follow.

An Afternoon at Central Market

Today I spent the afternoon on personal preparations for baseline, and I’m not talking about anything survey-related. I spent the afternoon purchasing non-perishable food to bring with me to Prey Veng.

Before I came to Cambodia, I never thought of myself as a picky eater. There are a few things I don’t like (to say I dislike ketchup is an understatement), but overall I can usually find something to eat. Growing up in Vancouver meant that I was exposed to multicultural cuisine from a young age. I love curry, dim sum, and sushi. My pre-travel research highlighted the prominence of fish, rice, soup, noodles and vegetables in the Cambodian diet. I love fish! I love rice! I thought I was set.

My first trip to Central Market in Phnom Penh was paradigm-shifting, to say the least. It could also be described as an olfactory assault. Before I even noticed what was for sale, I noticed how it smelled. There is an entirely unfamiliar, pungent odor that I now associate with Khmer food. Apparently I have an aversion to fish sauce, which is used in most dishes here as an easy way to enhance both the nutritional value and flavor (and odor) of food.

Outside of Psah Thmei, or Central Market

I forced myself to take in the scene at the market using my eyes rather than my nose. The offerings were more diverse than I expected. There were a lot of things I recognized, but even more that I didn’t. I had expected fish, but I hadn’t expected so many types of fish, prepared in so many different ways. Very few of the vegetables and fruits looked familiar. (I have since tried mangosteen and dragon fruit– yum!). Food that I thought I recognized turned out to be something different. Those hard-boiled eggs weren’t the hard-boiled eggs I’m used to – they were actually hard-boiled eggs with animal fetuses inside, for a little extra crunch. Things that I don’t even consider to be food were sold as food (see below).

Some of the offerings at Central Market

Left: Skewers of meat Middle: Boiling the skewers Right: Grilled Squid

Top left: Several types of fish available for lunch Bottom left: Roasted birds Right: fish and meat to purchase for home

I left the market with the few items I came for: some fruit and a tupperware container.

Left: fruit vendor Top right: dragon fruit Bottom right: mangosteen

Tomorrow I’ll stock up at Lucky Market, which sells Western food. On my shopping list: peanut butter, crackers, nuts, and dried fruit.

On my tuk tuk drive home from the market, I tried to process what I had seen and smelled. However, I ended up with more questions than answers. I wondered if a Cambodian person would have the same reaction to a Canadian market as I did to a Cambodian market. What foods at Granville Island would seem foreign or unappetizing to them?

I also wondered when the Western diet became so limited. In North America, it’s extremely rare to eat insects. It’s also unusual to eat all the parts of a fish (although I have seen this done – but usually when fish is on the menu, a boneless filet arrives at the table) or the organs of an animal (again, there are exceptions to this rule). When did we stop eating all the parts of an animal? Why did this happen? Is it because our society, as a whole, is affluent enough to be more selective?

Do Cambodians eat a greater variety of animals and animal parts for nutritional reasons, such as a lack of available Western sources of protein? Or do they eat these things because it’s what they’re raised to eat, so these foods are “normal” to them and are consumed without hesitation?

Protein-rich insects for sale

During my undergraduate studies at Barnard College, Columbia University, I took a course entitled “Edible Conflicts: The History of Food.” We discussed how food has shaped society from pre-historic times to the present. I’ve seen examples of this here in Cambodia, from the way people sit around a food stall at a market to enjoy their food and chat with the chef and other patrons (rather than going to a cluster of tables and chairs the way one might at a food court), to the way our survey defines members of a household as people who eat from the same pot in one house.

Eating lunch at the vendor's counter

But now I’m also trying to understand the Cambodian diet from a nutritionist’s perspective. After all, that’s what Fish on Farms is doing. We’re trying to take the Cambodian diet, which has developed along its trajectory due to historical and geographical conditions, and effect change in a culturally-acceptable manner to improve the lives of Cambodians. That’s why we picked aquaculture over chicken coops. Chicken and eggs don’t feature prominently in national diet, whereas fish is front and center.

I’m looking forward to observing several homes in Prey Veng during baseline to try to piece together my understanding of the Cambodian diet by integrating both a sociocultural and a nutrition perspective.

Countdown to baseline: 2 days!

Household Selection

While we were out in Kampong Chhnang on Friday, other important developments were underway for FoF: our household selection was completed. This means that we now have 900 households in Prey Veng who are committed to being part of FoF.

Certain criteria had to be met in order for households to participate:

  • The woman has to live at home year-round. Women who leave for part of the year to work in garment factories or rice fields will not show any changes in nutritional status, as they will not be home to benefit from our interventions.
  • The household has to have adequate land for planting fruit and vegetables (HFP group) or digging a pond (HFP + aquaculture group).
  • The women must have at least one child under the age of five.
  • The houses must have a similar socioeconomic status (SES). This is particularly important for our control, or comparison, group.

The countdown to baseline is on: 3 days!