Printer Friendly

Small but Strong: Cultural Contexts of (Mal-) Nutrition among the Northern Kwanga (East Sepik Province, Papua New Guinea).

The people of the Prince Alexander and Torricelli ranges of the Sepik coast, northern Papua New Guinea have a reputation for some of the lowest birthweights and child nutrition standards in the modern world. But is this a fair appraisal? How culture bound is the biomedical concept of 'malnutrition'? How useful is this diagnosis in reference to local perceptions of health, nutrition and health provision?

Small but Strong continues the debate over malnutrition, setting it in the context of the cultural system of nutrition of the Northern Kwanga, a non-Austronesian group of the Torricelli foothills. In particular, it focuses on the conflict that has developed between Kwanga mothers and biomedical-based child nurses over correct levels of nutrition and childcare and so raises a number of thorny questions about a disease that, by UN accepted definitions, now afflicts over 400 million people.

Discussing therapeutic systems of the nearby Lujere people, Warren Mitchell says that healing comprises 'basically moral acts, acts that are integrally related to society's views about what is right and good'. As Orbist argues, food intake and nutrition are equally moral issues. The essential point then is how these two moral systems -- the biomedical and Kwanga -- interrelate around the topic of food intake and health. In Small but Strong Orbist sets out to act as a 'mediator' between the two and to offer some policy directions for ensuring better health care.

Orbist's approach to this topic is clearly interdisciplinary. Using an eclectic range of tools given coherence by the methods of the new field of nutritional anthropology, she steadily narrows to a discussion of health and food. Her ecological approach begins with a description of the physical environment on which the conditions of Kwanga food production are predicated. It then moves on to a picture of social organisation and its role in regulating production, distribution and consumption. Nineteen months of field experience produce a detailed study of the importance of kinship obligations and avoidance rules in food use as well as demonstrating the political control of the local men's cults over foodstuffs. The next section on religion and worldview shows the relevance of food to health and the supernatural. The technology of the Kwanga for food procurement, preparation and distribution is then discussed in some detail in the next chapters. Throughout, there is a refreshing bias towards women's experience, recognising that they are the key nutritional decision-makers on a day-to-day basis.

According to the accepted biomedical standard, 65 per cent of Kwanga under-five-year-olds surveyed by Orbist are malnourished, while 19 per cent are severely malnourished. Levels of growth are lower than found in most other studies in Papua New Guinea. From the biomedical viewpoint, weight/age relationship is a key index of health and therefore, from the view of the nurses, the Kwanga are far from the ideal. For the Kwanga themselves health is more a function of vitality, with small size being a positive benefit rather than a sign of danger for mothers who have to carry children in the forest and gardens for long periods of the day. It is here that the conflict between the biomedical nurses and Kwanga mothers begin.

This conflict raises questions as to whether smallness is a productive adaptation to environmental problems and whether measures such as vitality are not equally appropriate as those of weight/size/age relations. Orbist wisely does not try to answer them.

An important conclusion that she does reach is that food is more than simply nourishment -- in fact it is hardly that at all in Kwanga conceptions. Orbist follows Levi-Strauss in arguing that food is an encoder of social messages. With the Kwanga the message encoded is one of egalitarianism (except where the men's cult is concerned), of conflict resolution, of strengthened social relations, of human-nature interplay and of supernatural communication. When the nurses counsel altered feeding regimes, they ignore this complex of meanings. Orbist suggests that greater sensitivity to this background would make for more effective child health service provision.

Furthermore, Orbist raises the sharp contrast between the more authoritarian and expert based biomedical culture and the relatively egalitarian Kwanga. Small but Strong would benefit from making this moral conflict more central, perhaps through examining the Kwanga impressions of the maternal and child health nurses or by looking at the historical background of biomedicine in the area, rooted as it is in a system where medical officers' edicts had the force of law up to the 1950s. Recent work by Frankel and Lewis (eds: A Continuing Trial of Treatment) and by Denoon et al. (Public Health in Papua New Guinea) is a good adjunct to this.

As it stands, Small but Strong shows a tendency to equivocate between, on one hand, an anthropology of the articulation of biomedical and Kwanga conceptions of nutrition and, on the other, an ethnography of Kwanga food concepts. Although Orbist claims the book is about the former, I feel that more could be made of the articulation. Nevertheless, Small but Strong does set the examination of food needs into a wider ideological and symbolic framework than has been the case with other nutritional analyses -- of which there have been a number in this geographical area. At the same time it develops an ethnography of enviable detail.

Small but Strong is a study that challenges biomedical nutritionists to look beyond the limits of current theoretical constructs and at the same time provides a rich picture of the contradictions between those constructs and indigenous conceptions of health in the instance of the Kwanga. It is a densely informative and adventurous contribution to a newly unfolding field of nutritional anthropology.

PAUL CHATTERTON University of Sydney
COPYRIGHT 1993 University of Sydney
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Author:Chatterton, Paul
Article Type:Book Review
Date:Jun 1, 1993
Previous Article:Die dreisten Frauen: Ethnopsychoanalytische Gespraeche in Papua-Neuguinea.
Next Article:Making Capital from Culture: The Corporate Form of Capitalist Cultural Production.

Terms of use | Copyright © 2016 Farlex, Inc. | Feedback | For webmasters