Eat, Paint, Love… and Diabetes

When I was coming to Vanuatu I expected to arrive in a land that was overflowing with exotic fruits and vegetables, to live with a coconut in my hand and a freshly caught fish on the dinner table (too bad that I’m actually allergic 🐟💀 but whatever, a girl can dream). What I expected was a real-life cornucopia of strange and enticing foods. The reality, however, was ultimately very shocking; not only is the food generally unvaried, the nation of Vanuatu is suffering from a crippling health epidemic which stems from this very issue.

Before I go any further, I will state that every island in Vanuatu is very, very different in terms of the availability and variety of food. On Ambrym, for example, the open air markets are few and far between and usually sport only a few bundles of wild yams, cabbage, and maybe the occasional onion. Malekula, on the other hand, has a number of road side stalls as well as a lively market in the provincial center of Lakatoro. There you can find a multitude of seasonal fruits and veggies, crabs, eggs, and even steak! My friend Matt, a PCV on Erromango, regularly goes spearfishing and treats himself (as well as his community) to some particularly tasty looking fish. The environmental diversity across these islands is nothing short of impressive. Nevertheless, Vanuatu as a whole is suffering from a serious health crisis. The problem? Diabetes.

In 2016, Vanuatu was ranked 6th in the world for the prevalence of Type II diabetes. This was a shocking revelation for the tiny nation, which is made up of a little more than a quarter of a million people. How exactly did this happen? In a 2014 WHO report, it was found that approximately 64% of the adult population was overweight, a key risk factor in the development of diabetes. Yet, despite the high prevalence of overweight and obese individuals, inactivity was surprisingly low.

This was something that I personally noticed within my own community; there are a shocking number of heavier individuals despite the fact that practically everyone, despite their age or health, walks considerable distances to go work in their gardens every day. As someone who has attempted to cultivate a bush garden (which is just a plot of cleared land in the jungle), I can tell you that it’s quite the punishing workout. Had I stuck with it, I’d probably have some pretty impressive island cannons by now! 💪🏻

So, why has diabetes become such a menace in the past few years? The Ministry of Health has attributed the increase to lifestyle changes, namely when it comes to food, that have gone unchecked in many communities thus far. Cheaply priced white rice, for example, has come to dominate the standard Ni-Vanuatu diet, consequently replacing traditional forms of aelan kakae (tr. island food). Nowadays many meals involve an impressively large mound of rice that dominates the plate, topped with a small amount of boiled vegetables (usually cabbage or manioc) and/or maybe some source of protein. On Ambrym, I’ve noticed that it’s not uncommon to have a meal comprised exclusively of carbohydrates and individuals (namely my aunties) are aghast when I insist on eating rice or noodles, but not both. With these factors in mind, nutritional awareness in communities is something many volunteers attempt to address. Unfortunately, terms such as “carbohydrate” or “glucose” don’t really exist in Bislama, making the task something of a translational nightmare. Even then, most Ni-vans are aware that they shouldn’t consume large amounts of rice and eat a balanced diet, but when rice and chips are cheap and readily available compared to the locally grown alternatives, it’s understandably a hard sell. In places where access to medical care is scarce and the consequences of conditions (such as diabetes) are poorly translated or understood, many locals fail to perceive the correlation between poor diet and poor health.

So how do you sell nutrition to isolated island communities while successfully crossing the language barrier? Although I most certainly don’t have all of the answers, another PCV and I took steps to address this issue. Considering that murals are ubiquitous in the US, many of us take their power of communication for granted. In a nation where murals are few and far between, however, these things can get peoples’ attention. Peace Corps has already recognized this fact; murals of the world map accompanied by the PC dove is a universal sign that a PCV has been at a site. Cyclone tracking maps are common project here in Vanuatu as well. If a picture is worth a thousand words, a strategically placed mural is worth tenfold.

In the past few months I’ve completed two murals depicting the three kinds of healthy aelan kakae commonly found across the islands accompanied by their relative proportions in a meal. The first was completed in Endu, a village in SE Ambrym not far from my own. The idea belonged to PCV Aaron Hilliker, a friend and health volunteer who was in the process of sprucing up his dispensary with several health-themed murals. A few weeks ago I completed my second mural, this one at PCV Maggie O’Grady’s aid post in Vao, Malekula (pictured below).

The mural took three days to complete and it was something of a performance piece for the villagers on Vao, small island. As I painted, those waiting to see the nurse would sit and watch, often attracting the attention of others. There were several times I was shocked to find a small crowd of entranced and impressively silent children sitting behind me. Our constant music-playing and The Killers singalong were also another draw. Although I personally don’t take much pleasure in being treated like a side-show, I realized how important it was for this information to be on the front of their aid post. It’s one thing to see this information on one of dozens of official health awareness posters dotting the aid post wall and another when it’s painted larger-than-life for all to see.

Do I think that this will have an immediate effect on these communities? Probably not. This being said, however, many PCVs are taking the first, albeit infinitesimal, steps towards addressing this issue within our communities. If you want to make a change, getting peoples’ attention is the first step. We can only go up from here!

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