Socio-economic causes and cultural explanations of childhood malnutrition among the Chagga of...

Sot. Sci. Med. Vol. 38, No. 2, pp. 239-251, 1994 Printed in Great Britain.

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SOCIO-ECONOMIC CAUSES AND CULTURAL EXPLANATIONS OF CHILDHOOD MALNUTRITION

AMONG THE CHAGGA OF TANZANIA

MARY HOWARD

Department of Anthropology and Sociology, Ohio Wesleyan University, Delaware, OH 43015, U.S.A.

Abstract-This study provides an in-depth analysis of the complexity of factors involved in selective child survival among the Chagga people of Mt Kilimanjaro, Tanzania. Carried out during the first of a series of post-independence economic crises, the study analyzes the impact of fluctuations in world economy, ecological stresses, demographic pressures, and class formation in creating conditions of poverty and lessening the ability of many Chagga to provide adequate care for their children. Qualitative and quantitative information are given from a follow-up study of families whose children were placed in a nutrition rehabilitation program during the drought of 1972-73. Four cases from that study further demonstrate the impact of macroeconomic forces on individuals and provide material for analyzing a complex pattern of cultural beliefs which made up part of the Chagga people’s explanations for child malnutrition.

Key words-Tanzania, Chagga, child malnutrition, selective child survival

INTRODUmION

The prosperous Chagga farmers, who live on Mt Kilimanjaro, Tanzania, are widely considered to be one of east Africa’s most affluent peoples. Tradition- ally patrilineal, patrilocal and polygamous (though relatively few men had more than one wife) Chagga farmers cultivate rich volcanic soils which are watered by a complex network of irrigation canals. Those who live on the mountain are involved in agriculture and those who are better off also work in commerce, civil service or professions such as teaching and practicing medicine. In spite of these signs of affluence, government medical statistics show the Kilimanjaro region to have significantly higher rates of child malnutrition than poorer Tanzanian regions. This paper will examine the roots of this apparent paradox from two vantage points: (1) an analysis of certain features of Chaggo history, demography, and political economy which contributed to the inability of some families to provide adequate child care and (2) an analysis of the cultural context of childhood malnutrition with a focus on kinship, marriage and taboo as key elements in Chagga understandings of the phenomenon. Case studies will be used to illustrate the circumstances of poverty, including lack of food, and the community’s interpretation of consequent cases of malnutrition in children. The analysis also draws information from other studies of the Chagga including previous eth- nographies [ld], health studies [5,6], agricultural studies [7, 81, and historical accounts [9].

The Chagga way of life was modernized at a pace

perceptibly faster than neighboring groups of pas- toralists and farmers. The Chagga comprised only 3.6% of the 1967 population in Tanzania, yet 12.4%

of secondary school students were from Kilimanjaro region and a substantial percentage of university graduates in the country are also Chagga. Kiliman- jaro has more health and educational facilities, and larger numbers of representatives in civil service, entrepreneurial and management positions than do other areas of Tanzanian. The area also has about 60% of the improved breeds of dairy cattle raised on smallholdings in Tanzania, and it produces about 30% of the country’s principal export, coffee [8]. Yet, Kilimanjaro was shown in a nutrition survey of children from 1 to 5 years of age to have a higher rate of severe proteinxalorie malnutrition (5%) than the regions of Tabora (1%) and Dodoma (4%), which have much lower per capita incomes [S].

According to the 1978 Population Census, Kiliman- jaro region had 902,000 inhabitants and a rate of natural increase of 3.5%, making it the most densely populated rural district in Tanzania [lo]. The explo- sive growth of the population assumes staggering significance for the region’s agriculture when one considers that ~500 square miles in the district are available to the Chagga for intensive cultivation. Figures from the 1978 population census show that there were 3.62 acres per person in the region, but only 0.54 acres per person of arable land.

Because of the growing population, farms have been greatly reduced in size forcing some Chagga to move to the dry plains, which are significantly less productive, or to urban areas in search of employment [ 11, 121. This land pressure coupled with a long tradition of social stratification based in part on a skewed system of land distribution has contributed to very visible class distinctions among Chagga families.

In the 1972-74 economic and environmental crisis

239

240 MARY HOWARD

in east Africa, drought, coffee berry disease, a drop in coffee prices and world inflation hit the Kiliman- jaro area simultaneously. Forty percent of children under 5 years of age showed signs of severe malnutrition and 50,000 heads of household, estimated as about one-fourth of those in the total population, asked for food relief during this period. Both the changes in world economy and its effects on a small community provide a rich context for the study of child survival.

Theoreticul background

Recent anthropological literature on selective neglect which examines socio-cultural factors found in association with child malnutrition [13-l 81 claims that various practices, such as traditional weaning diets and customs of separating child from mother during weaning, pre-dispose children to malnutrition. Substantial demographic research in some Asian communities documents excess female mortality among infants and children and large differentials in the distribution of food, clothing and medical care between children of different sexes [19-221.

More recently, Levine’s [23] anthropological study of Tibetan communities shows that in addition to the gender of a child, theorists should also consider such factors as sibling position, marital stability. child legitimacy and the state of household economy. Her research claims that even in an area of high preference for male children, gender as a factor in determin- ing dilferential distribution of resources cannot be understood without considering very complex con- texts. Those practices that allow for differential survival among siblings may have the unintended consequence of eliminating one too many children.

Clear intentions for selecting against child survival are less common in the Tibetan communities studied by Levine. For this reason, I prefer to use the term ‘selective survival’ rather than selective neglect. ‘Selective neglect’ has too frequently been used by the misinformed to blame victims of poverty. Even if a few cases within a community show evidence of malicious neglect, the bulk of the cases in the Tibetan and African examples, and I suspect elsewhere [19], appear to be reactions to catastrophes at the household level rather than clear intentions to abandon child care responsibilities. The very fact that some children survive in such circumstances is not only evidence of individual factors such as differing physical constitution but also of intact parental care. Favoritism of parents toward specific children probably occurs normally in most societies without signiti- cant detrimental effects. (Should a crisis befall even the most secure society, for example in a nuclear blitz in Europe, favorite children might fare better in tapping their parents’ limited energies.) Criteria for preference are idiosyncratic as well as culturally patterned, rendering their detection very complex. Further consideration of the concept of selective survival will be given in the summary of this paper.

Researchers in other geographical regions (Scrimshaw [l7, 181 and Scheper-Hughes [l4-161 in northeast Brazil) find similar complexity leading to selective child survival. Acknowledging multiple factors that are detrimental to child survival in northeast Brazil, including ecological and demographic, Scheper-Hughes identifies ‘the macroparasitism of class exploitation’ as causal of high levels of child morbidity and mortality. Her analysis gives priority to local health problems as local manifestations of international processes of disease and death associated with industrialization.

Scheper-Hughes, however, does not neglect the psychocultural factors which are often absent in macrolevel ecological and economic studies. She claims that much of infant and child mortality pat- terns among the poor in northeast Brazil result from factors such as birth order and the child’s constitution and temperament. For example, she attributes the high concentration of deaths at the beginning and end of women’s reproductive lives to the inexperience of mothers with their first born and to the economic and psychological stresses surrounding the birth of the last born.

My analysis does not attempt to delve into and evaluate the emotional responses of the afflicted families to their children’s illnesses as do others in a debate over intentionality [16, 241. Instead, it contrib- utes to the growing evidence of the role of organized global capitalism in creating the economic catastro- phe we are witnessing throughout the developing world. Historical development of social stratification and the beginnings of class exploitation provide a useful context for the study of a community’s handling of economic stresses during pre-industrial conditions. In addition, this study investigates the relationship between traditional Chagga cultural constraints related to abortion and infanticide and their possible reconstitution into more modern forms of selective survival [25].

Methodolog!,

The data analyzed in this study were collected from 1970 to 1975 and in a brief visit in 1989. I observed the beginning, duration and conclusion of the l972--74 crisis in which I kept field notes about the families with whom I was in contact, some whose children died of gastroenteritis. or became sick with marasmus and kwashiorkor.

I also participated in a study which collected data systematically from 418 mothers in a survey of maternal concepts of child cart sponsored by the Kilimanjaro Christian Medical Center. Five village areas with variations in quality of medical facilities and income levels were selected. Village leaders assisted in recruiting women with children under the age of 5, and nursing students and medical assistants administered questionnaires during a 2-hr interview that was followed by a detailed medical examination of the child [26].

Childhood malnutrition among the Chagga 241

The information from this survey was used in the planning of a nutrition education program (known as NURU from Nutrition Rehabilitation Unit) which was built on the grounds of the Kilimanjaro Christian Medical Center. It was also used as a basis for future comparison and for evaluation of the effectiveness of various types of health education programs,

In 1973, during the height of the crisis, I took part in a follow-up study of 42 out of a total of 200 families admitted to the program in its first year of operation. The 42 families were selected on the basis of proximity to the homes of 5 Chagga university women who assisted with the research for 3 months. In addition, 69 more families were added to the study for comparative purposes. They included all the families who were neighbors of those in the nutrition rehabilitation program and who completed the questionnaire.

I lived at the research site and carried out extensive interviews with 10 families with malnourished children, 8 of whom had children admitted to the hospital nutrition education program.

Each researcher filled out a detailed questionnaire on each family over the 3-month period. The questionnaire elicited detailed information on the household’s economic situation including income, employment, landholdings, and number of cattle; house type, education. religion, ideas about the child’s illness, and other information about the malnourished child. Visits to the families varied in number. For example, I visited families who lived only a few hundred yards from my residence almost every day, but I visited the most distant family, who lived a 6-mile walk up the mountain, only twice, as my ability to travel by foot was temporarily impeded.

In addition to the questionnaire, the study included participant observation focusing on the families with malnourished children. The researchers assisted mothers with household chores, ate meals at the households, and reciprocated with gifts of food, seeds, and medical assistance. A daily journal was kept for responses to open-ended questions, comments on questions from the questionnaire, and observations pertinent to the research [27].

HISTORICAL ROOTS OF SOCIAL STRATIFICATION

The distribution of wealth and poverty in Chagga society has long historical roots that extend to earlier systems of land tenure and welfare, which were redirected during European colonization and subsequent efforts at economic and social development.

Chagga society originated primarily from succes- sive migrations of various Bantu agriculturalists who were organized predominantly in patrilineal clans around a religious political system of ancestor wor- ship [I]. Age grades, probably adopted from the Masai [9], ranked men and women into inter-dependent groups with lineage elders politically dominant. hundreds of patricians maintained individual geo-

graphic areas of control, which were partitioned by natural ridges carved by rapidly flowing mountain rivers. Some historians suggest that the clans were already differentiated by wealth and resources prior to the 19th century colonial domination as a result of warring for control of the more productive areas [I, 2,9]. A complex system of irrigation was developed which helped to protect harvests during drought. This led to the rise of numerous hereditary chieftainships in which chiefs maintained the territo- rial boundaries delineated by rivers. The chiefs also oversaw the digging of a network of underground tunnels to hide cattle and people during Masai raids or inter-clan conflict. Chiefs generally regulated the systems of land tenure and social welfare.

Regulation of land tenure

Regulation of the traditional Chagga system of land tenure was in the hands of the chiefs and had two fundamental opposing tendencies; an egalitarian tendency in that all men can petition for land and a hierarchical tendency in that only some men and no women get land. Each chief traditionally was responsible for handling people’s petitions for kihamba land, in which the individual occupant has permanent freehold rights-although local opposition can pre- vent sales to someone outside the chiefdom. Chiefs annually reallocated the lower and more loosely held shamba land as well. Traditionally located in the irrigated middle belt of the mountain, the kihamba is where a man establishes his residence, stalls cattle, plants permanent crops, and cultivates a vegetable garden.

Usually a man provides a kihamba for each wife, and she in turn works the land and cares for any cattle placed with her. At the husband’s death, the land usually passes to his youngest son by that wife; if the land is large enough to be partitioned, the oldest son, who has priority over middle sons, receives a piece as well. If a kihamba is very large, each son may inherit a piece. Those not obtaining an inheritance an petition the chief for kihamba land. Should none be available in the traditional kihamba belt, the chief will give them shamba land, which then becomes incorporated into kihamba tenure [28].

Shamba land is less securely held. It lies on the lower slopes of the mountain, is utilized mainly for maize and beans and fewer plots are irrigated. Traditionally, shamba was held on a year-to-year basis at the discretion of the chief. As the shortage of land became more acute, the chief often gave shamba

land to someone else for kihamba tenure and the previous occupant had to find shamba land elsewhere. Today shamba tenure is growing increasingly secure and fathers desiring to acquire an inheritance for their sons are often obliged to purchase shambn land, putting a competitive premium on all the cultivable land. Middle sons were expected to develop their own land elsewhere but this eventually became virtually

242 MARY HOWARD

impossible because of land shortage. Chagga women normally have no rights to land inheritance.

Traditional Chagga welfare

The vagaries of Kilimanjaro weather and inter-clan warfare were two of the forces that prompted a hierarchical system in which commoners were pro- tected by the power of the their chiefs who accumulated surplus and redistributed it in times of need. In times of drought and other conditions of reduced food supply, the chief would call for a surplus to be redistributed according to status, rules of reciprocity, and need. According to these traditions, the destitute were under the care of the chiefs, who saw that they did not starve or go naked, and in return, they owed labor to the chiefs. Better-off lineage kin could obtain the help of others for house construction, care of cattle, and farm work in exchange for honey, milk. meat, clothing, and other materials necessary for subsistence. Should a poorer relative be faced with an economic crisis the wealthier kin were obliged to provide assistance. Although systematic health survey data are not available there is a basis for charac- terizing the general nutritional situation at the time. Accounts by travelers and ethnographers [ 1, 91 point to the absence of malnutrition in the population during times of abundance.

Matrilineal kin ties played an important role in inheritance of loose property and in increasing available assistance in times of need. Second born sons and daughters were aligned to their mother’s clan and would be sent to their maternal grandmother’s household shortly after being weaned to intensify family ties. This custom may have been a holdover from the earliest settlers of Kilimanjaro who were matrilineal foragers.

Religious beliefs based on the notion of the living presence of deceased ancestors, reinforced reciprocal exchange between kin. In rites of passage from one age level to the next, initiates learned the importance of reciprocity. Also included were teachings about the distribution of food between men and women and guidelines for timing sexual intercourse. Adherence to these teachings would have resulted in long intervals between births that would have reduced competition among siblings over resources. These belief systems were undermined with colonial transformation of Chagga subsistence agriculture and the introduction of Christianity.

The commercialization of Chagga agriculture

Immediately prior to World War I, colonial in- roads into Kilimanjaro were forcibly paved. The German government was given Tangyanika in the Berlin Conference of 1894 when all of Africa was partitioned out among European governments. The German government imposed hut and poll taxes to promote incentives for wage labor and cash. When this method faltered, they used guns to force able- bodies men into labor camps to work sisal planta-

tions which were important to their industrial growth. In reaction to rumors of Chagga plans for an uprising, the German administration publicly be- headed 14 of the most prominent chiefs. ‘Compliance’ with colonial powers continued after Germany’s de- feat in World War I when Tangyanika was made a British protectorate. Numerous sugar, wheat and sisal plantations were established by British settlers in the most fertile areas on the mountain. Some settlers also began coffee plantations which had to compete with Chagga coffee cultivation initiated in the late 19th century by Catholic missionaries. This crop became cultivated by nearly every household and the material amenities coming from the West promoted development of new tastes and modern values.

During the British era. middle sons were in a vulnerable position cis-a-vis colonial powers. They were recruited for forced labor on plantations far from home. Of those left behind, more fortunate individuals sought to enhance their material status and their security with coffee farming in an increasingly insecure world dependent on price fluctuations. Colonial governors, missionaries and the majority of the Chagga saw coffee as an opportunity to bring cash to the economy and hence facilitate revisions in housing, education, clothing and other materials now associated with maendeleo, an ‘improved’ modern way of life. What in fact took place was economic enhancement of European import companies and improved conditions for an elite Chagga who later came to act as entrepreneurs through the development of a cooperative marketing system for their produce. Although this system was originally de- signed to meet all the farmers’ needs, Kilimanjaro cooperatives almost exclusively benefitted those who had power and wealth. Zalla’s [8] study shows how all farmers pay membership dues to the coffee cooperative but only wealthy farmers were judged to be good risks for cattle loans given by the cooperative to improve dairy herds or monetary loans to support small business initiatives. One farmer in the follow-up study, for example, couldn’t afford to have a door placed on his barn. The cooperative would bypass his loan for someone else who could afford to protect his cattle from theft. This pattern persists in spite of the fact that a high proportion of loans are not paid back by the well-off recipients.

Coffee eventually began to compete for planting space with subsistence crops of beans, bananas, milk, meat. and millet. When prices for coffee fell below costs of production in the 1972-74 crisis, large numbers of Chagga faced precarious times. Heads of families found themselves competing with secondary school children for work on coffee estates. A daily wage of approx. 5 shillings (0.60 U.S.S) was insuffi- cient to sustain a family. These changes away from traditional expectations of assistance to a more modern pattern of class formation and exploitation contributed to an increase of impoverished families who couldn’t adequately provide for their children.


To summarize, the patricians of earlier times accumulated surplus controlled by the chief who was responsible for redistribution in times of need. Obli- gations for redistribution within clans and lineages counter-balanced the tendency toward economic differentition to some degree, although growing population pressures enhanced competitiveness and inequality. Colonialism ended this system. In the latter part of the 20th century the Chagga became almost wholly reliant on the coffee market, which then crashed and resulted in massive need and insuffi- cient resources to provide for it.

CHARACTERISTICS OF FAMILIES WITH CHILDREN IN NUTRITION REHABILITATION

This section describes the situations of families with malnourished children. Qualitative and quantitative analysis shows that the causes of child malnutrition in Kilimanjaro are exceedingly complex. it is apparent that reciprocity within kin groups and across economic strata is quite limited. Comparisons of families which children in nutrition rehabilitation show that there are general differences between the two groups, and that families with malnourished children tend to be much poorer than others, in a few cases have alcoholic adults, and often are censured by the rest of the community.

An overview

The following describes the growing pattern of inequities among kin in the same patrilineage:

In 1973 when researching the case of Hamisi, a 6-year-old with kwashiorkor, I located him in an unkempt mud structure with a banana thatched roof that had been built by his father Jumanne. Jumanne had been characterized as inept by prominent local men who guided me to his compound and publicly chastized him as he sought chairs for his company. His son Hamisi was still malnourished as were all of his four siblings. About 300 yards in one direction was another small mud house which belonged to Sampson, Jumanne’s first cousin who lost all 5 of his children. Next door to them was their ill cousin Paula whose wife was pregnant with her 13th child while the 12th was malnourished and unable to walk at 2’. Five of Paulo’s z children had died. These impoverished kmsmen took me to the house of another ill neighbor, Lucas Temba, who couldn’t afford medical treatment and who died a week after a series of visits in 1973. Two of his 4 children were severely malnourished.

Both Lucas and Paulo lived in banana thatched roundav- els, once the traditional Chagga house style but which stood as indicators of stark poverty in the 1970s.

Their first cousin and neighbor Edwardi Chuwa’s family home was situated in the center of these compounds. By contrast, his was a large cement brick ranch house with glass windows, electricity and filled with all the modern conven- iences such as refrigerator and stove. His 4 Jersey milk cattle lived in a barn built of the same materials. He had 9 healthy children whom he hoped would complete secondary school. Edwardi was a local chairman of the coffee cooperative and refused to answer any research question. In fact, he banished his wife to his mother’s house when he found out that she had become involved in the research process. He was said to be an alcoholic.

Judging from the concern shown by poorer kin toward one another, sharing does occur but is usually restricted to class. Efforts to organize impoverished men into a wood working cooperative were stalled by local politicians and the parish priest who all voiced reservations about such a venture when the ‘needs of the youth’ competed.

When I returned to this area in 1989, the poor households described above hadn’t changed. Jumanne’s family had lost 1 child but Sampson’s wife Lydia had given birth to 6 children all of whom were alive and appeared healthy. Paula had died, although his sickly child Revocarte, who was 17 years old, survived. However, Revocarte was severely stunted and mentally retarded. He survived in part because of the near heroic efforts of his mother Sophia and the support she received from her grown children. People also explained that the past few years brought ample rains and most had adequate food. I saw very few children with the tell-tale signs of reddish hair and swollen bellies during my recent stay, in contrast to 15 years previously. The director of the NURU center stated that fewer children were admitted for severe malnutrition and that her program had redirected its energies toward family planning. Others pointed to a return to subsistence farming by many Chagga who uprooted some of their coffee crop during the drought of the 70s.

The most significant change I encountered was extensive development of expensive housing on the lower slopes where the residents had easier access to Moshi town. Tanzania’s infrastructure had deteriorated over the years between 1975 and 1989 and Moshi town itself had unrepaired streets, unreliable transportation and no revenue to maintain its buildings. Medical personnel at the hospital explained that wealthier farmers and business men had profited during the hard times by buying up coffee estates of farmers who had failed. In fact, Edwardi was himself building a new home on the lower slopes and could conceivably be in a position to buy out his poor kin when they reached a point of desperation.

This description of economic inequality among members of the same clan contrasts greatly with older ethnographic accounts which specified norms for reciprocity and support. Further evidence of gross inequity was gathered during the follow-up study and will now be presented.

Quantitative information

Isolated from help with few good crops available for household consumption, the physical and psychological health of parents in the crisis of the mid-1970’s began to deteriorate. Table 1 summarizes factors related to malnutrition that were found frequently in the 42 families with severely malnourished children. They were based on the researchers’ observations, neighbors’ reports, and explanations given by the families themselves. No one factor can be singled out as being the principle cause; instead there is an accumulation of factors in almost all cases.

The 42 NURU families had a total of 52 children in the nutrition rehabilitation program. Of the 46 children in the study for whom hospital records were available, 33 were diagnosed with kwashiorkor and 11 marasmic-kwashiorkor. Two were admitted for parasitic infestations without severe symptoms of malnutrition. In 29 of the families, accompanying infections of pneumonia, measles, and parasites were

244 MARY HOWARD

Table I. Factors pre-disposing children to malnutritmn, ordered by frequency

Factor Frequency

I. 2. 3. 4. 5. 6. 7.

Infection of child Family had no cattle Father’s inadequate income One or both patents had no education Simplest type of housing or no household property Alcoholism of a parent Small amount of kihamha (higher quality) land

0-l acres 8. 9.

IO.

Frequent births to mother Small amount of sham/m (lower quality) land Sorcery allegatIons, curse or neglect of a

traditional obligation by a parent (relatives’ and neighbours’ explanations)

_.. ^ II. Illness or death 01 a parent

29 2x 22 20 I8 IX

I7 I4 I3

9

i

said to be precipitating causes of the children’s malnutrition.

Of the factors commonly associated with poverty (Nos 2, 5, 7 and 9 in Table I), lack of cattle was the most frequently reported. Of the NURU families 42% [18] kept no cows, either of their own or of other owners. In the sample of 69 neighbors, 29% [20] of the households had no cattle. The situation of the neighbors was typical of Kilimanjaro as a whole, according to a regional survey [8]. Thus, regarding cattle ownership, the NURU families were consider- ably poorer than the large majority of families in the region.

The same regional study of economic stratification developed four distinct income groups based on house types and possessions [S]. Twenty-two percent of families comprised the highest income group. with cement block houses or motor vehicles. Sixteen percent fell into the lowest income group with homes with grass roofs and had virtually no household possessions. In the follow-up study, only one NURU child belonged to the highest income group. with residence in a house built of cement blocks with glass windows, whereas more than three-fourths (79%) of NURU children lived in the lowest standard of house. Compared with the NURU family houses. over half (54%) of the neighbor family houses were of a higher standard. Thirty-eight percent [I61 of NURU families lacked latrines in contrast to 4% [3] of the neighbor families.

Landholdings for the NURU families were generally smaller than average In a study conducted by P. Maro [I21 in the same part of Kilimanjaro as the follow-up study, 64% of farms had 3 or more acres and only 6% had < I. The average farm size for the NURU families was 1.4 acres while that for the peighbor families was 2.3 acres. Regarding kihanzha (higher quality) land, only 10% reported having > 3 acres and 23% had (1 acre. Of the 56 neighbor households in the follow-up study who gave estimates 9% [5] had < I acre of kiharnha land and 29% reported having >3 acres.

Regarding some of the social factors which were considered to prc-dispose children to malnutrition (Nos 3, 4, 6. 8, and IO), alcoholism of a parent was said to be present in I8 Families. Table 2 compares NURU parents’ drinking habits to those of their neighbors.

Only the numbers of those reported to drink excessively were significantly different bctwecn the NURU mothers and fathers and the neighbor mothers and fathers. The effect of heavy drinking was particularly costly for low income families who cannot afford to support both a drinking habit and a family as well.

Fourteen NURU families complained about the mothers’ too frequent births and often added that children who were abruptly weaned had been poisoned by the pregnant mother’s milk. NURU mothers had an average of 4.9 live births but only

Table 2. Parents‘ drinking habits

Drinking habits of fathers NURLI fathera Neighbor fathers

Drinks excessivel) I2 x Drinks moderately ‘tmt a heavy drinker’ II 31 Drinks only a little or not at all 9 II No information 8 I6 Total 40 66

Drmkmg hablts of mothers NURL: mothers Neighbor mothers

Drinks excessively 6 I Drinks moderately 5 21 Drinks a little or not at all. ‘not a problem’ 31 36 No information 8 Total 42 66

Source: Ref. [27].


averaged 30 years of age. Chagga women generally continue child bearing into their mid-40s. Only 1 of the NURU mothers was over 40 and the youngest was 21. The neighbor mothers had had an average of 5.5 births, but the fact that this is higher than for NURU mothers can be explained by their older ages. Twenty-five were over 40 years of age. The average number of births per post-reproductive woman for the Kilimanjaro region was 7.9 in the 1967 population census.

Six of the 52 children were twins. According to ethnographic accounts taken in the 1930s twins are considered to be a bad omen among the Chagga. Parents would be expected to kill both children or keep 1 child of an unrepresented sex and kill the remaining child.

Not cited as a cause of malnutrition by the NURU families or neighbors was the age of the afflicted child. Weanlings, as in most other cultures, seem to be at higher risk among the Chagga. Of the 52 children in the follow-up study, 41 were under age 3, 6 were age 4, 3 were age 5, and 2 were age 6. (No ages were recorded for 2 children.) Chagga mothers ideally expect to breastfeed up to 3 years but in reality this had been shortened to 1 to 2 years [26].

Clearly, the NURU families suffered economic disadvantages and accompanying social problems at greater rates than did their nearby neighbors. For a more detailed discussion of these and other factors please refer to Ref. [27]. I will now examine ways in which cultural factors (No. 10 in Table 1) can add to the complex etiology of malnutrition on Mt Kilimanjaro.

SELECTIVE SURVIVAL IN 4 FAMILIES

Marginalization of impoverished families appeared to be a characteristic response among better-off kin and neighbors during the study period. When asked about traditional expectations for economic assistance during times of need, people responded, “You can ask for help once but not a second time.” Even though profits were sometimes accumulated during times of stress, wealthier families also shared the anxieties caused by rain shortages, inflation and reduced prices for coffee. As in Jumanne’s case, the wealthy saw their poorer kin as a potential chronic drain and thus defended themselves from their own responsibilities by blaming the victims.

Nine of the families visited by the university students explained that curse, sorcery or neglect of a traditional obligation such as refusal of the mother to be circumcized, were causes of their child’s malnutrition. I found similar social and cultural constraints in the 10 families I observed during the follow-up study. Stark poverty was evident in most of their situations and contributed to conflict between gener- ations which had differing interpretations of Chagga rules. Rules seemed to be used as rationalizations to help explain away lack of available resources and the

failure of some children to thrive. Four of those families predicaments are described as follows:

Lucas and Maria Temba

Lucas, a virtually landless middle son of a poor father, married Maria, a mildly retarded woman, quite late in life. Neighbors suggested this was because he was unable to pay bride price installments for a normal woman. His home was a single traditional roundaval made of banana thatch in which lived the adults and 4 children, 2 boys and 2 girls. No one in the family had ever used modern medicine. According to the nuns who ran the local clinic the boys were victims of chronic hookworm infestations and malnutrition, and were mentally retarded. The oldest was 11 and measured 3’8” tall; the youngest was 10 and 3’9”. At the time of my visit the family was near economic collapse because Lucas was dying. Yet, his 2 daughters, ages 14 and 8, were not debili- tated by hookworm infestations and appeared to be thriving and normal. In fact, the &year-old was nearly a head taller than her 2 older brothers.

Under better circumstances the mother’s intellec- tual incompetence would not be considered a factor in her boys’ illnesses since Chagga neighbors and relatives assist families with such members. To Maria, her first born daughter was of tremendous assistance and comfort. Not only did this child make major contributions in domestic work, she also contributed her earnings from daily labor on nearby estates. Both she and her younger sister, who was aligned to her mother’s clan, would bring extra security in bride wealth payments. The sons, who had little land to inherit, could hardly provide future security to the mother. That the younger son was comparatively healthier than the older one might have been because he was aligned to his mother’s clan and was entitled to his father’s tiny plot where his mother expected to reside after Lucas’s death. The elements of selectivity may have been present when this mother was forced to choose which of their children would receive the scarce meat and milk supplies purchased by her daughter. Though Lucas and his 2 sons both died shortly after the 1974 study, the 2 girls survived and appeared healthy. Each had a daughter of her own and they were living together at their father’s compound where they cared for their mother. The eldest had become a beer shop owner and had managed to improve the family’s housing and material needs from her earnings.

Maria Stephan

Maria Stephan’s situation was brought to my attention by a neighbor who said that 2 of Maria’s 4 children were malnourished. I was startled to be led into one of the wealthiest compounds in the area. The largest house was made of stone; two others were cement brick structures. There was a separate house for cooking and several cattle barns. On my first visit, the grandmother sat outside in a plush chair sur-

246 MARY HOWARD

rounded by 2 of her well-dressed sons, their wives, and a number of small healthy children. Her sons had advanced through high school and had clerical jobs in town.

When I asked to see Maria’s ill children the young men explained that their condition was due to hookworm. They had swollen bellies and their hair had turned light. When I inquired about what Maria fed the children in subsequent visits, the younger men told me privately that Maria did what she could. The problem in feeding, they said, was due to the grandmother. They added that she felt anger toward Maria and took it out on 2 malnourished children while favoring the other 2 children with ample food.

Maria had been married to one of the eldest sons in the compound and gave birth to 2 of his children. Later she had problems with her husband and even left him at one time. While she was staying at her parents’ residence, her husband was killed during an argument in a beer club. This misfortune may have been attributed by the grandmother to Maria’s failure as a wife.

Nonetheless, she felt compelled to return to her deceased husband’s compound to care for her children, in spite of the conflict that may have awaited her. She was reabsorbed into his family by forming an attachment to one of her husband’s younger brothers, who became the father of her last 2 children. They were the 2 children, both girls, who became malnourished under the grandmother’s care. Maria lived in a simple one-room mud structure that stood at the edge of this wealthy compound.

Damas and Ruth

Damas and Ruth lived on the edge of their father’s large (8000 tree) coffee estate in a small mud house with banana thatching. They owned sleeping mats and cooking utensils but no furniture or expensive items. Only the eldest of their 4 daughters was strong and healthy. The youngest had died and the middle 2 still had signs of kwashiorkor when encountered by the researcher.

Damas’s family had 4 sons and he was 1 of the 2 in the middle. The other had moved to Moshi town (as did the eldest) and the youngest son was still residing with their once prosperous father, Elikana. The sons had taken Elikana to court to force him to partition his land. He refused even when aware of the malnutrition of his grandchildren. In fact, Ehkana maintained a self-righteous stance toward Damas whom he claimed had squandered the paternal allot- ment for bride price for his own marriage on alcohol and consummated his marriage in shame. Without the bride price arrangements for the marriage, the children were considered illegitimate according to Chagga custom.

While the father, Elikana, lived in relative affluence, his son Damas was a day laborer at the mission where he worked for 5 shillings a day. Damas’s wife Ruth spent much of her time cultivat-

ing a subsistence plot miles below the family compound leaving her 2 malnourished girls in the care of their 8-year-old sister.

Theresa and Ngaria

Within walking distance from Damas and Elikana lived Ehkana’s nephew Ngaria who, as the eldest son, shared his deceased father’s estate with his youngest brother. His wife Theresa had given birth to 10 children after losing her first born-a bad omen to the Chagga which usually signifies parental miscon- duct. Their 1 Ith child had been at the nutrition rehabilitation center and appeared sickly at the time of the research.

While Ngaria worked on neighboring coffee estates as a coffee pruner for 9 shillings a day his younger brother earned a monthly wage of 340 shillings as a driver for the Ministry of Agriculture. Their homes’ furnishings reflected the disparities in wages. The most striking difference in the care of the two brothers’ children who played and ate together was the treatment given by their paternal grandmother who also shared the compound. She was openly hostile towards Ngaria’s wife, Theresa, though she seemed very attached to her youngest son’s wife. She pointed out that Theresa failed to space her children-5 were born from 1970 to 1974. Furthermore, according to Chagga custom, Theresa should not have had any more children after her own daughter gave birth. However, the only malnourished child in the compound was Theresa’s youngest son who was aligned with her lineage and was born shortly after her first daughter had given birth.

TRADITIONAL EXPLANATIONS OF MALNUTRITION

In addition to the contemporary factors related to malnutrition that are listed in Table 1, others such as the decrease in the price of coffee, inflation of food prices, the failure of the rains and the lack of vegetable gardens were also mentioned, but with less frequency. These explanations were given along with perspectives based in tradition.

Although better-off kin are still held accountable for economic support of relatives in hard times in accordance with traditional Chagga ideals as in Ju- manne’s, Damas’s and Maria Stephan’s cases, they now more easily focus the blame on the victims instead of themselves. The presence of poverty and even more the occurrence of kuvimba (to swell), the Swahili term people commonly use to describe one of the symptoms of kwashiorkor, tend to be taken as evidence of violations of Chagga cultural precepts regarding cosmological balance, particularly those which deal with marriage and reproduction.

Although kuvimba may be associated with impend- ing doom because it often develops in times of environmental stress, it has less dramatic, though still serious, implications for daily life. In traditional Chagga cosmology kuvimba can communicate a


moral failure of the ill child’s parents-often a failure to properly space children. Men and women are taught during periods of initiation to balance what are believed to be inter-dependent phenomena: their sexual activities, the division of labor, and the distribution of food among family members. Ideally, the balance works to protect the patrilineage in the same manner as did reciprocity between ancestors and the living, chiefs and commoners.

Some of the regulations that shape reproduction are (I) the post-partum sex taboo, the observance of which would space births 2 to 3 years apart, (2) prolonged nursing (l-3 years), and (3) cessation of nursing while pregnant, The abrupt weaning that occurs when the mother discovers she is pregnant is one reason why many Chagga weanling children are at risk. The explanation for any resulting kuvimba is that the weanhng was poisoned by milk contamined by the child in utero. This explanation may also be accompanied by suspicions of curse or sorcery. A fourth rule, referred to above in Theresa’s case, mandates that older women refrain from having any more children once their first-born girl is circumcized. This restricts the fertility of young grandmothers while also ensuring the availability of the older women’s time and energy during her daughter’s future reproductive life. Women who refuse to become circumcized (estimated to be about 40% by a KCMC obstetric GYN) are a special affront to lineage continuity. Ethnographic accounts claimed that such an infraction results in kuvimba-a claim also stated by 1 of the 42 families in the follow-up study.

Failure to adhere to traditions can have conse- quences for the resulting offspring. Past accounts of the Chagga claim that abortion and infanticide were common under such circumstances although no measure of earlier or current prevalence exists [ 1,2]. Both premarital and extramarital pregnancy were occasions for abortion. Infanticide also could follow an out-of-wedlock pregnancy or occur under the following conditions:

1. infants conceived while the mother was still nursing her previous child;

2. infants conceived 2 months after the death of another child;

3. infants conceived after the mother’s daughter had married;

4. abnormalities such as twins, breech deliveries, and infants whose upper incisors cut the gums before any other teeth.

All forms of selecting for or against future clan members probably intensified in times of crisis and can be better understood by a consideration of gender, birth order and clan alignment.

The role of gender, birth order and clan alignment

Gender has a bearing on how a child is perceived by the mother, other family members, and other kin.

Of the 49 children in the follow-up study whose medical records were complete (of a total of 52 children), 30 were girls and 19 were boys. A woman expects to be taken care of by her eldest and youngest sons when they each inherit a piece of their father’s land giving preference for male children a slight edge in Chagga culture. However, when the father’s landholdings become too small to split or when he becomes landless, a son will have problems in meeting his obligations. If an impoverished parent were forced to assess a child’s worth, girls would most likely be viewed as equal and in some cases more capable of reciprocating in the future because of the help and companionship they bring to their mother and the wealth in bride payments they bring to the whole family. Since most economic stresses are chronic and probably present before the child is born, it is possible that boys could more frequently die of neglect during early infancy than girls due to beliefs regarding the malevolent powers of an ill-spaced or illegitimate boy.

The importance of gender becomes even more challenging to interpret when considered along with the child’s birth order and clan alignment. Among the Chagga, birth order could play a significant role in putting certain children at risk although our research wasn’t able to verify this. Birth order is usually inter-woven with clan alignment in which children are affiliated with either the mother’s or father’s clan. Although all children are thought to be the father’s property, customarily, the first-born child of each sex is related to the patrilineage and the second boy and second girl have strong ties to the mother’s lineage. Subsequent sets of boys and girls follow the pattern of aligning the first born child of each sex to the father’s side and the second boy and second girl to their mother’s lineage. Customarily, weanhngs were sent to live with the grandparents of their assigned lineage.

The key to evaluating the weight of birth order and clan alignment is residential context. Normally, a family resides within the patrician influencing more favoritism of children on the father’s side. Mitigating circumstances may include residing at the mother’s compound or residence of the maternal grandmother at her son-in-law’s, and the child’s gender, birth spacing, and birth order. Children may live with their mother’s kin because of marital impropriety such as a divorced or unwed mother. In this situation, if any of the father’s clan-affiliated children were staying with the mother’s lineage they might suffer disadvan- tage due to fear of their powers, thought to be competing with the fortunes of the mother’s clan.

Constraints and strategies of women

One final aspect of Chagga culture that impacts the quality of child care is the considerable constraints affecting peasant women and their efforts to struggle against them. Their workload is enormous by any standards. Not only do they average 7.9 births per

24x MARY HOWARD

woman, they are often solely responsible for subsistence farming while the men tend the coffee or work as local day laborers or migrate elsewhere. Women plant and care for vegetable gardens near the home and expect also to cultivate a larger crop of maize and beans on the lower slopes of the mountain. Zalla’s study [8] of dairy farming showed that women whose husbands owned cattle spent an average of 20 hr per week (some as high as 40) transporting bundles of grass weighing up to 120 Ibs up from the plains to stalls near their houses. These jobs pull women away from the household and leave children in the care of nearby grandparents or older siblings.

The degree of women’s control over cash also added to their ability to care for their family. Women were not supposed to make inquiries about their husbands’ cash earnings although 2 of the 42 NURU mothers and 31 of their neighboring mothers did. It was also considered to be a threat to the authority of the husband if a wife had considerable income of her own. In cases which came before local courts, women were tined when husbands with irregular incomes complained of their wives’ beer brewing enterprises.

Cook and Kerner [29] studied Chagga women’s strategies for coping with food shortage during the economic crisis of the 1980s. They argue that women’s ability to raise income from commercial beer brewing offsets their insecure access to their husband’s income from cash cropping and livestock sale, and their husband’s overconsumption of beer and meat at the expense of his dependents, They agree that beer brewing proceeds are supposed to be redistributed by the husband but that this is hotly contested by women individually and collectively. Their research also discussed women’s public outcry in one Kilimanjaro community over illegal appropri- ation of free emergency grain supplies by the village leadership to make a killing on the black market.

One reason for such collective outcries is that Chagga women do not have inheritance rights to land and houses. they become incorporated into their husband’s lineage through the birth of sons. When their sons marry they gain a position of authority over their daughters-in-laws. Thus a woman with married sons in her household is generally in an economicaly secure position and she is relatively powerful compared with more junior women. This creates the potential for both women’s leadership in collective action and conflict among women within families,

The strain of women’s marginality is also eased somewhat through the exercise of various forms of indirect social control. They have, for example, some limited power over family affairs through the threat of curses ---usually directed toward other women. In two of the NURU cases the malnutrition was said to be caused by the father’s mother who had been heard saying that she would make her daughter-in-law continue to suffer.

Sorcery or ma/iisa was given as the perceived cause

of the child’s illness in 6 of the follow-up cases. Older Chagga claim that this is a relatively new phenomenon and that it accompanies land disputes and the suspicion and envy of an increasing number of unre- lated neighbors. Mufitsa and cursing are believed to be in the hands of women.

Another form of social control possessed by women and described in ethnographic accounts was the child’s first rite of passage known as ‘the food of the world’ test. The husband’s mother traditionally pre-masticated a special mixture of foods to spit into the infant’s mouth. If the child balked it was seen as weak and was supposed to be killed. Although the follow-up researchers didn’t inquire whether this rite-of-passage was still in practice, it is important to note that tradition gave older women clear powers to decide life or death over children.

As Chagga society undergoes modernization, many traditions are being discarded including the responsi- bility to care for and feed aging parents. Neighbors of some of the follow-up study families said that if grandparents’ anxieties and complaints are not heard they may very well refuse to provide the necessasry support for grandchildren left in their care. But even when children were under the care of better-off grandparents as in Maria Stephan’s case, Maria’s poverty and inability to alter the situation by moving or providing extra food was just as important a cause of her children’s malnutrition as was the grandmother’s indignation about broken traditions and her consequent underfeeding of the children.

The new values which accompany modernization and challenge Chagga customary practices make it easier for individuals or families to manipulate the situation to their own advantage. This is especially true for wealthier Chagga. In examining the plight of Kilimanjaro’s poorer women our study compared their position with their wealthier neighbors and suggested that women’s work load in a wealthier homestead was lightened by hiring help in the household and using paid laborers in coffee picking, in cultivating and in harvesting the maize and beans below the mountain. In addition. wealthier women can use buses or trucks for transport to the lower fields or hire a tractor to cultivate their plots [27].

SUMMARY AND DISCUSSION

This article has addressed the paradox of a relatively wealthy society that has a high incidence of child malnutrition. A wide variety of factors have shaped the phenomenon, including Chagga history, social organization, culture, population dynamics. and the world economy. The juxtaposition of affluence and child malnutrition was accentuated during the crisis of 1972 to 1974. when the economic security of many Chagga households crumbled and malnutrition intensified.

The analysis of information from the period of crisis has allowed the pinpointing of many factors


contributing to the development of malnutrition in children that might be more difficult to identify under more ordinary circumstances, when fewer families face situations of need and fewer children are malnourished. As the analysis shows, these factors are not unique to the crisis period, but they fundamen- tally belong to Chagga society and its wider regional and global context, and the analysis of the crisis is crucial to understanding malnutrition in more normal times as well.

The crisis of the early 1970s had roots in the history of Chagga society, colonial commercialization of their agricultural system, and their current vulner- ability to instability in world market prices for their major cash crop, coffee. Additional processes that triggered the crisis of 1972 to 1974 were ecological stresses including both severe drought and coffee berry disease.

Probably the most significant factor contributing to the latter 20th century Chagga’s history of economic insecurity was the impact of colonialism and its transformation of traditional social stratification into a system resembling classes in modern, industrial states. This change has involved the breakdown of precolonial social structure, political formations, and kin relations that encompassed countervailing tendencies toward redistribution and socioeconomic differentiation. The disintegration of precolonial mechanisms of redistribution left the tendency toward economic stratification as a major force characteristic of Chaggd society. The result has been the economic marginalization of some families in Chagga lineages, while their kin have retained greater amounts of resources as the obligations to provide for kin diminished. Under such conditions, wealthy elites gain greater access to resources and control over the means of production. Poorer individuals hire out their labor and become vulnerable to the lack of work and low wages. A poor family which relies on wage labor immediately sees its food supply dwindle when employment opportunities or wages shrink. This describes a number of the families in this study whose children entered the nutrition rehabilitation program.

Another major force affecting child malnutrition is the inter-play between land shortage and population pressure. Under the traditional inheritance system, Chagga men were generally to receive farm land; however, plots became so small in many cases that sons were left without any inheritance at all, while other wealthier families have consolidated their holdings into even larger plots. Landlessness is occurring to increasing numbers of male Chagga heirs.

The reasons for rapid population growth partly involve the erosion of traditions that formerly had the effect of regulating population growth through in- creased birth intervals and early cessation of child- bearing. This is not to imply that health conditions and population dynamics were ideal in the past, or that the mechanisms that regulated population growth came into existence primarily for that pur-

pose. Rather, the mechanisms that regulated population growth entered Chagga culture for reasons related to historical processes such as contact with the Masai, from whom the age grade system may have been acquired. Such historical processes were not determined by the needs of the Chagga population for stability.

The case and survey material analyzed above illus- trates some culture-specific traditions that contribute to malnutrition under specific circumstances. The clan alignment and gender of the child in the sibling constellation contribute to the status of the child in the eyes of kin. Another influence on the child’s status is whether the parents have broken any taboos con- cerning sexuality, rules governing marriage and bride price arrangements, and other rules of comportment. An examination of historical ethnographic accounts also suggests that infractions of traditional rules for spacing children were supposed to result in the abortion or infanticide of children associated with the infraction-ultimately affecting population size. Some of these rules, such as the necessity to circum- cize the mother, the need to breastfeed for prolonged periods and to cease when pregnant, the need to stop reproducing when the oldest girl is circumcized, and the prejudice toward multiple births, are still followed by traditional Chagga and become part of the explanation for and the stigma associated with child nutrition.

The effect of Chagga traditions of this sort on birth spacing and child care and feeding is situational rather then mechanical. That is, people do not uni- formly apply various rules advising voluntary abortion and infanticide in cases of marital infractions or anomalous births, including twins. Traditions that shape the status of a child in the eyes of kin may exert a negative influence on the welfare of a child when a family is in a situation of stress, whereas they may not come into play regarding child health at all when a family is in better circumstances. The traditions increase the probability of malnutrition in specific children but they do not inexorably determine who will get malnutrition in a completely predictable, mechanically determined way.

Constraints and strategies of women affect time and energy available for food production and child care while increasing both the tendency toward inter- personal conflict among women and the need to leave children with grandparents who might be more likely to act on traditional beliefs. Cursing and sorcery were discussed as sources of some power for women, who generally are marginal and powerless, and they were associated with 8 of the families studied. Women’s constraints and protests are intensified with the growing landlessness, lack of employment, and alcoholism among men. Constraints on women that arise from tradition are reduced in the most affluent households, thus favoring the welfare of their children.

In the analysis in this article I have introduced the concept of selective survival as preferable to selective

250 MARY HOWARD

neglect. Selective survival is a term that discourages tendencies to blame the victims of malnutrition and povery, the children who are afflicted by malnutrition and their families. These tendencies are apparent among outsiders, health workers, and within the Chagga community itself. Selective survival also em- phasizes a parental focus on the survival of children, rather than a malevolent orientation toward them. ‘Selective’ is being used here not in the sense that there is a mechanical designation or parental decision as to which child will become malnourished but to include the situational factors that may push some children toward malnutrition without necessarily having that effect on others.

The danger of the term selective neglect is that it may not sufficiently encourage researchers to understand the perspectives of the impoverished; rather it tends to orient them toward the reactions of neighbors, views of more powerful community members, and perspectives of outsiders who try to intervene to improve health. Lack of attention to the experience of the families with malnourished children has been a problem in much of the research that deals with parental intentions and behavior in the phenomenon of malnutrition.

Partly because the conditions are chronic and seemingly beyond the control of outsiders, the prfoes- sionals in health, development, and research tend to become frustrated with their efforts and sometimes vent anger onto victims-the powerless, unhealthy, and malnourished people whom their programs address. The term selective neglect can thus become a vehicle for victim blaming, focusing all efforts on individual parents and away from broader systemic factors, like the commercialization of agriculture, which bring about malnutrition. It may also accompany a growing Western interest in and awareness of issues of child abuse in industrialized cultures. This is not to deny that individual parents have no role to play in the complex web of causation. Instead, I am concerned that the term selective neglect too easily connects with the class-bound ideology that pervades industrial societies at the core of the world economy and that justifies the accumulation of profits at the expense of the people who, out of poverty and desperation, provide cheap labor to the system. These tendencies both distance the wealthy and powerful from the poor and release them from the responsibil- ity to address the situation of the poor.

The complex nature of the Chagga experience with malnutrition is not immediately apparent to the outsider nor is it easy to analyze. My own experience as a health worker in a Chagga community during the 1972 to 1974 crisis led me to question whether the people were apathetic and neglectful toward their children. The analysis presented here shows several avenues for approaching this question and demon- strates that a number of major factors must be taken into account to understand child malnutrition among the Chagga. Of greatest historical significance is the

colonial transformation of their economy by force, which was accompanied by the disintegration of traditional institutions that had provided for the needy and had countered the hierarchical dynamic of Chagga society. Parts of Chagga culture with more historical continuity include the systems of kinship, inheritance of property, and bride price, which determine today more than ever before the resources accessible to a person. These systems also affect the status of a child in the eyes of kin. The subordination of women and their daily strategies for providing food for their families affect how much time they can devote to child care and the probability of malnutrition among their children. Colonialism and its aftermath, in conjunction with fluctuations in the global economy, local population pressure, and ecological phenomena were additional major forces that have combined to produce a society that is one of the wealthiest and best educated in east Africa and that also has one of the highest rates of child malnutrition. My analysis has shown how major transformations in the 20th century have created an incipient class system, in which members of the same family and the same compound can vary greatly in access to resources, specifically food for their families, and in the rate of malnutrition among their children. Because of the rupturing of reciprocity within clans and compounds, it is necessary to examine factors at this level while also taking into account factors far beyond the reaches of the community in order to understand the development of malnutrition in Chagga children.

Ackno~led~emenIs-Partial support for this project was provided by a Thomas E. Wenzlau grant from Ohio Wesleyan University. I would like to express my gratitude to the following persons for their encouragement and involvement in a variety of studies during my stay in Tanzania: Marja-Liisa Swan@ Ulla-Stina Henricson. Michaelle Von Freyhold, Katherina Sawaki and Thomas Zalla. All were essential in developing research opportunities and in interpreting our preliminary findings. I am also grateful to the people of Lukaranga village with whom I shared 5 years and to Harry and Natalie Adams and Faye Simms who provided hospitality during my stay in 1989. I am thankful for the dissertation guidance provided by Cheryl Rittenbaugh and Harry Raulet at Michigan State University and for comments and suggestions for this article provided by Debra Schumann, Jim Peoples and the anony- mous reviewers for Social Science and Medicine. Finally, I would especially like to thank Ann Millard for her editorial assistance and for her longstanding support of my career as an anthropologist.

REFERENCES

1.

2.

3.

4.

5.

Gutmann B. Das Recht der Dschagge. English transition A. M. Nagler. H.R.A.F. New Haven, Connecticut, Yale University Press, 1926. Raum G. F. Chasxa Childhood. London. Oxford Uni- versity Press, 1940. Marealle P. I. Chagga customary beliefs and traditions. Tanzanian Notes Rec. 64, 5641, 1965. Moore S. The Chaga of Kilimanjaro. Ethnographic Survey of Africa. International African Institute, 1978. Kreysler J. V. An analysis of survey data pertaining to

Childhood malnutritio In among the Chagga 251

18. Scrimshaw S. Infanticide as deliberate fertility regulation. In Determinants of Ferfilify in Developing Countries (Edited by Bulatao R. and Lee R. D.). Academic Press, New York, 1983.

19. Miller B. The Endangered Sex. Ithaca, Cornell Univer- sity Press, 1981.

20. Chen L. C., Huq E. and D’Souza S. Sex bias in the family allocation of food and health care in rural Bangladesh. Popul. Dev. Rev. 13, 77-100.

21. Das Gupta M. Selective discrimination against female children in rural Punjab, India. Popul. Dev. Rev. 13, 77-100, 1987.

22. Rosenberg E. M. Demographic effects of sex-differential nutrition. In Nutritional Anthropology (Edited by Jerome N. et al.). Redgrave, Pleasantville, New York, 1980.

23. Levine N. Differential child care in three Tibetian communities: Beyond son preference. Popul. Dev. Rev. 13, June, 1987.

24. Nations M. and Redhun L. A. Angels with wet wings won’t fly: Maternal sentiment in Brazil and the image of neglect. Cult. Med. Psychiaf. 1988.

25. Harris M. and Ross E. Death, Sex and Fertility: Popu- lation Regulation in Preinduslrial and Developing So- cieties. Columbia University Press, 1987.

26. Lindner P. 1. Baseline Study of Mothers and Children Attending Under Five Clinics in Kilimanjaro. K.C.M.C., Moshi, Tanzania, 1972.

27. Swantz M. L., Zalla M. H. and Henrickson U. Social- economic Causes of Malnutrition in Moshi District, BRALUP Research Paper, 38 University of Dar es Salaam, Tanzania, 1975.

28. Johnston D. H. Some notes on land tenure on Kiliman- jaro and the Vikamba of the Wachagga. Tanzania Notes Rec. 21, l-20, 1946.

29. Cook C. and Kerner D. Gender and food shortage in Tanzania. Feminist Issues 9, Spring, 1989.

protein energy malnutrition. In The Young Child in Tanzania. Dar es Salaam, UNICEF, 1973.

6. Von Frevhold M. M.. Zalla H. and Sawaki K. Moshi District In The Young Child in Tanzania. Dar es Salaam, UNICEF, 1973.

7. Von Clemm M. Agricultural productivity and sentiment on Kilimanjaro. Econ. Bof 18, 99-121, 1964.

8. Zalla T. The economics and technology of dairy production on Mt. Kilimaniaro, Tanzania, Ph.D. diserta- tion, Michigan State University, 1983.

9. Dundas C. Kilimaniaro and Its PeoDle. Frank Cass, 1924.

10. United Republic of Tanzania, 1978 Population Census. Dar es Salaam, Government Printer.

11. Mascarenhas A. C. and Rudengren J. Spatial differentiation at ward level: the case of Kahe, Kilimanjaro Region. East African Universities Social Science Confer- ence, Dar es Salaam, 1973.

12. Maro P. Population and land resources in northern Tanzania: the dynamics of change, 192&1970, Ph.D dissertation, University of Minnesota, 1974.

13. Cassidy C. M. Benign neglect and toddler malnutrition. In Social and Biological Predictors of Nutritional Stalus, Physical Growth, and Neurological Development (Edited by Green L. S. and Johnston F. E.), p. 136, 1980.

14. Scheper-Hughes N. Culture, scarcity and maternal thinking: Maternal detachment and infant survival in a Brazilian shantytown. Ethos 13, 291-317, 1985.

15. Scheper-Hughes N. The cultural politics of child survival. In Child Survival (Edited by Scheper-Hughes N.). Reidel, Boston, 1987.

16. Scheper-Hughes N. Letter to the editor. Cult. Med. Psvchiat. 12, 1988.

17. Scrimshaw S. Infant mortality and behavior in the regulation of family size. Popul. Dev. Rev. 4, 383403, 1978.

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