Wednesday, December 06, 2006

License to...Confuse

Having lived and worked in a number of countries on various continents, I appreciate and accept differences in education systems, qualification procedures, even methodologies. However, there is an issue which I've encountered in Buenos Aires that would probably sit in my "to be reconciled" tray for a while.

It had been explained to me by Guillermo and a number of Argentine friends that the local university education of certain subjects takes much longer to complete than it would in other countries because a graduate under the Argentine system is also a licenciado (licensed practitioner) whilst in many other countries graduates who studied a vocational subject would have to work in the related field for a number of years after their graduation and then sit for professional exams in order to qualify with a practitioner's licence.

While my personal experience with licensed professionals here, especially medical doctors, has been a very good one, I have observed the following:

Firstly, the proverbial GP (General Practitioner) almost doesn't exist. Through our Medicus health insurance scheme, we can see a GP whose function is largely ferrying us to an appropriate specialist. How much these GPs keep up to date with latest medical research findings or professional development is anybody's guess.

Secondly, probably as an indirect result of the first - most Argentines I've come across including my own husband feel their medical condition, be it a common cold or an itchy eye, has to be looked at by a specialist.

Further, many of the patients, especially the older generation, feel the age of their doctor is one of his/her credentials. Again, how much a specialist keeps his/her knowledge fresh and updated is down to the individual. For this reason, my personal feeling is that the age of a doctor could actually be a handicap in some unfortunate cases.

Once I look beyond my personal experience, the bigger picture turns a lot grimmer. I've heard of medical doctors who recommend a spoonful of sugar a day for babies when they reach the solid-food stage at 6-months; or a friend who had gone through emotional turmoil and a few licensed fertility specialists to realise an elementary set of blood tests at the very beginning would have identified her condition and saved her much time, discomfort and disappointment.

If I look further than medical doctors to nutritionists, my horror more than doubles. While most healthy adults would seek advice from this group of professionals to improve their well-being, the more important job of nutritionists is in treating patients with real and serious conditions such as food allergies or guiding young first time mothers in nursing their babies.

I have witnessed a licensed nutritionist feeding butter, fatty cheese (queso cremoso) and yoghurt with more sugar and food colouring than nutrients (those tubs or bags of vanilla flavoured yoghurt on sale here are as artificially coloured and flavoured as the pink and orange ones) to her own 8-month old baby while her older son had already moved on to include chocolate and dulce de leche in the above list of dietary staples.

I can make myself reconcile with her introducing junk to children if only because, as unbelievable as it may sound, the society around us positively embraces such conduct. In addition to breakfast of alfajores (dulce de leche filled biscuit sandwich), I have read a popular local publication for mothers and their babies, Nacer y Crecer, in which another licensed nutritionist gave a pumpkin soufflé recipe intended for teething babies which included a heaped tablespoonful of sugar.

However, my shock and despair could not be contained any longer when the mother of our two year-old niece who has milk allergy recounted to me a licensed nutritionist had advised her that milk allergens exist only in milk but not cream!!?? Thank goodness this mother felt she'd better be extra cautious.

Since doll-like Maria-Paula's allergy has been confirmed, her family has to make radical changes to their meals. Her tired and stressed father conceded that it may be a blessing in disguise to force them rethink and adopt a much healthier lifestyle. At the moment, however, changes are agonising for the little one as she had been fed a typical diet of an Argentine child – very limited variety of food; mostly milk, sweetened and flavoured yoghurt, sweet biscuits, chocolates...and some meat and potato if her appetite had not been completely destroyed by then. The only fruits she had been exposed to, occasionally, were apples and bananas.

In many cultures, milk doesn't feature once babies could chew so it follows that there is no such strong feeling of doom and gloom if milk isn't a significant part of their diet. Naturally, I looked East while digging around for a dulce de leche alternative just in case Maria-Paula suffers withdrawal symptoms in her transition to an improved diet.

Kaya is a culinary symbol of a number of South-east Asian countries, equivalent to that of dulce de leche in South America. In place of cow's milk, its main component is coconut. Strictly speaking, Kaya is coconut curd.


Kaya, adapted from the worldly gourmand, Chubby Hubby

250ml coconut milk
2 tsp vanilla extract
275g caster sugar
1/4 teaspoon salt
8 fresh eggs

Combine the eggs, sugar and salt in a large bowl. Stir (do not beat) with a whisk until the sugar is dissolved.

Put the coconut milk and vanilla extract into a saucepan. Slowly heat it up until it begins to boil. As soon as it reaches the boil, pour it over the egg mixture, stirring it in carefully. When blended, strain the mixture through a sieve into the top part of a double boiler. Gently heat the mixture, stirring constantly, until it just begins to thicken.

Sieve the mix into a heat-proof container. If you use jars, use wider, shorter jars. Cover tightly with foil. Make a few small incisions in the foil so steam can escape.

Place the container (or jars) into a steamer and steam for 90 minutes to 2 hours, or until firmly set. Cool and then keep covered in your fridge. It will keep for a week.