Speech Cindy bij presentatie
van de boekjes met voedingsrichtlijnen
Deze speech is gehouden tijdens
een presentatie die ik samen met Naa Ashiley Van der
Puye heb gegeven op 21 april 2005 in het gebouw van
de UNDP in Accra.
De presentatie was gericht op
het verschijnen van het educatie materiaal op het gebied
van leefstijl en voeding die voor patiënten, familie
en verzorgers en gezondheidsmedewerkers zijn ontwikkeld.
Genodigden waren belangen organisaties voor mensen die
leven met HIV/AIDS, gezondheidscentra en ziekenhuizen,
lokale, nationale en internationale NGO's.
De locatie was beschikbaar gesteld
door de UNDP omdat mijn deelname aan het Leadership
for Development Programm van de UNDP heeft bijgedragen
tot het realiseren van dit project.
een aantal pagina´s van het ontwikkelde educatiemateriaal
door de PDF bestanden te downloaden (klik op de plaatjes
onderaan de speech of op de links in de kolom rechtsboven).
Om de PDF's te bekijken, heb je Acrobat Reader nodig
(zie link in de gele kolom).
Introduction my myself
First of all, I would like
to introduce myself to the people who havent met
me before. My name is Cindy Noordermeer, I am from the
Netherlands and I am a dietician by profession. Almost
two years ago, I came to Ghana to work as a volunteer
with Naa Ashiley at the International Health Care Centre.
This was not the first time for me coming to Ghana.
In 1999, I conducted my traineeship with the University
of Development Studies in Tamale. And the decision to
come back to Ghana was based on a wish to get more experience
on living and working in an African country. And I really
hope that this experience forms a fundament towards
a professional future in the field of International
Motivation for this project
Mister Kofi Nyarko and Yaw were the first patients I
met in my life, who where living with AIDS at that time.
And immediately I met them, I realized the importance
of nutrition in the care and support system for people
living with HIV/AIDS. Both patients faced all the food
related problems you can imagine. Yaw was the most wasted
person I had ever seen in my life and I was surprised
that he was even still alive. He was running diarrhea
day and night and his appetite was extremely low. His
mouth was full of fungal infection and sores. He had
no money to buy food.
Mister Kofi Nyarko was also very
wasted. Lack of exercise made him fully constipated.
He was a Fanti and continued eating white bread and
tea, which did not really contribute to the solution
of the problem. The constipation made him nauseous.
The wife finished all the money on buying expensive
foreign foods, what she thought was more healthy. The
Within the care and support programs, there seems to
be a gap where nutrition is concerned. is a gap (although
more and more is done by for example OIC and CRS).
Fresh in Ghana, I tried to put
all different kinds of structures in place in order
to fill this gap. But realized that I will be in Ghana
for a relative short time and will again leave a gap
I went round from institution to institution, looking
for practical information on nutrition and HIV/AIDS
in Ghana to be used in the clinic. But at that time,
I could not find where I was looking for.
How to fill the gap
Almost half a year later, the idea came up to develop
something by ourselves. A practical guideline adjusted
to the system and close to the understanding of the
people. In order to reach the people from the rural
areas coming to the clinic, I wanted to gain experience
about life in the rural areas. My interest in the rural
areas made me meet somebody who became interested in
my plan. I taught if I can develop something fitting
in the rural areas, it will also fit the urban
areas. Linking his organization in the north with the
clinic in the south and in this way reaching both areas
seemed a very good idea.
All nice ideas, but after a half year volunteering,
my pockets became empty and I had to find a solution
for getting means. Getting funding was also a whole
story all together, I almost taught that my idea will
only be an idea forever...but this is where the LDP
Role of the LDP
Luckily for me, I was introduced at the UNDP and could
take part in the Leadership Development Program in Elmina.
A program existing of three trainings between November
2003 to April 2004. A training which inspired me a lot.
And the goal is to create new type of leadership and
develop a breakthrough mentality that is needed to generate
a necessary change in local leadership approach to combating
the HIV/AIDS menace in the communities, institutions
and workplace. The training is carried out in many African
and Asian countries and has led to breakthrough initiatives
in the fight against HIV/AIDS.
I am grateful that I could take part. I applied the
skills on my own level and created opportunities for
my own initiatives. A message I take along since then
is that when you are inspired, you inspire others and
when others are inspired what is impossible becomes
possible. The inspiration I got from the UNDP and also
from the work spirit and commitment of Naa Ashiley made
me inspire others. I went to the Netherlands and organized
a fundraising campaign for the realization of our idea.
And although I faced many breakdowns as a manager of
my own project, I was committed to accomplish my initiative.
Thank you UNDP.
Before I will tell you more about the breakthroughs
and our result, I would like to share my constraints
with you. What is always nice to do afterwards.
Focusing myself on my own project is something I find
very difficult. The problems I saw around me, made me
start all different kinds of side-line projects and
activities. The number of people facing problems is
enormous and I wanted to carry everybody's load. And
in the end, there was only small time left to work on
my main project.
In total I spent 7 months in
the Upper West and I am very glad to have had this experience.
But working over there was extremely difficult. Comparing
the care and support system in Accra and Wa, the difference
is enormous. Despite the effort of some organizations,
the care and support is very very poor. Like in Accra,
I was touched by the problems faced by people living
with HIV/AIDS and tried to do all different kinds of
things to help them. I cycled to layed-back villages
where, due to marital tradition the virus spread within
the family and sometimes more than 15 orphans are left
behind. The high stigmatization, poverty and lack of
medical care made me see many people dying of the disease.
I really made a good start with the project. I mobilized
PLWHAs themselves to contribute towards the content.
Because I wanted to develop a guideline together with
the people who are going to patronize it.
But I involved myself too much in the personal problems
faced by the members, that I tried to help them carry
their load, and my own nutrition project lost its priority
for a while.
Coming back to Accra, people
asked me about my main project and I realized that when
I want to achieve something, I have to focus me on it.
I decided to come back to Accra, where there is more
access to information and support.
I came back to the clinic where I integrated the knowledge
from the north into the nutritional guideline. Accomplishing
a material for people in the urban and rural area as
If I look back at the two years
behind me, I have to laugh. I really taught, I knew
a lot. But if I am honest, what does a young obruni
in the complex world of HIV/AIDS in Ghana really know
in the beginning. I made many mistakes, and I went through
a process of trusting the wrong people, having high
objectives and not knowing exactly how and where to
pass. I realize that mistakes I made out of ignorance
made me insecure about my project, my result.
I was surprised to receive all
the positive reactions afterwards, what made me decide
to print higher number and let more people benefit from
it. If I had been so sure about myself and could have
kept my focus during the whole project, I would have
involved more institutions.
A breakthrough is that we are standing here, with a
finished a practical nutritional guideline based on
the Ghanaian traditional foods and culture. We printed
3000 copies and created possibilities for reprinting.
We also finished a second booklet about the aspects
of Positive Living in general.
The first booklet is a guideline that could be used
in health settings with or without professional nutritional
staff. In the IHCC for example, we dont have a
permanent nutritionist yet who will be continuously
available. But the counselors and/or ward assistant
can implement nutritional support by using the guideline.
The content is based on already
existing theory and research, I have translated this
into practical materials for the field. The most important
Eating well is important for
everybody, but especially for people living with HIV/AIDS.
Poor nutrition is very common in people with HIV/AIDS.
Poor nutrition can be seen as a vicious cycle; with
weight loss leading to decreased immune function, causing
more infections, resulting in poor intake and digestions
and more weight loss.
A good diet can help prevent
the cycle of weight loss, help maintain and improve
well-being, and contribute to the quality of life. Officially
there is no special diet for people who are HIV positive,
like there are diets for diseases like diabetes, kidney
failure etc. Our goal is to teach people the importance
and the basics about eating well and enjoying eating.
Advices for maintaining weight and minimizing the common
eating problems of people living with HIV/AIDS. Educating
people how to eat well can help them feel more in control
of their disease and their life.
More and more information is
becoming available about the positive effect of certain
food items and nutrients, that have positive effects
on the immune system. A very interesting area, especially
for areas where medication is not available. But going
into this area is going on scientific ground, and is
an area for future work.
The second booklet was very spontaneous.
Due to the high illiteracy and stigma, I used metaphor
to explain information in the Upper-West. The motorbike
is common over there. I had a motorbike myself in the
north and drove with my friend all the way from Wa to
Accra. Sitting on the back of the motorbike I got the
idea to develop this booklet on positive living, based
on the way people can look down upon themselves. I wanted
to draw them in a beautiful traditional way, to dispute
this negative attitude.
I suggest to go together through the booklets together.....
Future the booklet
We advise to use the booklets as educational materials
in health centers.
We printed 3000 copies of the nutritional guideline
and 1000 copies of the one about positive living. And
we would like to donate the in the following way:
Main treatment centers:
1000 copies to the Korle Bu Hospital...thanks
to Arjan Hogewoning
500 copies to Gavernoty Hospital in Kumasi.
200 copies to Agomoya...thanks to doctor Richard Amenyah.
200 copies to Anastasia Navele... for the Upper West
300 copies to the Ghana AIDS Commission, for all the
10 to every support association
5 copies to all the clinics and institutions working
in the field of care and support
We stimulate dissemination of
the guideline, and stimulate reprinting. The rest of
the health centers can apply at the IHCC.
Although very knowledgeable people involved themselves
in the project, we have already received advise for
adjustments for reprinting. We would really like if
everybody who came here will give their advises for
adjustment for a possible second version. Please, leave
your information behind, if you are working in care
and support area. Probably, within one year, I will
come back to Ghana and contact you for this information.
In this way we can work together towards a maximum result.
Also personally, this project is just a beginning. By
next month, I will go back to my country and start a
two years master in International Public Health. I really
hope you will hear from me in the future and wish everybody
who is fighting the pandemic in their own way all the
best. From the Netherlands, I will continue spreading
NACP/GAC - UNDP (Robert) - Yamens (Edmund Opari and
Mister Lamptey) - IHCC (Naa Ashiley) - Anastasia Navele
- Donors - Positive Living People - Apollo.
Het Nutrition booklet:
Het Positive living booklet: