Although my Blog is primarily used for my musings about sports-related nutritionand supplement topics, I would like to take some time and devote a portion of my Blog to something else that has recently become a major interest for me, if not a new found passion. A couple of weeks ago I spent seven days down in São Paulo, Brazil volunteering at a nutrition rehabilitation center along with seven other classmates and our professor. This was actually my second time traveling to this center (my first time was May 2011), so unlike the majority of newcomers in the group, this trip had a significant meaning to me – a meaning that I am still trying to make sense of today. So before I get ahead of myself, let me describe the nature of my trip and then follow up with a couple choice photos of my time spent down there (both last year and present). Hopefully, if anything, you will be able appreciate the amazing work that goes on to help some of the poorest and most nutritionally deprived children this side of the globe. Lastly, in addition to raising awareness, I hope for this to be an enjoyable remembrance – for myself and those – who took a chance to step outside our comfort zones and experience something new and exciting wherein, perhaps, we even learned a little something about ourselves.
Center for Rehabilitation, Education and Nutrition (CREN)
The center we “volunteered” at – called CREN – was envisioned in the early 1980’s and actually came to fruition by the early 1990’s. The center was established in order to provide nutritional and medical assistance to the most undernourished and impoverished children of São Paulo’s favelas (slums). Today, the center is funded by the Federal University of São Paulo (UNIFESP) and private donations from Italy. All nutritional, psychological, medical and social services are offered, free-of-charge, to the children who attend the center. In essence, CREN operates like a small day-care center (which I will refer to as semi-in-patient care) and health clinic.
The children arrive early in the morning and, after ~10 hours, are picked up in the evening by their parent(s). This facilitates two needs: quality nutrition as well as care for the child and time for the mother and/or father to make an income during the day. There are roughly 70 slots available for the semi-in-patient care at CREN; those children who are not admitted usually have appointments with the nutritionist (and often the psychologist as well) to gauge the growth and development of the child. Ideally this is what should happen; however, this is not always the case. This is because, in order to get to the center, mothers and their child(ren) must take – what could be – a rather long bus ride to the center. Although this may seem trivial to you or I, in actuality this is a fairly substantial added cost for those who live on very little money each day.
While at CREN, the children are given five meals throughout the day alongside various activities like games, reading, nap-time, etc. Each meal is home-made by the cooks who work at the center. Each meal usually incorporates some form of protein, complex-carbohydrate, vegetables, and fruit or freshly squeezed fruit juice. For instance, a typical lunch would be something like seasoned chicken, rice and beans (pinto or black), collard greens, and fresh-squeezed papaya juice; something we actually ate while down there. This is meant to provide the children with adequate nutrition for proper growth and development during these critical years. Without this intervention, many kids may become stunted (if they are not already) and possibly even cognitively underdeveloped (again, if they aren’t already). Most children, however, are either moderately-severely underweight and/or stunted. This not only puts them at a social disadvantage, but stunting and poor growth throughout childhood predisposes the children to an increased risk for non-communicable diseases like obesity, type 2 diabetes, dyslipidemia, and so on. Regaining ones height, however, is extremely hard to do, especially after the first two years of life. This is why it is so important for these children to come to CREN; that way they may receive the best chance possible to grow and develop properly. You have to remember, not only are they themselves affected, but so too are their children, who will be at even greater risk for being born with low birth weight and becoming stunted; the cycle continues.
The children can only take part in the semi-in-patient care from ages 0-5 years. After age five the children must attend the local public schools. However, they may come back for any medical attention that they may need, up until their 19th birthday – again, completely free-of-charge.
For us – the students – the trip serves as a supplement to a course called Global Nutrition that is taught by an amazing professor – Dr. Daniel Hoffman – whom I call a close friend. Last year I actually took the course and was fortunate enough to become a Teacher’s Assistant for the course this year. I also got to operate as a student chaperone for the incoming group. It was an opportunity that I can never fully express my gratitude towards.
The trip allows us (the students) to truly experience the nature of undernutrition that we might have otherwise never have seen. Our professor had done – and is still doing – research based out of CREN and, over the years, has managed to form an amazing relationship with the director who was gracious enough to let us come to the center and learn. Over the course of the semester we spent time reading about various micronutrient deficiencies (Fe, I, Zn, Vitamin A, etc.), stunting, the viscous cycle of poverty and health, and the context in which malnutrition manifests itself. Simply reading about malnutrition, stunting and wasting means absolutely nothing until you witness it with your own eyes. That being said, each one of us confronted humanity on a very intimate level and, in the process, discovered parts of ourselves we would have otherwise never have known. It was truly a remarkable experience.
Over the course of the week (both last year and this year) my peers and I got to do a multitude of activities; we saw individual case studies of severely malnourished children and the unique medical, nutritional and social problems that affected each child and how they developed; we got to visit the favelas and the homes (if you can call them that) of patients of the center; we got to sit in on nutrition counseling sessions between the nutritionist and some of the outpatients; and lastly, we got to interact (albeit much less than last year’s trip) with the children. As I already alluded to, I am still trying to wrap my head around everything that I saw and heard during my stay this year. This trip was definitely an emotional one for me, on so many levels. So rather than try to put it into words I have decided to leave many things unsaid until I can figure out how I want to say them. I will, however, leave you all with some choice photos that I think sum up the trip very nicely.
In closing, I have been seduced by a culture and a people that I would have never imagined being a part of. My time spent in São Paulo and at the center – although short – has been a time with life changing implications. I will be returning this winter for a couple of days, and then again next spring for another full week. I urge anyone who reads this to share it with others and to step outside your own comfort zone and experience something that you may have otherwise only read in a book. I know my life has been touched for the better and I can only hope that I made an equally profound impression during my time at CREN; although something tells me that’s wishful thinking. As promised, I leave you all with some pictures (courtesy of my professor and the lovely ladies I traveled with, both this year and last) of my stay in São Paulo, Brazil. I would also like to note that we did manage to have some amazingly fun times while we were down there. A special thanks goes out to last year’s group; Barbara, Marina, Erin, Samantha, Andrea, Tara, Rebecca and Melanie, as well as this year’s group; Thaisa, Janet, Lauren, Alexa, Jessica, Cody, Carolyn, and Eliza. I am honored to have gotten to meet you all and experience this trip with you. I hope I was able to make it as fun for you as you all made it fun for me. Lastly but not least, the biggest thanks goes out to Dr. Dan Hoffman, for without whom this trip and this life-changing experience would have never been possible.
I’m a dietitian from Australia and I’m very keen to volunteer in South America, while really learning a lot. Is it possible to do volunteer work at CREN if you only speak English?