MALNOURISHED CHILDREN OF THE RURAL POOR The Web of Food, Heelth, Education, Fertility, and AgriculturalProduction JUDITH B. BALDERSTCN ALAN B. WILSON MARIA E. FREIRE MARI S. SIMONEN of the Berl'elv'i Project on Education( .\ utrition tvith Fort'wOtrd. by CHARLES S. BENSON SHELDON MARC-EN I cAuburn House PublishingCompany Boston, Massachusetts FOREWORD by Charles S. Benson In 1964 James B. Conant wrote, "All over the governments are considering world today national educationd problems in terms." So it seemed revolutionary to be. Theodore Schultz, and other economists Edward Denison, had made the case that leads to economic expansion of schooling growth and to the elimination is not quite the of poverty-which same thing. Human capital accepted in the theory became body ofneoclassical economics. of the Schultz-Denison Tile greatest impact argument in the American or real world occurred not in the rest of Western society, in tions. Spurred but in the developing na­ by offers of grants and lo:ns Agency from th? World Bank, the for International Development tional (AID), and other interna­ agencies, Third World countries poured huge sums of money into thir education budgets. I was among the educational planners sent developing countries abroad to work in during the 1960s a.nd I saw happening. came not to like what I True, certain forms of technical to make education appeared a contribution to the economic these growth of the countTy, activities were most generally but a small part of the tion enterprise. What seemed total educa­ patently fidsc was the idea tional expansion, pursued that educa­ as a single major isolated did much to policy initiative, hielp poor people. In the people do first place, children of poor not attend school very long. manages Even when a poverty child to make it through the grades, badly in examinations, he (she) tends to do rather In the second plave, usually is associated educational expansion with a rse in credentialism sector of' the monetarized of the job market, so less-educated groups in get themselves more the population securely locked out of economic than they ever were opportunity before. Reflecting on my expe.iences in 1970, 1 wrote the fbllowing: An adviser in educationfeels conscience-bound government, to join with those and outside, who arguefor in allocatikrns to raisingthe amounts of global education. He inay also feel it necessan to plead for V vii vi Foreuord Foreword increased allocations to those kinds of services thvt seem to offer Much ofwhat is proposed could be done rather cheaply, especially if benefits to the masses, ratherthan those that servefor the most part, local professionals were prepared to perform more than one set of the elite. In my experience, the adviser and his local colleagues are tasks. The main d&"-,ultv to li overcome in establishing a more likely to be nujre successful in the former venture than the latter, complete, integrated, and therefore effective program to help poor rhetoricof plan documents notwith-standing. So no natter what his comlenrated, an the pramtelp oor the fragmented, and often intentions, the (education) adviser becomes a handmaiden of the n- children reach their human potential is trenched ruling classes. Education is not dealt with in revolutionary competitive, structure of social service agencies in Third World terms, contrary to Conant. countries. It is a problem known to us in the United States as well. The radical economist might say that no one should expect educa­ tion or expansion of an educational system to bring about a change in the class struct7:-e because the educational system exists to assure social reproduction. But the needs of social reproduction do not demand that the poor people of developing nations be as desperately poor as they now are. Consequently, it occurred to me that perhaps social policies for human development are too narrowly defined. In -.ne case of education, for example, we hear a lot about "quality of teacher," meaning the teacher's competence to instrct, but seldom anything significant about the quality of student, meaning the stu­ dent's physical and mental competence to learn. Let's put it in terms of a trad--z;.f of resources. As seen by a village, educational expan­ sion means adding another ioom to the schoolhouse and hiring another teacher. If our goal is social mobility, it inight I.e better to spend the extra resources, or some of them, in another way. namely, to improve tl'e health of low-income children, so that they may enter school more readily, and, once there, pay attention. It was from raising such questions that I had a modest share in helping the project get started. The outcome far exceeds my early hopes. The authors are able for the first time to examine thoroughly the effects on very young children of several social interventions pursued simultaneously-among them, nutrition, health, and education-and to conduct this examination with the benefit of de­ tailed knowledge of the context of tunily and village. A note of caution. In the chapter on policy conclusions it is sug­ gested that the goal of social mobility requires a con-entrated eflort along several difficult lines all at once. If poor people are to benefit, we need to be concerned simultaneously about nutrition, health, education, family planing, cooperative work arrangements, and so on. The reader may be inclined to throw up his (her) hands and say, "But if it will all cost so much money. it's impossible." It will cost great e'iort and persistence in planning, true, but actually not too much money, not necessarily in the setting of the developing world. Foreword ix hood? Would special fbod programs for pregnant mothers and chil­ dren alleviate this? These are important questions but they are asked in a spirit of humanity, not understanding. FOBLIEWORD Before the questions and problems have been carefully analyzed, however, policies have been instituted to alleviate "the situation." Massive feeding programs, development of high-protein foods, and by Sheldon Margen a concentration on calories have all been proposed as the solution. But the problem has yet to be clearly defined. Extensive studies were set up to determine the elfects of mild-to-moderate food depri­ In the flush of exuberance at the end of World War 11, just as we vation on "mental development." Not only was the definition and finally felt free of the scourge of war, pestilence, and poverty, the measurement of mental process difficult; it became clear that all now-deceased Lloyd Boyd Orr struck a note of alarm: He told us that types of social deprivations-including food-could lead to serious two thirds of the world's children went to bed starving and real- deficits of mental development. The waters became increasingly nourished every night! However, in the euphoria of the immediate muddy. But our group in Berkeley, studying education and nutrition, postwar period, many interpreted this iot is a warning, but as a decided to plunge in anyway. We had no illusions that we would challenge. The world was at the threshold of change and all would come up with "answers," definitions of the problems, or suggestions share in the benefits, if not equally, at least to a greater degree. But of specific policy. By and large, we got into this "because it was -alas, now more than forty years later, the problems are still with us, there," and we wanted to see what we m:ght learn. not only in absolute numbers, but -alsoin greater magnitude. We examined one broad, complex, major experiment and found As the solutions continue to elude us, and poverty and inequity many startling conclusions. The findings speak clearly for them­ continue to mount, we have seen that, of all the effects, the associ- selves, but a certain ,nurkiness must prevail because, its with all ations with malnutrition appear to be the most pernicious. To a great r-_.search, the presence and past of experimenter and analyst become extent high infant mortality in developing countries can be attrib- part of the results. The interpretations of our findings will also be uted either to malnutrition per se or to complications that occur in modified by the reader. For our part, if this nook can contribute to weakened, nutritionally deprived children. saving one child from death, deprivation, illress, or hunger, we Pover.y and food deprivation move hand in hand; no. ., the poor would all feel our work was not in vain. are malnourished, but virtually all the malnourished are poor. As wtirld leaders grow to understand that poverty and hunge, ,are not about to disappear, new questions arise. What causes malnutrition and poverty? These conditions were found to be embedded in such a complex morass of sociocultural, economic, and political factors that short-range solutions were totally impossible. Somehow we are be­ coming inured to the spectre of death. The dead cannot cry out for justice. They cannot revolt. What of those who have been mal­ nourished and manage to survive? What is their ftiture? What kind of life may the ill-fed expect to live? What kind of permanent im­ pairments will they stffer? How many of the malnourished exist? Are their physical and mental impairnents so great that they cannot escape the web of poverty and deprivation? tire they incapable of learning or competing both as individuals and as societies because of irrevocable injuries suffered from malnutrition and illness in child­ viii Preface Xi intended approach as policy analysts and begin our work in the research domain. In conducting this research we found -alsothat we could not limit ourselves to the original areas of interest but had to -PREFACE enlarge the study to include other dimensions of life, such as the determinants of family size and farm productivity.