For the final quarter of 2024, I spent one too many hours applying for the Peace Corps Small Grant, a maximum $2,500 sum towards any project within my objectives as a Community Health Volunteer (which are teen health and anemia prevention). After many discussions with friends, family, and local counterparts, I had my idea: improving household nutrition practices through Community Health Workers, otherwise known as CHWs. The idea is that we hold trainings (doubled as a cooking class) for the 30-some CHWs across the district of 8,000 people; one CHW for each of the 30-some small communities. A CHW is voluntary; it depends on truly altruistic community members that are dedicated to seeing their neighbors succeed. CHWs have never received a formal health education, and normally dedicate their days to their farms, families, or another means of work. It’s in their free time that they complete CHW duties, which include attending trainings at the health post and conducting house visits to needed community members, within the areas of infant nutrition, maternal health, chronic illness, and more.

I’ve found that my district’s CHW program is stronger than most; many of my volunteer friends have focused a lot of time on just starting a program – finding volunteers, holding trainings, etc. While our CHW network has been up and running since long before I arrived, I found something we could build on: nutrition. Despite local anemia-prevention efforts focused on mothers, pregnant women, and babies such as monthly nutrition demonstrative sessions, home visits, and iron supplements, almost 50% of children under 3 have anemia in the district, a disease which stems from iron deficiency. Anemia is one of the major public health concerns across the mountainous regions of Peru, where diets tend to lack iron-rich foods such as red meat. Due to the fact that steak and ground beef may be hard to come by, not to mention expensive, my project focuses on the inclusion of entrails, such as liver and blood, which are cheap and easier to find.

I have attended countless CHW trainings during my time at site, and I found that they are pure lecture, with hardly, if any, interactive element. Additionally, I have assisted many of the monthly nutrition sessions held for mothers at the health center, where assistance is low and the example plates provided are nothing anyone would want to eat. It’s saddening to see a plate half covered with lentils, a quarter covered with boiled carrot, and the final quarter covered in chopped, flavorless, boiled liver. Understandably, the mothers were historically not very captivated.

While I could have focused this grant on mothers, I chose to focus on the CHWs instead. Since moving to site, working with CHWs has been one of my priorities. I have woken up at 5:30am on Saturdays to walk alongside them for house visits. I have attended their trainings. I have gotten to know them, laughed with them, they’ve tried to teach me Quechua. They know me, and that is why this grant can work. In my first year of service, I many times felt like I wasn’t doing much. I showed up to countless meetings with no real motive, not even knowing what said meeting was going to cover. But I showed up because that is all I really could do. And now, that dedication is paying off.

To me, CHWs are the backbone of the community. The higher up the mountain you go, the more reserved the people become towards outsiders. Not just to me, but to the health post workers that are from nearby cities, and not our rural district. There is also a language barrier with Quechua, where CHWs fill a unique “middle-man” role – they learn from the health post and connect with the people in their communities.

After a long approval process, followed by a month-long delay in February due to the U.S. Admin change, my grant was formally approved and the money appeared in my bank account. My first purchases were the cooking class essentials: a portable gas cooktop, a gas tank, pots, and cooking utensils. I then began to experiment with three recipes: blood fried rice, liver omelettes, and mango blood mousse. Don’t knock it ’til you try it, seriously. I had never cooked with blood or liver in my life, and had eaten the former only twice before: once in a traditional Cambodian soup, and another during pre-service training in Lima where we focused on anemia prevention. I was pleasantly surprised.

The idea for the grant is to mobilize the cooking classes to each of the six health establishments in the district, which covers an area of 200 km2 (for reference, Washington D.C. is 177km2 and has 680,000 residents). Each health establishment oversees the training of 4 to 10 CHWs. Prior to each training session, I prepare the initial steps of each recipe – cooking rice and boiling vegetables and liver. Each training starts out with a nutrition talk, done by myself or the nutritionist, which discusses the food groups, the causes and consequences of anemia in children, prevention strategies, and the key nutrition messages published by Peru’s Ministry of Health. The first phase is also accompanied by an activity where we categorize foods depending on their iron content: low, moderate, or high. Once this phase is finished, we move onto the fun part… cooking! I put on my Gordon Ramsay cap and assign each CHW a role: chopping veggies or liver, starting up the cooktop, flipping omelets. After about 45 minutes, we have 3 plates ready to try (and I have recently added a fourth: pasta with a liver tomato sauce).

To date, I have conducted five such trainings across four health establishments, the farthest being a 45 minute drive up the mountain. In total, we have reached 15 CHWs and 18 mothers (while the grant is focused on CHWs, mothers may also attend). The sessions have turned into more than I had hoped for. They are truly novel ways to incorporate iron-rich ingredients into plates that children will eat, and many CHWs walk away inspired to cook said dish for their children, or share such dishes with their neighbors. They call cooking a love language, and it’s easy to see the way participants are able to let loose and laugh as we cook, eat, and learn together.

In the end, while I don’t expect this project to cure all anemia across the district, its one more power for the community to have as they fight this battle against anemia. And a tasty power, at that.

Photo Gallery of Sessions