Monday, August 24, 2015

African Cuisine: Botswana

Hello everyone, I know life has been exciting with Africa and hate to leave y'all hanging but but OCD will be on a brief hiaitus as I take my US Medical Licensing exam/ medical boards and it's crunch time! Wish me luck! 


You can read about my Africa journey here (what I'm doing), here (adjusting to expat life), and here (what seeing kids in HIV clinic is like)

I promise to share tons of Africa cuisine recipes and stories when I return. In the meantime, enjoy some photos of the fabulous food of Botswana / Africa which I'll update later, and as always, I'll keep updating in instagram

The traditional 3 legged pot to stew meat: here is seswaa aka pulled beef (their national dish) and fried beef.

Here is butternut sqush, pap (maize), and peanut morogo (African greens)

The famous Savannah cider of Africa. Delicious!

The adorable Courtyard Restaurant, right next to Botswanacraft market which sells amazing things!

 Sampu (corn), vegetable medley, and tomato morogo (African green)

Rooibos, or redbush, tea. Full of antioxidants and amazingly delicious, especially with milk and sugar (British style)

More rooibos tea time!

Delicious breakfast at the Chobe Bush Lodge! Love those African cloth patterns!

Tsamaya sentle (Goodbye/go well!) for now!

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Sunday, August 16, 2015

Spice Rubbed Steak and Egg Avocado Toast

I can't believe I'm already halfway through my pediatric HIV elective month in Africa! (Follow on instagram for frequent updates!)

Botswana has the 2nd highest HIV prevalence in the world at 25%, which is a shame since it's quite a stable and peaceful African country. The government has mounted a huge campaign, and anti-retrovirals are free for patients, paid by the government, grants, or international aid. I'm considered an "intern" here, so I have a lot of autonomy here which I love - the best way to learn something is jumping in and doing it. I write orders and prescriptions, decide what labs and drugs they need, and make the plan (after checking with an attending of course).

I even have medical officers (their residents) follow me on Mondays so I train them in clinic. It's really weird that as a medical student I'm actually teaching residents, lol, but we are basically equals here.
What's working at a clinic like in Botswana? Well, the patients are sooo much smaller and skinnier here. Too many 18 or 19 year old boys weighing less than me ... and I'm a petite 5 ft 1 in Asian girl! I've had patients underweight by more than 5 standard deviations! O_O'

Most are fairly normal on physical exam apart from the small size, but sometimes findings can be impressive - skin (herpes zoster and chicken pox scars, molluscum warts, pruritic papular eruption), heart murmurs everywhere from anemia/ malnutrition, significant intellectual disability from HIV encephalopathy, the most textbook perfect chronic lung disease signs (clubbing, barrel chest) in a boy living on an O2 tank for 16 years, side effects of years of HIV drug use (black nails, breast development, fat redistribution), scars from traditional medicine practices, etc - all this in just 2 weeks so far.
While patients are cool to see, my favorite part of the clinic visit is the counseling because I get to teach - why I'm in medicine!

The majority of the kids are adolescents/teens, so most of my time is counseling on medicine adherence (you absolutely cannot stop/skip taking HIV medicines or viral resistance develops). Each visit, the nurses count the pills to check compliance, but it's tough because there's still pill tossing or hiding the pill under the tongue and spitting it out. A lot of times we find out noncompliance too late ... when the labs monitoring the CD4 and viral load reveal the truth :(
While English is the official language and school is taught in English, there's still a language barrier with the younger and less educated patients. A lot of counseling is encouraging them to go back to school / stop failing school. For the teens, I always give the talk substance abuse, and more importantly, sexual protection. For a country with such a high HIV prevalence among youth, it's still hush hush, which makes finding acceptance even tougher.

And of course there's supportive care - psychology (for educational assessment, "disclosure" - when kids learn they have HIV and why they take HAART, depression), dietician for malnutrition (lots of patients), and social work (these are the saddest - kids will be doomed to treatment failure unless an adult takes responsibility, and it's rough seeing kids panned off from relative to relative without good care).
After clinic, I walk home back to my flat (thank goodness it's winter in the Southern hemisphere), which takes about 30 min. It's so dusty and dry that I'm covered with orange dust when I get home. One day, I happened to run into three cows wandering along the roadside - they had cowbells, but no owner in sight, and they just moseyed along. As I watched my dinner walk away, I nearly got run over; here they drive on the right side of the road British style, which is just so bizarre to me, and out of habit I keep looking at the wrong direction when crossing the road.

While the variety of food is limited to mostly starch and meat, there's no lack of protein. Beef / streak is BIG in African cuisine, and meat is plentiful. And they have SO many eggs - the cartons just sit out since they don't refrigerate them (NPR has a great article). While Botswana has to import a lot of its produce, avocados are super cheap.

So you can guess what I've been eating....yes steak, eggs, and avocado. Good for breakfast, lunch, and dinner!
I was delighted that my flat has a small kitchen (with the most darling plates), so I'll be sharing some African food in upcoming posts - this rub is from North Africa, with its many exotic Arab spices (I never had cinnamon on a steak before, but it's delicious!) I've also never had this type of avocado, but it's creamier than the Hass variety I have back home, making it a great spread for toast. I also never eat brown eggs, so it was fun playing with the color in the photos. Spice rub and steak adapted from Country Living.

I could ramble about my life here forever, but I'll stop for now, so you can make this recipe!

North African Spice Rubbed Steak and Egg Avocado Toast

2-3 steak, cut into pieces *
olive oil
1/2 teaspoon coriander
1/4 teaspoon cumin
1/4 teaspoon tumeric
1/2 teaspoon ground cinnamon
1/2 teaspoon peri peri (African chili) spice (or paprika)
sea salt and pepper, to taste

1 small ripe avocado
1/2 teaspoon peri peri (African chili) spice (or paprika)
pepper, to taste
2 eggs
2 slices bread

*Here in Africa, the groceries don't really label the cuts of meat, so I don't know what cut I have ... but you could use strip steak or T-bone.

STEAK: Rub steak with spice mixture, making sure to cover both sides, and marinate at room temperature for 20 minutes. Heat a large skillet over high heat until hot. Add the oil and pan sear the steaks until a brown crust forms.

EGG AVOCADO TOAST: Toast bread until golden brown. In a small bowl mash avocado with a fork and season with spices. Cook the eggs as desired (scrambled, poached, fried, over easy).** Spread the avocado on the toast and top with egg. Serve alongside the steak. Enjoy!

** Microwaved eggs cooking hack: Because I don't have a nonstick pan to cook eggs in my kitchenette here, I simply rubbed a plate with olive oil, cracked an egg on top, and microwaved in 30 second increments until the egg was cooked (warning: the egg will splatter).
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Saturday, August 8, 2015

Ombre Matcha Lemon Cake

I'm adjusting to life in Botswana in my first week. While many people were like "Gosh, you're in the middle of nowhere in Africa, there must be nothing there," it's not as destitute as it sounds. Gaborone is the capital, so it's got what I need, material wise.

People wise though ... one thing about not knowing a single person in an entire continent is it can be lonely. Because of the time difference (7-9 hours), the lack of having a cellular data internationally, and our very spotty internet/electricity, it's hard to videochat or facetime with people from home.

I work at the pediatric HIV clinic with Botswana doctors, and I'm the only medical student there. While official business is conducted in English, at lunch the staff chatter away in the native tongue of Setswana, and the doctors hardly eat lunch. There are a few other US expats, but all are fresh college grads who are in the (nonmedical) volunteer / social support aspect of the clinic, so I don't see or work with them.
The first day, I had no money (I could not find a place to get/exchange Botswana pulas until in Botswana), no food, no idea where to walk for work, and no sleep (plus jetlag) since I had arrived at midnight after 36 hrs of travel.

Luckily, kind people drove me, helped me get food and money, and introduced me to locals and suggested where to go/what to do. As the first week has passed by, I've adjusted and gotten to know people, local and expat, and everyone has been friendly. I'm not sure in America if people would go out of their way to help strangers.
I made this cake right before leaving for Botswana. Cake is such a social dessert since I always have to share it (I'd rather not eat a whole cake myself!) For my 25th birthday, my parents drove to visit, bringing me an amazing matcha lemon cake from Whole Foods that's been on my inspiration bucket list. I was delighted to work with Aiya matcha to make this awesome ombre matcha lemon cake.

This cake was a hassle (even more so than the pain it takes to make layer cakes in general) since I had to make the frosting three times. The first - a lemoncurd whipped cream - was my favorite tastewise, but much too soft for layering and made a mess. The second was to be a buttercream whipped cream that, alas, curdled and had to be tossed. The last was this lemon curd cream cheese filling that finally held up.

Ombre cakes are adorable, but it also definitely takes effort making sure the colors come out. Hopefully you can see the color gradient. You can certainly taste the stronger matcha flavor at the bottom!
I gave this cake to many friends - my roommate, who is kindly putting up with a subletter in my room this month; two who had birthdays that week (one who took his boards on his birthday!); my biking buddy who had to rescue me with a completely torn flat tire in the middle of the night shortly before I left for Africa (what a stressor! But now I know how to change a tire on an SUV); and a family friend who just started at my medical school (I am so excited to see the new baby first years start their journey!). As for my poor long-distance fiance, I could only text a picture, whose jealous belly is too far away, hehe.

So this cake has quite a few ties to my family and friends, and it makes me happy to even type this post up. I'm enjoying my adventure, but there's nothing like calling home when you're lost in the middle of a new world. Adapted from Allrecipes and Joy of Baking.

The wonderful matcha is from Aiya matcha - no food coloring needed. All post content is my own opinion. Enjoy!

Ombre Matcha Lemon Cake

1 1/2 cups all-purpose flour (or 50/50 all purpose and cake flour)
3/4 teaspoon baking soda
3/4 teaspoon salt
1/2 cup white sugar
3/4 cup vegetable oil
2 large eggs
1 teaspoon vanilla extract
3/4 cup plain Greek yogurt
1-2 tablespoons Aiya matcha (cooking grade)
whipped cream (storebought or homemade), to decorate 

2 large eggs
1/2 cup granulated white sugar 
1/4 cup lemon juice 
1 tablespoon unsalted butter
1/2 cup confectioner's sugar
1/2 8 oz package cream cheese, room temperature

MATCHA CAKE: Preheat oven to 350 degrees F. Grease and flour 3 6-inch round pans. Mix the flour, baking soda, salt, in a bowl and set aside. In another bowl, beat together sugar, oil, eggs, and vanilla extract until fluffy. Whisk in the flour mixture alternately with the yogurt, mixing just until incorporated (do not overmix). Stir in the matcha ** and pour evenly among the 3 pans. 

Bake in the preheated oven for 30 minutes, or until a toothpick inserted into the center of the cake comes out clean. Cool on wire rack for 30 minutes before turning out of the pans.

LEMON FILLING: In a stainless steel bowl placed over a saucepan of simmering water, whisk together the eggs, 1/2 cup of sugar, lemon juice, butter until blended. Cook, stirring constantly (to prevent it from curdling), until the mixture thickens to a yogurt consistency, ~10 minutes. Let cool at room temperature then refrigerate; the lemon curd will continue to thicken. Beat cream cheese with confectioner's sugar in another bowl, and combined mixture with the lemon curd - this will help it firm for assembly.

ASSEMBLY: When the cakes are completely cooled, stack the 3 cakes and spread a thin layer of lemon curd in between. Top the cake with whipped cream and dust with matcha for garnish. Tip: Freezing for a few hours can help keep slices neat.

For the ombre version, stir in a small amount (about 1/2 teaspoon) of matcha and pour 1/3 of the batter into a prepared pan. Add in more matcha into the remaining batter and stir until it's a darker green. Add 1/3 into another pan. Then add the remaining matcha into the batter, and pour the last 1/3 into the final pan - this should be the darkest green color. Adjust color with more matcha as desired - I love a good matcha flavor, but it can get bitter quickly!
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Tuesday, August 4, 2015

Hawaiian Pineapple Coconut Parfait

Dumelang (hello) from Botswana in Subsaharan Africa! 

I'm doing a month long pediatric HIV elective in Gabarone (the capital) through my medical school. I have never ever been to Botswana, or anywhere remotely close to it, so it's been quite the adventure!
I received a scholarship to help with airfare and vaccinations/malaria prophylaxis, and I'm super grateful to my med school for this awesome once in a lifetime opportunity. I've definitely a global adventurer, but B and my parents were less than excited about me traveling Africa.

Parents: Um, just so you know ... there's HIV there in Africa. I don't think this is a good idea.
Me: Yes, well, it IS an HIV elective, so I suppose there would be HIV there.

Going during August (the month before residency applications / the usual time people take their boards) wasn't ideal, but it was the only way I could fit it in my rotation schedule; the only other available month fit my schedule much better, but it would have been the month before the wedding, but the parents and B absolutely/adamantly/vehemently vetoed that idea.
Meanwhile, B and I are debating over where to plan our honeymoon - B wants somewhere relaxing and romantic with a beach, while I want somewhere adventurous and/or historical and far away. Greece was our original plan, but with the debt crises and the euro debate, we're hesitating a bit. B wanted Hawaii, which is gorgeous, but I definitely prefer somewhere more nontraditional (he vetoed Subsahara Africa although I told him Botswana has gorgeous locations lol).

Anyways, here's a Hawaiian parfait to get you all excited about exotic adventures. Pineapple and coconut are an awesome combo (hello, pina coladas!) and the yogurt makes for a filling and healthy snack.

For now, we'll keep debating about the honeymoon location - we're open to suggestions, either where you went or want to go! In the meantime, I'll give updates about life in Africa!
PS. I grew that orchid! She (yes, my plants have genders) was a birthday gift from B more than two years ago :)

Hawaiian Pineapple Coconut Parfait

1 cup plain Greek yogurt, divided
1 cup fresh pineapple, chopped
1/4 cup unsweetened coconut
1/4 cup cashews, roasted
1 teaspoon chia (or black sesame) seeds
1 tablespoon honey

Toast coconut until light brown (I used a toaster oven set to "toast" for about 2 min).

Layer your Greek yogurt on the bottom, then pineapple, then yogurt again. Top with pineapple, and sprinkle with coconut, cashews, and chia seeds. Drizzle with honey. Enjoy!
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