Malnutrition in Sierra Leone

Today, we had planned to visit outside the Wesleyan Church to begin taste testing.  We had all our supplies for the recipes, and we started the day immediately preparing our two products.  Chris, Kayla, and Karli spent the morning in Makambo using their oven to prepare the muffins.  Rachel, Seanna, Matt and Neena went to World Hope to prep the pudding and meet with Musa before heading out for the testing.  After speaking with Musa about our plan, he contacted the reverend and organized that we could come into the church.  At the end of the mass, the reverend was going to announce for mothers and children to stay after to taste test our products around 12:30.  This was exciting, as we finally had a concrete opportunity to begin conducting surveys and collecting data points.

(Shown above, Seanna mashes our pudding and Chris brings the baked muffins to WHI)

Unfortunately, most days don’t always go as planned… And today, everything that seemingly could have gone wrong, simply did.  To make the pudding, we had boiled our sweet potatoes, mashed them, and left them in the fridge at WHI the night before.  However, when we got there this morning, the fridge was unplugged, and the sweet potatoes spoiled from being enclosed in the now-hot fridge all night.  We had to trash the entire batch of pudding.  Rachel and Neena began firing up charcoal to boil fresh sweet potatoes, while Matt and Seanna tried to run to the market and gather enough other supplies to restart, in hopes we could still prepare something to present at our 12:30 deadline.  Meanwhile, back at Makambo the oven was taking significantly more time to bake the muffins than it should have.  After leaving them in for over 30 minutes, the muffins still weren’t baking all the way through.  Despite the smiles in the photos above, neither product was successful.  At this point, it was almost noon, and we had to make the decision to cancel our plans with the church.  Neena and Kayla went to the church to speak to the people in person about the change of plans.  Luckily, they were extremely forgiving, and offered up numerous other days for the upcoming week we can come and do tastings.  The people in the church were also very excited for us to come again with the products.

(Shown above are the muffins once taken out of the tin, revealing they were not completely cooked)

It was very disheartening that all of our product manufacturing fell apart, and we weren’t able to go to the church for data collection today.  The bright side is that we have plans now for many other days to complete taste testing there.  We have also laid out plans for accomplishing all our cooking successfully, day by day, so that we know who needs to do what to get everything done smoothly and efficiently.

Today was a great day, especially because we were able to sleep in until 11 today! Everyone was able to get a good nights rest to attack the day and hit the ground running. (Shoutout to Khanjan for that.) Our morning started with a group meeting to plan out the rest of our of time here in order to be as productive as possible and to alleviate the amount of downtime we have. After that, Kayla and Chris were able to boil sweet potatoes thanks to the Mushrooms team since our pot got locked in the bakery for the weekend. After a few failed attempts to get the fire started, we were eventually successful and had a rapid boil in no time.

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(The boiling purple sweet potatoes)

The next step was mashing them, so Neena and Karli decided to use the same mortar and pestle as we used for the ground nuts and the results were perfect. We also made extra batches of peanut butter in the way to use in the recipes later.

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(Matt smashing sweet potatoes into a paste)

Chris and Kayla took a trip to the market later that day to pick up additional food for the recipes to make for the next couple of days. Chris has a stroke of bad luck as a motorcycle drove over his foot, but he’s recovering well. Throughout the day Kayla and Karli were able to establish a good wifi connection and began to research possible grants and other money sources for the team in the future. The team also tried to establish an additional translator to help give questionnaires in front of World Hope. The team plans to bake the sweet potato cakes at the hotel in the morning, and then give them out in front of world hope later that day. As for the pudding, Neena, Seanna, Matt, and Rachel will make it at World Hope in the morning, and hand out samples to gather questionnaires outside of churches as they let out this morning.

Today was such a great day! Both malnutrition teams finally made their products – the sweet potato cakes for the 2 to 5 – year- olds and the sweet potato / plantain pudding for children 6 – 24 months. We were so happy with how they came out and think that we are off to a great start.

In the morning, Kayla and Chris went to the Betteh Bakery. They made the Tappler Bread with the workers. Chris was able to use the rolling machine to soften the dough and roll it out. They rolled the dough into what looked like little breadsticks, and then waited 5 hours for the dough to rise.

While we were waiting, they made the dough for the sweet potato cakes. We roasted some sweet potatoes (for the cakes) and boiled the rest of the sweet potatoes (for the pudding) in a wood burning clay oven. Alex helped position the sweet potatoes based on how they needed to be cooked and the temperature of the oven.

While the sweet potatoes were cooking, we prepared the rest of the dough for the cakes (bananas, palm oil, and corn flour).

While Kayla and Chris were at the bakery, Karli, Neena and Rachel stayed back at World Hope and prepared ground nut butter. Ground nuts are similar to peanuts in the USA, but more wet. We tried several methods of grinding the nut butter, including using a spoon, metal bowl, and sunscreen can. None of these were working efficiently, but thankfully Musa brought us a mortar and pestle and we were able to grind it much faster. We added a drop of palm oil so it would be a little bit less dry.

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After the ground nut butter was finished, Karli, Neena, and Rachel met the rest of the team at Bettah Bakery. We took the sweet potatoes out of the oven, peeled them, and mashed them. We added the roasted ones to the cakes and the boiled ones to the pudding (and also mashed bananas). We put the cakes in the oven to bake, and mashed the sweet potatoes, banana, and groundnut butter in the mortar and pestle to make the pudding.

All of the employees at the bakery tried both of the products and thought that they were great! The pudding went very fast and they even asked for more to bring home to their families.

The sweet potato cakes came out well too, but they were a too dry and were a little burnt. It was a different experience baking with local ingredients and a different type of oven. We are looking forward to revising our strategy and recipe so that we can make them better. It was a very validating experience for us to see how much everybody liked our products!

Today was a very productive day for the malnutrition teams. Some of us, Neena Shah, Rachel Caffrey and Karli Manko, were able to travel to two clinics, the Kalangba Clinic and Kamabai Clinic, to not only garner information about these places, but to establish relationships with the head community health workers (CHWs) and other employees. Meanwhile, the others, Christopher Fereno, Matt Feryo, Seanna Corr and Kayla McMillan, worked at Betteh Bakery to help build relationships with the bakers we will be working with in the next 3 weeks.

First, we headed to the Kalangba Clinic where a neo-natal clinic was being held. Being that this was our first time experiencing a foreign clinic, the team took a few minutes to tour the building and generally get a sense of the clinic’s capabilities. We were greeted by Osmon Movlai Contola, the head CHW, and Zaiuab Deen-Conteh, the head of nutrition at the clinic. We were able to talk to them, communicate our mission, explain our products in depth, and discuss the impact we hope to make. Next, Karli, Neena, Rachel, Osmon, and Zaiuab conversed about the other malnutrition products on the market (Bennimix and Plumpy’Nut), which the CHWs were already familiar with and have a history of using in the clinic. After asking their opinions on these products, Neena, Karli, and Rachel found out that there has been a shortage of these items for about the past 4 weeks and therefore, they have generally been hard to access and generally too inexpensive. We were able to ask Osman and Zaiuab if we could come back with lots of our products and have mothers and their children sample them and answer our questionnaires so that we could make any improvements possible. The CHWs happily agreed and told us that they would confirm with their superiors and send the word out to other CHWs to encourage children and mothers to visit the clinic on a date that we will agree on. The team very much looks forward to working more with Osman, Zaiuab, the mothers, children, and the Kalangba Clinic in general!

(Inside of the Kalangba Clinic)

Next, the team headed to the Kamabai Clinic where they met Ramotu O. Kamara and Vivat Kamara, two helpful CHWs. Similar to our conversation at the Kalangba Clinic, our team communicated what we were doing and how impactful our products could be. We were also able to learn about the measurements the CHWs use to test malnutrition in these children, which include height, weight, and mid-upper arm circumference (MUAC). After conversing for a while, Ramotu and Vivat agreed to have us come back multiple times on their vaccination days (Mondays) and malnutrition days (Fridays) where the team would have access to many children and mothers under five who we could test our products with! We plan to go back as soon as this upcoming Monday, the 12^th, with lots of our products and an eagerness to gain feedback.

While Neena, Karli, and Rachel were at the clinics in the morning, the rest of the team, Matt, Seanna, Chris, and Kayla, revisited Betteh Bakery. We were able to join Katis and the bakers as they made their first batch of dough to create their first loafs of tea bread and hamburger bread!

(Dough being made at the Betteh Bakery)

After making the dough, we were taught how to roll and reshape the dough into spirals for tea bread and balls for hamburger bread. Next, Catherine and the other bakers explained to us how the dough must ferment for about four hours and then can be baked for about 20 minutes. We were very lucky to be able to experience the Betteh Bakery’s song and dance as they celebrated taking the first successful loafs of bread out of their wood-fired ovens!

(Tea bread made at the Betteh Bakery)

(The team with the bakers and the manager of the Betteh Bakery)

This morning we started training at the Betteh Bakery at 9am. We were welcomed by the trainees with a song (IMG_3235)! They reviewed the first two days of their training where they learned proper hygiene and how to use the machines in the bakery.

The bakery is run by the Wesleyan Church, with Katis Bangura as the Project Manager. Katis and Councilor Ismail Mugun Bangura stressed that they want to empower women at the bakery while also providing quality bread to the people of Makeni. Catherine, the Betteh Bakery manager, also said that while she knows Sierra Leone has been behind other countries in terms of women empowerment, she’s excited to make a change as a leader of the project.

(Seanna Corr with Catherine Kouroma, Bakery Manager)

The machine the trainees learned to operate is used to compress and mix the bread dough before putting it in the oven. A mechanic in Sierra Leone constructed the machine with a diesel engine operated by a crank and parts from an old Mercedes Benz car. The engine and crack turned a fan belt which turned the large rolling pin on the dough machine. We used a flour and water mixture to practice using the machine and learn different bread shapes.

(Dough machine)

(Photo of a bakery trainee after getting the diesel engine to run after 3 attempts!)

(Mixture of flour and water that were used to practice using the dough machine and kneading the dough into shapes for the oven)

(Neena Shah and Karli Manko learning the proper ways to prep the dough for the oven)

The trainees learned four different bread recipes that they plan to cook in the bakery. The first two were taught by Alexzandra (Alex) Pee. Alex is from Freetown, Sierra Leone and has over 25 years of baking experience.

The first recipe he gave was for Tappler (pronounced “Tapalapa”), a popular bread in Makeni. The bread is not preserved well, but would be sold in small quantities each day. The recipe calls for:

• 1 bag of flour
• salt
• 1 tablet/baromate per bag of flour (for fermentation- crushed and dissolved in water)
• yeast

The second recipe was for Butter Bread, which is more expensive, but the bakery managers believe it will be profitable. In Freetown, this bread would be sold for 5,000 Le, which is around 0.50 USD. Most breads, including Tappler, are sold for 1,000-2,000 Le in Makeni. The bakery managers want to sell Butter Bread in smaller sizes so more people can afford it. Betteh Bakery will be the first bakery in all of Makeni to bake this type of bread. The recipe includes:

• 1 bag of flour
• salt (less than the first recipe)
• 1 tablet per bag of flour
• yeast
• butter
• nutmeg
• sugar

The last two recipes were presented by Thuimu Bangura, a younger bakery trainee with more baking experience than the rest.

The third recipe was for Ghana Bread, which calls for:

• 1 bag of flour
• sugar
• salt
• butter
• yeast
• milk
• eggs
• nutmeg
• flavoring (banana, pineapple, coconut)

Unlike the other bread recipes, Ghana bread is cooked in a small bread pan. The others are baked on something similar to a cookie sheet.

The last recipe Thuimu presented was for Sugar Bread. The recipe includes:

• flour
• sugar
• yeast
• milk
• salt
• butter

Each recipe is fairly different, but the Betteh Bakery is excited to try each of them. Tomorrow (August 8), we will spend the day baking and perfecting each recipe with the trainees. The bakery will become fully operational on Monday, August 12, and will only sell Tappler for the first month or so. They plan to sell one piece of bread for 1,000-2,000 Le and to start small but expand later.

Throughout the day, we were introduced to Pastors and Reverends at the Wesleyan Church, and everyone was extremely welcoming and happy to have us. At the end of the day, Alex, Ismail, and Katis encouraged us to share what we learned and loved hearing that the marketing strategies for our products aligned with theirs.

Today was our rainiest day yet, but we were able to get lots of things accomplished. Our team is excited to return to the bakery tomorrow to try out the recipes! Some of us will also have the opportunity to visit a few health clinics to build connections with mothers and children that can taste our products next week.

(Pastries given to the team as a welcoming gift from Catherine Bangura)

(Matt Feryo, Seanna Corr, and Rachel Caffrey took a short, but rainy, trip to dinner in the back of a pick-up truck!)

Today was our second full day in Makeni, Sierra Leone. While the day consisted of minimum outdoor excursions, it was full of logistical and practical meetings inside the World Hope office.

The first thing we did was meet with Katis Bangura, the project manager of the World Hope bakery and Catherine Kouroma, the World Hope bakery manager. We learned that the bakery is employing roughly 10 women (and men) and teaching them the practice of bread making. Katis and Catherine were extremely helpful during our meeting and are allowing us to use their facilities to cook/produce our products. As of right now, we are planning to start the beginning of the baking process at the bakery Monday August 12. They are also allowing our group to attend one of their training sessions for their employees tomorrow, Wednesday August 7. We are meeting them at 9AM to learn their policies, protocols, and just generally learn how their machines work. Catherine told us that most, if not all, the women that were employed in the bakery had children and we would be able to test our products and complete the surveys with them. She said that there is a possibility that we will be able to meet the children and the women at the training session tomorrow and even though we don’t have products for them to try, it will be a great opportunity to meet them and familiarize them with our products. This is really exciting for our team!

Immediately following that meeting, our team had another meeting within our group to determine specific goals and internal checkpoints as well as more concrete plans for the next few days. Tomorrow, Wednesday August 7, after the training session our goal is to go back to the markets and pick up the necessary ingredients and supplies that we need to start baking our products. Thursday August 8, our team is planning cooking at the resort we’ve been staying at from 10AM-12PM. With these finished products, we will hopefully be able to return to the bakery and get input on the products.

The last two things that we accomplished today was 1) setting up the project budget for this trip so we know where our money is going and 2) we could work with Jawara regarding our survey for the mothers/children. The purpose of getting Jawara’s help was to make sure that the questions would be easily translated and communicated to the people we intended to interview.

Our budget is as follows:

Food – 500,000 SLL

Translators – 100,000 SLL

Hotel Gas (cooking) – unknown

General Work (anything not accounted for) – 100,000 SLL

Bakery Payment – 100,000 SLL

We also were able to re-explore the markets and taste some local foods.

Today was a very rainy day, but we were definitely able to enjoy it! We are really excited to continue our work tomorrow with more in depth and active in field research.