Working In the Rain

Things have been a bit hectic here and we've had to do a lot of rearranging of our plans this week! The safari was amazing and we had a great time! We also missed most of the REALLY terrible weather that was here in Cape Town. We don't know if you heard but it rained a lot and that caused a lot of flooding. This was partly what caused us to have to rearrange our plans! Because of the rain, the club members have not shown up for the past 2 weeks. We have yet to give them the menu because of the rain. So we had to figure out something fast, we couldn't wait ANOTHER week to give out the menu because we don't have another week! We called the two women who run the health club and live in Khayelitsha and they came to meet us at the health club. We gave the menus to them as well as the journals and we gave them the directions for what we wanted the health club members to do. They said that they will give out the menus to

the health club members, that way by Thursday they can already be trying out the menus and we can start receiving some feed back. We were a little concerned for a while that this project was not going to happen because of the weather. But we are glad that the health club members have the menus, that they are now being tried out, and that hopefully we are receiving a lot of feed back!

However, we are very concerned about our report now. We have been working on the report steadily over the entire time we've been here, so we have the goals of our project, the methods, and an introduction. However, we have no raw data and we definitely haven't been able to analyze any data. But we are hoping that at the last minute everything will come together!

Hostel, Omelets, and Journals

We went forward with the project this week. On Thursday we went into Khayelitsha and we were able to meet with almost 20 of the club members! We made them omelets to try and then told them how to make the omelets and how much it would cost to make per serving. They were really receptive to it and it looked like they really enjoyed it! We also were able to give the initial introduction survey to get a feel for how much people already knew about the South African dietary guidelines and how much they were already following it. We then were able to present the South African dietary guidelines through our translator. The reason we wanted to present the guidelines was to refresh the memory of those who were aware of them and to give the information to those who didn't know the guidelines. We believe that our goal is not to just give them a menu and to have them follow it; instead, our goal is to actually make them aware of their diet and how to change it so that they will be healthier. So we thought the first step in this is to make sure that everyone was aware of the dietary guidelines, how many fruits/vegetables/starches/etc they should be eating, what foods are in those categories, portion sizes, things to be wary of, and the importance of a diverse diet. The ladies were really receptive and our translator, although still very liberal with her translations, was helpful and included some anecdotes about what foods to wary of, like fizzy drinks/coke, that really helped the club members to understand what we were discussing. We had also wanted to present the menu to the club members this week, but the menu is still being reviewed by the dietician at the UWC. After revising it, we sent it to Thandi and from her suggestions made even more changes.

Though we did not present the menu on Thursday, we were able to tell them how we made the menu (their answers from the interview + the South African dietary guidelines) and about the journals. We bought the journals and pencils that when we do present the menu we will hand out to them so that they can write down if they were able to follow the menu, if they couldn't why not, what they liked about it or didn't like the menu, and just on a day to day basis how it was to follow the menu. Apart from the original surveys, the journals are the way that we are going to measure the success of the menu. The journals will be the best indicator of what worked and what didn't about the menu. So we really tried to impress upon them that when we do pass out the menu, that the journal is a really important part of following the menu. We figured that the more we mention the journals, the better it will be and then they know clearly what we want in the journal.

On a personal note, we love Cape Town but we are anxiously awaiting our safari! Both of us are just really excited about it and so the days seem to be creeping by a little slowly! Ha ha! It?s OK, but Cape Town has been beautiful this week. We also met up with the other Duke Engage group that is here doing a project on recording the memories of the anti-apartheid movement and service projects. It has been really nice to meet up with them and it's amazing because it has made us realize a few things. First, how far we've come since our first days in Cape Town! We just feel so comfortable here and we know our ways around really well! We're both very happy that our group is so small. We like the fact that we have each other but we also like the fact that we can't just shut our selves off to the rest of Cape Town and we are able to easily socialize with people from all over. We also feel lucky to be staying in the hostel! In case you haven't noticed, we LOVE our hostel! It was probably the best decision we made! We feel that staying in the hostel and being in a smaller group has allowed us to really experience Cape Town.

Tentative Plan for the Coming Days/Weeks

• This Thursday, the 19th, we will present our menu and passing out the journals for the health club members to keep track of how the menu works for them. We will also be giving the introduction survey that has been translated and will give us a good idea as to current diet habits before the menu and then we'll take another one at the end to see how and if people's habits have changed.

• Next Thursday, the 26th,we will present the dietary guide lines as well as to how the menu fits those guidelines

• The 3rd of July we will leave for the Safari which is Friday through Monday and then we will return on Tuesday night.

• The 10th of July we will be interviewing the community health club members who participated in using the menu and asking them how it went, what they liked, didn't like, would change, etc.We will also collect the journals.

• On the 14th, based upon what the journals and the interviews revealed we will be modifying the menu and will re-present it to the health club members.

• The 22 we will be going in to take the final survey and adding those results to our report.

• After the 22nd until we leave, we will be finishing up the report for Thandi. So we will be spending a lot of time in the library.

This is still a tentative schedule, it could change depending on if attendance is regular and everything but we are pretty optimistic!

Health Clubs in Winter in South Africa

So it’s been about a week and a half since arriving in South Africa and we have been busy both adjusting to life here and to work! As you know, we’ve moved from Dr. Puoane's house to a hostel in Cape Town proper.

As far as experiencing the Cape Town culture, Sarah and I have been playing tourist a bit with seeing Table Mountain, Boulder Beach where there are African Penguins, and taking a hop on-hop off bus around town. We are hoping to go to Robben Island on Monday and Cape Point when the weather is nice. We’ve also been just walking around Cape Town’s popular Long Street, listening to lots of South African music, and talking to the hostel owners about anything and everything South African!

As far as work goes- we’ve now been into Khayelitsha twice, last Thursday and this Thursday to see the health club, meet the women that own it, the members, and see their routine. The health club is slow in the winter because many of the members are elderly and suffer from arthritis or do not want to brave the cold or the rain. So last Thursday, none of the members came because it was raining and this Thursday only 5 came because many of them had the flu. However, Sarah and I have been taking it all in and making relationships with the Community Health Workers, seeking their advice for the project we are working on. As far as that goes, Dr. Puoane has asked us to interview the members about current exercise and dietary habits in order to create a menu for the health club that they can follow given cultural and financial restrictions and the accessibly to food. I’ve included in this e mail the questions that we came up with and that Dr. Puoane has gone over. We’ll be asking these questions next Thursday when we meet with hopefully more members of the group. During the meeting next week, we plan to conduct this interview as a focus group type session. Based on their answers, we will design a menu with the South African dietary needs in mind and taking the foods that are accessible to them, cheap, and that they like to eat. The following Thursday, we will present our menu that we have made from the previous weeks interview, pass out journals (which I will explain) and have them take a written survey. This written survey which Sarah will include in her e mail, will be given twice, once at the beginning and once at the end. We decided that taking weight, body measurements, and blood pressure may not be helpful because we will not see a noticeable or accurately measurable difference in 8 weeks. Instead, by taking the intro and outro survey, we can see if people were able to incorporate the foods from the menu and lessons from the dietary guidelines into their daily life. For example, we are hoping that someone who only ate 2 servings of fruit at the beginning of the project will be able to incorporate 5 servings at the end and that the survey will reflect this change. From the survey, we will be able to make any conclusions about how successful the menu was or not. We also plan to give the health club members journals and pens so that they can write down if they follow the menu, if they like it, if they don’t follow it and why they don’t follow it. The journals will be really important for us to know why people don’t follow the menu and why they do. We will pass out the journals when we present the menu. The following week, after we’ve passed out the menu, journals, and intro survey we want to present to them the South Africa food based dietary guidelines so that they can understand what foods are important, why, and also why the menu is set up in a certain way to include the amounts of certain foods and types of foods. We also want to talk about portion size and perhaps even if time allows get some feed back on how the menu is going. If that doesn’t work out then we will wait until the next week to receive any sort of feed back.

Also work related, Sarah and I have already started to keep notes on how we are approaching the project in order to have it ready for when we write a final paper for Thandi before we leave.

So far, the only obstacle to our work plan is the fact that the attendance of the health club is sporadic and doesn’t look too promising since it is winter. Sarah and I were ready with the group interview questions today in hopes of getting started on the menu this weekend but since we were missing a lot of club members we had to post pone our interview until next week. So to solve this we’ve though of a few things. First, we’ve decided that instead of going in to Khayelitsha every day or even only twice a week to one of the health clubs (there are two health clubs, one meets on Monday and Wednesday and the other meets on Tuesday and Thursday), that we will only go in once a week in the hopes that the bulk of the members will decide to come when we are there and participate in the research work. We have also decided to provide an even stronger incentive to the club members for coming: lunch! Since it is cold and we are discussing food, we have provided the health club community workers with funds to make a vegetable soup for the club members in hopes that more will brave the cold weather for hot food. This will also give us a chance to share healthy recipes and to get to interact and talk with the health club members.