Nourishing a Community
A nutrition counsellor discusses the challenges of ensuring patients have a healthy diet
The day starts early for Tayebe Sadat, one of the few full-time, professional working mothers in Afghanistan. As a nutrition counsellor, a European Union grant supports her role at the Ali Chopan Health Clinic in Mazar, in the north of the country.
Tayebe prepares herself a nourishing breakfast of eggs and glass of milk and breastfeeds her 7-month-old baby, Elina. Recently, Tayebe has also begun to introduce foods, such as soft fruit and bread dipped in meat gravy, into Elina’s diet – guidance that she shares with the mothers she counsels at the clinic.
In Mazar, there are often unpredictable electricity outages and water shortages which can make leaving for work on time difficult for Tayebe.
“It’s always a rush to get out of the house and remember everything I need for Elina during the day.”
Holding Elina tight, Tayebe leaves the house at 07:30 and walks 4 kms to work. It takes her around 25 minutes to get to the clinic. With temperatures as high as 45C, it can be a tiring journey. As she walks, her mind often wanders. She worries about the deteriorating security in her country, the drought, and how her patients, mostly impoverished mothers, will cope as nutritious food becomes more difficult to find.
Having completed 14 years of education, Tayebe has been a nutrition counsellor for the last 6 years. She loves her job and is motivated by the desire to help mothers and children in the community in which she grew up to be healthier and happier.
Sometimes patients ask her questions she can’t answer which frustrates her. But she’s ambitious. She plans to study medicine and become a Doctor.
The clinic is open from 08:00 to 16:00. It is a busy facility and Tayebe is only able to spend around 10-15 minutes with each mother. Depending on their level of literacy, she counsels them using charts and photographs to show them what to eat, how to cook and how to breastfeed.
“As a working mother, I know I’m unusual in Afghanistan, and I’m very lucky to have such supportive colleagues. Elina gets so much attention and love every day. There’s always someone to cuddle her. I make sure to have moments dedicated to Elina throughout the day to keep her stimulated. Being able to take a break and bring her to the garden is so important. In the clinic, the air is heavy with sickness and grief; out here, it’s clean and fresh and healthy. It calms us both down and I feel rejuvenated.”
"My patients are often poor women. When I ask them about healthy diets, they get embarrassed and shift their feet nervously. Then, we talk about their situations at home and I change from being a nutrition counsellor to a mental health counsellor. I have to be resourceful and think about what works for them in their circumstances. They can’t afford meat. So, for example, I tell them, ‘maybe your neighbour has a cow, and you could ask for a cup of milk; if he has hens, ask for an egg; if you have grains, you can cook them with vegetables for a nutritious meal.’
"Being a working mother is a balance. Having Elina with me in the clinic can be difficult because I have a lot of mothers to counsel; I also have a lot of responsibilities at home so it’s tiring. But I try to care for Elina first, and feed her and give her time, while doing all I can for the patients who come to see me. I know that my job is important and already this role has proved so worthwhile. We can see the impact of the counseling on our nutrition charts. My greatest joy is when I see what I say making a difference. With more time, we will have even more impact.”
“The best thing about my job is finding a mother who doesn’t know about healthy diets; often her child will be malnourished. Then, hand in hand, we go through the process of nourishing the child and educating the mother. The mother listens and begins to use ingredients differently to cook better food, and then, slowly, slowly, we see the child gain weight and become more energized. It’s not easy because the people are poor and don’t have much money to buy nutritious food but I tell them that with some small changes they can, for example, cook beans with a vegetable for a healthy meal.”