Swedish Family Medicine Gardening Project Fights Malnutrition Among Children in Rural Nicaragua

Swedish Family Medicine Gardening Project Fights Malnutrition Among Children in Rural Nicaragua

SEATTLE, May 19, 2009 -- Malnutrition, especially among children, is a constant concern in many corners of the world. For families in the town of Mulukuku, in rural eastern Nicaragua, that concern may significantly diminish in coming years.

With the help of two Swedish physicians, the Mulukuku School and Community Gardens Project kicked off in April 2009. The project's primary goal: to develop school gardens to combat poor nutrition and improve public health. The secondary goal is youth leadership development.

"This region of Nicaragua has some of the country's highest malnutrition levels," said Scarlet Soriano, M.D., a Family Medicine resident at Swedish's Cherry Hill Campus. "With this project, we're hoping to enhance the local diet with foods that are known by the community, but are too expensive to purchase at market."

Valory Wangler, M.D., initiated the project a couple of years ago after learning about malnutrition in Mulukuku from Dorothy Granada, one of the leaders of the Maria Luisa Ortiz Women's Health Cooperative. "Swedish has an ongoing relationship with the cooperative," said Dr. Wangler, also a Cherry Hill Family Medicine resident.

"We learned that children in the region had deficiencies in micronutrients – the most common type of malnutrition in Nicaragua. These are deficiencies in vitamin A, a leading cause of blindness, and iron and zinc. We wanted to help."

Gardens in Mulukuku

The standard diet among Mulukuku's children is rice, beans and corn. Carrots, beets, green leafy vegetables, potatoes and legumes offer the missing micronutrients and are familiar, though usually unaffordable, vegetables. They were the main crops planted at the five schools selected as pilots for the project.

Parents, teachers, principals and students were all encouraged to participate in the gardening. The project will support and expand existing efforts by the Ministry of Education and the National Program for School Nutrition to include 'school gardens' in the official school curricula and improve the diet of children.

"We wanted to complement an effort that was already in place," says Dr. Soriano. "To be successful, we knew that the project had to be important to the community."

At each of the schools, training was held on health, nutrition and hygiene, as well as gardening. Six agricultural students from a nearby university are providing technical skills and expertise, in areas ranging from pest control to harvesting seeds.

To fund the project – to purchase seeds and gardening tools – Drs. Wangler and Soriano applied for, and were awarded, a $5,000 grant from the Seattle International Foundation. They then spent the month of April in Mulukuku, working to get the project off the ground and developing a five-year continuity plan.

Youth Leadership

The two Swedish physicians also developed a youth leadership curriculum for the local students, to help ensure the continuity plan fulfills its promise. The curriculum focuses on skills that can be applied to life, as well as gardening, and the youth will be trained to be 'multipliers' so they can pass on what they learn to others. This will help the gardening project reach its next objective: expanding into 12 more schools.

"We put together a manual that will be used to train youth leaders," said Dr. Soriano. "Everybody was incredibly enthusiastic and we received overwhelming support, which gives us great faith that this project will blossom."

Though neither Dr. Soriano nor Dr. Wangler – both of whom are fluent in Spanish – has plans at this time to return to Mulukuku, they do hope the project, which completed their International Medicine area of concentration, will receive follow-up attention by a future Swedish Family Medicine resident.

"This was really a unique opportunity," said Dr. Wangler, "to design a public-health project that serves a community and provides a solution to a need the community had identified as crucial to the health of children."

Since 1974, the mission of the Swedish Family Medicine Residency Program has been to improve the well being and health of the medically and socially underserved by training doctors to provide comprehensive, high quality, and continuous health care to diverse populations. There is also a Family Medicine Residency Program on Swedish's First Hill Campus.

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