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Running Head: IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 1 Improving Health in Sololá, Guatemala, Through Innovated Cooking Methods Emily Borgstrom Woodruff Weber State University Bachelor of Integrated Studies Program November 2016 Description : This spring, I traveled to Sololá, Guatemala, to gain experience interpreting for medical staff of the Love in Action organization. During my travels, the need was apparent to me that better nutrition practices and a change in food preparation methods would promote healthier living habits among the indigenous population in Sololá. Chronic obstructive pulmonary disorder (COPD) and other respiratory related illnesses are very prevalent in this area due to cooking over open fires within the home. I observed that alternate methods in cooking, such as solar ovens, can help eradicate these illnesses. This paper will discuss my experience, the discovery of the illnesses, and a solution of alternate methods of cooking. Area of Emphasis 1: Nutrition Committee Member: Jennifer Turley, Ph. D. Area of Emphasis 2: Latin American Studies Committee Member: Electra Fielding, Ph. D.

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Running Head: IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 1

Improving Health in Sololá, Guatemala, Through Innovated Cooking Methods

Emily Borgstrom Woodruff

Weber State University Bachelor of Integrated Studies Program

November 2016

Description: This spring, I traveled to Sololá, Guatemala, to gain experience interpreting for medical staff of the Love in Action organization. During my travels, the need was apparent to me that better nutrition practices and a change in food preparation methods would promote healthier living habits among the indigenous population in Sololá. Chronic obstructive pulmonary disorder (COPD) and other respiratory related illnesses are very prevalent in this area due to cooking over open fires within the home. I observed that alternate methods in cooking, such as solar ovens, can help eradicate these illnesses. This paper will discuss my experience, the discovery of the illnesses, and a solution of alternate methods of cooking.

Area of Emphasis 1:Nutrition

Committee Member:Jennifer Turley, Ph. D.

Area of Emphasis 2:Latin American Studies

Committee Member:Electra Fielding, Ph. D.

Area of Emphasis 3:Spanish

Committee Member:Thomas Mathews, Ph. D.

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 2

TABLE OF CONTENTS

What is the most prevalent illness that is being seen by the Love in Action doctors? Are there cultural links to the reason for this illness? Can it be eradicated through nutritional and health based means? What can I do to positively effect change in Sololá, Guatemala? Audit Report PhotosFlyer for FundraisingLetter from Doctor Laurence Smith Personal and Professional Growth Assessment Community Engagement Contract

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 3

Literary Review

In April of 2016, I traveled to Sololá, Guatemala, with a humanitarian organization called Love in

Action. For this particular mission, they gathered several different volunteer teams consisting of medical

and oral surgeons, family practitioners, nurses, and interpreters. I had the privilege of aiding the

organization as an interpreter for a family practitioner and to help with any other members of the team

who were in need.

My purpose in going to Guatemala with this organization had many facets. I went to gain

experience in the field of interpreting and use the cultural knowledge I had learned. I wanted to find

answers to questions that I had created concerning the indigenous population and their health status,

discover a manner in which it could be changed for the better, and lastly to get hands on experience as

to how humanitarian missions are conducted. I was successful in discovering what I had intended and

was blessed to learn even more than I had expected. This paper will expound on the impact each field of

study had on my project and how I intend to move forward with the knowledge and experience I have

gained.

Before traveling to Guatemala, I created questions that would help me focus on the areas of

emphasis I had chosen:

What is the most prevalent illness that is being seen by the Love in Action doctors?

Can it be eradicated through nutritional and health based means?

Are there cultural links to the reason for this illness?

With the knowledge I have gained, what can I do to positively effect change in Sololá, Guatemala?

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 4

I will address my three areas of emphasis through these questions and with the experience and

information I gained both during and after the mission to Guatemala. After returning home from

Guatemala and reflecting on the experience I had, these questions helped me to formulate the whole

picture. Before I could begin to think about discovering answers to these questions, I had to focus on the

language.

The first day of the mission was a very long and tiring day. We arrived in the Guatemala City

airport at 5:30am. The idea that I had just left the United States for the first time had not really struck

me until we stepped outside the airport doors into the hustle and bustle of the street. From the

moment we exited the doors my husband and I were bombarded with questions. ¿Quieren comprar

flores? ¿Quieren usar mi teléfono? ¿A dónde va? While around us, others begged for money and

explained their impoverished condition. All of a sudden, it hit me, and I realized I was no longer siting in

my classes practicing Spanish—this was real. All of the conversational practice I had learned was now

racing through my mind. Once I embraced the culture shock, I was able to converse with several people

and figure out which bus we needed to get on in order to be taken to Sololá. Once we arrived at the

medical compound, we immediately began to set up stations where the doctors and patients could

meet, and we were given our assignments.

I was assigned to work as an interpreter for Dr. Lawrence Smith. Dr. Smith is an MD and has

worked as a primary care and urgent care doctor for 39 years. When the first patient walked into our

little station made of blankets suspended by rods, I was full of excitement and nervousness for the job

that lay ahead. The clinic was only open a couple hours that first day, and during that time, I was to be

evaluated by the director while I interpreted to make sure I could clearly understand and appropriately

respond. After being evaluated during two patient visits, I was cleared to work alone with the doctor.

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 5

The information I had gained through medical and cultural Spanish classes were now invaluable to me as

I not only understood the words they were saying but also the cultural context behind them.

One example would be the phrase ‘mal aire’ which directly translated would simply mean ‘bad

air’. This translation could be taken as a way to explain a bloated or gassy feeling within the body, but

the cultural meaning is very different than this. This phrase has connection to a folk belief that is

accepted through several Latin American communities where, “If cold or nighttime air enters into a body

orifice, it can cause, for example, discomfort, pain, cold symptoms, or a muscle spasm. To help alleviate

the problem, a cup can be squeezed a little, then the rim surface pushed onto the skin, then let to

reform its shape creating a little vacuum, thereby suctioning the skin. . .” (PracticingSpanish, 2007). With

this definition and the knowledge of what symptoms they associate with this phrase, it can be properly

diagnosed for the physical ailment it is, while not discounting the cultural belief, and then properly

treated. Without cultural understanding of Latin America and specifically Guatemala, that particular

doctor visit would have ended in frustration and a false diagnosis for the patient and the doctor.

Language was the first aspect to be addresses during my trip, and through it, I was allowed to

experience and gain understanding about the people and their needs. I would like to share the whole

picture through addressing each of these questions.

What is the most prevalent illness that is being seen by the Love in Action doctors?

Being able to work with Dr. Smith was very insightful, as he had traveled with this mission and

several other medical missions throughout his career. Between patients, he would tell me to watch for

certain behaviors that he had discovered were very common among these people. Several times

throughout the week, Dr. Smith would stop in the middle of the appointment and ask me to have them

explain to me a cultural aspect of their life, such as the type of clothing they were dressed in or the kind

of work they were involved in so that I could get a better understanding and a love for the Guatemalan

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 6

people. They were always obliged and very excited to share their customs and beliefs with me, making it

even more engaging. Because of this practice of stopping and discussing throughout the day, I was not

surprised when he began to explain that the doctors very rarely found different diagnoses from day to

day or even from mission to mission within Latin America. The doctors generally had to address the

same problems and would find something new only on occasion. He explained that this was due to the

living conditions of the indigenous Guatemalans, their societal class, and the medical aid that they were

able to receive.

The Love in Action Mission only comes to Sololá once or twice a year, and the people line the

streets for days waiting to be seen for all sorts of illnesses. One thing that Dr. Smith wanted me to be

aware of was the response to the question: “How long have you been suffering from this sickness or

pain?” The responses were alarming to say the least. The shortest amount of time that I heard was still

given in a number of months and many others were given in years, yet they had still traveled to the

clinic on foot, toting their children, and planning to continue working harder than many of us in the

United States understand, whether or not they received good news about their condition. I was

completely aghast at the gratitude and kindness they showed the doctors for giving them something as

simple as Benadryl or other similar medications that would seem extremely mild to the average

American.

To give an example of the humility these Guatemalan’s have I will relay an experience that

occurred near the end of our trip. I was once again working with Dr. Smith, and the majority of the day

had been similar to the days that had preceded it. A young man came into the office near closing time

and brought his 82-year-old grandfather with him that only spoke K’iche’. He would translate what his

grandfather said to Spanish, and then I would relay the information to Dr. Smith. The older gentleman

had come because he was experiencing a lot of pain in his ear and having trouble hearing for several

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 7

months. There was not much Dr. Smith could do, so we discussed possible options, and then he got up

to leave, but his grandson stopped him. They spoke in K’iche’ for a moment, and then the grandson

asked if the doctor could look at his grandfather’s back before they left. Dr. Smith obliged, and as his

grandson lifted his shirt we were both surprised to see what was uncovered. There was, what looked

like, a cyst the size of a softball bulging beneath the man’s skin right in the center of his spine. He had

no intention of showing the doctor this growth and had planned on continuing his life with this

immeasurable pain; he simply wanted to know what was wrong with his ear.

Dr. Smith had seen cysts such as this form on the back of men in this village due to the manner

of work they performed. They would make backpacks out of pallet boards so that they could carry huge

amounts of produce, grain, or other materials that needed to be taken down the mountain to market.

This man at 82 years old provided for his family by carrying these pallets for hours each day with this

fibrotic growth on his back, and he planned on continuing this effort for as long as he could. He was

immediately taken in to surgery for the removal of what was thought to be a cyst but ended up being a

very large and deeply rooted tumor. I had the experience of interpreting for the medical students in

training at the clinic during the procedure. I had to sit down for fear of passing out, but in the end it all

turned out very well, and the grandfather was able to return home with his grandson to rest.

Besides this surprising event, the majority of patient visits fell into their own similar categories. I

began to watch and listen for those similarities that Dr. Smith had mentioned. By the second day, I was

accustomed to the symptoms that would be explained and the response that Dr. Smith would give.

Several of the women and young girls would come in to our little room and explain that they had been

having chest and stomach pain and intensive headaches for months, sometimes longer. They explained

that they had difficulty breathing, a cough that would not go away, and they became exhausted very

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 8

easily. It was so interesting for me to witness the number of people who came in describing nearly the

exact same problem.

After this had happened numerous times in a row, Dr. Smith talked to me about why this was

such a prevalent occurrence and why it would continue to be a prevalent problem in the future. There

were needs that were not being met and information that was not being taught. The diagnosis that

would be given time after time would be respiratory related illnesses, chronic obstructive pulmonary

disease (COPD), and gastritis. All were linked to changeable living conditions that I had not yet seen.

Treatment for temporary relief could be given to the individuals, but the life style they returned to

would inevitably bring back the symptoms that they had waited months to alleviate.

I found an answer to one of my basic questions: the most prevalent illnesses in Sololá,

Guatemala, were linked to respiratory diseases. However, there is more to it than simply prescribing a

medicine; this issue has cultural implications that need to be addressed first. In order to fully

understand how this problem can be fixed, we need to look at another question.

Are there cultural links to the reason for this illness?

Culture is one of the great influencing factors on an individual’s nutrition. The relationship

between food and culture is symbiotic and is shown in many distinct ways throughout the world. An

individual’s culture and the traditions that have been passed down to them for generations not only

influence the foods they will consume, but also the methods that they will use to prepare the food.

Within the indigenous population of Guatemala, cultures as well as societal class affect both nutrition

and preparation methods.

In order to see the influence that culture and class have on food consumption, an analysis of

past and present food habits is needed. The typical daily Guatemalan diet is influenced by the

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 9

consumption habits of the Mayan culture, “The ancient Mayan Indian Empire flourished here over 1,000

years before the Spanish conquest” (Brittin, 2011). Many of the Mayan traditions are specifically

prevalent among the indigenous groups of Guatemala where the ancient Indian dialects are still heavily

spoken.

The staple foods that are consumed today by the indigenous groups can be seen by looking back

to the Mayan tradition, “Early Mayan records indicate that the foundation of their diet was corn and

beans, supplemented with squash, tomatoes, chiles, tropical fruit, cocoa, and some game. Black Beans

are especially popular in Guatemala. . . corn is eaten mostly as tortillas. . . and pickled vegetables such as

cabbage, beets, and carrots are consumed daily” (Kittler, Sucher, & Nahikian-Nelms, 2012). There is not

a lot of variation between the meals consumed throughout the day in Guatemala, especially in the

indigenous areas. I spoke with Miriam Lemon who is a native of Guatemala and now the organization

director of Love in Action Missions. She informed me of the daily dietary patterns among the very poor

indigenous groups and gave me examples. These are the individuals who would be cooking over open

fires in the home. Exact amounts are difficult to reference due to the literal day-to-day lifestyle that

these indigenous groups lead. Economic variance occurs but the staple foods remain the same (see

Table 1).

Table 1Indigenous Meal StaplesBreakfast: Eggs tortillas coffee black beans

Lunch: Corn tortillas Tamales black beans coffee(If they have the means some are able to afford vegetables or meat to make soups, but this is generally uncommon)

Dinner: black beans tortillas coffee

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 10

She also informed me that even the poorest people are content as long as they at least have black

beans and coffee. Both of these commodities are very cheap and can help curve hunger throughout the

day. As you can see here, their daily dietary consumption patterns are lacking in several categories.

The amount of food an individual will consume varies from day to day, but an estimated amount will

be shown in a chart below (see Table 2). By looking at a sample dietary analysis through MyPlate, the

current USDA nutritional guide for healthy living habits, based on the information above, we can see an

example of the nutritional status of the indigenous groups in Guatemala (see Table 3). This analysis will

be based off of a hypothetical character that will represent the individuals that are being affected by

COPD. The bulk of those affected are the grandmothers, mothers, and young girls. This is due to the

cultural norms that prevail in the Sololá and the responsibilities that these women have, namely the

cleaning and food preparation for the family. The MyPlate character will reflect a woman that is 39 years

old, 5’ tall, and weighs around 180lbs.

Table 2Estimated Daily Consumption Breakfast Lunch Dinner Snack ½ cup Black beans,

canned or cooked, with animal fat

1 mug (8 fl oz) Coffee, brewed, regular

2 large egg(s) Eggs, fried in animal fat

2 medium tortilla (6" across) Tortilla, corn

1 cup Black beans, canned or cooked, with animal fat

1 mug (8 fl oz) Coffee, brewed, regular

1 tamale Tamale, plain, meatless, no sauce, Mexican style

3 medium tortilla (6" across) Tortilla, corn

1 cup Black beans, canned or cooked, with animal fat

1 mug (8 fl oz) Coffee, brewed, regular

3 medium tortilla (6" across) Tortilla, corn

1 mug (8 fl oz) Coffee, brewed, regular

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 11

Table 3Nutrient Analysis of meals included in Table 1

MyPlate AnalysisNutrients Target Average Eaten Status Total Calories 1800 Calories 1577 Calories OK

 Protein (g)*** 46 g 61 g OK Protein (% Calories)*** 10 - 35% Calories 15% Calories OK

 Carbohydrate (g)*** 130 g 204 g OK Carbohydrate (% Calories)*** 45 - 65% Calories 52% Calories OK

 Dietary Fiber 25 g 48 g OK

 Total Sugars No Daily Target or Limit 9 g No Daily Target or

Limit Added Sugars < 45 g 3 g OK

 Total Fat 20 - 35% Calories 34% Calories OK

 Saturated Fat < 10% Calories 12% Calories Over

 Polyunsaturated Fat No Daily Target or Limit 6% Calories No Daily Target or

Limit

 Monounsaturated Fat No Daily Target or Limit 14% Calories No Daily Target or

Limit Linoleic Acid (g)*** 12 g 9 g Under Linoleic Acid (% Calories)*** 5 - 10% Calories 5% Calories OK

 α-Linolenic Acid (% Calories)*** 0.6 - 1.2% Calories 0.5% Calories Under

 α-Linolenic Acid (g)*** 1.1 g 0.9 g Under

 Omega 3 - EPA No Daily Target or Limit 1 mg No Daily Target or

Limit

 Omega 3 - DHA No Daily Target or Limit 57 mg No Daily Target or

Limit Cholesterol < 300 mg 412 mg Over

Minerals Target Average Eaten Status Calcium 1000 mg 473 mg Under

 Potassium 4700 mg 2853 mg Under

 Sodium** < 2300 mg 1845 mg OK

 Copper 900 µg 1499 µg OK

 Iron 18 mg 16 mg Under

 Magnesium 320 mg 399 mg OK

 Phosphorus 700 mg 1512 mg OK

 Selenium 55 µg 49 µg Under

 Zinc 8 mg 8 mg OK

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 12

Vitamins Target Average Eaten Status Vitamin A 700 µg RAE 158 µg RAE Under

 Vitamin B6 1.3 mg 1.0 mg Under

 Vitamin B12 2.4 µg 0.8 µg Under

 Vitamin C 75 mg 0 mg Under

 Vitamin D 15 µg 3 µg Under

 Vitamin E 15 mg AT 6 mg AT Under

 Vitamin K 90 µg 19 µg Under

 Folate 400 µg DFE 413 µg DFE OK

 Thiamin 1.1 mg 1.3 mg OK

 Riboflavin 1.1 mg 1.5 mg OK

 Niacin 14 mg 8 mg Under

 Choline 425 mg 465 mg OKNote. The far right column, labeled status, expresses whether or not the individual is receiving their required daily intake level for each nutrient. The goal of Myplate is to help individuals reach their target daily value in order to supply them with a balanced diet.

The greatest impact that is visible in the nutrient report would be the lack of vitamins their diet

provides. They also experience a severe imbalance as it pertains to the five major food groups. This

deficiency can cause many other illnesses including malnutrition but it is not directly linked to COPD

which is the focus of this project. Their impoverished condition does not allow for more than the few

food choices they have, which provide them with small amounts of protein from eggs, plenty of

carbohydrates (depending on the amount of food they are able to consume at each meal) and rarely if

ever any dairy, meat, or fruit. Variation in food is a luxury that some of these individuals never

experience. These deficiencies can be seen in the larger picture through examination of the food groups

based on the daily sample diet of the 39-year-old woman (see Table 4).

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 13

Table 4Food Group & Calorie ReportFood Groups Target Average Eaten Status Grains 6 ounce(s) 8½ ounce(s) Over Whole Grains ≥ 3 ounce(s) 0 ounce(s) Under

 Refined Grains ≤ 3 ounce(s) 8½ ounce(s) Over

 Vegetables 2½ cup(s) 2¾ cup(s) OK Dark Green 1½ cup(s)/week 0 cup(s) Under

 Red & Orange 5½ cup(s)/week 0 cup(s) Under

 Beans & Peas 1½ cup(s)/week 2½ cup(s) Over

 Starchy 5 cup(s)/week ¼ cup(s) Under

 Other 4 cup(s)/week 0 cup(s) Under

 Fruits 1½ cup(s) 0 cup(s) Under Whole Fruit No Specific Target 0 cup(s) No Specific Target

 Fruit Juice No Specific Target 0 cup(s) No Specific Target

 Dairy 3 cup(s) 0 cup(s) Under Milk & Yogurt No Specific Target 0 cup(s) No Specific Target

 Cheese No Specific Target 0 cup(s) No Specific Target

 Protein Foods 5 ounce(s) 2 ounce(s) Under Seafood 8 ounce(s)/week 0 ounce(s) Under

 Meat, Poultry & Eggs No Specific Target 2 ounce(s) No Specific Target

 Nuts, Seeds & Soy No Specific Target 0 ounce(s) No Specific Target

 Oils 5 teaspoon 0 teaspoon UnderLimits Limit Average Eaten Status

 Total Calories 1800 Calories 1577 Calories OK Added Sugars < 180 Calories 13 Calories OK

 Saturated Fat < 180 Calories 189 Calories OverNote. This table focuses on the amount of food being consumed as it pertains to the five major food groups. The target amounts are based on weekly consumption habits which would not vary in the case of indigenous Guatemalan’s due to daily diet patterns. Status would remain ‘under’ on the majority of food groups.

Malnutrition, especially among the indigenous population of Guatemala, can lead to deficiencies

in vital nutrients that can cause serious health issues, aside from COPD, if not addressed. Social factors

such as poverty open a gateway of malnutrition and poor living conditions that begin to affect large

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 14

amounts of people. These affects can be seen in the research conducted by the United States Aid

International Development Agency (USAID).

Guatemala has the highest prevalence of stunting (49.8%) in the region of the Americas

and the sixth highest prevalence of stunting among children under five in the world.

Chronic undernutrition is attributed to high rates of poverty, food insecurity, inadequate

hygienic environments, structural problems of inequality and exclusion, and also

insufficient child stimulus and care. The most vulnerable are the Mayan communities

who live in the highlands, where stunting affects almost 70% of children under five.3

Nevertheless, underweight and wasting are rare at the population level. Stunting is

inversely related to maternal education levels and wealth, higher among children living

in the poorest households (70.2%) than among children in the richest households

(14.1%) and higher in children whose mothers had no education (69.3%) than children

with mothers who had secondary or higher education (14%). 4 Micronutrient

deficiencies have been addressed for many years. Thus, iodine has been added to salt

since the 1950s, vitamin A to sugar since the 1970s, and wheat flour has been fortified

since 2002 with iron and B-complex vitamins (B1, B2, niacin, and folic acid), following a

Central American formulation. (USAID, 2016)

The general nutritional habits of these individuals could be changed a great deal in order to influence

positive change in the overall health of these people, but the deeper concern right now is the way they

prepare their meals and the serious health effects that it is causing. The issues of nutrition enhancement

and safer food preparation weigh heavily upon the quality of life these people are able to live.

This issue can also be seen through the lens of Maslow’s Hierarchy of Needs. Self-actualization

represents the needs of the individual, while Physiological represents the deficiencies the people are

experiencing. Both aspects are connected, but need to be separately addressed in order to improve

quality of life. Their lives are greatly affected by the cultural preparation methods they use on a daily

basis. Without education and a means for change this pattern will continue.

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 15

Figure 1. Maslow’s Hierarchy of Needs. McLeod, S. (2013). Maslow's Hierarchy of Needs. Retrieved October 8, 2016, from http://www.simplypsychology.org/maslow.html

The issue of the food that is consumed has been addressed, and is a major factor relating to

culture. Another issue that must be addressed is the food preparation methods. As mentioned

previously, the indigenous groups of Guatemala live in impoverished conditions and do not have the

worldly conveniences and means that many others do. One very obvious difference in these indigenous

communities is the lack of power as it pertains to food preparation.

The result of this is seen in the use of open fires within the homes to cook several meals a day.

One case study relays the negative health impact that this occurrence is causing:

With 40% of the world's population relying on solid fuel, household air pollution (HAP)

represents a major preventable risk factor for COPD (chronic obstructive pulmonary

disease). Meta-analyses have confirmed this relationship; however, constituent studies

are observational, with virtually none measuring exposure directly. We estimated

associations between HAP exposure and respiratory symptoms and lung function in

young, nonsmoking women in rural Guatemala, using measured carbon monoxide (CO)

concentrations in exhaled breath and personal air to assess exposure. Methods: The

Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE)

Guatemala study was a trial comparing respiratory outcomes among 504 women using

improved chimney stoves versus traditional cookstoves. The present analysis included

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 16

456 women with data from post intervention surveys including interviews at 6, 12, and

18 months (respiratory symptoms) and spirometry and CO (ppm) in exhaled breath

measurements. Personal CO was measured using passive diffusion tubes at variable

times during the study. Associations between CO concentrations and respiratory health

were estimated using random intercept regression models. Results: Respiratory

symptoms (cough, phlegm, wheeze, or chest tightness) during the previous 6 months

were positively associated with breath CO measured at the same time of symptom

reporting and with average personal CO concentrations during the follow-up period. CO

in exhaled breath at the same time as spirometry was associated with lower lung

function [average reduction in FEV1 (forced expiratory volume in 1 sec) for a 10%

increase in CO was 3.33 mL (95% CI: -0.86, -5.81)]. Lung function measures were not

significantly associated with average post intervention personal CO concentrations.

Conclusions: Our results provide further support for the effects of HAP exposures on

airway inflammation. Further longitudinal research modeling continuous exposure to

particulate matter against lung function will help us understand more fully the impact of

HAP on COPD. (Pope, 2015, p. 285-292)

As the above case study defines, household air pollution is a very significant issue throughout

the world and the negative effects can be blatantly seen within Guatemala. While I was in

Sololá, I was able to personally see the symptoms and the problems that are associated with

HAP and the need for an alternate form of cooking.

This isn’t just a problem in Guatemala. The book Food Culture in Central America states,

“Despite changes in other realms, many people in Central America still rely on wood or other biomass

fuel as an energy source for cooking. More than 50 percent of the households in Nicaragua and

Honduras and the World Health Organization report that 1.6 million women and children around the

world die each year from respiratory diseases caused by the toxic smoke produced from indoor burning

stoves used for cooking” (McDonald, 2009).

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 17

There are alternative methods that can help solve the issue of COPD that is being caused by the

inhalation of toxic gases in the home. In the above report the method of adding improved chimney

stoves to the homes for ventilation was given. Another option would be the use of solar ovens in place

of the common cook stoves. There is no chosen method up to this point that is sweeping across Latin

America, but any effort to help is an effort made in the right direction.

Analysis

Can it be eradicated through nutritional and health based means?

Now that the issue has been discovered, how can it be solved? I cannot say at this moment that

the issue of toxicity due to cooking methods in Sololá can be eradicated through any one mean, but I can

state that I have a vision and a plan I intend to carry out so that it can be realized.

It has been my dream since I was a child to help people in need—to find those individuals whose

needs were so basic that I myself, took for granted what they completely lacked. Sololá, Guatemala, is

where my outreach has begun, but my desire is to create global change through humanitarian aid. I will

assist in providing alternate cooking methods, better living conditions, and nutritional education to

those in need. All of this will come to the village of Sololá, free of any charge to them and with the hope

that the education and aid will be passed on to their future generations.

What can I do to positively effect change in Sololá, Guatemala?

After returning home, I was able to take time to reflect over the mission and notice how each

area of emphasis I had chosen played a great role in my success in Sololá. But what was it going to help

me do now? The first problem that needs to be solved is a replacement method of cooking within the

homes of this village. I have already contacted companies that specialize in solar energy and I plan to

continue finding more companies willing to contribute resources. One of the organizations that was

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IMPROVING HEALTH IN SOLOLÁ, GUATEMALA, THROUGH INNOVATED COOKING METHODS 18

willing to help in my project is called SunFlair. They create environmentally friendly solar ovens of

different sizes and functions (see Appendix C). These ovens are marketed for outdoor recreational use

online and can be purchased by the general public. After speaking with the organization, they agreed to

sell their solar ovens at cost in order to help further my project. I have contacted businesses and

individuals who would be willing to sponsor families in Sololá. My short-term goal is to provide at least

fifty families with alternate cooking means before we return to Guatemala in 2017. I am half way to this

goal, and I have many more steps to pursue (see Table 5).

Table 5Future Steps Continue contact with Biolite/Sunflair for donation implementation Reach goal to cover 50 families in Sololá by receiving donation of $2500 before January

2017 Ensure shipment of stoves to Guatemala before March 2017 Design & practice seminar for implementation of alternate methods of cooking to the

people in Sololá. (Spanish) Travel back to Guatemala April 2017 Prepare & distribute ovens and handouts centered on MyPlate information to encourage a

better lifestyle. Pick focus families in Sololá and record outcomes to prep for future missions. Return from Guatemala May2017 Review results and impact of stoves. Find new communities in need of this project.

Thanks to the BIS Program at Weber State University, I was able to create this project and

expand my horizons. This project gave me the opportunity to not only graduate and see the personal

benefits of education, but it also allowed me the chance to change the lives of others along the way.

Each department played a crucial role in developing my project and preparing me for a future career.

Studying Spanish through Weber State University’s Foreign Language Department was the basis

for all the future career plans and goals that I had set. I have always had a deep fascination for languages

and Weber State facilitated a way for me to finally connect with the Spanish language and gain

understanding of the language as a whole.

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Nutrition has always been a very important subject to me. I have been blessed with the ability to

focus on nutrition as an academic pursuit, whereas the people I served in Guatemala see nutrition

through the lens of survival. Based on what I have learned at WSU and through continued study, I can

reach out and teach the importance of nutrition and healthy lifestyles. These lessons have the potential

to change the lives of an indigenous village in Guatemala and expand to other countries in the future.

The knowledge I gained through Latin American Studies provided me with a new cultural

perspective. I believe that the cultural proficiency that I have gained has allowed me to see past spoken

languages and into the heart of the Latin American people. There is more to an individual than simply

their language. The language in and of itself tells a story that must be culturally defined in order to truly

connect. The education that I earned through each of these departments is invaluable to me. With the

education that I have gained, I can begin a new career focused on humanitarian aid.

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References

Brittin, H. C. (2011). The Food and Culture Around the World Handbook. Boston, MA: Prentice Hall.

Choose MyPlate. (n.d.). Retrieved October 6, 2016, from https://www.choosemyplate.gov/

Kittler, P. G., Sucher, K., & Nahikian-Nelms, M. (2016). Food and Culture. Australia: Wadsworth.

McDonald, M. R. (2009). Food Culture in Central America. Santa Barbara, CA: Greenwood Press.

McLeod, S. (2013). Maslow's Hierarchy of Needs. Retrieved October 8, 2016, from http://www.simplypsychology.org/maslow.html

Pope, D., Diaz, E., Smith-Sivertsen, T., Lie, R. T., Bakke, P., Balmes, J. R.,Bruce, N. G. (2015). Erratum: “Exposure to Household Air Pollution from Wood Combustion and Association with Respiratory Symptoms and Lung Function in Nonsmoking Women: Results from the RESPIRE Trial, Guatemala”. EHP Environmental Health Perspectives, 124(3), 285-292. doi:10.1289/ehp.124-a48

PracticingSpanish.com - Medical Spanish. (n.d.). Retrieved October 7, 2016, from http://www.practicingspanish.com/culture.html

USAID. (n.d.). Guatemala: Nutrition Profile. Retrieved November 13, 2016, from https://www.usaid.gov/what-we-do/global-health/nutrition/countries/guatemala-nutrition-profile

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APPENDIX AAUDIT REPORT

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Date Description Time Total Hours

1/30/2016 Found Love in Action organization, emailed and contacted Miriam Lemon 2-3pm, 6-8pm 4

2/3/2016 Found out more about Love in Action organization, time schedule and details 11-12pm 1

2/14/2016 Finalized plans and payment for trip, over the phone and through email with Miriam Lemon 5-8pm 3

4/2/2016 Met with Dr. Smith for the first time to discuss Guatemala trip 10-12pm 24/9/2016 Finalized plans with Dr. Smith in person, 2nd time 6-8:15pm 2.254/15/2016 Guatemala- Traveling, flight to Guatemala 3pm-12:15am 9.25

4/16/2016Guatemala- Arrived in Guatemala 5am, met medical staff at Barceló Hotel, 5 hour drive to Sololá, met rest of staff at compound

6:30am-8:30pm 14

4/17/2016 Guatemala-Set up medical booths and pharmacy, Began interpretation for Dr. Smith 6:30am-8:30pm 14

4/18/2016 Guatemala- Interpreted for Dr. Smith 6:30am-8:30pm 14

4/19/2016 Guatemala- Interpreted for Dr. Smith, Helped with prescriptions and care of children 6:30am-8:30pm 14

4/20/2016Guatemala- Interpreted during operation, several more visits, Break times spent with children, had medical staff dinner—no English spoken at the table, helped interpret

6:30am-8:30pm 14

4/21/2016 Guatemala- Travel Day, Interpreted for medical team in Antigua 6:30am-8:30pm 14

4/22/2016Guatemala- Travel Day, Interpreted for medical team, toured town and living conditions, tourist attractions contacted local and patients unable to leave their homes

6:30am-8:30pm 14

4/23/2016 Guatemala- Travel Day, airport for journey home 5am-5pm 12

5/25/2016 Journal Entry’s compiled from trip to Guatemala, housing, visa, country requirements, people 11-12:30am 1.5

5/27/2016Journal entries compiled from trip to Guatemala: doctors, operations, needed expenditures, photos. Began writing Capstone outine

7-9pm 2

7/24/2016 Searched and found Solar Ovens and emailed companies 10-12pm 27/26/2016 Contacted Sunflair and set up deal 9-11:15am 2.25

7/27/2016 Shipping solar ovens configuring and logistics- contacted Love in Action business director 10-12am 2

8/2/2016 Created flyer notes and compiled on computer 5-8pm 38/6/2016 Updated Flyers after review from peers 9-9:45pm 0.758/15/2016 Met with Mr. Mueller, associated food contact 10-11am 1

8/17/2016 Met with owner "Just-a-break" foundation Greg Thorpe, discussed non-profit and donations 10:45-12:30 1.75

8/23/2016 PayPal set up for receiving donations online and through email 10-11:30pm 1.5

8/25/2016 Donor perfect set up in place of PayPal to receive payment, 3-6pm 3

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Linked and Facebook posted8/30/2016 Grammar adjusted on flyer 12-1pm 1

9/4/2016 Met with Dr. Laurence to discuss other donors and direction from the trip for the project 7-9pm 2

9/6/2016 Met with Greg Thorpe to learn how to set up means of payment and who to contact for donations 9-10:30am 1.5

9/8/2016 Met with Woodruff's for explanation and donations 9-10:30pm 1.5

9/17/2016Contacting potential donors for project at family event and on personal time. Devin Reed, Rob Summers, Dave Lowry, Greg Lofgran, and Jason Kuipec

1-6pm 5

9/25/2016 Contacted Borgstrom family to spread word of mouth and collect donations 4-5:30pm 1.5

10/1/2016 Emailed Donors and set up Facebook post about donations 11-2pm 3

10/2/2016 Emailed/Called Emily Lemon about how to follow up with donors , follow up with Woodruffs 7-8pm 1.5

10/3/2016 Contacted Kimber Kable- donation given 2 days later 11-12am 1

10/12/2016 Follow up meeting with Dr. Laurence about common illness found 3-5pm 2

10/20/2016Finalize project details with Miriam Lemon (Director) and spoke with Emily Lemon (Business Manager) in regards to paperwork for affiliation with Weber state

11-12pm 1

Total Hours: 173.25

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APPENDIX BPHOTOS