Jonathan: Putting “study” back into “abroad”

February 8, 2011

I haven’t spent my whole time here going to the Taj Mahal or arguing with rickshaw drivers. In fact, I have at this point had about a week and a half of classes which have provided an interesting context to begin my analysis of both what I’m observing on the streets as well as more macro-level issues I find both interesting and vexing.

As a student of public health, I am clearly most interested in viewing how health relates to issues of ‘development’ in the so-called Third World.  This at times manifests itself in interesting and unexpected ways.  Two days ago we had a guest lecturer talk to us about food security, a deceptively complicated subject which is essentially most interested in assessing a population’s ability to access adequate nutrition in a sustainable fashion.  This involves thinking of a number of important factors including the expected—trade policies, capital and infrastructure development, ecological sustainability, income/purchasing power—but also questions of gender (how many calories does a wife consume if she must eat after her husband has had his fill), diet (such as the nutritional value of food, and factors in production of foodstuff eaten [meat takes thousands more calories to create than simple cereals]), and public health issues such as hygiene.

Indians consume roughly 25% the amount of kilo-calories (kCal) that people do in the west.  This ‘disparity’ is not as dramatic as it first appears; rather, the Indian diet is 70% basic cereals while the American diet is more significantly meat based.  Meat involves a tremendous amount of kCal to produce (i.e. the amount of resources fed to a cow, chicken, or lamb), especially when compared to the low impact foods Indians eat (beans, wheat, cereals, vegetables, and milk).  The diet is naturally high in nutritional value, including protein, even though close to half of the country is vegetarian (and those who are omnivorous only eat meat less than once a week).  If the world conformed to a less kCal diet such as Indians, we would have global food security.

This, of course, is not feasible, and even after learning this will continue to eat meat.  However, it dramatically changes the ways that we begin to understand hunger, especially in India.  Based on professionally accepted conceptual understandings, India is ‘food secure,’ however this carries little meaning in the actual slums or villages.  Yes, deaths from malnutrition are rare, but some Indians (a large absolute number even if it is a low percentage) continue to consume fewer calories than what is deemed necessary.  All of this leads to two very important questions:

(1) Why are the Indian states with the highest kCal intake per activity expenditure (which are also the poorest) the ones with the greatest indicators of malnourishment?

(2) Why are some of the lowest kCal intake states per activity expenditure (which are also the most educated and have the lowest rates of ‘poverty’) the ones with rising rates of obesity?

The answer lies not in the nutritional value of the foods consumed, the differences in physical activity, or even the relative quality of the goods eaten. It lies largely in diarrhea.  It does not matter how many kCal one consumes if they expel a majority of their nutritional intake shortly thereafter. Adherence to basic hygiene practices such as hand washing, covering of food, sanitization of cooking surfaces, and also accessing potable water and hospitals all have dramatic affects on ones ability to consume the necessary amount of kCal to live.  Furthermore, understanding of hygiene are linked to education levels of a population, adding further complexity to the issue.  Food security is thus an analysis of agricultural practices and economic policy, but it is also dramatically shifting our conceptualization of consumption, nourishment, and the intersection between food, health, and social justice.

And with that, I am off to Pushkar tomorrow where I will visit the sites of Hindu pilgrimage including a 16K bike ride through the mountains, a visit to one of the only temples of Brahm (the creator god), and a four hour bus journey.



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