malnutrition in Aceh

Here is something that I recently wrote for my NGO that I found particularly interesting. Please forgive the double dip as well as the 'corporate voice:'

In Aceh, the unfortunate problem of malnutrition is not merely confined to poor families. Rather, raising healthy children is a challenge that tests the entire Acehnese community. Positive Deviance (PD) is one of the novel methodologies that S_____’s health sector promotes to address children’s health and nutrition.

As a method, PD seeks to describe children who grow and develop adequately in spite of a background of poverty. Accordingly, these families have adopted ‘positive deviant practices,’ in essence strategies that promote health and nutrition in spite of more structural disadvantages. In turn, PD focuses on how such ‘deviant’ strategies can be applied throughout the broader community.

S_____ coordinates PD training for key health actors, particularly midwives and healthcare volunteers from communities where malnutrition is above 30%. The 12 day training program is led by 2 facilitators from the Department of Health and teaches the six steps of PD, from defining the challenge, to discovering the ‘positive deviant’ strategies, to effective dissemination in the community.

At a recent training day in the T_____ sub-district of Pidie Jaya, 26 trainees from three villages met to discuss and determine the practices that contribute to good nutrition. After participating in an activity in which participants pinned symptoms or activities onto cartooned posters of either the ‘healthy child’ or ‘unhealthy child,’ Mohammed, healthcare volunteer in the Rawa Sari village spoke to the practicality of PD: “The theories that we learn here have a direct application in our lives and help us devise new ways of helping each other; helping us to connect both rich and poor.”

And indeed, one of the hallmarks of PD is devising solutions that healthcare volunteers can both relate to and immediately apply. It can be said that PD is the practice of new behaviors: solving problems by better using the existing resources available to all, rather than focusing on needs and solutions that require external aid. PD is both highly sustainable and culturally appropriate.

Interestingly, malnutrition is often more of a problem amongst Aceh’s wealthy than it is among the poor. Therefore, PD participants learn to identify habits, often rejected by some members of the community for social/cultural reasons, which actually hold solutions to malnutrition problems. One such example is the inclusion of small fishes, dried and eaten whole, into the diet. Rich in calcium and other nutrients, these fishes are seen by many wealthy people as ‘garbage’ and of no value because they are ‘for the poor.’

Faphlina, another volunteer from Rawa Sari, articulates another example, “Rich people in the village do not like eating boiled bananas in a pancake, and yet it is truly better for our nutrition, not just a snack for poor people.”

Instead, PD trainees learn to look to the successful habits of the poor for nutritional wisdom, learning to identify, mentor, and communicate strategies that promote nutritional content and healthy habits. Faphlina emphasizes, “When things like nutrition and health are not good, we have to work together in the village to solve our problems.”

PD succeeds when it empowers members of the community to look for solutions from within their communities and communicate them effectively. As Faphlina espouses, S______, through strong partnerships with these communities, is instrumental in intervening to help the neediest children and strengthen Aceh’s social fabric.