Nutrition as a public health problem (1900-1947)

This working paper examines the construction of a ‘native’ diet in India by the British from the early 1900s to mid 1900s when the country gained Independence. It was not until the 1920s that malnutrition was ‘discovered’ and constructed as an imperial problem worthy of systematic scientific inquiry in the colonies. This period also coincides with the increasing attention paid by the international public health community to nutrition. In the west, the existence of food deprivation in the context of plenty leads to the scaling up of standards of nutritional requirements and for defining the welfare role of the state as a way of solving the problem of the agricultural industry. Nutrition enters public policy and public policy influences nutrition. The term malnutrition is coined to describe inadequacy in diets of impoverished colonial people and quality rather than quantity of food is emphasized in nutritional research and advice. At the same time, a differential standard of nutritional requirement for the ‘native’ population is recommended as a practical way of attaining realisable goals. Depending upon the prevailing economic reality, science is brought in to justify standards and norms and to explain the exiting nutritional state of the deprived (workers in the west and natives in the colonies). Within the nationalist movement in India, the dual standard does not go unremarked. However, the continuities within the scientific community ensure that the dominant notions of nutrition are carried over even after the country is decolonised

COVID-19: a biopolitical odyssey

This paper examines how and why a zoonotic, ‘novel’ coronavirus disease, Covid-19, became a pandemic of such magnitude as to bring the world to a standstill for several months. Though the WHO inaccurately projected Covid-19 as the first pandemic by a coronavirus, it had been preceded by two others also caused by a similar coronavirus: SARS (severe acute respirator

Meat-eating in India: Whose food, whose politics, and whose rights?

Transitioning towards a plant-based diet is considered both ethical and environmentally friendly from a Western perspective of high per capita consumption of flesh foods. However, in contemporary India, beef-eating has emerged as a political act of subversion in the context of its current ban by the Indian state which is transforming unapologetically into a theocracy under the aegis of Hindu fundamentalist groups. To understand the contemporary discourse on beef-eating, it is important to locate it in the discourse prevalent during the Independence movement, when there was an attempt to unify the Hindus to forge a nationalist identity, and to bring the ‘outcaste’ ‘untouchables’ – who were a sub-group acknowledged to consume beef – within the Hindu fold of ‘caste purity’. Data from an ethnographic study of over fifteen months in a village in the Indian state of Tamil Nadu, demonstrate the place of flesh foods, including beef, in the everyday lives of people, and question the concept of a ‘normative’ Indian diet. The paper argues that contrary to the notion that vegetarianism is morally superior, in the context of Hinduism, where vegetarianism is a marker of upper caste identity, the food hierarchy is a function of the caste structure. Hence, the protests, particularly from the former ‘untouchable’ caste groups, reclaiming the right to eat transgressive foods as a marker of their identity, poses a serious challenge to upper caste hegemony. The violence which ‘vegetarian’ India has unleashed on such transgressions has laid open the structural violence embodied in the caste system and questions its claim to moral superiority

In the name of science: Ethical violations in the ECHO randomised trial

It was in the 1990s, that the possibility of increased transmission of HIV with the use of injectable contraceptive Depo-Provera®, was first flagged in medical literature. This has posed a challenge for its use in countries, particularly in the African region, where the prevalence and transmission rate of HIV is high. In 2015, a randomised ‘clinical’ trial, the Evidence for Contraceptive Options and HIV Outcomes (ECHO) was launched in four African countries to resolve the question whether the increased risk was causal. Contrary to expectations, the ECHO trial successfully recruited and randomised the specified number of girls/women participants. This paper argues that this was made possible by exercising undue influence, by using incentives, coercive language, and by concealing the real nature of the clinical trial during recruitment. The ECHO trial is unique in subjecting a group of healthy girls/women knowingly to a contraceptive drug with an intention not of finding out whether it is efficacious as a contraceptive, but to find out how risky or life-threatening its use could be. Thus, the ECHO trial has violated one of the central tenets of the Helsinki Declaration by privileging pursuit of knowledge over the interests of the girl/women trial participants from Africa

Support for children identified with acute flaccid paralysis under the global polio eradication programme in Uttar Pradesh, India: a qualitative study

Background Cases of polio in India declined after the implementation of the polio eradication programme especially in these recent years. The programme includes surveillance of acute flaccid paralysis (AFP) to detect and diagnose cases of polio at early stage. Under this surveillance, over 40,000 cases of AFP are reported annually since 2007 regardless of the number of actual polio cases. Yet, not much is known about these children. We conducted a qualitative research to explore care and support for children with AFP after their diagnosis. Methods The research was conducted in a district of western Uttar Pradesh classified as high-risk area for polio. In-depth interviews with parents of children with polio (17), with non-polio AFP (9), healthcare providers (40), and key informants from community including international and government officers, religious leaders, community leaders, journalists, and academics (21) were performed. Results Minimal medicine and attention were provided at government hospitals. Therefore, most parents preferred private-practice doctors for their children with AFP. Many were visited at homes to have stool samples collected by authorities. Some were visited repetitively following the sample collection, but had difficulty in understanding the reasons for these visits that pertained no treatment. Financial burden was a common concern among all families. Many parents expressed resentment for their children's disease, notably have been affected despite receiving multiple doses of polio vaccine. Both parents and healthcare providers lacked information and knowledge, furthermore poverty minimised the access to available healthcare services. Medicines, education, and transportation means were identified as foremost needs for children with AFP and residual paralysis. Conclusions Despite the high number of children diagnosed with AFP as part of the global polio eradication programme, we found they were not provided with sufficient medical support following their diagnosis. Improvement in the quality and sufficiency of the healthcare system together with integration of AFP surveillance with other services in these underprivileged areas may serve as a key solution

Digital bodies and digitalised welfare: North-South linkages in the politics of food assistance and social welfare

This paper examines North–South linkages in the politics of contemporary food assistance and social welfare, and in particular the normalisation of poverty and humanitarian crisis caused by increased digitalisation, privatisation and individualisation of aid or welfare. Migrants and displaced populations are considered as extreme cases and we examine how these policies and practices are leading to the growth of a global precariat who are constantly on the edge of survival (or death). We use Sudan, India and the UK as case-study countries which have seen persistently high levels of acute malnutrition or rising levels of hunger (as in the case of the UK), as well as the introduction of new digital welfare systems. Digital practices often aim to improve access to food and form a key part of humanitarian and welfare assistance, thereby creating digital welfare states. In the past decade Sudan has seen a shift from emergency food aid to digital cash interventions, including the establishment of a new national cash-based Family Support Programme (FSP). India’s Public Distribution System (PDS) has been undergoing digital transformation since 2010. In the UK, welfare has been digital by default since 2012 and from 2016 assistance for asylum seekers is provided through biometrics and debit cards. The Covid pandemic has accelerated processes of digitalisation across all three countries. In this paper, we argue that digitalisation has not addressed hunger, but instead is likely to lead to exclusions and invisibility of the already politically marginalised groups. Additionally, a number of troubling political and economic questions linked to identity, surveillance and profit have been subsumed in the la

The awkward struggle: A global overview of social conflicts against private debts

Over the past two decades, indebtedness has been at the centre of the world's attention, but social conflicts against private debts have only rarely been studied. Drawing on a global database of 65 cases ranging from 1765 to 2020, we offer a preliminary glimpse at such mobilisations. We find that anti-debt conflicts seem to have increased exponentially since the early 1980s and that they have involved different social classes with various political objectives, ranging from ‘populist’ to ‘revolutionary’, hence their multifaceted ‘awkward’ nature. Credit/debt relations are an underestimated root cause of many economic conflicts because of their foundational role in the (mis)workings of capitalism, their lasting consequences in terms of discipline and dispossession, and their potential to change one's class location, downwards or upwards. While the repression of anti-debt protests and the particular subjectivity associated with debt have often deterred mobilisations, we argue that the situation seems to be changing, as ever more people are discontented with the ‘debtfare state’ and the financialisation of everyday life, including that of farming

Bhopal : a test case of toxic industries for UNCED

Environmental NGO position papers for UNCE