Interview with Joanna Cummings, MS, RD, CNSC – CR Laos

Interview with Joanna Cummings, MS, RD, CNSC

CR for Lao PDR, Director of OHSU-Lao Nutrition Education and Research Partnership

By Crystal Leatherman

Meet Joanna Cummings

It is with great pleasure that I introduce the CR for Lao PDR, Joanna Cummings. Joanna is an instructor, mentor, mother and leader. She maintains a humble view of her role in initiating and facilitating positive change, while strengthening partnerships to address the nutrition situation in Lao.

In 2016, the Lao Government reached out to the United States Government for assistance with providing education on nutritional needs and interventions, as part of the Sustainable Development Goals and National Nutrition Strategy of Lao PDR. A Priority 1 Intervention aimed to “promote capacity building in organizations in order to ensure nutrition and food security interventions are efficient and effective.” To achieve this priority, a partnership between Oregon Health and Science University (OHSU) and the Lao Ministry of Health started in 2016 to train Lao health care providers in the screening, assessment, diagnosis, intervention and evaluation of patients at risk for malnutrition at central, provincial and district hospitals throughout Lao. At the start of this partnership, Joanna was asked to move to Lao and has since led numerous projects from teaching clinical nutrition to cohorts of nurses and doctors in the Lao language, to large pilot studies and other nutrition research in Lao. Currently, Joanna is working with other central nutrition organizations in Lao to assist in the establishment the Lao Nutrition Association in the next two years.

Health Issues and Nutrition Trends in Lao

Lao is a low-income, low-resource country particularly susceptible to malnutrition and its consequences. Access to clean water, sanitation, safe food, electricity, education levels and healthcare are main factors that affect quality of life. Joanna explains that nutrition is a “thread through all sectors” and is stuck in a cycle whereby environment and disease affect nutritional risk while poor nutrition leads to or worsens disease.

In the late 1990’s, the Lao Government made significant changes and began to accept development assistance. Educational efforts by international development organizations have made significant impacts, such as about providing babies with colostrum and its immunological effects have helped change harmful traditional practices – now 98% of mothers report giving colostrum to their newborn. Aid from China is being used to build hospitals, including the goal of foodservice within one of the national hospitals. Further, there is a greater awareness overall about nutrition and impacts on health, such as an increase in label reading with diabetes education. Joanna highlights the country’s efforts and acknowledgement of the importance of nutrition despite barriers and limited resources.

Significance of Traditional Foods

The Lao traditional foods and overall diet are diverse and fresh – harvested and cooked to order with very few additives or preservatives. With around 80% of the population working as subsistence farmers, “farm to family” is the norm. Marketing of new energy dense convenient Western foods should be discouraged, rather the traditional foods they have should be embraced and celebrated. For example, Joanna states, white rice is a huge part of the Lao culture, and is an integral piece which makes up the collective society and culture around rice production, which takes a whole village.

Opportunities and Challenges

Dietetics is still a very foreign concept in Lao. Joanna recognizes that education is a great equalizer, but first we must understand why specific dietetics knowledge is important. In neighboring countries, most dietitians work in foodservice so there is no model for clinical dietitians. The question must be raised whether a clinical dietitian is even affordable or acceptable in a resource poor country. Further, without easy access to nutrition intervention, dietitians are limited in their ability to make significant impacts.

Inspiration for Joining IAAND

When Joanna moved to Lao in 2016, she had little experience in global or international development. She found that the Academy had an international affiliate and sought out involvement while overseas. She was the Strategic Communications Chair for 2 years, which expanded her base of contacts and led to a greater understanding of what dietitians are doing globally. Ultimately, she has enjoyed working with a fantastic group of dynamic individuals and continues to enjoy working as a Country Representative and member of IAAND.