Friday, July 12, 2013

Bittersweet Health Disparities Moment. Time Spent With The Bhutanese In Tucson, Arizona.


Kamana Khadka

     Tucson, Arizona is home to about 1,400 Bhutanese; one of the newest refugee communities in America.  Among many health issues faced by Bhutanese who come from fairly underserved and sub-standard living conditions in refugee camps in Nepal, poor nutrition related health concerns remain one of the most voiced by Bhutanese residing in Arizona. Bhutanese have not only shown keen interest but have actively participated in establishing a healthy lifestyle in a new country. 
    
     On June 29,2013, I was asked to facilitate Bhutanese Community Health Promoter Training with Bhutanese Mutual Assistant Association for Tucson (BMAAT) in partnership with the Pima County Health Department and Mel & Enid Zuckerman College of Public Health, University of Arizona.  My role as a facilitator was to emphasize on cultural sensitivity. Having worked extensively with the Bhutanese in Phoenix and also on Healthy People 2020 funded Nutrition Project in 2011, I was excited to share my experiences. 

     Learning about the Food Plus program was the bittersweet health disparities moment for me.  Food Plus, is a USDA food program that provides emergency food boxes in Tucson to low income mothers, children, and the elderly on a monthly basis.  According to what was shared in the presentation, the emergency food boxes that are circulated contain pasta, milk, flour, canned vegetables, beans, cheese, beef stew, and juice for the most part.  Let me tell you, majority of the food that are included in these emergency food boxes are not only new to the Bhutanese and might never be used by them, but delivering beef stew, for instance, to a Bhutanese household, is very offensive. 
Cow is sacred in Hindu religion. 
Majority of the Bhutanese are Hindus. 
I doubt that majority of the food items included in those emergency food boxes would be used by refugees and immigrant population.
     Don’t get me wrong.  I truly appreciate the thought behind the emergency food boxes and commend USDA Food Programs for being consistent with their services.  Yes, the food that goes into those emergency food boxes solely run from donations from the public.  I believe that one of the main reasons why USDA Food Program have been able to consistently provide Food Plus/Emergency food boxes to the Tucson residents for years is because the donors strongly believe that by donating food they are able to fill the much needed gap in their community.  The fact is, our communities have changed and so have the choices of food consumption.  
     If the USDA Food Program would inform and provide demographics data to their faithful donors, I believe that there will be more variety in the food donations.  Perhaps the donations can actually benefit the ones in need and it will not be an addition to the list of already provided services to minority communities that is a pretty clear indication of “checking the box service” provisions.  If nothing is done to change the current trends of collecting food donations, Food Plus will continue contributing towards health disparities in America’s attempt to eliminate health inequalities.
     My health disparities comment regarding food content in the emergency food boxes is no reflection of the Pima County Health Department staff or the excellent work blossoming in Tucson, Arizona.  I was very impressed with the group lead by Dr. Karen Heckert.  This group has stretched a small grant of $5,000 to the limits.  The quality of their Community Trainer Program is at the same level, if not more, with some of the heavily funded projects.  Dr. Heckert has more than 30 years of experience working globally with some of the renowned organizations such as WHO, USAID, John Hopkins University etc.  Currently Dr. Heckert is with the University of Arizona and is doing what she does best – bridging theory and practice as public health practitioner in academia.
I had an instant connection with Dr. Heckert as she greeted me with a warm “Namaste” on the phone and she also has traveled to my birthplace Kathmandu, Nepal.
     I would also like to take this moment to congratulate 11 BMAAT Community Health Promoters – Purna, Ram, Santa, Keshab, Bishnu, Indra, Purna, Chadra, Mousami, Sumitra, Jamuna, and Yamuna who successfully completed their training on Nutrition & Diabetes Education.  Staff of the Pima County Heath Department – Soraya, Gabe, Kasey, and Lilly were absolutely amazing and of course Dr. Karen Heckert and her 'super intern' Kristin without whom this project would not have been such a tremendous success.
     Please join me in congratulating the team. 
     I hope to join them soon for the outreach planning.     


     



     













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