As I peer into the oven, the Victoria sponge is rising perfectly, a little earlier than I would expect in the UK but it just looks so beautiful. A little while later I peer in again through the slightly sticky oven glass to see the top of the cake begin to take a golden brown colour. I look in a third time, my mouth watering, hopes are dashed as I see a slight ribbing of the cake surface and it is sinking, it is definitely sinking! Knowing it’s too late to change the outcome I go and make a cuppa to comfort myself. Andrew asks if he can dilate my eyes again tonight, there’s a recurring pattern here, many sunken cakes and blurred vision, he has some new gadget to test. In the back of my mind I know baking at high altitude is different due to the lower air pressure and so I have adapted the cake recipes by using less raising agent, but the time has come for a little more research. I’m not sure if I can handle another sunken cake!
We are living at 2000m above sea level, a perfect training zone when running but a little more of a challenge when baking. As altitude increases air pressure decreases which means baked goods will rise more quickly and lose more moisture. Liquids evaporate more quickly and water boils at a lower temperatures with lower air pressure, which means dry crumbly cakes. With lower air pressure, resistance is less to the growing air pockets in the dough or sponge causing them to grow quicker which may lead to over stretched cell walls or large irregular air pockets both of which will lead to collapsing baked goods. The remedies include reducing the raising agent and for our altitude is as much as half the original, adding more moisture to the uncooked mixture/dough, adding an extra egg as this is the setting agent, and when more of it is around it can help form the cooked shape, slightly higher cooking temperatures can also help fix the shape quicker.
So I added an extra egg than I normally would, whisked the egg and sugar for 3 minutes rather than 5, halved the raising agent and daringly turned the oven (random temperature generator) up by 10°C, as this is a vegetable sponge i.e. no added fat I wouldn’t expect it to have dome shape but I really didn’t want it to sink! As I take the two halves of the cake out the oven and place them on the top of the cooker, I watch, wait, watch, wait and have a cuppa whilst making the mango jam. It’s actually not sinking, dare I say I’ve conquered baking cakes at altitude?!….
Whilst I was dealing with my own atmospheric pressure problems, Andrew was having to deal with the complications of high eye pressure in the field…
Today we are in a run-down building with smashed windows. Apparently it was over run in the clashes of the last elections and has not been repaired since. At least the windowless windows mean we are able to pass a cable from a generator directly through to the equipment. We set up, avoiding the various types of animal poo that surrounds the building as the patients wait to come in.
An old man is guided to me at the slit-lamp; he has a wooden stick in one hand and is being guided by one of the team. He is not one of our study patient’s but we have an open door policy and examine and treat anyone we can from the community who hears we are here. His wife accompanies him and they are excited, as they’ve heard other people in the room have been offered sight-restoring surgery and are hoping they will get the same. I recognise the wide-eyed, searching look and suspect this man has glaucoma. Unfortunately my suspicions are correct and it is of a very advanced nature meaning he is already blind and beyond treatment. Unlike cataracts, glaucoma blindness cannot be corrected, only prevented. It turns out he has been aware of sight problems for some time and had been given treatment from his local chemist (no prescriptions needed here). He pulls out a tatty bottle from his pocket, I read the label, he has been using steroid eye drops for months to years. Steroids eye drops have many unwanted effects including raising eye pressure, which for this man most probably sped up his journey to blindness. I feel both gutted and frustrated that such unregulated treatment can be given out, had this man seen a trained eye care professional when he first had his problems he would have had a fighting chance of still having useful vision. I remind myself that this is why we are here, although not able to help the man sat in front of me we hope to stop others like him being in the same position.
Recipe – Cashew and Butternut sponge
Ingredients – sponge
3 medium eggs
160g castor sugar
200g grated butternut squash
100g rice flour
100g ground cashew nuts
1 tsp baking powder
1tsp vanilla extract
Pinch of salt
Ingredients – Mango Jam
1lb ripe mangos
3/4 cup white sugar
1. Pre-heat the oven to 180°C and line two 22cm half cake tins with baking parchment.
2. To make the sponge, whisk the eggs and sugar at high speed until three times the volume for 3 minutes in a mixer.
3. Grate the butternut squash and whisk in.
4. Beat in the remaining sponge ingredients. (I ground cashew nuts in the coffee grinder).
5. Add the sponge mixture equally to each cake tin and put in the oven for 20 mins, until slightly coming away at the edges and a lovely golden brown on top.
6. Whilst cooking start the mango jam. Chop the mangos into 1 cm cubes or smaller and add all the ingredients to the pan.
7. Put on full heat and stir gently as required, remove from the heat when it becomes more of a gooey jam consistency or begins to ripple if you put it on the back of a metal spoon and push it gently with your finger nail.
8. Let the cake cook for at least 20 mins in the cake tin, once cool and once the jam is nearly cool spread the jam over the base cake and place the better looking cake on top for a mango cashew nut sponge.