Disclaimer: I am not a nutritionist at all. All I can claim is that I am a mommy raising my children in rural West Africa, living alongside my African sisters. We all share the desire to give our children a good start in life, and this has given me an interest in nutrition. Here's some of my favorite resources and findings. But I am definitely no authority on the subject. Your comments, criticisms and additions are needed at the end of this article!

 

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For someone raising their children in Africa, there is much to be intimidated and discouraged about in the many health fads and diet guidelines that abound in the West. I am sure that chia seeds and walnuts and blueberries and quinoa are good and healthy, not to mention delicious, but they are not options for me. And even if by some fancy logistical footwork and help of Western friends I was able to get some, they would still be out of reach for all my friends who make their meals with whatever they can grow on their farm. When it comes to nutrition, what I am really interested in is foods that are not only nutritious, but cheap and accessible as well. For us, and for the people we are living among.

 

As far as food groups, vitamins, minerals, etc, there is a lot of information out there. I like the following resources:

 

Nutrition for Developing Countries by Felicity Savage King and Ann Burgress

 

Agriculture, Food and Nutrition for Africa by FAO (read HERE) especially chapter 7

 

So how do we make sure our families are getting adequate nutrition? In a way, the answer is quite simple. Eat a variety of foods, whole foods whenever possible, fresh fruit and vegetables and protein. You know the drill.

 

And yet sometimes, that is so much easier said than done. We have a 5 month dry season with no rain. Fresh vegetables are difficult to get. Fruit is sometimes abundant, and sometimes non-available. We live in a small village where you can't buy anything. Occasionally, someone butchers an animal but meat is usually not found. We have no electricity yet and stuff just doesn't keep all that well in 100 F. I am sure that whatever your location is, you have your own set of obstacles. It may be cost, or availability. Shall we resign ourselves to a dismal diet? No!! I firmly believe that with an open mind, ready to learn from our local neighbors and from the many resources available to us, we can eat healthier than we thought at first was even possible.

 

Animal proteins tend to be more expensive, and harder to obtain and store. However, the good news is that you can get protein from plant foods. Whole grains, legumes, seeds, even vegetables can be surprisingly high in protein. The old ideas that these plant proteins need to be carefully combined to form "complete proteins" are now believed to be myths (albeit very long-lived myths that are still endorsed in many books!) It is always best to eat a variety of foods but you don't have to be a scientist to cook nutritiously :)

 

So on to practical life. I have been searching for a cheap, accessible solution to some of these questions. Meat is just not a really dependable option for us though we do enjoy it when we have some. Fish is a little more available. We like eggs and eat them... but we can't haul too many dozen from town. However, in our area, black-eyed peas are commonly grown and are comparatively cheap. FAO has a list of all the nutritional requirements we have, with foods that supply each, and dried beans are listed as significant suppliers of every single one of these: protein, iron, calcium, folic acid, other B vitamins and biotin.
So bring on the beans! I think they deserve the title of Superfood for Africa. Our family eats beans every single day for lunch. I cook on charcoal, so I simply use my breakfast fire to simmer a pot of beans all morning. We usually eat them with a sprinkle of gari (dried ground cassava) and shito (a spicy oil-based sauce that is also common here. One of the main ingredients is tiny dried whole fish that are pounded to powder and are an awesome source of calcium - hello fish bones! I make my own sauce so it is a little less spicy, which helps my little people to eat more of it. I love this sauce since you can make a big batch of it and it keeps without a fridge! One of the few convenience items we have.)
(bonus points!!! having the same thing for lunch every day has been a major stress reducer and brain-space-saver for mommy! :)

 

This is just an example of the kind of thing that I am looking for. It's good for us, AND we can actually get it, AND so can our neighbors and friends.

 

Some of the other items we can easily get our hands on are mangoes, papayas, avocados, and a variety of green leaves. Each of these things have their seasons, but there is usually some kind of leaf available, whether a tree leaf, or what we would call a "weed". One of our favorite leaves is Leaf Amaranth, which is pulled out of gardens in the US and known as red root. This is high in calcium and iron. Cassava leaf is surprisingly high in protein. It really pays to learn from your local friends what "weeds" are edible. I may not be able to have carrots and spinach all the time, but we can get some vitamins all the same. Another good example of this is the baobab fruit... It has a dry pulp with a nice flavor that is very high in vitamin C. In the middle of dry season, when there was very little fresh available, my children were out with the village kids, munching on these fruits.

 

Besides for learning from our local friends, there is a wealth of information out in the big wide world. My favorite source is the ECHO community, an organization devoted to ending world hunger. It is a huge network of people all over the world, working with Agriculture and Nutrition, and they have so many resources available! I spent about a week browsing the ECHO library in Florida while my husband took one of their classes... but i could have stayed a lot longer. My favorite books from them are

 

Amaranth to Zai Holes
Agricultural Options for Small-Scale Farmers

 

Both are full of countless bits of information related to growing, processing and preparing all kinds of nutritious foods. They are available from echocommunity.org. You can also sign up for their newsletter which is always full of such interesting things. From ECHO, we have learned about several incredible, easily grown green vegetables such as Chaya, Katuk, and Malabar Spinach. And of course Moringa. Moringa trees are easy to grow in Africa and the leaves are a true superfood. I keep a supply of dried moringa in the city where we sometimes stay for a break, and my kids have no objection to green smoothies as long as they taste good. (bonus points!! moringa is even one of those fads in the US! Haha, it's not like I really keep up with those even when we are Stateside. :)

 

Just a few more examples. We can't get walnuts and sunflower seeds, but it is very easy to find sesame seeds and a variety of other seeds that I don't know in English. Instead of white rice, we can get locally grown brown rice which adds a boost of fiber and vitamins. Whole grains are common here - corn, sorghum, and millet. Millet is very nutritious and high in protein - why not cook millet instead of rice sometimes? We like coarsely ground millet grits for breakfast. Fonio is another ancient grain available here, high in iron, calcium and protein. By the way, the whole hotly debated gluten question (if it is a concern to you... not trying to open the debate here!) would basically be a non-issue here in our area since the only wheat products are luxury items that are only found in town.

 

Of course, your location may have completely different food options and limitations. Basically, the point of this long story is to get creative and keep an open mind. You may not going to be able to have a big kale salad with olive oil dressing every day... with a grilled chicken breast and mashed cauliflower. But with an open mind and a learner's attitude there is also no reason to exist on white rice alone. Of course a lot more could be said about this subject - and there are myriads of practical questions as far as how to prepare some of these things so my kids (and their parents...) will actually eat them. It's a journey! :) Some final bonus points? Lack of Vitamin D (formed in the human body by exposure to sunlight) is a growing concern in North America, but living in Africa... well... We have things to worry about but that one is crossed off my list. :)

Have you found any creative solutions for your family's nutrition? We would love to hear!!

 

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Lysanne is a mom of two who currently juggles (more or less successfully) at least three cultures in her daily life. She was born in Holland, lived in the US, married an American in Africa, and is currently raising her own tck's (or is it 4ck's?) in a small village in West Africa. This life is often fun, sometimes not, but is certainly interesting, and she is glad to be on this journey with God and with the man of her dreams.Lysanne

I have asked myself this question more than once in Africa. The thought is a very depressing one. But it seems like we went from one diarrhea episode to the next, and we were at the point where I could hardly sleep at night waiting for one of the girls to start throwing up. Then they both got malaria at once. At that point, I was ready to call it quits. I am so glad for the encouragement of my colleagues. Things are going much better now! Here's a few of the things I learned.

 

1. Pray! Coming to Africa, my worst fear was that my kids would always be sick. And the first couple months, they certainly were. Looking back now, I see it as a precious time where I had to face my fears, my faith, and the reality of God's love. These things are certainly not too small for God. We have seen so many prayers answered and we are so thankful.

 

2. Filter your drinking water. We carry a Sawyer filter everywhere we go and it has made a dramatic difference.

 

3. Build the immune system. When we first moved to a small village it was overwhelming to think of the amount of dirt and germs my children came into contact with. But one of the senior members of our organization encouraged me not to worry so much about germs, but more about keeping their immune system strong. Did you know a large part of the immune system is based in the intestines? You can feed the beneficial flora in your gut with lots of fermented products. When we have access to refrigeration, we eat lots of yogurt. Also, our people in West Africa have several fermented dishes that we learned to like and eat as often as we can. On the other hand, sugar and refined starches do not help your intestinal health so you may want to cut back some on those. We also take a probiotic supplement sometimes. Especially if it has been necessary to take an antibiotic for any reason, try to rebuild your intestinal health.

 

4. Set up a hand washing station. We do not have running water so my husband came up with a nifty way to solve this problem. He connected a small faucet to a bucket with a lid and built a kid-size table for it. A basin catches the water and a bar of soap hangs from a string on the bucket handle. Now, my girls can wash their hands easily.

 

5. Breastfeed, if you can. You won't have nearly as many worries about clean water, sterilized bottles, etc. My youngest is currently twenty months old and (shhh!) I'm still nursing her. I'm not at all sure I would do so in the States but it really does wonders for the immune system. Plus, if they do get sick, you can nurse and be sure to keep them hydrated. Obviously, not everyone can do this. But it is a thought to consider.

 

6. Consider new allergies. Neither of my children was allergic to anything in the US. But after more puke episodes than I'd like to remember, i finally figured out that my youngest is allergic to African (true) yams, and it causes projectile vomiting. Thank you very much, it was SUCH a relief to find a solution for that problem.

 

7. Find a malaria preventative you're happy with if malaria is a problem in your area. Okay, it's hard to be happy about having to take any preventative but malaria is truly dangerous for children. Also,  use nets, etc.

 

8. Teach your children not to put anything or their unwashed hands in their mouths. And yes, that's easier said than done and we are still hardcore working on this one.

 

9. De-worm regularly. Wear sandals or shoes outside since some types of worms enter through the feet.

 

10. Rinse dishes and raw vegetables with water with a few drops of bleach. If desired, rinse again in clean drinking water.

 

11. Lastly, try to have everyone get enough rest. It does wonders for your health. And with that said, I'm going to sign off. Goodnight! :-)

 

What are some of the things you've found helpful for your family's health?

Note: Sometimes even when we're doing all the "right" things, our children will still get sick! Don't blame yourself . . . and hang in there! It won't last forever, even if it feels like it!

Malaria, cholera, typhoid, dengue fever . . . the list of potentially-deadly diseases that we face overseas is long and frightening. We do what we can to avoid them - taking prophylaxis, using bug spray, drinking only purified water - yet we still face the possibility of contracting on of these sicknesses.

I am no medical professional - I have had basically no training, and my husband has had just a little. Yet in our three years in West Africa, we were forced to study and learn to diagnose many common illnesses as we raised our children without good access to medical care. {Let me put a plug in here for Missionary Medical Intensive. We highly recommend their training if you are living in a location with poor medical care. We also highly recommend learning to use their "Village Medical Manual" even if you can't take the course - we use the manual in America too, not just in Africa!} One thing that I was surprised to learn was the true "killer" of most children in third-world countries. It's not malaria or cholera, although these may be the root cause - the actual cause of death in many, many cases is dehydration. And it can happen just as easily with a case of the stomach flu in America as it can with malaria or typhoid overseas!

Please realize I am NOT minimizing the dangers of these tropical diseases. However, I do want to HIGHLIGHT the danger of dehydration! Recognizing and treating dehydration quickly can mean the difference between life and death. The younger the child, the more serious the threat of dehydration. So what are the warning signs of this dangerous condition? And what can you do to treat it?

Any of these signs indicate that your child is dehydrated or is becoming dehydrated:

  • More than six hours without urinating
  • Dark yellow, strong-smelling urine
  • Lethargy
  • A dry, parched mouth and lips
  • No tears while crying
  • Sunken fontanelle (soft spot on baby's head)

These signs indicate that your child may be seriously dehydrated:

  • Less elasticity in the skin (doesn't "bounce back" when pinched into a fold)
  • Sunken eyes
  • Hands and feet that feel cold and look splotchy
  • Lightheadedness, dizziness, or delirium
  • Excessive sleepiness or fussiness

 Obviously, prevention is the best cure. If your child is running a fever, he needs more liquids than normal and will probably not feel like eating or drinking. You will need to work and make sure he is staying hydrated. Don't wait until your child is showing signs of dehydration before you start giving him extra liquids. Any vomiting or diarrhea can cause dehydration very quickly, especially in a younger child or infant. If you need to, use a teaspoon or medicine dropper to give your child a small amount of liquid every few minutes. Seriously, set a timer if you need to and make sure your little one is getting a sip LITERALLY every 5 minutes. This could save you a trip to the hospital, depending on the cause of vomiting or diarrhea.

If your child is showing signs of mild dehydration, you can still get on top of things. Use Pedialyte or an ORS powder if available, or make your own rehydration fluid (ORS recipe below). Get your child to drink as much and as frequently as possible. (With vomiting, frequent tiny amounts are essential, do not let your child gulp large amounts or it will probably come right back up!) If your baby is breast-feeding, let them nurse as often and as much as they are willing. Fluid replacement can take more than 24 hours, so keep pushing the liquids even if your child begins to feel better.

For severe dehydration, your child may need IV fluids in the hospital. If you feel that your child is not improving or is getting worse, or if you are not able to keep any fluids down at all, see a doctor right away.

Oral Rehydration Solution (ORS) Recipe:

Combine 2 Tbsp (6 tsp) granulated sugar, 1/2 tsp salt, and 1 liter water. Be accurate in your measurements! Mix well until salt and sugar are dissolved. This will keep in the refrigerator for several days, or at room temperature for 24 hours.

 Do you have any tips or wisdom to add? Any stories to share about a time that your child was sick and in danger of becoming dehydrated?

I am part of a couple groups for women overseas, and quite a while ago, one of the members asked this question:

"Has anyone else dealt with feeling physically "off" when you first moved to a new country? It seems like I have a few good days and then am flat on my back with some sickness or other AGAIN. I almost never feel normal. Any suggestions of things that worked for anyone? Or an idea of how long this will last?"

Good question! Most of us overseas have dealt with this, so I think it's worth discussing here. Yes, it's normal, and mostly you just have to wait it out. I think it can easily take a year to get used to the climate and "bugs" of a new place. But here are a few things to keep in mind as well . . .

1) Get plenty of rest. Give your body a break. You are dealing with a TON of new stuff, physically and emotionally, and it's exhausting. If you've just moved to a tropical climate from a temperate one, you're dealing with the heat which is very draining on your body. Take naps. Go to bed early whenever you can.

 

2) Drink plenty of water. Especially if you're in a hot climate. Drink, drink, drink! The average recommendation of 64oz a day may not be enough for an active lifestyle in a tropical country. Set a timer to remind you to drink a glass of water every couple hours, or do whatever it takes to make sure that you're staying hydrated.

 

3) Take a good multivitamin. Your diet is most likely not as varied and "enriched" as it was in America, and you need to make sure your body is getting the micro-nutrients you need. I really recommend one of those green smelly kinds made from whole foods, rather than the cheap ones you can get at Walmart. :-)

 

4) Eat a good diet. At first, give yourself some grace on this one, as you're learning to cook with strange foods and limited variety. But have a long-term goal of eating as healthy as you can with what you have available. I hope to write an article specifically on this topic soon.

 

5) Avoid what stress you can. Obviously moving to a foreign country is hugely stressful. There is no way around that. Stress takes a measurable toll on your body, and people who have high stress levels are much more likely to get sick. So take this into account, and take special care of yourself through the first stressful months of life in your new country.

 

What am I missing? Do you have any tips to add?

Today's reader question is on a medical topic. If any of you are medical personnel, we would especially love to hear from you! But let's all chime into this discussion with the understanding that we are sharing our own experiences and choices, not giving medical advice!

Question:

What do other people do for malaria prophylaxis, especially for their children?

My Answer:

We have been told by a doctor that since we are long-term residents of Africa, we should not use prophylaxis but rather allow our bodies to build up a natural resistance to malaria. Another doctor was shocked by this advice and instructed us to be on prophylaxis at all times. We have chosen a 'happy medium' that has worked well for our family. Our babies begin taking prophylaxis when I begin to wean them at 12-15 months old. Our whole family stops taking prophylaxis for a few months in the height of dry season, when the mosquito population is significantly decreased. Of course we take as many other precautions as possible, especially not spending a lot of time outside in the evenings.

We use proguanil, brand name Paludrine, which has few or no side effects and is reasonably priced. It is safe for pregnancy and children. I also recommend Malarone (combo of proguanil and atovaquone), which is more effective than proguanil alone, but also significantly more costly.

**Please be sure to do research or ask a medical professional IN YOUR AREA OF SERVICE. Many regions have developed resistance to certain medications, so not all drugs are effective in all parts of the world.**

What have you done for malaria prevention? Do any of you have natural remedies that have worked for your family?