Community Nutrition: Armed with Knowledge and Tools, Kasese Families are Fighting Back

community nutrition kasese families fighting back
bakonzo children nutrition

The beautiful, rolling hills of the Rwenzori region hide an uncomfortable fact; nearly 55% of the Bakonzo children are stunted or chronically malnourished. Throughout their lives, if health conditions are not addressed with better nutrition, they will have infections, cognitive issues that stifle learning and even premature death.

Families are fighting back.

Nestled in the hills of Kasese, Joy lives with her three children. She represents thousands of young mothers who struggle daily in gardens to eke out 82 cents per day. Joy is one of 32 family heads that took a new community nutrition program designed by GlobalRise; and it’s truly changing her life.

“Our field workers are trained and spreading the program in the community,” said Karen Salazar, RD, a nutritionist with GlobalRise who has dedicated the past 6 years creating both an orphanage and nutrition program that meets local dietary needs. The program is being rolled out in the Rwenzori Mountains where the Bakonzo population is estimated at one million.

Faced with poor nutrition and extreme poverty, zero infrastructure and climate change, leaders in the community gathered at the Kasese Better Living Center to develop a plan and created a battle-cry to “Kick Stunting Out of Kasese!”

Officially tasked to build a community nutrition program, GlobalRise, after 5years of research, is building a Digital Food System – a multi-thematic community initiative that impacts nutrition, health, finance (linking mountain farmers to markets using drones), soil fertility, saving indigenous knowledge and more.

“The plight of the Bakonzo represents the height of inequity across so many issues,” said Tom Dean, chair of GlobalRise. The organization believes that by improving nutrition in a sustainable way, GlobalRise can send a wave of improvement in household income, health and more; helping families to pay for school, improve home sanitation and more. There are many ways that a Digital Food System could transform life for extremely poor mountainous farmers.

Building our Community Nutrition Program

To design a useful and sustainable program, GlobalRise first surveyed how local foods are used, cultural practices, dietary preferences, infrastructure and much more. The team was already working in the field for three years so, equipped with knowledge from implementing a “Farm to Plate Protocol” at Christalis Home (local orphanage), GlobalRise designed a meaningful survey. Specialists in surveying indigenous populations at the University of Costa Rica were consulted as well.

Next, two local Bakonzo were trained to administer the survey using the local language, Lukonzo. As they delivered the survey, they geo-marked each home so we could return with any questions.

Once administered, the survey data was shared with nutrition experts including Sylvia Klinger, DBA, RD, board member of GlobalRise, and Lauri Wright, PhD, president-elect of the Academy of Nutrition and Dietetics and Executive Director of University of Northern Florida’s Center for Nutrition and Food Security. GlobalRise’s lead nutritionist, Karen Salazar, RD, then authored the Community Nutrition Program or CNP, engaging with our field partners for local context.

Working through the pandemic, the CNP was finally completed and ready for implementation during our 2022, three-month mission. Three villagers, all Bakonzo, were selected for our “train the trainer” education – an intensive 2-week program that included a focus group of 6 families. Adjustments were made before it was re-tested with two more focus groups in succession – both over 13 families. Finally, our CNP was born!

Today, our trainers continue to administer and improve the CNP with families in Kasese. Our nutritionist, working remotely, guides the program’s effectiveness and collects outcomes that will be used in our first grant. GlobalRise is writing this grant in 2023 in a teaming relationship with Baylor Uganda, a 20-year project of Baylor University in Texas.

With our CNP in operation, GlobalRise is focusing on a cargo drone system to carry crops from mountain farms to food markets and settle financial transactions. This “uber in the sky” is being designed to help the local people to improve finances – a key requirement for sustainability.

An exit survey of CNP attendees showed enthusiastic acceptance of this technology, especially among the women heads of household who indicated it could save over 12 hours walking every week. This could improve finances, increase time with family and improve family life.

Rwenzori International University

rwenzori International university

A new “first” for Kasese!

In Uganda, university-level education started 100 years ago when Makerere University was established in 1922. Today 60 universities operate in Uganda, yet none serve the area around the Rwenzori Mountains where over one million Bakonzo live…until today. In June 2022, Rwenzori International University was granted the first university license in the Bakonzo territory!

There is a good reason for this new development. In Kasese District over 50% of the people are extremely poor. This adds to a heavy malnutrition burden; one out of two children are stunted. Universities are catalysts of development with a profound multiplier effect on the host community.

Well-funded and resourced universities have a tremendous social and economic impact on the community. As hotbeds of innovations and entrepreneurship, universities are economic engines.

Beginning August 8, 2022, the new University will offer:

Degree programs

  • Bachelor of Science in Agribusiness and Agricultural Economics
  • Bachelor of Agriculture Extension and Community Development
  • Bachelor of Business Administration in Accounting
  • Bachelor of Primary Education
  • Bachelor of Social Work and Administration

Diploma programs

  • Information Technology
  • Tourism and Hospitality
  • Early Childhood Development
  • Primary Education

…and a number of certificate courses.

As members of the Board of Trustees, GlobalRise is excited because the University provides a workforce development component for the Rwenzori Food System. This includes training in drone aviation, digital health, ICT and more.

Congratulations to Dr. Walemba and the fine academic team in Kasese! We are looking forward to working with you – “together we will!”

Digital Health Week in the Mountain Jungles

digital health week in mountain jungles

One of the most exciting things about non-profits is working with people who share a similar heart-felt cause. Discussions become so dynamic and meaningful! This is what happened when we started to bring in groups from HIMSS…and then BMS and others.

But what does “digital health” have to do with “digital food systems”? What does it have to do with better nutrition?

At the very foundation of health is good nutrition. Without it, we see health conditions that can take life away from kids. Acute and chronic malnutrition is a health condition. These conditions can be managed with digital health tools. In fact, we see the application of digital health in the mountain jungles as a cornerstone for healthy transformation of malnourished kids.

So when GlobalRise presented the keynote at HIMSS22’s Global Health Equity Symposium and met the VP of Digital Health at Bristol Meyers Squibbs, we got pretty excited! BMS is looking at global health equity, digital health and projects that can help to drive discovery in this emerging arena. Our conversations lead to the convergence of activity between HIMSS Institute, BMS and GlobalRise in a powerful way! In fact, it lead to scoping of a new Digital Health Week with participation by HIMSS, BMS and GlobalRise in Kasese, Uganda, during our Mission2022.

With HIMSS and BMS, we are conducting consultations with three hospitals in areas of low resources, like Kasese, as well as a unique surgical hospital, supported by Mt Sinai Medical Center in NYC, that offers oncology services and more. As part of this we are consulting with Kisoro District Hospital, a project of Montifore Medical Center. We are also reviewing medical initiatives at Rwenzori International University, Bugema University and Makarere University in the Kampala area.

As we learn, we will make better decisions about how to position our multi-thematic Digital Food System to sustainably lift hundreds of thousands out of disease and poverty in southwestern Uganda…and beyond!

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Farm-to-Plate Protocol

farm to plate protocol

In 2016 an idea sprouted at a strategy meeting in India…orphanages struggle with professional nutrition examination of their children. This is because of multiple competing priorities coupled with how incredibly hard it is to develop sustainable giving programs…clothes, shoes, shelter, food, healthcare, education and the list goes on. With so little in annual income, how is it even possible to bring in a nutritionist?

We asked a number of orphanage owners and found the need is great. Orphanages usually start with a person’s heart connection for helping kids. Friends and family funding kicks off the new program but it can only go so far. The founder may not have formal training or may have expertise in some but not all of the areas that underly orphanage management. The venture takes root and then what follows is an annual struggle for funds.

farm to plate protocol orphanage

Thus in 2017, GlobalRise was started with the idea that we can help.

Farm-to-Plate Protocol was developed for orphanage management to bring good nutrition into their residential homes or orphanages. It takes a broad, community perspective including local infrastructure, sanitation, food availability via local farming and much more – and then boils that down to how to create a nutrient-rich food systems environment at the orphanage level.

Materials were created with the orphan and orphanage needs in mind. For example, a graphically-oriented hand washing poster was created that can help keep the importance of this activity in mind. A skills assessment program for kitchen staff was created that can be used to help in hiring chefs that can help kids eat better…and much more.

The program was first implemented at Christalis Home in Kasese, Uganda, by a professional nutritionist and an agronomist/public health expert. Their existing food system was evaluated including food preparation and storage, the kitchen, washing of utensils and more. As you can see from the photos we took time to remove smoke from the kitchen. As soon as we walked in we were crying! This involved an infrastructure project developed by a local engineer.

We also took a hard look at the food budget. We wanted to make sure that the nutrient requirements of the orphanage population were being met with food purchases. Of course this also included a thorough review of food preparations and diet preferences. As we reviewed the food budget it became necessary to visit the farmer’s market, document and track food prices, food types during different seasons and so forth. All of this, the work of the nutritionist, is required to finally build a nutritious weekly menu. The menu drives food purchases, preparations and services for the children.

farm to plate protocol kasese

Farming is also part of this analysis. If the orphanage has land, raising crops can help to reduce operating costs attributable to food. Our agronomist went to work on this part of the equation, reviewing the existing farm, its capacity (both in terms of arable land, local and reliable talent that could be hired, build out costs and more). In the final analysis at Christalis Home, we opted for changing the food budget versus supporting the cost to build a new farm. Some items are sourced from the farm even today from this effort but because the Kasese farmer’s market is so robust and active, we found that food availability and costs were quite favorable.

Today, we visit the orphanage once a year to maintain our farm-to-plate protocol. Much of the initial changes are now operationalized. We offer help with the nutritional aspect of baby onboarding (initial assessment), reviewing baby formulas and, with the help of a pediatrician on our advisory board, providing clinical observations. Use of digital health records provided by PocketPatientMD helps with continuity of care for the precious kids.

Finally, whenever we want to implement a change we create what we call “funded recommendations” for orphanage management and/or board-level review. Approval of the recommendations by management then leads to implementation to transform the orphanage food system. Our donors fund the recommendations thus removing this burden.

farm to plate protocol Rwenzori

Unfortunately GlobalRise is not able to help every orphanage that reaches out to us. We have an overriding vision – Digital Food Systems – that drives the location of our work. This is because we believe that we can help the greatest number of kids by implementing digital food systems. Our work at the orphanage level is symbiotic and helps us to leap frog learnings of the local food system dynamics. This helps us to understand how to position our technology and expertise to raise the level of nutrition in areas of high stunting.

Today we are targeting Subsaharan Africa, India and Guatemala. This is because these areas have high stunting zones. Subsaharan Africa is the only region in the world where the stunting rate is increasing. India hosts the most stunted children on the planet. And Guatemala – its western highlands like Heuhuetenango – has one of the highest rates of stunting with 70% being recorded by USAID.

Our journey is just beginning…but we need your help!

Consider becoming a nutri-ambassador with GlobalRise and joining us as we build A World of Healthy Kids!

Join us!

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Drones or Donkeys?

drones or donkeys

In what could be one of the most significant failures to improve the life of mountainous small holder farmers in Kasese, the use of donkeys was recommended to help farmers move their crops down to formal markets.

Why donkeys?

Today, most of the small holders in the mountains are women. They walk down the mountains with their crops for 3-5 hours, baby on back, to sell whatever they can carry. This is one key reason why mountainous families, over 150,000 households, are locked into poverty today.

The researchers asked: why not send in donkeys? It makes a lot of sense. (By the way, finding this research was hard. It may not get much publicity because the project failed. But with this failure we may find foundational concepts that can ultimately succeed.)

Candidly, we never knew this project existed when we were granted a visit to the Mayor’s office. “Mayor,” we pleaded, “we think a fundamental development issue in the mountains is nutrition and to address this means somehow improving household income.” If you look at the research, improving nutrition and income always go hand in hand. In other words, a nutrition program is typically unsustainable if incomes aren’t improved.

The Mayor agreed. After convening two strategic meetings, his office concluded that steep terrain is one of the deep issues that is blocking socioeconomic development in the mountains. He was aware of the donkey project. “They ended up eating them for food,” he said. The project failed. The people are hungry.

When that failed the group met again and determined that it might be possible to implement “trams” at various points in the Rwenzori mountain range, however, this proposal is very expensive, ecologically insensitive and was off to a slow start. So when we mentioned using drones, the Mayor was intrigued. We explained the platform and our early ideas of how this could work.

Drones…Not Donkeys!

Today we are working with a group of social visionaries to develop a cargo drone platform, linked to mobile payments, that mountain small holders can use. Its sort of like an “uber in the sky” on a “pay as you go” basis. Before onboarding the platform, mountain small holders must go to Village Trainings in nutrition, soil fertility and financial planning…so the link between better income and nutrition improvement is sealed.

GlobalRise is building a Digital Food System that will deploy cargo drones for food, medicine, soil inputs and more. We are also implementing digital health tools that can monitor the journey of children in the mountains from stunted to healthy!

The “system of systems” will be proven and we hope that it will eventually be handed off to the government via a PPP (public private partnership) and scaled. This will require workforce development in UAV aviation, digital health, food and information technology and much more!

To enable this, one of the GlobalRise team is a board member of Rwenzori International University in Kasese, helping them to create a Tech Innovation Center for student training.

Click here to learn more about our program:

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