THE RIDDLE OF MALNUTRITION
PERSPECTIVES ON GLOBAL HEALTH
Series editor: James L. A. Webb, Jr.
The History of Blood Transfusion in Sub-Saharan Africa, by William H. Schneider
Global Health in Africa: Historical Perspectives on Disease Control, edited by Tamara Giles-Vernick and James L. A. Webb, Jr.
Preaching Prevention: Born-Again Christianity and the Moral Politics of AIDS in Uganda, by Lydia Boyd
The Riddle of Malnutrition: The Long Arc of Biomedical and Public Health Interventions in Uganda, by Jennifer Tappan
THE RIDDLE OF MALNUTITION
The Long Arc of Biomedical and Public Health Interventions in Uganda
Jennifer Tappan
Ohio University Press
Athens, Ohio
Ohio University Press, Athens, Ohio 45701
© 2017 by Ohio University Press
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Library of Congress Cataloging-in-Publication Data
Names: Tappan, Jennifer, author.
Title: The riddle of malnutrition : the long arc of biomedical and public health interventions in Uganda / by Jennifer Tappan.
Other titles: Perspectives on global health.
Description: Athens, Ohio : Ohio University Press, [2017] | Series: Perspectives on global health | Includes bibliographical references and index.
Identifiers: LCCN 2017006596| ISBN 9780821422458 (hc : alk. paper) | ISBN 9780821422465 (pb : alk. paper) | ISBN 9780821445914 (pdf)
Subjects: | MESH: Malnutrition—prevention & control | Infant | Child | Public Health | Preventive Health Services | Uganda
Classification: LCC RA645.N87 | NLM WS 115 | DDC 362.1963/90096761—dc23
LC record available at https://lccn.loc.gov/2017006596
Dedicated to Wednesday, Oscar, and Sid
CONTENTS
ONE. Diagnostic Uncertainty and Its Consequences
TWO. Medicalizing Malnutrition
THREE. The Miracle of Kitobero
FOUR. In the Shadows of Structural Adjustment and HIV
Epilogue: Remedicalizing Malnutrition and the Plumpy’Nut Revolution
ILLUSTRATIONS
Figures
1.1. “Bed for metabolic studies,” c. 1952
2.1. Child treated for kwashiorkor at the MRC Infantile Malnutrition Unit, Mulago Hill
2.3. Label for milk packets
2.4. Magalita at fifty-two weeks
2.5. Petero at thirty-four weeks
2.6. Waswa and Nakato at sixteen and a half months and their mother
3.1 and 3.2. Women delivering therapeutic formula to malnourished children at Mwanamugimu, c. 1965
3.3 and 3.4. Cooking demonstrations at Mwanamugimu
3.5. Mwanamugimu Nutrition Rehabilitation Unit as seen from original entrance
3.6. Staff of Mwanamugimu Nutrition Rehabilitation Unit, c. 1965
3.7 and 3.8. Measuring using a handful and informal discussions
3.9. June 1969 calendar
3.10 and 3.11. Mwanamugimu certificates
3.12. Weight chart
3.13. Mother with her daughter during a follow-up visit two years after admission
3.14. Mother with her severely malnourished daughter on admission
3.15. Mother with her daughter and second child after three weeks at the unit
3.16. Mother together with her subsequent children after five years
3.17 and 3.18. Protected springs pictured during construction and following completion, Luka Mukasa seated on right
3.19. Tusitukirewamu club
3.20 and 3.21. Bwamaka bulungi and the “simple frame shelter,” Luteete Health Center in background
3.22. Demonstrating how to prepare kitobero in rural area
4.1. Deputy Minister of Health, Mr. S. W. Uringi, delivering a speech at the opening ceremony of the MRC Child Nutrition Unit’s Expansion in 1969