IAAND Laos Country Representative
By Lisa Dorfman, MS, RD, CSSD, LMHC, FAND, CR Chairperson

Life has a funny way of guiding you to places unknown in your personal & professional life. For Joanna Cummings, CR for Laos, timing and talent and the faith to take a journey from Oregon to Laos has proven to be life changing.

As a recent graduate and bright shining nutritional student from Oregon Health & Science University with an interest and growing expertise in inherited metabolic diseases, the program director Dr. Diane Stadler saw something beyond Joanna’s years. She saw the opportunity for her to lead a groundbreaking program in Lao People’s Democratic Republic (known commonly to most as Laos) to coordinate and develop the Lao-American Nutrition Institute and train the first dietitians for the country.

A five year commitment, she and her new husband said “I do” and traveled thousands of miles to start a new life.

Meet Joanna Cummings

A Colorado native who enjoys mountain biking, running and everything outdoors, Joanna has found her transition to her new country fairly seamless, moving into an ex-pat community of dozens of other American professionals and a culture that offers endless opportunities to grow as an educator, clinical coordinator and dietitian; delicious food and fascinating food cultures to build her international appreciation of Laos rich history of culture.

Country Health Issues Impacted by Nutrition

With nearly 50% of the population suffering from malnutrition and life expectancy outside the capitol of 50 years old, Laos is also challenged by high liver cancer rates due they believe in part to parasites and pesticides in local fish and farmed products. The peripartum population also practices food avoidance such as eating only sticky rice up to 4 months post-partum, avoiding certain food combinations, eliminating some rich sources of protein and appeasing the 32 “guardian spirits” or khwan that bind the body and provide good luck.  These food practices lead to vitamin and mineral deficiencies in mothers, breast milk and infants, further exacerbating the rates of childhood stunting and wasting in the low-income country.

Opportunities & Challenges in Laos Dietetics

While Joanna welcomes the opportunity of working with this joint program between the Laos Government, Oregon Health & Science University, and US Government, it offers a plethora of unchartered unknowns which are sometimes hard to plan for and will take trial and error to perfect.  The strong desire by the Lao Government and the people of Lao to improve their health and well-being makes this work rewarding and fulfilling.  Challenges exist in access to resources, education and infrastructure but Joanna remains positive that the work and education provided at the Lao-American Nutrition Institute will help improve lives over the generations to come.

What are new Laos foods, seasoning, rituals and recipes you have found most interesting, tasty and/or unusual?

Joanna finds one of the most interesting aspects of Lao culture to be the social and ritual significance of sticky rice.  The Lao eat more sticky rice per capita than anywhere else in the world.  It provides sustenance but also plays an important role in cementing social relations and links the Lao with the spirit world.  Jai yai or “big-heartedness” is a Lao expression for good will and generosity, where Lao will provide others with rice and food whenever needed or during times of celebration.  Joanna was in a very small, rural Hmong community in northeastern Lao and experienced this generosity first hand.  It was Hmong New Year, a time to “shake off” the past year and fill the New Year with well wishes and prosperity.  From one simple wooden sided home, music was playing and the clinking of glasses with laughter could be heard from the path.  The women cooking for the celebration caught sight of Joanna and her husband and immediately invited them inside.  Sitting on small stools around two tables filled with rice, soups, and BeerLao were 12 men.  Within minutes, the beer was poured, bowls were filled, and the rice replenished.  Many toasts to health, prosperity, well-wishes, and fertility were offered over the next few hours.  The afternoon ended with a “baci” ceremony for a young couple just married.  Joanna and her husband offered their well-wishes, tied strings around their wrists to appease the “khwan”, and promised to come visit when they were in the village again.

The Lao also have a strong belief of food as medicine, where food and drink can have both beneficial and harmful effects on the body.  There is a traditional saying in Lao “bitterness is medicinal and sweetness is but air” – meaning bitter tasting foods are good for health.  Many of the traditional dishes in Lao are bitter and bile-juice is typically added to meat dishes to give them a slightly bitter edge.    Joanna says “it is definitely an acquired taste to the foreigner, but one I am learning to crave in all my meals now.”

What inspired you to become involved with IAAND?

Joanna is especially inspired to be connected to other dietitians globally given the uniqueness of her position in Laos and the similarities that other nutrition experts have, are and will be facing in countries birthing new dietetics programs, careers, curriculums and organizations. She is excited to share what she learns with other members and looks forward to serving as Country Representative and on our executive Board in the years to come.

You can read more about Joanna’s adventures and experiences providing more depth in education into the culture and nutrition of Lao and surrounding countries at www.thelandbetween.tumblr.com.