Hayley Heino, Cindy Chen,

Jessie Crawford, and Oscar Jan

Nutrition Grant Proposal: The Happy Carrot Food Truck

Executive Summary:
Food insecurity is one of the major issues that affect the population of refugees
migrating to Europe. A demographic of major concern is breastfeeding mothers and their
infants. Deficiencies of certain nutrients in the mother can affect the content of those
nutrients in breast milk. One such vitamin that is essential to infant health and survival is
Vitamin A. Vitamin A is integral in maintaining immune function and preventing blindness
in children. Our goal is to mitigate malnutrition and Vitamin A deficiency in the Syrian
migrant population, particularly breastfeeding mothers, by providing food trucks that
contain Vitamin A rich foods along with other nutritious options. Our goal is to also educate
breastfeeding mothers about the importance of meeting their Vitamin A requirements so
that they have the incentive and background knowledge to select Vitamin A rich foods. We
will utilize a happy carrot system to assess compliance and participation in our program.
We will also assess the efficacy of the program by obtaining biochemical measurements of
Vitamin A levels in the infants. By promoting consumption of Vitamin A rich foods by
breastfeeding mothers, we hope to indirectly improve the Vitamin A status of their infants.
Target Group:
The target groups of this intervention are breastfeeding mothers and their infants
who are travelling from Syria and camping in refugee camps located in Budapest, Hungary
and Vienna, Austria. This migrant population is food insecure and the vitamin A content of
the mothers diets and the breast milk for the babies is of concern. Other members of the
community are welcome to use the resources we will be providing, but breastfeeding
mothers are our main priority.

Specific Aim and Background:

Vitamin A deficiency is a common issue in the migrant population in Europe. It can
lead to not only blindness in children, but can also increase their risk of infections. Thus, it
is essential to ensure proper vitamin A intake as early in the childs life as possible.
Additionally, vitamin A is one of the only micronutrients in breast milk that is affected by
the mothers intake. For these reasons, we propose a nutritional intervention that targets
lactating mothers in order to indirectly improve the vitamin A status of their infants.
It is our hope that by 2018, the percentage of vitamin A deficient infants within Syrian
refugee camps will be less than 20%. By 2018, 70% of the women in our program will
choose between 14 and 28 happy carrots per week, indicative of their vitamin A
consumption. We also hope that by 2018, at least 80% of breastfeeding women in Syrian
refugee camps in Budapest, Hungary and Vienna, Austria will participate in our program.

Proposed Intervention:
We would like to send trucks to migrant camps, containing many ready-to-eat foods,
such as fortified cereal, produce, and pre-prepared meatballs, with particular emphasis on
vitamin A-rich foods. There will be 2 food trucks stationed in the Budapest camp and 2
trucks stationed in the Vienna camp. Individuals will be able to enter the truck to select
their food from displays and must stop by a cash register to check out upon exiting. While
all migrants in the camps will be able to access the food, priority will be given to

Hayley Heino, Cindy Chen,

Jessie Crawford, and Oscar Jan

breastfeeding women enrolled in the program. These women must register and allow their
infants blood to be tested for vitamin A levels every two weeks in order to continue
receiving priority. To this end, 2 blood vans per camp will be available each week on days
based on the availability of the refugees. Due to the safety concerns inherent in the
preferential distribution of food to a desperate population, we will station bodyguards near
the truck during operation to ensure orderly conduct.
In addition to this, we will implement the happy carrot system to track the amount
of vitamin A rich foods breastfeeding mothers are taking from our program. We can track
this activity by the use of medical ID bracelets that the breastfeeding women can wear.
Every time they visit our food truck, we will give them a complimentary reusable bag, input
the type of food they take using the Point of Sale (POS) systems (similar to the ones in
restaurants), and their medical ID bracelets will be scanned. This POS system is
preprogrammed with foods that we are giving out and information about the vitamin A
content in each food. Happy carrot stickers will go on the shelves so women can see them
when they are selecting their food. The women will be required to attend a brief education
session explaining the importance of their vitamin A consumption in relation to the babys
health. At that time, we will also explain how the happy carrot system works. The
breakdown of the happy carrot stickers are based on the amount of vitamin A per serving
as follows:
1 happy carrot= 25%-49% of daily value/serving
2 happy carrots= 50%-74% of daily value/serving
3 happy carrots= 75%-100% of daily value/serving
4 happy carrots= over 100% of daily value/serving

All of this data will be saved into the system and can be used as data for monitoring the
vitamin A-rich food selection by participating women.

Expected Outcomes:
The outcomes that we will measure in our intervention are:
Serum Vitamin A status of the infants of participating mothers.
Participation rates of Syrian breastfeeding mothers in camps at Budapest, Hungary
and Vienna, Austria.
Vitamin A-rich food selection by participating women.
Timeline:
Year 1
September 2016-October 2016:
prepare four food trucks for service
hire staff: translators, refugee assistants, etc. (see budget)
train employees on protocols and responsibilities
identify local food and produce suppliers
prepare sterile blood vans to collect samples from infants
administer survey to participants related to convenient times
for blood draws

Hayley Heino, Cindy Chen,

Jessie Crawford, and Oscar Jan

November 2016:
establish program at camps
collect participants (perform initial vitamin A assessment)
perform brief vitamin A education session and introduce happy
carrot system
December 2016-August 2017:
food trucks visit each camp every other day
have blood vans visit camp once every week (alternating
days/times depending on availability indicated by survey)
Year 2
September 2017-May 2018:
Continue to serve women in specified camps
try to increase participation in program
hire additional employees as necessary
June 2018-August 2018
establish and implement sustainability plan
establish long-term follow-up plan

General Budget and Justification:

Project Staff Budget
-Cindy: train employees/refugees; observe operations at Austria camp; HR
$80,000
-Jessie: train employees/refugees; observe operations at Hungary camp; HR
$80,000
-Oscar: facilitator for Hungary camp. Blood van coordinator.
$80,000
-Hayley: Planner/facilitator in Austria camp (organize collaborations; set up where to
obtain food); Finances.
$80,000
-Body guards: 3 per truck (12 total)- 2 remain at truck, 1 to escort women home if
necessary. $30,000 x 12
$360,000
-Truck crew/food stocking team: 2 refugees per truck (restocking and translations, general
assisting). $30,000 x 8= $240,000; 1 driver per truck. $60,000 x 4=$240,000; 1 cashier per
truck. $50,000 x 4= $200,000
$680,000
-Blood crew: 1 driver per van. $60,000 x 4= $240,000; 1 phlebotomist per van. $30,000 x
4= $120,000; 2 clinical chemists. $60,000x2= $120,000; 1 translator per van. $45,000 x4=
$180,000
$660,000
-IT person: 2 total part time, 2 days/week. $24,000 x2
$48,000
-Nutrition educators: RDs with MS degrees for vitamin A education. $80,000x2
$160,000

Hayley Heino, Cindy Chen,

Jessie Crawford, and Oscar Jan

-Custodial staff: refugees, 2 per truck. $30,000 x8

$240,000
-Marketing coordinator: 1 to spread awareness. $30,000; plus 2 assistants
$10,000 x 2
$20,000
Total staffing budget: $2,488,000 x 2 years= $5,006,000

Equipment Budget
-Food trucks: $125,000 for trailer; modification $75,000 = 200,000 total per truck;
$200,000 x 4
$800,000
-Personal vehicles: for four project leaders (group members) plus two nutrition educators.
$10,000 x 6
$60,000
-Blood vans: vans equipped for blood draws are $30,000 each. $30,000x4
$120,000
-Maintenance: $1200 for trucks and vans for a month, want for $1200x12 months x2 years
$28,800
-Gas: $500 per month. $500 x 12 months x 2 years x 8 vehicles
$96,000
-Insurance: $1000 a month fro food truck and blood van insurance. $1000 x 12 months x2
years x 8=
$192,000
Total equipment budget: $1,296,800

General Supply Budget

-Marketing resources/ carrot stickers: $1000 per year. $1000x2
$2000
-Medical bracelets: $35 per person, preparing for 1000 women. $35x1000
$35,000
-Blood storage refrigerator: 1 per blood van. $600x4
$2400
-Medical equipment for blood vans: $25,000 per van. $25,000x4
$100,000
Total general supply budget: $139,400

Food Budget
-Food: 20,000 people total x 24 months x $35=
Total food budget: about $17,000,000
Total Budget

Hayley Heino, Cindy Chen,

Jessie Crawford, and Oscar Jan

Total asking budget: $23,442,200= approximately $23.5 million

Monitoring and Evaluation Methods:

We will be keeping track of Syrian breastfeeding mothers participation in the
program for both the Budapest and Vienna refugee camps. Each woman will be given a
barcode bracelet linked to her unique identification code. Women will use this bracelet as
identification both when picking up groceries from our trucks and when having their
infants blood drawn. The bracelets will be scanned at both of these activities, so our
computer database will be able to track how many women are actively participating in the
program.
We will be assessing the serum retinol and serum retinol binding protein levels of
the infants of participating mothers in order to track the adequacy of vitamin A
consumption in the mothers diet. Blood vans will be accessible for blood draws every
week, though participating women are only required to have their infants blood drawn
every other week. We will assess the vitamin A status of the collected blood and enter it
into our database, connecting it with the mothers unique ID code. This way, we will be able
to track vitamin A status over time.
Finally, we will be keeping track of the vitamin A-rich food selection of the
participating women using our happy carrot labeling system. When the women are
checking out at the cash register in our truck, the cashier will select the items that the
women have chosen. The computer will contain each food items happy carrot value, so
when the womans barcode is scanned when she is checking out, her selections will be
linked to her ID. We will only pay particular attention to foods that have happy carrot
values.
Sustainability Plan:
One of the secondary goals of the project is to help the migrant community to gain
independence. Refugees will be employed as workers on the food trucks already. Hopefully
once our project ends they will be able to continue working and will take over much of the
daily operation duties.
Over the course of the project we will have partnerships with several markets,
farmers, and other food vendors. We will have some of our food donated from these
companies using the incentive of tax write-offs. They will also be able to donate
undesirable foods which are not perfectly shaped or close to their expiry date and
therefore less likely to be purchased. Once the project funding ends, these individuals may
continue to donate food for the refugees.
Additional sources of revenue to fund the program can be obtained by asking the
refugees for a small membership fee to use the truck (which would still be a discounted
rate to the cost of food from stores). Also, we can allow the stores to advertise their
companies on the side of our trucks to improve visibility and reputation of their brand.
Long Term Follow Up Plan:
The permanency of this program can be assessed through international agencies
such as the World Health Organization. The infants can be followed and assessed over time
to determine whether the program had a lasting impact. Biochemical indicators such as

Hayley Heino, Cindy Chen,

Jessie Crawford, and Oscar Jan

serum retinol and serum retinol binding protein can be used to measure whether vitamin A
deficiency has decreased over time. A second method of determining the success of the
program is to look at population data and determine the change of incidence of night
blindness and vitamin deficiency- related infections. Finally, the participating womens
purchasing habits should be routinely surveyed to determine if they are continuing to
choose foods high in vitamin A, even in the absence of the happy carrot system.
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http://www.payscale.com/research/US/Job=Security_Guard/Hourly_Rate
http://fleetowner.com/blog/big-rigs-big-costs

http://www.payscale.com/research/US/Job=Phlebotomist/Hourly_Rate
https://www.glassdoor.com/index.htm

http://www.truckfoodfinds.com/food-truck-start-up-costs.html

http://www.12volt-travel.com/12-volt-refrigerators-c-630.html

http://www.worldvision.org/news-stories-videos/syria-war-refugee-crisis