Looking Back on My Work in the Cambodia Nutrition Management Department

Hello! My name is Kawai and I have worked in the nutrition department since March 2020.
The other day, I left the hospital after about 15 months of working and I would like to report on our activities and take a retrospective.

Japan Heart Cambodia has various departments and each department has Japanese staff, volunteers and trainees working together with English-speaking Cambodians.

However, the Nutrition Department has no Japanese staff and only one of the Khmer staff speaks English while the rest only speak Khmer.
There are no nutritionists and people rarely even use the word “nutrition”, so it is a very challenging environment for a new graduate.

One year ago, I came to Cambodia with the intention of helping Cambodian children, but in retrospect I learned more than 90% of what I needed to know from the local people.
I felt over and over again about how ignorant and shallow I had been to assume that they were poor and needed my help, when I knew nothing about this country. My days were filled with such wonderful lessons and experiences.

活動を終えて(カンボジア栄養管理部・川合) ジャパンハート

In the beginning, we were really starting from scratch, and made countless mistakes and there were many times when I ran to the bathroom and cried because things didn’t go so well.
However, in the end, I feel that I learned more from my failures than from my successes.

For instance, when creating the menu system, I spent a month analysing all the Cambodian dishes and completed a perfectly nutritionally balanced menu.
However, people rejected my menu and told me “You don’t know anything about Cambodian cuisine”.
Some people write on the internet that “Cambodian food is not very unique”, but this is not true at all, it is very deep.
I felt the difficulty and fascination of a foreigner intervening in food culture.

There was a time when my desire to prioritize nutrition and the cooking staff’s desire to provide delicious food clashed, causing distress to valued staff.
The perception that “nutrition is important because we are in a hospital” is a perception that exists in a country where nutrition already exists.
We started with an explanation of the difference between a nutritionist and a cook.

There were many days when I felt bad for asking the staff to follow me.
I was younger than their average age and had no experience whatsoever.
Now, they do things like measuring the food intake rate, physical measurements, meal rounds and intensive cleaning on holidays.
At first though it was hard to get them to understand and I got pushback like “Why is this necessary?” I couldn’t even cook Cambodian food nor speak the language and was in charge.
I can understand why it was difficult to follow me.

Over time, the language barrier got weaker, we spent more time together and gradually came to understand each other’s viewpoints and values.
The relationship went from one where we were facing off against each other to one where we were facing the same direction.
This was true not only for the cooking staff, but also the children and mothers who served the meals.
The time I spent with the staff, children and mothers, transcending the barriers of being a foreigner or a medical professional, were the happiest time of my career.

活動を終えて(カンボジア栄養管理部・川合) ジャパンハート
活動を終えて(カンボジア栄養管理部・川合) ジャパンハート

As my first time in the workforce, I had some difficulties, but the happy fun filled memories occupied most of my days in Cambodia.
It was truly a dreamlike environment where I could use 120% of my time every day doing the activities I had always wanted to do as well as for my personal growth.

What I have always valued in forming the Nutrition Management Department is keeping the Cambodian style and making it a business that the local staff can and want to continue.
We believe that this is the most important priority for creating a sustainable system.
To achieve this, it is vital to understand the culture and values of the people we are working with and to build a relationship of trust, rather than saying “this is how we do it in Japan, please copy us”.

I also feel that the nutrition business in Cambodia has a lot of potential for expanding the hospital nutrition system and building a foundation for training nutritionists.

Going forward, I will leave the field for a while. However, I would like to bring my experiences spending everyday with patients, their families and the staff who supported our activities discussing our values to the next place I work.
Through nutrition, I hope to create a system that can bring smiles, not only to the people in front of me, but also to many more people.

I hope that this choice will not take me away from the children in front of me, but bring me back to them in a bigger way.

活動を終えて(カンボジア栄養管理部・川合) ジャパンハート

Through my experience at Japan Heart, I have come to realise that I will continue to be involved in the nutrition of children in developing countries for the rest of my life.

Thank you for this wonderful experience ❤ Please continue to support the Cambodia Children’s Management Department.

Kawai,
Nutrition Department

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