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HIV Cooking Demo Spices Up Health

By Lane Hartill

Sarata's in a rush. She's got a grocery list a mile long and guests arriving soon. With a bucket in her right arm—that's her shopping bag—and her purse on her left, she dives into the market.

Woman spooning peanut butter into a plastic bag.

A woman in a market in Kolda, Senegal, spoons peanut butter into a plastic bag. Photo by Lane Hartill/CRS

First on her list: peanut butter, big oily spoonfuls wiped into a take-home plastic bag. Then some gnarly-looking eggplants and some bruised tomatoes. She eyeballs them, hesitates, throws them in her bucket and moves on. No time to be picky.

Snail meat is next. White as apple flesh, the meaty foot of a gastropod is Sarata's secret ingredient. The snails are as big as papayas and, Sarata tells me, packed with nutrients.

Then it's dried fruit from the baobab tree. They don't call the baobab "tree of life" for nothing: Everything from the bark to the leaves is useful. The 7-inch-long pieces of dried fruit, used to make juice, have more vitamin C than a Florida orange.

Sarata quickly throws in the ingredients that make up the bulk of the recipe—rice, potatoes, carrots. Then she hustles out of the market and heads for the community center where the dinner will be held.

Pulling Out All the Stops

This dinner is going to be something. Sarata's pulling out all the stops. She's preparing her famous mafé—beef in peanut sauce over rice—and she wants to blow the flip-flops off the crowd.

That's right. Dress is informal this afternoon. And nobody is obliged to bring a side dish. This group has been sharing dinners for months, and the women know the drill once they arrive: Grab a paring knife, take a tuber, crouch like a catcher behind home plate and get to peeling.

Some are less helpful. One woman stretches out on the floor, uses her arm as a pillow, and takes a snooze. Another keeps to herself, fanning her back.

But nobody seems to mind. These are friends, and they have one thing in common: They all have HIV.

Sarata dishes up mafé

Sarata dishes up mafé, a peanut and meat sauce, as part of a cooking demonstration that teaches members of an HIV support group how to prepare healthful meals. Photo by Lane Hartill/CRS

Welcome to the Ballondiral Association, a 67-member support group for people with HIV in Kolda, a city in southern Senegal.

This group, though, has a twist. Twice a month, members take turns doing a cooking demonstration. There's no studio audience or fancy lighting. The goal here is simple: Teach Senegalese with HIV what foods contain the vitamins they need to stay healthy. Then teach them how to prepare it.

Vegetables, for example, are a hot topic.

"People usually leave the vegetables in the bottom of the bowl," says Ambroise Diatta, Catholic Relief Services HIV and AIDS coordinator in Kolda. "They don't eat them."

It's no wonder. Senegalese food is known for its succulent chicken, rich sauces and spicy fish. But vegetables end up overboiled mush. Their flavor and nutrients are leached out of them, and they offer no competition for their neighbors on the plate.

'Always Hungry'

As Sarata cooks—cutting ropes of excess fat off beef—she explains that people with HIV are always looking forward to their next meal.

"I'm ready to eat anything," she says. "This morning I had café au lait, bread with mayonnaise, and an egg. I'm always hungry."

Ambroise says people who have HIV must eat often. Otherwise, excess gastric acid will collect in their stomach and cause ulcers.

Sarata's mafé arrives on platters the size of manhole covers, and it doesn't disappoint. To the untrained eye, it has the rusty brown look of fresh mud. But take a pinch with your right hand, as is customary here, pack it into a tight, bullet-shaped wad, and tuck it into your mouth. Imagine tenderloin cubes soaked in tangy barbecue sauce with more than a hint of peanut butter. The mountain of mafé is studded with red-hot peppers, if your throat can handle them.

But for the guests there, the dish isn't meant to be fawned over. It's more elemental; it's the first time many have eaten meat in weeks. In distant villages, millet is the staple food and there's often little protein to supplement it.

"Some people don't have enough money," to buy the right food, says Ambroise. "But with these community meals, we explain to them how to prepare [nutritious] meals with the little they have."

A group of women eat mafé.

A group of women eat mafé, a peanut and meat sauce, over rice. The women are part of a CRS-supported HIV support group in Kolda, Senegal. Photo by Lane Hartill/CRS

Sharing Dinner and Conversation

As the group gathers in a circle, conversation accompanies digestion. One woman volunteers that the ingredients in the mafé were full of vitamins. This comment prompts a discussion of what foods people with HIV need. Vitamin C—like the juice made from the baobab tree—enables people to absorb their antiretroviral medicine better. If people with HIV don't get enough Vitamin C, and their medicine isn't absorbed properly, their CD4 count (the measure of how strong a person's immune system is) can plummet.

"To vary the dishes, it's very difficult from the month of July to September," says a stately man in a gray suit. "You can eat the same dish for an entire week." This is the hungry period, when the previous year's food stock has finished and the current crops aren't yet ready to harvest.

That's why Sarata's mafé today, and the company of other people with HIV, is a relief for many.

Ambroise points out that everything in the dish was grown locally. And even those group members who live in remote villages can get peanuts, rice, gumbo and oseille (a kind of hibiscus whose flowers are used to make juice and whose leaves are high in vitamins C and A).

'Isolated and Stressed'

The discussion slowly veers from food to stigmatization. And the mood in the room takes on a new feel.

One woman says residents in Kolda now assume people have HIV when they are simply sick.

"In town, people are talking," says a plump woman in the corner. "Even if they see a person who is sick, who's lost weight, they say: 'Look at what he looks like. I think he has HIV.' "

Another woman, in a bright dress, pipes up.

"When you are discriminated and stigmatized in your neighborhood, it's total rejection," she says. "You are isolated and stressed until it reaches death."

People in Senegal can't keep secrets, says another. If you tell one person you're HIV-positive, it will be all over the village before you know it.

That's why groups like this are key, says Ambroise. People can let their guard down, talk about problems and how to solve them.

"When I come here, I'm completely at ease," says a woman. "And what I ate here today, it's been a long time since I've eaten like that."

Sarata is a pseudonym given to her to protect her identity.

Lane Hartill is the western and central Africa regional information officer for Catholic Relief Services. He is based in Dakar, Senegal.

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