malnutrition: a disease of development

THE PRICE OF PROGRESS
MALNUTRITION: A Disease of development
Malnutrition, particularly in the form of protein deficiency, has become a critical problem for tribal peoples who must adopt new economic patterns. Population pressures, cash cropping, and government programs all have tended to encourage the replacement of traditional crops and other food sources that were rich in protein with substitutes, high in calories but low in protein. In Africa, for example, protein-rich staples such as millet and sorghum are being replaced systematically by high-yielding manioc and plantains, which have insignificant amounts of protein. The problem is increased for cash croppers and wage laborers whose earnings are too low and unpredictable to allow purchase of adequate amounts of protein. In some rural areas, agricultural laborers have been forced systematically to deprive nonproductive members (principally children) of their households of their minimal nutritional requirements to satisfy the need of the productive members. This process has been documented in northeastern Brazil following the introduction of large-scale sisal plantations. In urban centers the difficulties of obtaining nutritionally adequate diets are even more serious for tribal immigrants, because costs are higher and poor quality foods are more tempting.
One of the most tragic, and largely overlooked, aspects of chronic malnutrition is that it can lead to abnormally undersized brain development and apparently irreversible brain damage; it has been associated with various forms of mental impairment or retardation. Malnutrition has been linked clinically with mental retardation in both Africa and Latin America, and this appears to be a worldwide phenomenon with serious implications.
Optimistic supporters of progress will surely say that all of these new health problems are being overstressed and that the introduction of hospitals, clinics, and the other modern health institutions will overcome or at least compensate for all of these difficulties. However, it appears uncontrolled population growth and economic impoverishment probably will keep most of these benefits out of reach for many tribal peoples, and the intervention of modern medicine has at least partly contributed to the problem in the first place.
The generalization that civilization frequently has a broad negative impact on tribal health has found broad empirical support, but these conclusions have gone unchallenged. Some critics argue that tribal health was often poor before modernization, and they point specifically to tribals’ low life expectancy and high infant mortality rates. Demographic statistics on tribal populations are often problematic because precise data are scarce, but they do show a less favorable profile than that enjoyed by many industrial societies. However, it should be remembered that our present life expectancy is a recent phenomenon that has been very costly in terms of medical research and technological advances. Furthermore, the benefits of our health system are not enjoyed equally by all members of our society. High infant mortality could be viewed as a relatively expensive and egalitarian tribal public health program that offered the reasonable expectation of a healthy and productive life for those surviving to age fifteen.
Some critics also suggest that certain tribal populations, such as the New Guinea highlanders, were “stunted” by nutritional deficiencies created by tribal culture and are “improved” by “acculturation” and cash cropping. Although this argument does suggest that the health question requires careful evaluation, t does not invalidate the empirical generalizations already established. Nutritional deficiencies undoubtedly occurred in densely populated zones in the central New Guinea highlands. However, the specific case cited above may not be widely representative of other tribal groups even in new Guinea, and it does not address the facts of outside intrusion or the inequities inherent in the contemporary development process.

QUESTION: Does progress or economic development increase or decrease a given culture’s ability to satisfy the physical and psychological needs of its population or its stability?