As a DaVita renal dietitian, Hanna from Maryland advises her patients to be careful of how much phosphorus, potassium and sodium they consume. At the same time, she understands that certain cultures embrace foods that are high in these substances. That’s one of the reasons she adapted a dish from her native Ethiopia to make it healthier for those on the kidney diet.
Hanna emigrated to the U.S. and is now an American citizen. She attended Howard University in Washington, D.C. and currently works at a DaVita center in Maryland.
“We have many dialysis units that are dealing with multicultural patient populations,” she explains. “The Ethiopian community is growing not only in the U.S. as a whole, but in our dialysis units as well. High phosphorus, high potassium and excessive fluid weight gain between dialysis treatments may be prevalent in this group.”
Typical Ethiopian food, such as spicy vegetable and meat dishes called wott, may contribute to high levels of phosphorus, potassium and sodium for Ethiopian patients. Wott is a sort of stew that is served on top of injera, a soft, spongy bread traditionally made from an Ethiopian grain called teff. Injera is available in the U.S., although it’s made with other types of flour instead of teff, which is found only in Ethiopia. Ethiopians use injera to scoop up the wott and other dishes, since utensils are not used in the African nation.
Ethiopian dishes tend to be spicy. The key seasoning used in Ethiopia is berbere, which is made from chili, salt and garlic. Berbere is used to flavor a variety of Ethiopian dishes, but this ingredient may cause an increase in fluid intake, so it’s not advisable for renal patients. Mitmita, another type of Ethiopian spice that is usually served with meat dishes, is made from red chili powder, salt and cardamom.
Knowing the drawbacks of using Ethiopian spices, Hanna has adapted a recipe for a popular Ethiopian dish, Beef Tibbs, so that it is healthier for kidney patients. Rather than using berbere or mitmita, Hanna has recommended using either jalapeño pepper for a spicy flavor or green pepper for a less spicy version. You can adjust the degree of spiciness to your own liking by reducing or eliminating the jalapeño.
Beef Tibbs can be eaten with injera. If you want to follow Ethiopian customs, eat it with your right hand. In Ethiopia, food is considered a gift from God, and eating with your left hand is viewed as being disrespectful.
When it comes to working with her dialysis patients, Hanna does more than simply provide them with factual information. She says, “I give my patients not only dietary support, but I also listen to them when they need an ear and give them encouragement.”
She appreciates seeing her kidney patients interested in learning more about their health and asking questions so they can better understand what they need to do to stay on a healthy track. Together, Hanna and her patients work toward resolving problems and finding answers to their questions.
Hanna’s approach to working with patients varies, based on the individual’s own understanding. She tailors her approach to each person and believes in constructive teaching, using graphs, visuals and handouts to illustrate her points. She also refers patients to DaVita.com and other resources for additional information.
“I think the most important things patients can do to improve their health are to really understand what they are facing and know that they can control it by working with their health care team,” Hanna explains.
Every day in her work as a renal dietitian, Hanna is faced with the challenge of keeping patients motivated. But she reports that seeing the smiles on her dialysis patient’s faces when she gives them good reports on their lab work makes it all worthwhile.
As an 8-year veteran of DaVita, Hanna thrives on the teamwork she experiences on the job. “They’re a great bunch of people,” Hanna says of her colleagues.
There is a great deal of variety in Hanna’s work. “Our center is a multicultural unit, as far as the teammates are concerned. However, our patients are predominantly African American. The medical director has been leading this unit for the last 15 years. She’s originally from Australia. I think she is a very special lady. Everyone I work with is superb. I could not ask for more.”
Take Hanna’s suggestion and try her recipe for tempting Beef Tibbs. It’s an out-of-the-ordinary meal that tastes so good, yet with Hanna’s kidney-friendly modifications it can fit into many kidney diet plans.