Which Formula?
So this is my blog’s thirty-sixth post. And, wow, what a year it’s been. Thank you, dear readers, for staying the course, and I promise more for 2012. This, though, is going to be the last essay for 2011. I’ll be spending December eating, cooking, researching, and teasing the cat. Really, it’s going to be wild. But before the fun begins, I’ll be in the UK for ten days, to present a seminar paper and to do a little research at the amazing Wellcome Library.
My real, live academic research pertains to the history of childhood in the British Empire. My PhD thesis traces the ways in which ideas around childhood and youth changed in the Cape Colony during the second half of the nineteenth century. It pays particular attention to the role and impact of Dutch Reformed evangelicalism in this process. But my postdoctoral project – which is being funded by the National Research Foundation (peace be upon it) – looks at the work of the Mothercraft movement within the British Empire between 1907 and 1945.
Mothercraft was pioneered in New Zealand in 1907 in response to concerns about the very high child mortality rates among the country’s Pākehā population. Dr Truby King devised a twelve-point programme to teach specially-trained nurses – known as Plunket nurses in New Zealand and Athlone nurses in South Africa – how to encourage mothers raise healthy babies. The success of Mothercraft was such that King was invited to establish a Mothercraft Training Centre in Britain in 1917. First called the Babies of the Empire League, it sent its nurses around the Empire: to Canada, Australia, India, east Africa, the Caribbean, and South Africa. My project focuses on the work the South African Mothercraft Centre and League, which were established in the mid-1920s.
But what, I hear you say, does this have to do with food? Well, a surprising amount. One of the main emphases of Mothercraft was on the proper feeding of babies. King was an enthusiastic promoter of breastfeeding.
We have a misconception that most babies were fed by wet nurses during the nineteenth century. It bolsters the view we have of middle-class Victorian ladies who were so terrified of their own bodies that feeding their babies was simply beyond the pale. This wasn’t strictly true, though. To begin with, wet nurses were expensive to hire and only the very wealthiest families could afford them. Most middle class women fed their own babies, as did many working-class women too.
In fact, the majority of women who relied on others to feed their babies were poor. In a time when working hours were yet to be properly defined by law, long days in factories or shops were the norm for female urban workers. Those without relatives, paid ‘baby farms’ – a house run by a woman who would care for babies and young children – to care for their offspring, often for weeks at a time. The quality of the care in these early crèches was variable: some were good, but many neglected the babies kept there. All over the world, baby farms had astonishingly high mortality rates.
Most of the popular childrearing manuals of the 1800s recommended that women breastfeed their babies. Thomas Bull, the author of the very popular Maternal Management of Children, in Health and Disease (1840) recommended breastfeeding on the grounds that it benefitted both mother and baby.
The period of suckling is generally one of the most healthy of a women’s life. But there are exceptions to this as a general rule; and nursing, instead of being accompanied by health, may be the same cause of its being materially, and even fatally, impaired. This may arise out of one of two causes, – either, a parent continuing to suckle too long; or, from the original powers or strength not being equal to the continued drain on the system.
If the mother could not breastfeed, then the best alternative was to hire a wet nurse. Only if this was an impossibility should the child be raised ‘by hand’:
To accomplish this with success requires the most careful attention on the part of the parent, and at all times is attended with risk to the life of the child; for although some children, thus reared, live and have sound health, these are exceptions to the general rule, artificial feeding being in most instances unsuccessful.
Bull acknowledged that the various concoctions fed to babies tended often to undermine, rather than fortify, their health. Popular recipes for baby formulas usually included corn or rice flour mixed to a paste with water or milk. This had little or no nutritional value, and would have been very difficult for immature digestive systems to process. Other popular substitutes were cows’ or goats’ milk, tea, and thin gruel.
It’s little wonder, then, that the Mothercraft programme placed such emphasis on breastfeeding. Many Mothercraft Centres provided beds for new mothers, who could spend up to a fortnight there, learning how to feed their babies.
At around the same period, infant formulas were beginning to improve in quality and producers, most notably Nestlé, began to promote them as a healthy – even the healthier – and clean alternative to breast feeding. Nestlé is credited – rightly or wrongly – with the invention of formula milk in 1867. The popularity of powdered baby milk only began to grow during the 1940s and 1950s. Nestlé promoted Lactogen through recipe books, pamphlets, and free samples. Problematically, these were usually distributed at hospitals and clinics – at precisely the places where women would be taught how to breastfeed. By the middle of the twentieth century in the west, it was increasingly the norm for babies to be bottle fed.
I don’t particularly want to address the fraught debate over whether women should breastfeed or not. I am, though, interested in the politics of bottle feeding in the developing world, where big companies – like Nestlé – have promoted formula assiduously since the 1950s. Here, the issue with bottle feeding is not so much the quality of the formula, but the fact that it’s mixed with dirty water or fed to babies in unsterilized bottles. Also, many of the women who use formula can’t afford it, so they water it down, meaning that their children don’t receive adequate nutrition.
In 1974, War against Want published a pamphlet accusing Nestlé of profiting from the deaths of millions of children in poor countries. Three years later, an international boycott of Nestlé began, causing the World Health Organisation to proscribe the promotion of Lactogen and other formulas in its 1981 International Code for the Marketing of Breast Milk Substitutes.
But the Code has been poorly policed, and even in developed nations, compliance has been slow. In Australia, for instance, the advertising of baby milk powders only ended in the mid-1990s. There is much evidence to suggest that Nestlé and others continue the practice, albeit under different guises. In the United States, for instance, the Special Supplemental Nutrition Programme for Women, Infants and Children (WIC) distributes more than half the formula sold in the US every year. Companies provide this formula to the WIC at a discount.
All over the world, governments are endorsing breastfeeding in the first six months of life as the best – the healthiest and the cheapest – way of feeding a baby. Companies like Nestlé are actively undermining this, despite the best intentions of the WHO. The implications of the continued use of formula in the developing world are devastating:
According to Save the Children… infant mortality in Bangladesh alone could be cut by almost a third – saving the lives of 314 children every day – if breastfeeding rates were improved. Globally, the organisation believes, 3,800 lives could be saved each day. Given that world leaders are committed to cutting infant mortality by two thirds by 2015 as one of the Millennium Development Goals, protecting and promoting breastfeeding is almost certainly the biggest single thing that could be done to better child survival rates.
A few weeks ago I wrote a post which criticised the World Food Programme’s decision to go into partnership with a range of exceptionally dodgy multinationals – Cargill, Vodafone, Unilever, Yum!Brands – to reduce world hunger. I really don’t have anything against public/private partnerships, and am an enthusiastic supporter of corporate social responsibility (when it’s done well, though). But it’s deeply concerning that the WFP is providing unwitting PR to a group of particularly nasty businesses.
In a recent article for the Guardian, Felicity Lawrence discusses growing concern about big food companies’ decision to shift their focus to developing markets:
As affluent western markets reach saturation point, global food and drink firms have been opening up new frontiers among people living on $2 a day in low- and middle-income countries. The world’s poor have become their vehicle for growth.
SABMiller, Unilever, and Nestlé have developed campaigns to target poorer markets:
The companies say they are finding innovative ways to give isolated people the kind of choices the rich have enjoyed for years and are providing valuable jobs and incomes to some of the most marginalised. But health campaigners are raising the alarm. They fear the arrival of highly processed food and drink is also a vector for the lifestyle diseases, such as obesity, diabetes, heart disease and alcoholism, which are increasing at unprecedented rates in developing countries.
This is Nestlé’s strategy in Brazil:
Nestlé’s floating supermarket took its maiden voyage on the Amazon last year and has been distributing its products to around 800,000 isolated riverside people each month ever since. Christened Nestlé Até Você, Nestlé comes to you, the boat carries around 300 branded processed lines, including ice creams, and infant milk , but no other foods. The products are in smaller pack sizes to make them more affordable. The boat also acts as a collection point for the network of door-to-door saleswomen Nestlé has recruited to promote its brands. Targeting consumers from socioeconomic classes C, D and E is part of the company’s strategic plan for growth, it says. Nestlé has also set up a network of more than 7,500 resellers and 220 microdistributors to reach those at the bottom of the pyramid in the slums of Rio and São Paulo and other major Brazilian cities.
Even if Nestlé does respect the terms of the International Code for the Marketing of Breast Milk Substitutes, and I hope it does, not only is it selling unhealthy processed non-foods, but it also gains legitimacy via its partnership with…the United Nations. Earlier this year, Nestlé supported the UN’s ‘Every Woman Every Child’ initiative, which aims to improve child and maternal health. So an organisation implicated in contributing to the high rate of child mortality in the developing world, and in facilitating a global obesity epidemic, is working with the UN…to improve child health.
Merry Christmas.
Further Reading
Texts quoted here:
Thomas Bull, The Maternal Management of Children, in Health and Disease (London: Longman, Orme, Brown, Green, and Longmans, 1840).
Christina Hardyment, Dream Babies: Childcare Advice from John Locke to Gina Ford. Revised ed. (London: Frances Lincoln, 2007).
Virginia Thorley, ‘Commercial Interests and Advice on Infant Feeding: Marketing to Mothers in Postwar Queensland,’ Health and History, vol. 5, no. 1 (2003), pp. 65-89.
Other sources:
Linda Bryder, ‘Breastfeeding and Health Professionals in Britain, New Zealand and the United States, 1900-1970,’ Medical History. vol. 49, no. 2 (2005), pp. 179-196.
Linda Bryder, ‘From breast to bottle: a history of modern infant feeding.’ Endeavour, vol. 33, issue 2 (June 2009), pp. 54-59.
Linda Bryder, Not Just Weighing Babies: Plunket in Auckland, 1980-1998 (Pyramid Press, Auckland, 1998).
S.E. Duff, ‘What will this child be? Children, Childhood, and the Dutch Reformed Church in the Cape Colony, 1860-1894’ (PhD thesis, Birkbeck, University of London, 2010).
Nancy Rose Hunt, ‘“Le Bebe en Brousse”: European Women, African Birth Spacing and Colonial Intervention in Breast Feeding in the Belgian Congo,’ The International Journal of African Historical Studies, vol. 21, no. 3 (1988), pp. 401-432.
Tangerine and Cinnamon by Sarah Duff is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License.
Feb 5
Justice, not Philanthropy
This week José Graziano da Silva, the Director General of the UN’s Food and Agriculture Organisation, announced that the famine in Somalia has ended. A combination of good rain, the most successful harvest in seventeen years, and the effective dispersal and deployment of food and agricultural aid means that most Somalis now have adequate access to food. But this is likely to be a temporary reprieve: it’s uncertain if food stocks will last until April, when the next rainy season begins and the main planting is done.
This already fragile situation is compounded by Somalia’s complicated politics: the southern part of the country is still controlled by the Islamist group al-Shabaab, which banned the Red Cross from operating in the area this week, and has disrupted food supplies in the past. Tellingly, around half of the 2.34 million people still in need of humanitarian assistance and seventy per cent of the country’s acutely malnourished children are in southern Somalia.
The end of the famine is no cause for celebration, then. Thirty-one per cent of the Somali population remains reliant on food aid, famine looms in another three months, and there are the after-effects of the famine to cope with: the plight of the refugees scattered around Somalia, Ethiopia, and Kenya; and the generation of malnourished children.
It’s estimated that between 50,000 and 100,000 people died in this famine, half of them children.
Clearly, something isn’t working.
And as one famine comes to an end – or, at least, a halt – in East Africa, another one seems to be developing on the other side of the continent. Niger, and, indeed, its neighbours Chad and Mali, is both drought- and famine-prone. Even in good years, it struggles to feed itself. Fifteen per cent of the world’s malnourished children live in Niger. But poor rainfall at the end of 2011 and a spike in global food prices means that the country’s population faces famine.
Niger’s last famine was in 2010, when the World Food Programme provided food to 4.5 million people. But things seem to be more hopeful there than in Somalia, and largely because Niger has a government which functions relatively well. Realising that it needs to store its food supply properly, provide jobs so that its population can afford to buy food, and also limit the growth of its population, the government of Niger is introducing measures to improve people’s access to food. One new piece of legislation will make it compulsory for children to remain in school until the age of sixteen, partly because of the strong link between girls’ education and declining family size.
Somalia’s weak and ineffectual government can’t do anything to prevent famine from occurring there again. With all the will in the world, there is no way that Somalia’s food crisis will end until its political situation stabilises.
The comparison of Niger and Somalia is particularly useful for demonstrating the extent to which responses to famine – from the media, NGOs, charities, and other international organisations – are heavily politicised. Reporting on the Niger famine in 2010 was fairly muted and I’ve only seen a couple of references to its most recent food crisis. Somalia, though, never seems to be out of the news. The reason for this is depressingly simple:
Al-Shabaab is loosely affiliated to al Qaeda and the United States fears that the Horn of Africa could prove to be a useful base for planning future terrorist activities. It probably also helps that Somalia has media-friendly pirates too.
So all famines aren’t equal. All famines are complicated. Indeed, the whole question of ‘hunger’ is complex. I was amused to note that Monday marks the beginning of the WFP’s Free Rice Week. The project encourages individuals to play a game on a website. For every correct answer, Free Rice Week’s sponsors donate ten grains of rice to the WFP. The aim of the project is to ‘provide education to everyone for free’. Hmm…. ok – it includes some basic, if vague, information about ‘hunger’. And also to ‘help end world hunger by providing rice to hungry people for free.’
Huh?
So this is going to end world hunger by giving all hungry people rice?
Seriously?
Other than the fact that it would be as – or even more – effective for the project’s sponsors and participants to skip the cute competition and simply donate rice to the WFP (or, even better, to a local feeding scheme or food bank), this really isn’t going to end world hunger.
I know that this seems like a soft target to shout at, and, really, there’s nothing wrong with donating food or money to the WFP, but my annoyance with projects and competitions like this one, stems from the fact that they’re dishonest. There is no way that Free Rice Week is going to end world hunger. It’s a pity that the WFP sees fit to inform people that by taking part in it they’re contributing to solving the food crisis.
In fact, I think that Free Rice Week and other, similar projects actually contribute to the problem.
Firstly, they fudge the meaning of ‘hunger’. Over the past year or so, we’ve become familiar with the FAO’s horrifying statistic that one billion people go hungry every day – that one sixth of the world’s population does not have adequate access to food. But there are problems with this statistic:
These figures need to be accurate because they ‘are also used to help guide where to send foreign aid, track progress towards international development goals, and hold governments to account for promises made.’
Moreover, it glosses over the fact that there are many kinds of hunger: the extreme events – the famines – which are the products of natural disasters, conflict, and state collapse; the hunger which is the product of poor diets and an inability to buy or access enough food; and the hunger in developed nations. In Britain and the United States, the numbers of people now reliant on food stamps and food banks has spiked during the recession.
Secondly, these projects ignore the fact that responding to various kinds of hunger requires far, far more than throwing money at the problem. In fact, the WFP’s website even acknowledges this: ‘People can go hungry even when there’s plenty of food around. Often it’s a question of access – they can’t afford food or they can’t get to local markets.’ Famines in the twentieth- and twenty-first centuries occur as a result of a collapse of distribution systems, usually caused by conflict or a crisis in government. Famines tend not to happen in stable democracies. The WFP must receive money for food aid – that is absolutely non-negotiable – but long-term change, as we’ve seen in the cases of Somalia and Niger, can only occur once stable, effective governments are in place. No amount of free rice is going to end famine in Somalia.
In other cases of hunger, it’s clear that people are simply too poor to buy food: employment, education, good health systems, and higher wages will go far in remedying this situation. But even then, we have to accommodate the choices that poor people make when spending their money. In an article for Foreign Policy’s special edition on food last year, Abhijit Banerjee and Esther Duflo took a closer look at the lives of the ‘one billion hungry’ and came to some interesting conclusions:
We need to take people’s choices about how they spend their limited funds, more seriously.
Thirdly, by focussing on raising funds, the WFP transforms itself into a philanthropic organisation. Donations of food and other forms humanitarian aid are absolutely necessary to alleviating food crises, but they won’t end these crises – or end ‘hunger’ (whatever we may mean by that). In an excellent article for the Guardian, the UN’s Special Rapporteur on the Right to Food, Olivier de Schutter argues:
Food aid doesn’t address the deeper, structural problems underlying the food crisis. It doesn’t consider bad governance; the impact of food speculation on rising food prices; and agricultural efficiency, particularly in the light of climate change.
By appealing to people to donate money to fund their response to food crises – which could have been avoided – the WFP and others cast hunger as something which can be remedied with old-fashioned philanthropy. It’s certainly true that philanthropic organisations can do immensely good work – like reducing rates of polio and malaria in the developing world. But this doesn’t necessarily solve the problems which give rise to these crises:
Precisely. The world’s poor should not be dependent on the goodwill of wealthy people who have the time and inclination to play games on the internet.