E129: Reducing Malnutrition in South Sudan with Chelsie Azevedo

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In this episode, I share an interview with Chelsie Azevedo, who has a masters in Public Health and is a Registered Dietician (RD), and was previously the Nutrition Technical Advisor for Rise Against Hunger. She shares the story of a powerful multi-year project she helped lead in South Sudan with students at Hope for South Sudan, a residential school and orphanage set up to prevent trafficking, violence and exploitation. Rise Against Hunger partnered with Lift Up the Vulnerable! to provide food security for these children.

The project reduced malnutrition from 7% (27 students) to 0%, and it has stayed at zero malnurished children for the past 2 years. Her project helped her achieve her Green Belt certification through Global Six Sigma USA.

In this lengthy episode, we go into many details about the project, starting with the reason it was funded, the unique approach taken, the problems with data quality, walking the food journey, reducing time to identify students at risk, empowerment of local students and faculty, root causes of hunger and long term sustainment.

00:00:00 – Introduction and Guest Welcome

00:00:18 – Chelsea’s Journey in Public Health

00:00:30 – Early Life and Family Health Challenges

00:00:46 – Educational Background and Career Beginnings

00:01:01 – Teaching Experience and Global Aspirations

00:12:39 – Human-Centered Design and Empathy

00:25:05 – Adaptive Management in Global Aid

00:30:10 – Nutrition and Agriculture Program Design

00:30:46 – Role of Ethnography and Story Collection

01:11:27 – Cultural Shifts and Sensitivity in Projects

01:17:38 – Improving Food Security and Nutrition

01:43:50 – Conclusion and Gratitude

I hope you take the extra time to listen to this incredible case study of what can be done with a little investment.

Listen to the podcast on this page, download it on your favorite podcast player (search “Lean Six Sigma for Good”) or watch the entire interview at https://www.youtube.com/watch?v=f0pf8XBlHQw

https://www.youtube.com/watch?v=f0pf8XBlHQw

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Have you ordered the book, “Lean Six Sigma for Good: Lessons from the Gemba (Volume 2)?” The book is made up of 8 chapters written about experiences from Lean and Six Sigma practitioners, to give you tips and tricks to help you work with nonprofits in your area. All proceeds donated to charity. Now available in audiobook as of Feb 2024. You can also order Volume 1 released in 2019.

Transcript
Note: may contain typos and errors, generated with AI

Brion

Okay, welcome everyone. Today I have a wonderful guest, Chelsea Azevedo. Hi, Chelsea. Thanks for joining me from this podcast.

Chelsie

Yeah, thanks for having me. It’s great to be here.

Brion

So I wanted to have everyone get to know you and learn about some of the great work you’ve done. Can you talk us through your journey through public health and food insecurity?

Chelsie

How did we get here? I think I have a really not normal or average journey in life. My family had a lot of health issues when I was younger, cancer, brain tumors, things like that. And I always knew that I wanted to do something, I think, health related or to at least improve the human situation around me. So in college, I was pre-med. I studied biology. I was actually working as a vet clinic for a couple of years. I thought I wanted to be a veterinarian. But something was really pulling me to go global. I think the idea of doing one thing forever really felt like a bird in a cage situation. So I taught at a high school locally in Florida, where I’m from, for a year. I was the biotechnology and biology teacher. I loved teaching. But I again, just felt really pulled. So I moved to Thailand and I was teaching in Thailand and then I moved to China, living in China. I was teaching, I was also performing and working at a mushroom farm using a lot of my biology skills and lab skills. And I was exposed to a lot of Eastern philosophies and just alternative perspectives of health and life and culture and ways of living. And it really sparked something inside of me to think differently about maybe what I thought health was or healthcare was. And it became a much more holistic view. So I applied for UNC Chapel Hill, their Masters of Public Health Nutrition Program. And I became a dietitian. And while I was there, I was studying global health, their global health certificate, because I was just always drawn to more global perspectives and experiences. Being in school there, I was also the graduate research assistant of the Global Health Program. So I got to interact with a lot of global students who were studying global health, but also were themselves immigrants or global or coming from overseas. And again, that exposure to different cultures just really excited me. There was also a quality improvement course that I took in grad school. And I think this was my first real introduction to Lean and Lean Six Sigma. And I just totally drank the Kool-Aid. As soon as we talked through all of this, I was like, oh my God, I had intrinsically been doing these things my entire life. These sort of philosophies of it’s, you know, 80-20. Where am I going to put most of my effort for like maximum gains in like the smallest amount? That’s how I always studied. That’s how I always went through school. So I would excel, but with like a very focused, a very focused energy of what I was, my prioritization was. And all of that really fit naturally into Lean. So I decided to sign up for this yellow belt training when I was in grad school. I was the only person in my program. It was mostly health administration students that did it, but I jumped in. It was offered. I went for it. And again, I really loved it. Also because I’d been a teacher for three years and I’m a performer. I really enjoyed teaching and facilitation. So I could see how some of these concepts would work even in facilitation when I would be guiding groups or guiding teams of people. Then I got an internship at Rise Against Hunger, which is a global nonprofit who was doing food aid. Most of their work is in food aid, especially the US office. When I joined, they started building their technical programming. and they started doing more food security projects. The difference being food aid is a packaged meal you would drop off. Food security is more about how do you strengthen capacity in the community so that you can also work on the prevention side. So you’re helping them grow food, you’re helping them establish markets, helping them to have a sustainable food system locally so that they don’t require food aid. And how do you make that resilient even in times of stress like COVID, pandemics, conflict, climate change. So we started working on those types of projects. And that’s where I started incorporating a lot more lean, lean thinking, and also human-centered design. For me, it’s a really natural pairing of these two. Lean is very, you know, it’s like founded in industry and it’s very technical and sometimes a bit dry. And I feel like the human-centered design, which is an approach to problem solving, is it starts with empathy. And when you’re working in international development, ethnography, the study of cultures, is essential to your success. You can’t just go in anywhere and not understand the local context that you’re working in. So understanding how to empathize with people, using stories, conversations, sharing meals together, you know, stories are data. Really, really a strong understanding of where you’re at. And then using that to build and test in tiny iterations, these small cycles of iterations to improve situations, all in collaboration with local people. I felt like human-centered design, which I took many of those workshops in grad school because I also love that, and Lean, they sort of just, they crossed over a lot in my mind, along with like some of the adult pedagogy training I had gone through when I was younger to do my teaching overseas. I did my CELTA. a certificate of English language teaching for adults, which is done through Cambridge University. And they have a very specific way of doing teaching. It’s very adult focused. They have different formats. And that also crossed over into lean and humans. It’s all like, okay, start with the person and their perspective. So there was, you know, social behavior change is another term that you hear in development. and global health. And it all means the same thing. All of these things are basically getting at like, who’s the person that you’re trying to help and what do they think about this problem? How can you understand their perspective? We can come up with all sorts of terminology, but all of it seemed to layer on itself in my experiences in life and having opportunities to teach. I was also a coach, I was volleyball coach. Having these opportunities to work with people just fed right into global programming, where then I was the nutrition technical advisor and I was building and designing nutrition programs with local partners in their context in East Timor, which you guys talked about on your last podcast I was just listening to. In South Sudan, which is what my project is about, we’ll talk about. Malawi, Zimbabwe, like all these areas. But when you can have your approach and philosophy of empathy and understanding and then building systems around it, applies everywhere. So that was really what brought me to global health. I did that for five years. I’m still in love with that work, but current political and funding climates being what they may, a lot of global health projects have been shut down. My programs were also shut down, sort of unrelated to that, but same time. And so I’m currently working with a local nonprofit in North Carolina, Trees for the Triangle. And our whole mission is to improve the social ecological resilience through the planting of native trees. And I’m learning there’s actually a lot of crossover with trees and food security because the soil is the foundation for everything. And a lot of what we were doing with nutrition had to do with regenerative and climate smart agriculture. And trees are a big part of that. So the next thing I think I want to learn about is agroforestry and agriculture and forestry and how those connect so that I can keep building on my skills and food security, but really use the classroom I’m in now to advance that. So that kind of brings us up to today.

Brion

Nice. Got a couple questions, really cool background. Trees are amazing. Study that and learn that, what it does for water and floods and the quality of the soil and protecting our homes and cooling our homes. And there can be annoying at times, but the benefits are so great. The air quality, yeah. Big fan of trees. So yeah, I think that’s great. I didn’t really understand the connection with food. Can you explain that?

Chelsie

Yeah. Well, where does your food come from and where do trees grow? The soil. And the soil is truly the foundation of our health because The more we deplete our soils, the less nutrients they have. And our food, the nutrients in our food comes from the soil. So now there’s studies showing because of industrial agriculture and decades of chemicals and pesticide usage and just pour, you know, a lot of tilling. Basically, when you look at nature, nature doesn’t till. You know, nature preserves the land. It lets things fall. It lets things decompose. And all of that enriches the nutrition of the soil. It’s its own ecosystem, truly. So when we deplete that, which we have, now they’re showing like how much iron is in our beef today compared to the beef 100 years ago. And we are seeing nutrient losses in our foods between like 20 to 60% less now than it had decades ago. And that’s because of the soil. Trees grow in soil. The stronger your soil, the stronger your trees. So when we talk about things like floods, hurricanes, all these climate disasters that keep increasing, if your trees aren’t rooted in strong soil, then they’re not healthy as well. We all feed from the soil. And so you’re going to see more trees falling on homes. You’re going to see sick trees. You’re going to see all those limbs. It becomes more annoying to us. Whereas if we just invested in our soil health, things like composting, and just better practices all around of land management, especially development, which I’m learning a lot about right now. And a lot of it has to do, it’s all politics, which is insane. Because actually I’m meeting developers and builders who want to do good for the environment. I know shocking, they tend to be the bad guys, but they’re not. We’re talking to a builder now who’s like, we actually do want to plant native trees and plant them at the right time, but we’re forced to plant in the summer. So 80% of their trees at this development have died. So I’m learning a lot about the inner workings of why things happen. But the soil is the foundation for everything.

Brion

Nice. You also mentioned the Thailand and China. How did you end up there?

Chelsie

My boyfriend in college, his brother and his wife. had lived in South Korea for like 8 years. And I just, I saw them and I thought, you have some, you have a spark. Like there’s something about you that’s different and I want that thing. And I think it was global experience and perspective. I think it really changes you as it should. So I just looked at different opportunities. I think I was drawn to Asia because it’s on the complete other side of our planet, completely different culture, completely different language. And I’m definitely a person that likes to be thrown into new and novel situations. I love challenges. I love novelty. And I thought, that’s where I’m going to go. I was 24. I just took my suitcase and I had a one-way ticket to Thailand. And that’s where I went. And I found this. They were an education, like a teacher, sort of recruiting teacher agency, and they placed you in different schools. So that’s how I did it.

Brion

Okay. Very cool. Human-centered design. So you talked through a little bit of that process. I think that’s something that is a big gap in our process improvement is, you know, we touch on and lean respect for people, respect for humanity. It’s a little vague at times. It’s not a lot of structure on how that’s done other than interacting with people in the processes and getting their ideas and making sure you’re treating them with respect. And Not talking down to them and things like that. But I don’t think as in-depth as what you would go through in human-centered design. Anything else you can share about that process for people who are not familiar with it, which is a part of the audience?

Chelsie

Sure. Well, I’ll just start with human-centered design, but then I also have my own take on it. So human-centered design, it starts with empathy. So you want to empathize and understand the person, the customer, the client, the individual that you’re working with, whether you’re working in a business and you’re selling them a product or you’re doing community-based programming, which is what I was doing. You’re looking at the experience or the user in your project. So once you have a decent understanding and there are some tools you can use to do that, some of them are pretty fun. I’m a big fan of gamification and using play as a way to learn and teach. And so one of them is role play. So I might tell you, Brian, I want you to be Chiba. You’re A 13-year-old girl, and this is your situation. I might give you like a role play description. And then I want you to sit and interview with me, and I’m going to ask you questions. And you’re going to get into the mindset of Chiba, this 13-year-old girl. Based on what I’ve told you, your mind will create stories. You will use her story to expand your imagination. We love creative constraint, and our brains will go crazy in that environment. So you’ll sit, we’ll do some role play. We might even switch back and forth so that you can experience listening to, I would then be Chiba, and we would go back and forth. So role play is a great exercise to empathize into the minds of someone. We also do empathy mapping, where you would have a worksheet, you would actually draw or put in a description of a person in the middle. It might be that same girl, Chiba, who’s 13. And then you would start mapping out, what does she hear from the people around her? This is like all about culture. What are the things that her culture is telling her? What does she see? So not just what she’s hearing, but what is she observing in her environment? What does she feel? So does she feel, and this is tricky because there’s what does she think? And there’s a difference between thinking and feeling. Feeling is specific. So it’s kind of like get your feelings wheel out. If you do therapy, you know, it’s like feelings are oppressed, disrespected. There’s emotions attached to it as opposed to thinking. What are the thoughts she has about herself? I am worthless as opposed to I feel worthless. They’re 2 different things. So you would kind of map out these different layers to understand what are the external and internal influences on this person. And that’s also a great tool for empathy mapping. So that’s your first step, really getting into the minds of the people. You can do it through focus groups, interviews, observation, shadowing. And then you would define your problem based on those experiences, ideally with the people you’re working with, if they’re a part of the project or solution. And then you would ideate also again together. And there’s different approaches to brainstorming. there’s good evidence to show that people need a little bit of alone time and then a bit of shared time because you learn from each other. And then you go back to alone time because that creativity kind of builds on itself. Then you would prototype. And this is where I think where Lean comes in too, because in QI, quality improvement work, you do PDSA cycles, plan, do, study, act, and you do that a little bit, just like a little change, and then you study it, a little change and you study it. And in human-centered design, it’s the same thing. They call it prototyping and testing. It’s the same idea. You’re doing little short iterative cycles to see your improvements. and then you would analyze those. And this is where I think Six Sigma comes in. I think they all go together. I’m creating like a new approach in my mind.

Brion

I like it.

Chelsie

Six Sigma would come in, support what you’ve just done with hard data, and then you would essentially create in your Lean Six Sigma control phase, all of the standards, tools, protocols, checklists, visual cues, regular scheduled meetings, things you’re going to use to control and sustain the improvements that you’ve just made using human-centered design and lean philosophy. So I also want to add, even in human-centered design, there is, with the empathy specifically, this is where I think there’s room to grow because I was working in international development. And if you’re going to be doing community-based programming, your client or user looks very different than someone in, business corporate world that you’re creating a new app for or something. And so much of their experience is influenced by trauma. And I haven’t heard anyone use this term. I started using trauma-informed development because in healthcare, we have it. I’m also a dietitian, so I’m like a little bit in the clinical world, a little bit. And we use trauma-informed healthcare as a term to start addressing, oh, people aren’t improving or like responding well in meetings with their doctors or dietitians, or why is that trauma? And if you follow people like Gabor Mate, who’s a trauma specialist, who’s like, he’s a physician and he has a great story, or people like Brene Brown, who talk about trauma and shame, you can’t ignore the human or the spiritual element of a person. when going in to do something that would benefit them. So specifically in development and community-based programming, I made it my personal goal to understand the trauma and those influences that also impacted these people. Because in the world of global health and development, you hear a lot about children. And we’ll talk about that in my project, I think, because it’s at a school and you hear about, God, the children, these children are so impacted by trauma. Yeah, but what happens to those children? They grow up and those children become adults who are then the teachers at the school. They’re the country directors. They’re the school staff. Those people also have their own unaddressed traumas because most cultures don’t talk about trauma. So it’s having the patience to, when you’re entering someone else’s world, country, culture, just like check yourself, enter a new phase, enter a new mindset to turn into like the student and just be as curious as possible about everything about this person, trauma included, so that you can be gentle and strategic in how you communicate. There was an interview I listened to, a therapist said, the purpose of communication is not information, it’s connection. And that just totally changed the way that I think about how I facilitate groups, how I was leading my training programs, especially in trauma impacted zones. So I think that’s a huge piece of the puzzle that’s not specifically talked about. I think it’s because maybe it feels too mental healthy or spiritual or woo-woo, whatever the term, it’s very soft as opposed to like something that feels very hard and technical. But at the end of the day, your human spirit and who you are and all of those human experiences you come in with impact your emotions and your stories and all of those things are data.

Brion

Yeah, I love it. When we talk about root cause analysis and five whys, I think we tend to stop at the individual. We kind of go to the processes and the infrastructure and what’s in place here. And then once it gets into why are they doing that, why are they reacting like that, we kind of say, well, that’s kind of like their own personal things happening. And we don’t tend to, at least in the business world, tend to go down into that next why, into the trauma, into the perceptions, the thinking, the tell me more, why are you thinking that way? Why are you reacting like that? Why are you resistant to this? Yeah, maybe you feel like we don’t have the permission to go that deep. We talk about if you don’t get to those root causes of the source of the problem, we’re only going to be solving for the symptoms. And that’s not going to be as effective. And we’re not going to make as much progress there. So I think that’s something that’s definitely an opportunity to figure out how we can go deeper in a way that is allowing that person to feel open and have that trust. And that’s part of the culture is you have to build that trust and you have to make it safe, a safe space for people to share those things. And if they don’t believe that, they’re not going to open up and share anything or go deeper. They’ll just say, because, or this is my decision. You know, like it’s a difficult thing to do, but it’s very important.

Chelsie

Yeah, you’re so right. And you see it everywhere. I mean, like you said, even in the corporate world, we feel like it’s unprofessional or you’re getting too personal and talking about this. And I think that’s kind of what happened when you see the shifts in. I have some friends who work in the private and corporate world, and it’s so not human anymore. That’s why there’s no loyalty in either direction. And people aren’t stupid. I mean, you have intuition when you’re talking to someone and they say, oh, just because. there’s more to that story, but either you don’t know how to ask the next question or you feel uncomfortable or like you can’t ask the next question of, hey, I’m sensing a shift in the force in the room. Like something just happened. You shut down. What’s going on? I’m curious to understand why. We’re so afraid to have that conversation with people. Yeah, I think it’s impacted a lot of places, private and public alike.

Brion

And you said, you know, the communication It’s about building connection, right? And so if your communication has been about information, then you haven’t built the connection and therefore you can’t have those conversations because you don’t have that trust or that connection built up already. So yeah, I think that’s, I think that would be great to figure out how to do that work a little bit better. And I think maybe some of these tools from human-centered design could be really helpful for that.

Chelsie

The shift to virtual platforms and working from home is great for convenience. It is not great for connection because the psychosocial studies about like really effective teams, how do you build this trust that you’re talking about and build connection amongst teammates? It’s actually all the side conversations. It’s all the non-work-related, how’s your dog doing? Or how was your date last night? It’s the personal life stuff that gives your team psychosocial safety that when there is something going on at work, they can say, hey, I noticed that you’re kind of falling behind in the project. And it doesn’t feel offensive because you’re involved in that person’s story. So teams that actually perform better have more side conversations. But in a virtual world, how often are you going to G-chat a co-worker and be like, hey, you want to have a quick five-minute break? I can’t, I’m in between meetings. And then you’re in meetings and you feel like it has to all be work-related. So we’re just limiting all the opportunities for things that made us feel human at work.

Brion

Yeah, I agree. I think that’s one big drawback is the side conversations and networking that used to happen in person. I just went to an event yesterday. And the conversation before the meeting was really valuable and meeting people and getting to know them and having conversations. Then we got to the meeting and then it felt like a normal meeting, right? And then there’s conversations afterwards and those other conversations were just as valuable as what was shared during that meeting. But in a Zoom or a online thing, those two things are cut out of that. There’s no like, okay, now we’re going to hang out for a while and We’re going to split off into different groups or side conversations here. And it’s like, nope, meeting’s over. And you go off to something else.

Chelsie

We’re not getting paid to chat. Exactly.

Brion

Let’s go to the Rise Against Hunger project. How did that get started and kind of, yeah, walk us through that whole multi-year project.

Chelsie

This is such a like serendipitous sort of all of the stars were aligned at the right time, I think, for this project. It was first of all, like privately funded. It was Rise Against Hunger is not USAID funded. So we had the extreme privilege and opportunity to be really flexible. Like people talk about adaptive management and really contextualizing your approach to the culture and the people. And we were really able to do it. Like no one was telling us, no, it doesn’t fit into indicator 2.7. it was like, nope, we got to go create our own indicators. So I just want to like preface that this was kind of a magical experience. And I don’t know how often this had happened or will happen again, but who knows with the future of global aid.

Brion

But that’s a good comment because I think I’ve heard that multiple times is the rigor of some of these grants and nonprofit work is a waterfall approach of here’s the next two year roadmap and you better stick to that plan regardless of what is actually happening and what has changed and how things are actually progressing and what you’re learning. And it’s counter to all these things we just talked about of, well, that was the original idea, but now we’ve learned more and that’s not going to work and that’s not the right root causes and that’s not going to solve the problem. So I think that’s a common issue people struggle with that makes their projects less effective because they can’t have that flexibility. So that’s great to hear.

Chelsie

I could do a whole nother podcast about.

Brion

I think we might have you on for that. Yeah, let’s do that.

Chelsie

I have so many thoughts and opinions about funding and how that influences how things are done. So bookmark that. And then, okay, so this project, considering the magical alignment of planetary experiences. So anyway, this was The ELNA Project, empowering leaders through nutrition-smart agriculture. Here’s the context. There is a school that’s also an orphanage in South Sudan in Eastern Equatoria. And South Sudan, world’s newest country, established in 2011, but it had gone through two really long civil wars before then. It has essentially always been in conflict from before it was a country, tensions between Sudan North, Sudan South, and then they got independence and then they had their own internal conflict until 2018 and 2018 to now. I mean, they still have conflict now. So there are global systems to look at food security specifically, and you’ll see South Sudan consistently shows up as a classification that’s like, you know, emergency, it’s like ringing alarm bells kind of all the time. And it’s just consistently been in a state of food insecurity and conflict. And that matters because if you’re constantly in a state of conflict, your roads don’t look good, your politics is full of corruption, your education systems are broken, you don’t have strong infrastructure. And so you keep pushing people further and further behind from their potential. So this orphanage in school was really a safe haven. for children who were in the surrounding region, not even always from South Sudan, to come in because of their own trauma-backed stories. So a lot of them came, their parents were shot in conflict, robbed on the road. They were witnesses or also they were victims of rape. Just really, really trauma, a lot of trauma in the stories of these children who were orphans. And they also had children coming from the surrounding community. And it was interesting because the school was kind of placed between two different tribes who did have conflict a few years back, but they sort of agreed, let’s have peace because there’s a school in the middle. We both send our kids to this school. Let’s have some peace for the school’s sake, for the children, right? It’s always the children. So also kind of a weird serendipitous like, okay, it’s like a sweet spot right here. So We were asked, we partnered with Lift Up the Vulnerable, which is a fantastic nonprofit. They do anti-trafficking work in South Sudan and also I believe Uganda. And they’re fabulous. So they partnered with us and we kind of went over as consultants and advisors to help them design A sustainable homegrown school feeding program. Because the school was saying, we can’t be importing all this food anymore. We’re A landlocked country. By the time you get food shipped here and you’re going down dirt roads with these huge trucks, you always have to have bribe money because you’re going to get stopped. You’re going to get robbed. And it’s way too risky for these drivers to be carrying food in food insecure areas that are full of armed rebel groups. So by the time the food gets there, if it’s still good, if there’s enough left, and do the kids even like it? So it’s like, this is just so unsustainable. So they actually were using Rising and Hunger meals at first as an emergency because they were going through different issues that existed in South Sudan. So we came in, they said, but we only want your food for one year. We want to use your nutrition and agriculture expertise and program design. Help us create a farm. Help us create a nutrition feeding program. We were like, let’s do this. So we were using human centered design, lean approaches. We were doing a lot of capacity strengthening. We talked a lot about knowledge, attitude, practices. Those are the core root things that when you leave, those things stay. Those things will stay with those people. So we did a lot of ethnography. We did a lot of story collection. We did a lot of observation, shadowing with the kitchen staff, with the nursing staff, with school staff. I went back with the children after dinner most nights, and we would do storytelling and sing songs. And they would over time share more and more about their lives, about their experiences at the school. So we would visit, the first time I went was a one month visit, and we’re sleeping in tents on campus in South Sudan. I’m actually wearing the dress and the earrings that one of the staff members gave me as a gift. And you wear these long dresses because it’s 110 degrees outside and there’s no electricity or air conditioning. So that’s kind of the setting and the context to paint you this picture. Very low resourced, but really motivated, really, really motivated group of people. My favorite thing, like, you know, in Lean Six Sigma, it’s the Gamba walk or the waste walk. And before we even knew what that was, we called it the food journey. Because if you think about like, God, where do you even start? Like, how do you develop a school feeding program? Well, you just follow the journey of food. Where’s the food grown on the farm? So we walked, we got all the staff, we got the kitchen staff, we got the agriculture staff, project staff, school staff, the director. And we took the steps. It took about 3 hours. We started at the farm. And our agriculture experts started asking them all these questions like, when do you plant this? Why do you plant it this way? Do you use, do you dig? Do you till? Why do you do that? Like all these really just pulling all this information out to understand their practices and why. And a lot of it comes back to culture. That’s how I saw my parents do it. That’s what we know. So they’ve lost actually a lot of their indigenous knowledge. because they had been observing a lot of these foreign aid programs. And there was a huge influence of global aid, but in a relief mindset. People had kind of lost their ability to feel empowered, like they had control over their lives and health. They would rather walk two weeks to a food distribution center, grab 2 kilos of rice and oil, and walk two weeks back, four weeks, They could have planted their whole farm in four weeks, which could have fed their family for the year, but instead they feed their family for two months. That’s the mindset when you have like consistent relief going in without thinking about capacity strengthening and development. So we were asking all these questions and you move from After the food is grown, it’s harvested. How do you harvest? Then we move to the warehouse. What are your storage practices? First in, first out. Are you logging things? Is there an inventory tracker? From the warehouse, you move to the kitchen pantry, short term. Do you use pest control? Are things raised up off the floor? Do you have mice? Do you know what you’re tracking? Do you weigh the food? Going from the pantry to the kitchen? What’s the sanitation and hygiene? Do you have water access? What energy-saving stoves do you have, if at all you’re cooking over open fires? How does that impact your health? Like, what’s the morale of the team? And then after that, what’s the school, the service, the food service itself? Is it organized? Does every student eat? Oh, you don’t know? You don’t have a way to track that? Well, how do you wash the food? Oh, you don’t wash the food. The children bring their own plates. Where do they get the plates? What happens if they lose a plate? Like, and then from there, Compost, what happens to your food waste? Are you just dumping it? Can you feed it back to the animals? Can you put it back on the farm? And now we’re back at the beginning of the food journey. When you think of things as stories or processes, same, same, it becomes really clear and easy, oh, this is what we have to work on. So we did that for agriculture and for nutrition. So from there, we were pulling out all the areas and all the little gaps, and then we would work with them very sensitively and very lovingly. Like you have to approach this work with love and graciousness when working with people. Again, it’s the trauma-informed development. So you can’t just say, hey, I noticed that all your food is spoiling. How come you guys don’t use pest control? Stop doing that. Yeah. Right. It’s, you know, it’s like just check yourself, come in, open your heart. Hey, why do you think all this food went bad? Oh, I hear you reflect back to them. It’s all the communication styles. And there’s like tricks of the trade. Like you can learn to be a better facilitator and communicator. You reflect back to them. What I’m hearing you say is this. That sounds really challenging. So something, introduce your own input. Something I learned is that if we apply pest control at these intervals, then it will reduce this by this amount. Hand it back to them. What do you think about that? Boom, like you do that consistently and people will start to think through their problems and you’re introducing knowledge in conversation. It doesn’t feel like you’re preaching, you’re asking for their input, you’re asking for their reflections. We did this consistently. And so the school feeding program itself, the whole goal at the end of all of it is like to prevent and treat malnutrition. And I went in and I was like, okay, what are the current levels of malnutrition? And they were like, I don’t think we have malnutrition on campus. So there’s already a gap in understanding what is malnutrition? How do you even identify it to know if you have it? And then once you identify it, what do you do? There were a lot of cultural beliefs about malnutrition that talked about it as like fate or a curse. You know, somebody planted a tree, now your kid has malnutrition. So it’s also re-educating about, no, you have control over this. Like you can change this, you know? That’s empowerment. When a mom feels like she can actually change the health of her kid and it’s not just the fate of some community member that cursed her child, that’s life-changing. So we started working on first kind of the clinic side, and I’m a trained dietitian. But I will say the global tools for malnutrition tracking, technical jargon heavy. You’re working with people that have low literacy in Excel. They were still using paper. So before, the nurse was tracking everything by date in paper binders. Like she had a wall of just binders. But what happens if you have a child, you’re trying to get an understanding of a child’s health history? You now have to search through 20 separate binders for that child’s name, because it’s done by date. So changing their… their record keeping to be done by child’s name, you can then track them through time and get a really clear picture of their health history. So that was one. We also shifted them, we did Excel training, we shifted them to computer-based, and they found it really easy to use. There were so many things that were done here when trying to understand the baseline level of malnutrition, because the global standard tool is WHO Anthro Plus. I swear it’s from like the 1990s and no shade to the people that made it. It’s a great tool. It has served its purpose, but it’s pretty buggy. It’s difficult for someone to use. And then you have to go back and interpret all of these, like it’s like Z scores, BMI height for age and weight for age Z scores. And no, you can’t have someone who has like very low Excel literacy, computer literacy, who uses a hand calculator using this tool, even understanding how to interpret what that means. So we shifted from this super complicated process that took about 2 1/2 weeks. By the time they sent us raw data, we had to go through that, interpret it. took two staff members, the monitoring evaluations person, and then it was me interpreting the data, typing it up into English so you could actually understand it, and then provide it back to them to know how to even treat and do something and intervene on this data. We got rid of all that.

Brion

And this was 2 weeks of. It’s 2 weeks of waiting. child gets weighed and checked. And then two weeks later, you find out if they’re malnourished or not.

Chelsie

Yes. So that child is malnourished for two weeks. And that’s precious time. We switched to a system that used actually this tool, which I can’t take credit for it. I found it, but it’s FHI 360 founded this tool. You basically, you line up their height and weight. It gives you the BMI. You move this over to the age of that child, whether they’re a boy or girl, it tells you the BMI ranges and their health status. I mean, in seconds, and I trained on this tool in like 10 different countries, and everyone can learn it. It’s so simple. So instantly they knew. We also went over like consent and dignity and child, you know, a lot of cultural practices and norms had to be talked through, inviting children to be participants in their own recovery, which is a new concept to a lot of people. But we did. And what we found is we started to have a screening program and a way to identify malnutrition. And we found that there were undiagnosed tuberculosis cases, chronic. For years, kids had chronic tuberculosis and malnutrition that went unaddressed. And we got them treatment. And we did it using local foods. This was another huge thing we did. They said, we do not want to import any specialized foods. Global standard is plumpy nut. Number one, plumpy nut is a patented recipe. It’s fat, milk, sugar, peanuts. It’s oil. And it’s processed and it’s packaged and it’s imported and it’s expensive and it’s hard to get. And then talking about beliefs and the relief mindset, you find that people start selling it in local markets. You find that people start losing their ability to treat malnutrition with food because they only associate treating it with plumpy nut. So clinics would actually shut down if they didn’t have plumpy nut because they didn’t know how to treat malnutrition using food. What were we doing before plumpy nut people? We’re eating food. I found a recipe called Tom Brown, and it’s a 6-3-1 proportion, six parts staple. And they were growing sorghum, which is a grain, also corn, could use either, three parts soya beans, which has high proteins and essential proteins. It’s one of the only plant sources of those essential proteins. And then one part groundnut paste, peanuts. which is a really great hit of fat, which is what you want. They started growing those foods on the farm, first of all. Then they started making this and we put kids on a protocol where they would eat this additional meal twice a day, in addition to school meals, which we were also improving from agriculture and farming. And we found that kids were recovering, usually in like 2 weeks. Three months is like kind of the standard. You want a kid to fully recover in three months. All of them were recovering in three months. There was the two cases of really stubborn tuberculosis. Those kids took closer to six months to recover because they had to be put on medication. There were some underlying issues and we did get them treatment at the Capitol Hospital. But once they were treated, every single student has maintained a healthy status. This project was implemented. I think the most recent data where they got down to 0 was 2023, 0 cases of malnutrition. I still WhatsApp the nurse in South Sudan. They’re still at 0 cases and 0 recidivism. In South Sudan, like, let’s go back to the country that we’re in. This is unheard of. This is unheard of for an orphanage of extremely vulnerable children with trauma-filled backstories in a community that’s been affected by conflict and food insecurity for decades. And now they have a lush, vibrant farm that is so diverse. They’re growing foods that people in the community walk through the farm and they go, what is that? That’s okra. What’s that? I’ve never seen it. What’s that? That’s eggplant. I don’t know what that is. Like the students start, the students that come in from the community to go to school, they go home and they tell their parents, we’re eating eggs at school. And their parents are like, oh my God, is this like a restaurant? Like, what are you guys eating? The food has improved, the diversity has improved, and now they have a malnutrition treatment protocol that screens. Every child gets measured if they’re gone more than two weeks from the school, every child. And they have a screening random sampling through the year. So no child gets left behind. Everybody gets caught and they all get treatment. They’ve maintained 0 malnutrition with 0 recidivism for over 2 years now. It’s unbelievable.

Brion

Yeah, that’s incredible. I think we left off, you were talking about the process to get the data originally and how that was something you started to dig into a little bit, just to make sure that the numbers were actually correct. Can you talk a little bit more about that?

Chelsie

Okay, so for context, We were virtual. This was during COVID. So I was in the United States. The implementing team was doing measurements in South Sudan, and there was no way for me to physically go and be there. And they had a nurse on staff. And so you’re sort of just trusting people’s self-assessment of their level of knowledge and ability and skill to be able to deliver on the tasks that you need. We needed a baseline measurement of malnutrition on campus to know where the kids were so that we knew, okay, how many kids are we going to be treating? And this is where it’s a delicate dance because you want to have trust and assume that, you know, people know what they’re talking about on their own self-assessment. She’s a trained nurse. And so I said, okay, are you able to do heights, weights, sex, age, and then we’ll basically give me that raw data and I’ll plug it into, I think I mentioned WHO Anthro Plus, which is a pretty old tool. It’s not the easiest to navigate in terms of like some college class needs to go and do like a user experience, I think, on this tool and kind of improve it, bring it to the modern day. So it’s a little bit buggy, but I would get sent the raw data from the nurse in South Sudan. And I would then put that into this program, AnthroPlus, and analyze it. But it would give you different measurements because it’s trying to give you Z-scores, but it’s giving you Z-scores for three different things. One is for like stunting, so your height for age. which is really only useful for kids under 5. So if you’re 8 years old, that’s a useless piece of data for me. I don’t need that, but it still shows up. Then there’s weight for height, which is useful to me because that’s more like your BMI. Then there’s weight for age, which is also not necessarily the most helpful. If you think logically about some people are taller, some people are shorter, some people are going to weigh more, some people are going to weigh less. So you’re sort of getting like you’re looking through keyholes to try and understand what is what’s happening in this room of like health status. Each of each of these pieces will give you a little bit of a different perspective, but not the whole thing. Well, I was noticing that heights and weights would be fluctuating like a kid height, a kid’s height. They’d be taller one day and shorter the next day and taller one day and shorter the next day. And I thought, okay, now I’m starting to question the validity of this data. And it all goes back to communication. relationship. This is like the human centered aspect, because I can’t just go back to this nurse and be like, what are you doing? Why are the, you know, kids aren’t shrinking. And it’s all about your tone and your attitude. And so approaching with curiosity, and she explained the process of using the height stick. And I really didn’t understand because I wasn’t there. It’s like, it’s also so important to be in person when you’re doing this type of work. because it took me months of looking at data, trying to figure out what’s going on. And by the way, from her sending me the raw data to actually trying to analyze it, give it to my monitoring and evaluations manager, who that’s really his job to do. He was trying to do that. It kept bugging out, it would close, it wouldn’t, you know, it was like, okay. And then send it to me to interpret. And remember, I have to interpret this in language that is easy enough to understand for someone who is now in South Sudan using paper and pencil to keep records of children’s health. So I have to really be conscious about the language and how to simplify all the results of this data. And sometimes it was tricky to do and it’s hard to not be so wordy because at the time we didn’t have a malnutrition treatment protocol. So what happens if The clinic in South Sudan has been receiving plumpy nut, and now that’s the way they associate malnutrition treatment is plumpy nut. The use of food to treat malnutrition was lost, and people associate plumpy nut with the treatment. But they didn’t have plumpy nut because of, again, their inland, long roads. It’s very expensive, by the way, this product. It’s of limited supply always because it’s only produced in a couple countries. and they have to ship it around the world. And I don’t know if malnutrition is growing and it’s everywhere. So it’s actually very difficult. Supply chain’s an issue, price is an issue, access is an issue. So you’re like on all fronts. There was no treatment protocol, even if we were to find malnutrition. So I was also trying to give advice when I was giving the results back of like, these are the kids that have malnutrition. Here’s the foods you guys have available locally. These are the foods to focus on, you know, trying to give some guidance. because they’re really low resourced at the time.

Brion

On the scores themselves, so they’re getting the Z-scores, which in the statistics, we’re basically normalizing the data for their typical average and standard deviation for that age group. And figuring out where do they fall above or below that average by a certain number of standard deviations. And so I don’t remember what that cutoff is, but if they’re outside of a couple of standard deviations of what they should be, then that puts them in a malnutrition category, correct?

Chelsie

Yes. And this is also global malnutrition gets very technical. I actually attended a webinar about like, why not just call it all malnutrition? Why do we even have to, you know, because You’re right. The cutoff for moderate acute malnutrition is negative 2 to negative 3 standard deviations. Severe acute malnutrition is anything below negative 3. I was seeing standard deviations of negative 14, which is like statistically impossible, which is also why I started questioning the validity of the data because the Z-scores I was seeing were really crazy. And then the overall prevalence of malnutrition, moderate plus severe, was like 20 something percent. And just for context, in the international space, when you’re looking at identifying a food crisis, it’s called the IPC. It’s going to tell you based on the level of global acute malnutrition, if it’s less than 5%, like the United States, probably has less than 5% of kids who have acute malnutrition, right? That’s an acceptable range. It’s giving you some sort of context for your numbers. Because if you.

Brion

Say, yeah, outside 2 standard deviations, you’re in the couple percent range, you know, 2 to 3% naturally.

Chelsie

Right. So yeah, using that micro data to then look at like population level data, if the prevalence of acute malnutrition in your population is 10%, that’s a serious issue. That’s how they classify it’s serious. Above that is critical, which is like 15 to 30. Above that is extremely critical, 30% or more. That’s like famine, okay? But this was a school that had been consistently serving food. I would not expect to see 30% famine levels of food insecurity. So to see something like 20, 27%, it was very high. All of these things were clues telling me that I couldn’t really trust this data. There was something going on, the data wasn’t valid for the baseline. Unfortunately, I didn’t have the ability to travel there and have eyes on the process for many months. And at that time, we’re also giving them advice on the agriculture side to improve their agriculture. So this is where practical, real life programming gets really messy because it’s hard to know a true baseline and it’s hard because you’re also implementing projects and building capacity and improving while you’re trying to measure a true baseline for malnutrition here. So by the time many months had passed, I was able to go in person and essentially I just, I said, you just do your thing. Let me observe what you guys do. And I immediately noticed the height stick, which, and again, it’s like, it’s simple things, but if that height stick didn’t come with instructions, how would you know how to use it? You know, so it’s a three-part stick and you have to move the bottom piece all the way up. before you then move the next piece up and then the final piece up. If you didn’t know that, you would just pull it up. So they were trying to do math. Like they were trying to essentially, I saw them write the numbers and try and calculate and bring in another measuring stick to compare. And I was like, this is interesting. Let me look at this height stick. And then I even had to like take a few minutes to figure out how to use it. So We finally figured out it was a height stick issue. Also noticed that the scale they were using wasn’t being tared. So they would let it just sit. So after a while, sometimes it would go 3 pounds over. Well, 3 pounds might not seem that much for you and me, but three pounds for an eight-year-old could be like 5% of their body weight. You know, it’s like, that’s kind of a lot. So that was also happening. So through a lot of these observations, I realized we needed like a visual checklist. And I also was excited to be there because I had found simpler tools. So to remind you that AnthroPlus tool, by the time they measured many kids to compile a list to then send to me to run through the program, interpret, get right, give them recipes, send it back, it was like 2 weeks. That’s a kid that has malnutrition for two weeks. That can’t happen. So instead, I found, I think I shared, I found this tool. They were, we trained on this tool. They were then able to find BMI for age, which is a much simpler reference than the three ones I shared previously. We still use, by the way, it’s MUAC tape. It’s this tape that goes around the arm, the middle of the upper arm for children who are under 5. Once you hit 5, BMI wheel time. That’s the best way to measure malnutrition for those. And it’s clearly marked like poke yoke. Like it’s just like, if it’s red, yellow, green, you know, immediately. And it’s very simple to use and train on. So that was easy. But the rest of them, this wheel was a lifesaver. It’s so easy to train on. I trained four different staff members, including the nurse. And they, after many, like watching them do, you know, we did it together. And this is where, like, measurement systems analysis, I wasn’t thinking of how many should I observe versus how many should I, but I was definitely thinking of the trend of I’ll do a bunch, you shadow me, I watch you do a bunch, and then I slowly taper myself away, and then I just observe. And after watching them do 200 measurements, I felt pretty confident that they were able to do it moving forward, and we would get the same results. So more of a guideline as opposed to trying to hit 30 times 2 and have you randomized and you do these kids like we didn’t do all that.

Brion

Right. But that’s a, but you got to the end result is consistent measurements that you can trust and that is accurately representing the status of the malnutrition for each kid.

Chelsie

Exactly. And then what we found is 7% malnutrition, which makes way more sense for their context, because it was a school who was already serving consistent meals. It also makes sense because at that time, they’d had almost a year of like food aid support and agriculture support. So it’s very possible that the true baseline a year, like when we first entered this project, it’s very possible that it was higher than 7%. But we had already been doing some interventions by the time a year later, we were able to go in person, train on the ground, and get the numbers there that were reliable.

Brion

So then you’ve got new data, you’ve got a better baseline, you have a certain number of children that are, or kids, I guess, because they’re different age groups, but a few that are now in this risk category. How do you work through the kind of the containment and the initial, like, let’s get them out of this dangerous range?

Chelsie

Yes.

Brion

And then kind of lead into the fixing of the whole underlying issues.

Chelsie

Yeah, great question. This was also where I think you just have to be so practical in how you approach things. It’s like, don’t let perfect be the enemy of good. And this is where I think nutrition can get very over technical. to the point of, it’s like irrelevant now. So what I mean is the separation between moderate acute malnutrition and severe acute malnutrition. If you are a nurse in South Sudan and you have 10 kids in front of you, some of them have severe, some of them have moderate, what difference does that make to you in terms of how you treat them? And So we needed to come up with something that was a localized way to treat these kids that was efficient, that would reach all of them and help all of them improve. Really what you’re looking for in severe acute malnutrition is an underlying illness. So this is like, so we basically had to start talking about, we created a decision tree. So severe and acute malnutrition for all intents and purposes are the same for us. They’re the same because if you are uncomplicated, meaning you’re in good spirits, like you have good energy, you don’t have any edema, which is the swelling of water when it like leaves just like holding water. You don’t have any infections, no diarrhea, you’re alert, you’re responsive, you have an appetite. All of those things are clues that you just need food. The other category is complicated. This is like, You have edema, which is swelling, usually indicative of something else. You have fever, dehydration, you have no appetite. Maybe you have some sort of infection or like extreme diarrhea. You have to start asking kids these questions to understand, is there something else going on? Because even if you gave them food, if you’re just having extreme diarrhea, you’re not absorbing those nutrients. So food can’t be the only solution here. Those are the kids we would refer to the clinic. And those were few and far between. That’s why most kids were just able to be treated with food. The rest of them we would send to the clinic. And that’s how we found there were two or three kids that had like underlying tuberculosis, like chronic, undiagnosed for years. But the rest of them we could just treat with food. So then it’s like, okay, what food do you use? Because we don’t have plumpy nut. You got to do what you can. You can’t just tell these people nothing. So we looked at what was available on the farm. I ended up doing some research and I found a recipe called Tom Brown. I think I shared it was a 6-3-1 ratio of like a staple food, soya beans, and peanuts. So they started growing all those foods on the farm. In the meantime, we would purchase those foods from like local markets or maybe from Kenya and ship them up, which they were able to do. Now they grow all those ingredients so they don’t need to ship anything. But that’s what they started serving to these kids twice a day. in addition to their regular meals. And all of those, all of the kids improved. We came up with an intervention that was localized, that was easy to do for the actual, for the kids, for the kitchen staff. Like everyone needed to participate in a way, but we tried to really ease the burden of participation for everyone. And then the measurement itself, to keep things really clear. This is like an example of 1, it’s like 5 parts. And we just put this on the wall in the clinic. And we went through and we did role play. We did scenarios with each other to talk about best practices in person. Because in this culture and in many African cultures, it’s like children are meant to be seen but not heard. So there’s this idea that like, you just, you call a kid over and you start examining them. without a discussion beforehand about, hey, here’s why you’re here today. My goal is to assess your health status, see if you have malnutrition. If you do, I’ll give you some treatment, but is it okay if I like touch your face and kind of press your feet? Like asking them before you just start touching their body. And that, you know, we trained on all, we did role play with each other. We had discussions about Why would you want to invite a child to participate? Because at the end of the day, you can tell them to eat, but if they don’t understand why or if they don’t want to, they won’t do it. So the kid needs to understand, because the ages are like, at that time, I think the youngest was five or four, and the oldest was like 19. So it’s like you’re spanning. They’re old enough to understand. I’m not feeling great. And if there’s something I can do to feel better, I’ll probably do it. These kids don’t want to feel bad. So invite them to participate. Like let them in on what you’re trying to do. So that was also part of it. And that’s the human part. You know, you’re not going to read about that in a technical manual. That’s not in there. It’s like, these are the cutoffs. This is the treatment protocol. Okay, but how do you talk about the problem and get people to participate? So that was also a big discussion and we did some role play scenarios on that too. And then I watched them do it. And the dynamic shifted, like the conversations shifted. Kids started opening up a lot more. They felt like they were, they could actually express how they were feeling a bit more freely. A negative side effect is what we didn’t talk about was like privacy. And what ended up happening is the nurse would just share out loud, like, you have malnutrition, and the rest of the class would hear. And we were finding that kids who were diagnosed with malnutrition, because they were being sent back at special times to receive this food, they kind of got made fun of for being sick. So there was sort of this stigma that was built for kids on campus that had malnutrition. And so And it actually was the local staff that brought it back to us. And we were like, right, didn’t catch everything. So the local team said, well, our solution is to, instead of saying, you are malnourished, or this is the malnutrition food, we’re calling it special food. We’re just going to call special food, you get special food now, special food privileges. And that worked. Like it changed the stigma, it changed like just the energy about what people were hearing around this language and kids didn’t feel as embarrassed to go get their special meal. And that really took care of it. So that’s also like the local team needed to come up with a solution to that one, because I would not have thought that would have made a difference, just calling it special, but apparently that fixed it for them.

Brion

So it’s a special meal, but what about that meal was it? I thought you were talking about at one point. getting extra meals or it was just a mix of what they were getting normally because the current meal or what they were picking wasn’t to their liking or can you go into that a little bit?

Chelsie

All great questions. So normally kids will get three meals a day and they’re served at specific times. The additional meal for kids with malnutrition, it was 2 meals a day. It would be served between breakfast and lunch and then after dinner. before they went to bed. They would get an additional, it’s like a bowl of porridge basically is what they would eat. And so you’re kind of touching on like, okay, we’re talking about treatment, what happens after malnutrition, but what happens before malnutrition? How do you prevent in addition to just treating? And this is where the agriculture piece comes in. And this is where I think so many nutrition programs get it wrong because they’re so heavily focused on treatment. But you can’t talk about malnutrition and not talk about food. And where does your food come from? And how are you going to grow your food? And the answer can’t always be food aid. It has its purpose. There are emergencies. What happens when that emergency ends? People need to have the capacity to be able to grow diverse foods of sufficient quantity to sustain a good health status. So this is where agriculture was a huge piece. So we did, the Gemba walk, we did the walk of the food journey, and we identified root causes at each step of all of that. And some of them were cultural beliefs or like fear-based practices, like people who had grown up with famine. Again, this is like trauma-informed development. The director of the school, his last name means hunger, because he grew up in the time of hunger. And that’s very common in African names, like whatever is happening at that time, that’s your name. And so he grew up in times of hunger and famine. And so in his mind, it made the most sense to store at all of your food rather than look at how much you have, compare that to what you need. And if you have surplus, sell it in the market, make money back for your school to then diversify your menus, improve your textbooks, you can do whatever you want with it. But if you’ve grown up in hunger and extreme hunger and famine, you’re not selling extra corn. you’re holding on just in case. Like these are real practices that people do because of their background. So some of it is that, so some of it is because of the trauma and coping. Some of it is just like, oh, we didn’t know about first in, first out. Okay, now we know, thanks, that’s easy, you know, check that box. Or maybe not having access to the right resources. This is a really interesting story that I want to talk about. This is at the kitchen level. When we were at the kitchen, this is where I like to spend a lot of my time, because one, kitchens are often overlooked in food security projects, because food security is either focused on agriculture or nutrition. They don’t tend to combine them. And so people know about agriculture, that’s like its own thing. And people talk about nutrition in terms of like, three out of five food groups and then treatment plans. But the kitchen is where the magic happens. So I spend my time in the kitchen. I’m working with these women, mostly women. But they did have a couple of men, which is cool. And I’m looking at water access. I’m looking at, and I’m asking them questions about like, oh, you guys have to travel like back and forth all day to carry buckets of water. Why don’t we, but it’s kind of right there. Why don’t we just buy a hose? connect the hose to the water pipe and get you a big bucket of water so you always have fresh water in the kitchen. Yes, that would be great. Thank you. I noticed that they had these two energy saving stoves that they never used. And they were doing open fire cooking. Open fire cooking, by the way, uses way more firewood because your firewood is exposed to oxygen on 360 degrees. It’s really smoky. So, and it’s by the way, South Sudan, it’s like 120 degrees outside. So you’ve got women standing over open fires in extreme heat in the sun. They’re getting headaches, migraines, they’re inhaling all this smoke, which is horrible for your health. And it’s dangerous. I mean, you’ve got little kids, some kids are, you know, amputees, some kids have epilepsy and you’ve got all these open fires. So it’s just a bad situation all around. So I said, why are you guys using open fires? They said, They sort of looked at each other and didn’t want to share with me with the answer. I could see there was more behind their faces. So I said, I said, what? if I try and use the energy saving stoves? Maybe I try and practice on like a Saturday, like a Saturday evening, like I’ll cook a meal and try and use these stoves. then, because I had started to do the process, they all came over. And then I had this group of people around me watching me all, oh my gosh. Like they were like waiting for me to figure it out. And I said, you guys, these stoves are terribly designed. And they were like, yes, they’re terrible. What had happened was the kitchen staff showed up one day. And these were here. And I said, who built these? And they were like, I don’t even remember the country. It was some European country, some nonprofit, some, Western agency came in and installed these energy saving stoves. We did it. Good for us. And they put up this big plaque with their name on it, like this, these energy saving stoves brought to you by, you know, And they sat there for two years. Nobody used them because I don’t know if you can see in the design, but it’s in a corner. And I don’t know if like, if anyone listening has ever seen the big souffurias, the big pots that they used to cook. They’re like, they’re bigger than a basketball hoop. They’re humongous. You could basically like a tiny person could sit in there and take a bath. Like they’re really big. If it’s filled with soup and beef or, you know, that thing weighs like 100 pounds. So you would have these women trying to climb up on these counters and stir, and also the pots didn’t fit well into the whole area. So if you see all the smoke’s just coming out anyway, so you’re standing in the smoke. If you slip in You’re falling into the soup. You can’t stir. Nobody can lift that without really hurting your back. It was so horribly designed and they didn’t ask for it. They just came and it was there. They showed up one day and they were there. So, and then it’s like, okay, well, all of these issues existed in the kitchen for two years. Why did nobody fix it? And this is also where you have to think about cultural dynamics. power. You’re working in a kitchen, which is mostly women. This is women’s work. Are women treated with the same level of respect? And do they, are they allowed to take up as much space? No, actually in South Sudan, women don’t have the same rights. A man can beat and rape his wife and there’s no legal recourse. So women are like truly second class citizens there. So when you have women dominated work, they don’t get the same space in rooms to speak up about their issues. It’s not, they’re not taken seriously. So we had to create some communication channels. And I don’t think, I won’t blame leadership at the school because it’s cultural, like that’s the water you’re swimming in. But after having some conversations around it and developing a communication channel with like monthly meetings with representatives of kitchen staff, agriculture, you know, Everyone could then come together and share what they needed as professionals and leaders of their teams. Like we were kind of like separate culture from work. when you show up at work, this is how you are. When you go home at the end of the day, we don’t have any control over that. But when you’re here working on this project for school safety and child safety and protection, this is how things need to work. And so That’s a huge change. That’s a huge cultural shift. And to navigate those conversations is, it’s very sensitive. What we ended up doing was providing a meeting space for the kitchen head to come and share, basically advocate for her team. And we worked together beforehand on the bullet points and the talking notes so that she felt confident going into the conversation. And I was with her, we were there together. And we were all there together. And It was very uncomfortable, to be honest. Like it was very clear that this was not the norm. But she was very grateful afterwards for the opportunity and that she felt like she was able to do it and was hopeful. And then things changed. The kitchen was better upgraded. They were well resourced. The picture on the right, they took out the old ones and they installed these nice ones here. You can lift, everything fits perfectly. Like they’re cooking in this one, you can’t totally see, but that’s steam. The smoke actually comes up through these tubes and they’re cool to touch. So the women are in shade, they’re indoors, there’s breeze, they’re not inhaling smoke. It was such a better situation for them. So that’s sort of like a microcosm of looking at root causes. And a lot of the times it’s power dynamics, it’s people, it’s relationships. much less than it is a process. Processes are kind of easy, like let’s get you an inventory checklist so you can track what’s coming in and out of your warehouse. That’s an easy conversation. Power dynamics around gender and like cultural norms, those are really tricky. And as sensitive as you can be, and as much as you can like get in with and build trust and understand and see what these dynamics are and learn who you need to talk to so that you can go, maybe you need to talk to this person because they’ll talk to this person who knows how to get things done. It’s kind of like understanding all the social dynamics. That is a huge part of development work and where you’ll see things be successful or not successful. Yeah. Very cool. There’s so many examples like that happened all over, but that’s like, that’s one. So some easy things are like shelving in storage areas. So this one had like no shelving. There was no system for how to organize different things on different shelves. Pest management was huge. We had, you know, shelving and we would have organizational systems and know where to put what, and then having some sort of log to track what was coming between the big food store warehouse and the kitchen pantry, because it’s different, which also meant like taking a step back, well, how does the kitchen know what they need to get from the storehouse? So this is where menus come in. And this was one of the biggest things we did. And I’ve never seen this done in another food security program, but my partner in crime, the agronomist, because I was the nutrition side, he was the agriculture side, but we worked in lock step. We would co-lead workshop because everything is food, whether you’re growing it, whether you’re eating it, storing it, it’s all food. And we wanted people to understand that it was really just food. And in that way, it also kind of separates the gender differences. Because if you say nutrition or kitchen or cooking, people, that’s women’s work, agriculture is more men’s work. But if you just say food, it’s like, where does that go? Where does that classify in my mind? Everyone’s involved. Okay. So what we found, my colleague, Brian, Brian Pride, he I said to him, I want to know what you’re growing on the farm and how to plan for that based on what I want to serve in the kitchen. And he was like, yeah, that would be great. It would be really cool if we could figure that out. And I said, do you have any sort of, like, does it exist in agriculture? Because I don’t know anything about agriculture. like yields, like, peanuts, you should be able to get this much yield or this many kilograms of peanuts per acre. Does that exist? He said, yeah, that exists. That’s like some standard, that’s how you plan your farms. I said, okay. So what we found was these numbers existed. But in my mind, why do those numbers exist if you’re not putting them into the greater context of nutrition? Because if I said to you, plan your farm, you can get 150 kilos of groundnuts per acre. You can get 200 whatever kilograms of soybeans per acre. I give you all the yield outcomes, but how do you know what to do with that? How do you know really how to plan your farm? How many acres of soybeans versus how many acres of groundnuts? Like, what’s your goal? So we actually created a nutrition agriculture farm plan tool. We started with nutrition targets. So if we know that there are, you can choose, every country has its own dietary guidelines, but let’s just say we have like 6 food groups and every day you should be eating 100 grams of fruit, average. If every day you should have 100 grams of vegetables, 50 grams of animal product. Like once you get those numbers per person, you just multiply it out for the number of kids you have for the number of days in a year to know how many, how many kilograms of vegetables do you need. And then you can use your yields to say, we want to have sukuma wiki and we want to have spinach and we want, then you can start to plan out. Let’s say you have five different vegetables. Well, then you only need, I forgot the numbers now, but you know, 20 kilograms each. Well, then you can start planning your plots based on that. So it starts with nutrition. You can then create your farm plan based on that. meant we needed a meeting of the minds. So we, they started scheduling monthly meetings. where the head of nutrition and head of agriculture staff and school directors leadership would come and the warehouse manager. The kitchen staff would say, what’s in the pipeline? Like what’s going to be harvested that we can use from the farm? All these things. All right, let’s create a menu. And when we first started the project, they were at three out of five food groups. But the thing that you don’t see when you see this number is quantity. So just if they had one spoonful of vegetable, it counted. So the thing that you don’t see is like actually how poor the ratios were. Like Pasho, which is essentially, they made like a sorghum corn porridge, like a stiff porridge. That was huge. That was most of the plate, which is carbohydrates. But meat would be like one bite. You know, it was really, really small. But after, when we started doing the farm plan based on nutrition targets, the quantities of these foods grew. So the amount of beans grew, the amount of vegetables grew. Before they were eating vegetables once, twice a week. Now they’re having vegetables like five days a week. So if you have your nutrition targets in mind, then you can work your way backwards and create farm plans. But to be able to like, how then do you implement it is with the regular meetings and planning meetings and conversations. And how do you have better meetings and conversations? Psychosocial safety, how do you build relationships and trust? Like it all goes back to people and how people work together so that you can actually implement these awesome solutions.

Brion

I like also connecting the dots between the processes, like you talked about, the whole value stream, right? It’s not just how can we grow better food, how can we cook better food, how can we serve kids better? It’s connecting everything together and aligning it and getting a process that connects those processes cleanly together, nicely together. that end up with good outcomes and everyone’s on the same page. And I think that’s a challenge in any organization is getting everybody on the same page and aligned to serve that customer or that recipient. In this case, the kids getting the right meals, the most nutrition, and addressing all these little issues that are getting in the way of them getting quality meal every day.

Chelsie

Yeah. one more thing we found was the service of the food. Because I was talking to the kids. I would go have, story time and sing with them after dinner most nights. And even during the day when I had chances to walk through and see them during mealtime, I try and observe. And I was observing kids didn’t have consistent plates. Some kids had plates. Some kids would bring like a, like a Tupperware container from home or they were, you know, random utensils were being used. And not every kid had one. And I would see some kids sharing and going back and forth. And so I started asking the girls, because you kind of asked them, I asked the girls what’s going on. They said, we don’t eat every day. And I was like, why don’t you eat every day? Sometimes, I don’t know. There’s just not enough. Or sometimes I forget my plate. And you know, when you leave your plate in the dorm, they lock the dorms because we’re in school. So I can’t go get my plate. And I was like, you don’t have a plate so you can’t eat? And they were like, I left it. Or I washed it and I left it on the drying rack, but someone in the community came and stole my plate. So now I don’t have a plate anymore. So sometimes I don’t eat. And I was like, what? Then I went to talk to the boys and the kind of the similar situation. And some of the boys, they would rather than risk forgetting their plate in their dorm, they just hid a plate under a log and like, kept it in the bush. but it still had food on it. So then it had this like old crusty food and it tracks bugs and they’re just like wiping off the bugs and then going to serve. And I was like, okay, hygiene, like there’s so many things here. So I brought it up to our, you know, the project team. And the reason they wanted them to have their own plate, keep track of their own plates is they wanted to inspire a sense of responsibility for these kids. And I, and this is, like, what’s your, if this is something that you did, because it’s like when I was a child, it was my responsibility to have my plate. It was very important. So that’s what we’re trying to do here. Okay, so we’re just passing down the things that were given to us without pausing to think, is this helpful or is this harmful? Is this helping me achieve the results I want to achieve? So we did a role play scenario. I said, okay, I went to the storage and I got seven plates. I had seven people standing. I gave all of them plates. I said, you all have plates. Go up and serve yourself food. We had imaginary food. I set it up. And then I said, great, you all have eaten. Okay, now your plate was stolen by a community member. You forgot your plate in the dorm room. You stole his plate because you’re hungry. You had three hours of soccer yesterday. Now everyone go up and get your food. And 2 of them didn’t eat. I said, what’s the problem? Why didn’t you eat? Where’s your plate? Where’s your sense of responsibility? And I think it’s okay to do this because one, I’ve already built enough trust with them. And 2, it’s really eye-opening. Like role play is powerful and I highly recommend it for everyone because immediately it wasn’t my idea. It was their idea to say, I think the plate should be stored in the kitchen. And I think the children can have responsibility by rotating who washes all of the plates at mealtime. And I was like, that’s a great idea that you came up with, right? That’s awesome. So that’s what they ended up doing. And in addition to that, we needed a way to track, because at that point, we didn’t have a way to track who was eating. I didn’t even know that so many kids weren’t eating. And they didn’t know. Nobody knew. So we needed to measure it. We needed a way to measure that. This is also very cultural because we were talking to the teachers and the teachers said, well, teachers eat separate. So we would send girls, it’s always girls, we would send girls up to the kitchen out of class to go fetch our food and put it in the teacher workroom. This is where sometimes I was like, okay, I don’t like to pull the donor card, but like this is a child protection facility. You can’t be pulling girls out of class to go get your food. Which again, like these are hard conversations. They’re very difficult conversations. You’re challenging cultural norms. But in my mind, human dignity always comes above culture. You know, if your culture is like, we never eat these two foods together, okay, I’m not going to challenge you on that. But if it’s actually harming people in the process, yeah, I will challenge you on that. My side note on this is like, culture is, depending on how that term is used, is different from the oppressive group, the oppressed group. The oppressive group will say, that’s our culture. That’s what we do. We’re allowed to do this. And they view it as their right, as opposed to the oppressed group when you talk to them about the culture, they say, it’s because of culture that we are treated this way. culture. And you’re like, culture can be a tool or a weapon, depending on your perspective. When you’re working in child protection, you’ve got to be really serious about upholding those values, even when it’s uncomfortable. So we had those conversations. And the teachers didn’t want to spend time walking students back to the kitchen because that took away from their lunchtime. I said, how long do you think it takes to walk the children? They said, oh, it could take 15 minutes. I said, let’s go right now. I have my stopwatch right here. It took us a minute and 37 seconds. Role play is powerful. And that’s exactly what we did. I said, let’s role play how long it would take if you, as the teacher, had a stack of like ID cards for each child. You would hand each child in your class their ID card. That child would then drop that card into a bucket at the kitchen in exchange for a plate that they would then use to get served and eat. So the teacher knows how many cards am I holding and it has their child ID on it. So they know which kids are not eating because they’re not there that day. They also, you also know which kids are eating because you can look at the IDs in the bucket. Now the plates thing has been sorted. So now you’ve got lines of kids. It’s a system now. It’s an orderly fashion. So here’s the difference, these two photos. The one on the left, you can see there’s like different serving utensils. There was no adult present here. Actually, these are all students, their children serving children, because the kitchen staff, they weren’t working on different shifts. Everybody had the same shift, which meant at dinner, there was not always an adult present. So we also worked on scheduling to make sure that everyone had the same hours, because there was also some cultural, like tribal issues happening in the kitchen. We had different tribes represented and that caused tension. So we like, we really viewed it from like, let’s view it like an HR, you know, like Let’s just look at the schedule. Let’s just look at scheduling and fix the schedule and that fixed the tension because then everyone felt like it was fair. And you also had an adult present. And then if you look at this picture on the right, now you’ve got kids lined up in an orderly fashion. You’ve got adults because now you’ve got teachers escorting them for meals. All the kids have their plates because they exchange, you know, their clean plates because they’ve been washed and they’re stored in the kitchen. So now there’s a way to have kids go and it’s very orderly and every child eats. eats. Another thing was it’s okay if a child wants to eat twice, especially these like 17 year old boys who after they’re done with school, they just play soccer until the sun goes down and they eat. If they can, they’ll play more sports and then they’ll go to sleep. These kids are exercising like 4 or 5 hours a day. They’re going to need round two of their lunch and dinner. And that was another thing I wanted to get into. The mindset was like, no, you only get one. You can only eat once. I said, no, let’s just grow more food so they can eat twice. Eat three times if they want. Like these kids are burning calories like crazy. So that was another sort of a mindset shift of like, let’s just get them more food. If they need more food, get them more food. And it was like, oh, okay.

Brion

And the boys were a lot of them in the malnutrition range, right? If we were looking at that, yeah.

Chelsie

Yes, this is something that I have my philosophies about. Like if I were to continue research, because it was surprising. You usually hear about girls, especially teenage girls being at high risk of malnutrition. But here there were more boys, like disproportionately more boys than girls who had malnutrition. And I kept thinking, why is that? And I think it’s because the girls weren’t as active because they would sit and talk. They would socialize, they would do story time, they would braid each other’s hair if they had hair, they would, the boys would just go play sports. And it also got me thinking, like, when I think about trauma-informed development, I’m like, think about the bonds and connections that are made in sports versus the bonds and connections that are made in conversation. constant like conversation. And it’s very, this is a very gendered thing. And so I kind of wonder also about like the coping mechanism to your situation and girls will talk, girls will socialize, girls will create stories, girls will form these bonds. They’re extremely socially adept. And the boys just go play sports. They play sports. they’re not experiencing the same level of social bonding and intimacy as the girls. This is my own, like, I’m just curious about that as they grow older. And we see this in the United States. We, you see it everywhere where patriarchy encourages boys to be strong and encourages girls to be soft. And you see it happening here, even at a small scale. And I kind of wonder how that plays out moving forward. Who are going to be the people that stand up to the conflict and violence versus who will be the ones to continue that normal? It’s just interesting to think about.

Brion

Yeah. Just even my own personal growing up, that was how we coped. That’s how we had friends. We decided what sport we’re going to go play. And that’s how we bonded is By playing the sport. We didn’t have conversations about feelings and how we’re doing. And only later in life do you realize, wow, I missed out on a lot of those conversations that are really helpful now. But at the time, it was just my good friends are people on sports teams. That was just kind of natural. So I’m sure there’s something to that. But is that healthy? Probably not. Seeing that a little bit, it’s okay for guys to talk about their feelings and it’s good for girls to be competitive and in sports. And so hopefully we’re moving in the right direction.

Chelsie

Yeah, I think there’s a shift. The more adults can get their heads around it and set the positive examples and kids see that and they’ll think it’s normal. So we did paired T-tests where we looked at the kids who had malnutrition before and after treatment with Z-scores and with BMI, because it was interesting to look at both. For z-scores, remember I shared the cutoff for malnutrition is negative 2 and below, basically, severe negative 3. So we looked at the changes in z-scores before and after treatment. And the average z-score improved by 1.124, which could be an entire category of nutrition status.

Brion

That’s one standard deviation improvement. So shifting everybody up on average. So that’s a that’s a big change.

Chelsie

Yep, exactly. And it’s supported with the BMI. The B1 is cool. BMI one is cool because when you look at did any students stay the same? No, every single child improved, which was really cool. And the average improvement in BMI, which we didn’t do BMI for age, that’s the Z scores, but BMI itself, the average improvement was 1.4, which if you’re not like super familiar with BMIs, that might mean nothing. But again, it’s showing that could be a change in nutrition status. You know, you’re just kind of shifting up. Everyone started here, either moderate or severely malnourished, but through time they became healthy. Some kids, boom, you got them on food. They were good right away. Some kids, it took a little longer, like this one up here. This was one of the ones that had like chronic underlying issues that needed treatment. And then this one definitely, this is the child that had severe malnutrition, undiagnosed, chronic tuberculosis, got them treatment. They at least improved to moderate. But you’re talking about someone whose entire life was essentially spent sick. So they’re not going to recover as quickly as these other students. They did end up recovering. It took almost a year. with various treatments and getting them up and consistent feeding and getting them to a point where their body was healthy enough to absorb all the nutrients and recover. And that student became captain of the running club and participated in the national marathon and won bronze after recovering from severe acute malnutrition with like undiagnosed tuberculosis for most of their life. So by the end, all had recovered. And we reached 0 malnutrition in August of 2023. We’re now in September of 2025. And I messaged the nurse in South Sudan and we’re still at 0 with 0 recidivism, meaning no student is slipping back into malnutrition. So that means students come on campus. If they have malnutrition, they’ll get treatment, but we haven’t had any because the school feeding now on the prevention side, the menu is so rich. They’re eating eggs. They’re eating, there’s like all these jokes from some of the high school kids that were going to school in town because they hadn’t yet built their secondary school on site. The high school kids, the secondary students were like, we want to come back. Everyone’s getting fat. Look at them. These children are fat. You’re feeding them like they’re at a restaurant. We want to come back to the school. So it’s like, just kind of funny to hear the commentary around it. But yeah, the school feeding program is doing really well. and they still have just zero malnutrition for two years in South Sudan. It’s like a food sanctuary. The implementers of this program, the school, the school staff, the project team, Lift Up the Vulnerable, they’ve done such a phenomenal job of sticking with it, like staying with the improvements because they see the impact it’s having. To put you back in the time It was 2020, 2021. This was during the Trump presidency when we were listening, hearing a lot about walls, like build a wall, build a wall, it was huge, it was everywhere. And the school director said to us, hey, now that we’re growing all this food on the farm, we’re noticing a lot of community members coming in to steal food. They’re coming in at night, they’re coming in to steal this food. How can we, in my mind, I’m like, I know what he’s going to say. He’s going to say, let’s build a fence. He’s like, how can we build an agriculture training program so that we can also teach them to grow their own food? I cried after that meeting. Like I felt like, whoa, whoa, like what a community minded leader to be like, my community and people are suffering so much that they’re stealing from the school. That’s how bad they are. We need to help them. I was like, whoa, it was really a moving moment for me. Yeah. So they started doing that. They started doing community trainings. They did a farmer field school. I think the funding may have ended. So I don’t know that they’re able to continue, but they were doing that. Yeah. And they were teaching. I have the curriculum. It was nutrition agriculture to train community members about it. was great.

Brion

And that’s the great part, you know, taking the lessons and then not only just improving the school, but now it’s starting to reach to the community level. And the impact that this one project can have or is already having just magnifies and spreads, that’s really exciting. And the impact that could have in the whole country as that starts to propagate and people are like, what’s going on in this region, in this village? What are they doing differently? How can we learn from that and adopt some of the same ideas modified for our culture and our tribe and all those things? That’s really cool.

Chelsie

It’s such, it’s so important to have examples of hope, examples of that’s empowerment. When you can see someone doing it, changes your mind. It was a Holocaust survivor talking about Maslow’s hierarchy of needs is wrong. At the bottom, the foundation of everything is hope. When you lose that, you can lose your shirt, you can lose your home. If you lose hope, that’s it for you. So it’s like, when the community starts to see this happening, they think, I could do that. I could grow okra, Yeah, it’s life-changing. We actually did a podcast. It’s called Meals to Fields. And we recorded it and we had like little intro music and we asked the school director and the Stella, who was the child welfare coordinator. She was over the nutrition. And we talked to Eugenio, who’s the project manager. we’d interviewed all of them. And I was listening to their interviews this morning. And I was just again, like, God, this project is like magic. And even they talk about how it’s a really unique project. We’ve never seen any, like, that’s how special, like this project was drawing attention from people and they would come and visit and be like, how are you guys doing this? How does your soil look so healthy? How are you guys growing all these crops? Like, How are you doing in South Sudan? Like this is meant to be like a food desert, desert, desert. It was so magical. And to hear the feedback and the reflections from the school director and Stella and the stories that they share, the before and after, wow, transformational.

Brion

Great story and it’s great success. And the long-term sustainment is really incredible.

Chelsie

Very, very local, very locally led. done in relationship, through relationship.

Brion

So you set them up for success. They’re keeping it going, which I think goes back to that it was done the right way, right? It’s not, we’re coming in, we’re gonna tell you what to do. This is based on all our research and science behind it and makes sense, but what is it gonna, what’s gonna work for them and how do you get the people bought in with their ideas and their empowerment of that program? And that’s harder. It takes longer to do that. It’s easier to go in there and kind of plop in a brand new stove and say, check, we did that to get them to use it and adopt it. And is it even the right thing for them and the problems that they’re dealing with? Understanding that and going through and breaking that down and figuring that out is more time consuming. But to be able to have that flexibility, like you said, in that program to shift the plan and figure out what’s actually going to work here. So how can people get a hold of you?

Chelsie

Maybe we can post my LinkedIn and my e-mail. You can message me on WhatsApp. I’ll put my WhatsApp number up there. Yeah, please feel free. This project is so near and dear to my heart and this type of work, this very human centered development work is my life’s work. I believe it is what I’m meant to be doing. It’s what I, it’s all I want to be doing. So yeah, I would be happy to learn even what other people are doing in the space and continue to grow and improve and see what we can do. Yeah.

Brion

You want to play us out with a song?

Chelsie

Yeah, I would love to share, because I shared, I would go back after dinner and hang out with the girls, and we would tell stories and sing songs, and they would always walk me back to my tent. One night, they said, okay, let’s stop and let’s sing this song together. So that’s what this is.

Girls

Let’s sing. One, two, three, start. Departure, departure, departure is so painful. Departure is so painful, so what shall we do? Departure, departure, departure is so painful, departure is so painful, so what shall we do? Where are you living? Where are you living? Brother Brian, where are you living? Where are you living? Departure, departure is so painful. Departure is so painful, so what shall we do? Departure, departure, departure is so painful. Departure is so painful, so what shall we do? Sister, Sister Chelsea, where are you all living? Where are you all living? Sister, Sister, where are you living? Where are you living? Ah, ah, ah, ah, ah. Zada, brother, Brian, where are you living? Where are you living?

Brion

That makes it worthwhile right there.

Chelsie

Oh my gosh, it’s so sweet. They’re saying departure, departure is so painful. What shall we do?

Brion

That’s what we do. So cute. Beautiful voices.

Chelsie

Yeah. I know. They have a lot of time to practice their harmonies and they are good.

Brion

Very good.

Chelsie

Thanks so much for having me.

Brion

Thank you, Chelsea, you so much. Yeah.

Chelsie

Being my mentor and helping me through the project. I really appreciate your support and guidance. May it continue. Please don’t leave me.

Brion

I didn’t do much. Yeah. I think all we did was work on that last part of the data confirmation and analysis part. You had all that other stuff already laid out nicely. You just kind of went back and checked the numbers. That’s it. So.

Chelsie

Well, may it continue. Thanks for this opportunity and for interviewing me on the podcast.

Brion

Thanks for sharing. All right.

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