The Price of progress John Bodley In aiming at progress.. you must trol their own resources and define their less ethnocentric criteria, the important let no one suffer by too drastic a relationship to the market economy question to ask is: Does progress or eco- measure, nor pay too high a price nomic development increase or decrease upheaval and de PROGRESS AND THE a given culture's ability to satisfy your innovation QUALITY OF LIFE physical and psychological needs of its Maunier 1949: 725 population, or its stability? This question One of the primary difficulties in assess- is a far more direct measure of quality of UNTIL RECENTLY, GovErnmeNT ing the benefits of progress and eco- life than are the standard economic cor- planners have always considered eco- nomic development for any culture relates of development, and it is univer- nomic development and progress benefi- that of establishing a meaningful mea- sally relevant Specific indication of this cial goals that all societies should want to sure of both benefit and detriment. It is standard of living could be found fo strive toward. The social advantage of widely recognized that standard of liv- society in the nutritional status and progressas defined in terms of in- ing, which is the most frequently used eral physical and mental health of its creased incomes, higher standards of liv- measure of progress, is an intrinsically population, the incidence of crime and ing, greater security, and better health ethnocent ric concept relying heavily delinquency, the demographic structure, are thought to be positive, universal upon indicators that lack universal cul- family stability, and the societys rela goods, to be obtained at any price. Al- tural relevance. Such factors as GNP, per tionship to its natural resource base. A though one may argue that tribal peoples capita income, capital formation, em- society with high rates of malnutrition must sacrifice their traditional cultures to ployment rates, literacy, formal educa- and crime and one degrading its natural obtain these benefits, government plan- tion, consumption of manufactured environment to the extent of threatening ners generally feel that this is a small goods, number of doctors and hospital its continued existence, might be de- price to pay for such obvious advantages. beds per thousand persons, and the scribed as at a lower standard of living In earlier chapters [in Victims of amount of money spent on government than is another society where these prob- Progress, 3rd ed ] evidence was pre- welfare and health programs may be ir- lems did not exist sented to demonstrate that autonomous relevant measures of actual quality of tribal peoples have not chosen progress life for autonomous or even semiautono- Careful examination of the data to enjoy its advantages, but that govern- mous tribal cultures. In its 1954 report, which compare, on these specific points, ments have pushed progress upon them the Trust Territory government indicated the former condition of self-sufficient to obtain tribal resources, not primarily that since the Micronesian population tribal peoples with their condition fol- to share with the tribal peoples the bene- was still largely satisfying its own needs lowing their incorporation into the fits of progress. It has also been shown within a cashless subsistence economy, world-market economy, leads to the con- that the price of forcing progress on un-""Money income is not a significant mea- clusion that their standard of living is willing recipients has involved the sure of living standards, production, or lowered, not raised, by economic deaths of millions of tribal people, as well-being in this area"(TTR, 1953: 44). progress-and often to a dramatic de well as their loss of land, political sover- Unfortunately, within a short time the gree. This is perhaps the most outstand- eignty, and the right to follow their own government began to rely on an numer- ing and inescapable fact to emerge from life style. This chapter does not attempt ation of certain imported consumer the years of research that anthrop to further summarize that aspect of the goods as indicators of a higher standard have devoted to the study of cost of progress, but instead analyzes the of living in the islands, even though change and modernization. Despi specific effects of the participation of many tradition-oriented islanders felt best intentions of those who have pro- tribal peoples in the world-market econ- that these new goods symbolized a lot moted change and improvement, all too omy. In direct opposition to the usual in- ering of the quality of life often the results have been poverty, terpretation, it is argued here that the A more useful measure of the benefits longer working hours, and much greater benefits of progress are often both illu- of progress might be based on a formula physical exertion, poor health, social dis- sory and detrimental to tribal peoples for evaluating cultures devised by Gold- order, discontent, discrimination, overpopu- when they have not been allowed to con- schmidt(1952: 135). According to these lation, and environmental deteriorati
1 Article 35 The Price of Progress John Bodley In aiming at progress… you must let no one suffer by too drastic a measure, nor pay too high a price in upheaval and devastation, for your innovation. Maunier, 1949: 725 UNTIL RECENTLY, GOVERNMENT planners have always considered economic development and progress beneficial goals that all societies should want to strive toward. The social advantage of progress—as defined in terms of increased incomes, higher standards of living, greater security, and better health— are thought to be positive, universal goods, to be obtained at any price. Although one may argue that tribal peoples must sacrifice their traditional cultures to obtain these benefits, government planners generally feel that this is a small price to pay for such obvious advantages. In earlier chapters [in Victims of Progress, 3rd ed.], evidence was presented to demonstrate that autonomous tribal peoples have not chosen progress to enjoy its advantages, but that governments have pushed progress upon them to obtain tribal resources, not primarily to share with the tribal peoples the benefits of progress. It has also been shown that the price of forcing progress on unwilling recipients has involved the deaths of millions of tribal people, as well as their loss of land, political sovereignty, and the right to follow their own life style. This chapter does not attempt to further summarize that aspect of the cost of progress, but instead analyzes the specific effects of the participation of tribal peoples in the world-market economy. In direct opposition to the usual interpretation, it is argued here that the benefits of progress are often both illusory and detrimental to tribal peoples when they have not been allowed to control their own resources and define their relationship to the market economy. PROGRESS AND THE QUALITY OF LIFE One of the primary difficulties in assessing the benefits of progress and economic development for any culture is that of establishing a meaningful measure of both benefit and detriment. It is widely recognized that standard of living, which is the most frequently used measure of progress, is an intrinsically ethnocentric concept relying heavily upon indicators that lack universal cultural relevance. Such factors as GNP, per capita income, capital formation, employment rates, literacy, formal education, consumption of manufactured goods, number of doctors and hospital beds per thousand persons, and the amount of money spent on government welfare and health programs may be irrelevant measures of actual quality of life for autonomous or even semiautonomous tribal cultures. In its 1954 report, the Trust Territory government indicated that since the Micronesian population was still largely satisfying its own needs within a cashless subsistence economy, “Money income is not a significant measure of living standards, production, or well-being in this area” (TTR, 1953: 44). Unfortunately, within a short time the government began to rely on an enumeration of certain imported consumer goods as indicators of a higher standard of living in the islands, even though many tradition-oriented islanders felt that these new goods symbolized a lowering of the quality of life. A more useful measure of the benefits of progress might be based on a formula for evaluating cultures devised by Goldschmidt (1952: 135). According to these less ethnocentric criteria, the important question to ask is: Does progress or economic development increase or decrease a given culture’s ability to satisfy the physical and psychological needs of its population, or its stability? This question is a far more direct measure of quality of life than are the standard economic correlates of development, and it is universally relevant. Specific indication of this standard of living could be found for any society in the nutritional status and general physical and mental health of its population, the incidence of crime and delinquency, the demographic structure, family stability, and the society’s relationship to its natural resource base. A society with high rates of malnutrition and crime, and one degrading its natural environment to the extent of threatening its continued existence, might be described as at a lower standard of living than is another society where these problems did not exist. Careful examination of the data, which compare, on these specific points, the former condition of self-sufficient tribal peoples with their condition following their incorporation into the world-market economy, leads to the conclusion that their standard of living is lowered, not raised, by economic progress—and often to a dramatic degree. This is perhaps the most outstanding and inescapable fact to emerge from the years of research that anthropologists have devoted to the study of culture change and modernization. Despite the best intentions of those who have promoted change and improvement, all too often the results have been poverty, longer working hours, and much greater physical exertion, poor health, social disorder, discontent, discrimination, overpopulation, and environmental deterioration—
combined with the destruction of the tra- trend. The progressive acquisition of life, imported food, and motorcycles, ditional culture modern degenerative diseases was docu- sugar and salt intakes nearly tripled, high mented by an eight-member team of blood pressure increased approximately DISEASES OF New Zealand medical specialists, an- ninefold, diabetes two-to threefold, and DEVELOPMENT thropologists, and nutritionists, whose heart disease doubled for men and more research was funded by the Medical Re- than quadrupled for women, while the Pe search Council of New Zealand and the number of grossly obese women in- lic health specialists to start talk World health Organization. These creased more than tenfold. among the ing about a new category of searchers investigated the health status New Zealand Maori, sugar intake was diseases.. Such diseases could be of a genetically related population at var- nearly eight times that of the Pukapu called the diseases of develop ious points along a continuum of increas- kans, gout in men was nearly double its nd would consist of those ng cash income, modernizing diet, and rate on Pukapuka, and diabetes in men pathological conditions which are urbanization. The extremes on this ac- was more than fivefold higher. while based on the usually unanticipated culturation continuum were represented heart disease in women had increased consequences of the implementa- by the relatively traditional Pukapukans more than sixfold. The Maori were,in tion of developmental schemes of the Cook Islands and the essentially fact, dying of"European"diseases at a Hughes Hunter, 1972: 93 Europeanized New Zealand Maori, eater rate than was the average New while the busily developing Raroton- Zealand European. Economic development increases the gans, also of the Cook Islands, occupied Government development policies disease rate of affected peoples in at least the intermediate position. In 1971, after designed to bring about changes in local three ways. First, to the extent that devel- eight years of work, the teams prelimi- hydrology, vegetation, and settlement populations suddenly become vulnerable c ry findings were summarized by Dr. patterns and to increase population mo- opment is successful, it makes developed an Prior, cardiologist and leader of the bility, and even programs aimed at re to all of the diseases suffered almost research as follows ducing certain diseases, have frequently exclusively by“ advanced” peoples led to dramatic increases in disease rates Among these are diabetes, obesity, hy We are beginning to observe that because of the unforeseen effects of dis- pertension, and a variety of circulator the more an islander takes on the urbing the preexisting order. problems. Second, development disturbs of the West, and Hunter(1972)publishe traditional environmental balances and he is to succumb to our degenera lent survey of cases in which may dramatically increase certain bacte tive diseases. In fact, it does not ment led directly to increased disease al and parasite diseases. Finally, when seem too much to say our evidence rates in Africa. They concluded that development goals prove unattainable, now shows that the farther the Pe hasty development intervention in an assortment of poverty diseases may atives move from the quiet, relatively balanced local cultures and appear in association with the crowded carefree life of their ancestors, the environments resulted in "a drastic dete- conditions of urban slums and the gen- closer they come to gout, diabetes, rioration in the social and economic con- eral breakdown in traditional socioeco- erosclerost.s. o ditions of life Traditional populations in general Outstanding examples of the first sit- Prior. 1971: 2 have presumably learned to live with the uation can be seen in the Pacific. here endemic pathogens of their environ- some of the most successfully developed In Pukapuka, where progress was ments, and in some cases they have native peoples are found In Micronesia, limited by the islands small size and its evolved genetic adaptations to specific where development has progressed more isolated location some 480 kilometers diseases, such as the sickle-cell trait rapidly than perhaps anywhere else, be- from the nearest port, the annual per cap- which provided an immunity to malaria tween 1958 and 1972 the population ita income was only about thirty-six Unfortunately, however, outside inter doubled, but the number of patients dollars and the economy remained es- vention has entirely changed this picture treated for heart disease in the local sentially at a subsistence level. Re- In the late 1960s, sleeping sickness sud hospitals nearly tripled, mental disorder sources were limited and the area was denly increased in many areas of Africa increased eightfold, and by 1972 hyper- visited by trading ships only three or four and even spread to areas where it did not tension and nutritional deficiencies be- times a year; thus, there was little oppor- formerly occur, due to the building of gan to make significant appearances for tunity for intensive economic develop- new roads and migratory labor, both of the first time(TTr, 1959, 1973, statisti- ment. Predictably, the population of which caused increased population cal tables) Pukapuka was characterized by rela- movement. Large-scale relocation some critics argue that the tively low levels of imported sugar and schemes, such as the Zande scheme, had Micronesian figures simply represent salt intake, and a presumably related low disastrous results when natives wer better monitoring due to eco- level of heart disease, high blood pres- moved from their traditional disease-free nomic progress, rigorously controlled sure, and diabetes. In Rarotonga, where refuges into infected areas. Dams and ir- data from Polynesia show a similar economic success was introducing town rigation developments inadvertently cre
Article 35. The Price of Progress 2 combined with the destruction of the traditional culture. DISEASES OF DEVELOPMENT Perhaps it would be useful for public health specialists to start talking about a new category of diseases.… Such diseases could be called the “diseases of development” and would consist of those pathological conditions which are based on the usually unanticipated consequences of the implementation of developmental schemes. Hughes & Hunter, 1972: 93 Economic development increases the disease rate of affected peoples in at least three ways. First, to the extent that development is successful, it makes developed populations suddenly become vulnerable to all of the diseases suffered almost exclusively by “advanced” peoples. Among these are diabetes, obesity, hypertension, and a variety of circulatory problems. Second, development disturbs traditional environmental balances and may dramatically increase certain bacterial and parasite diseases. Finally, when development goals prove unattainable, an assortment of poverty diseases may appear in association with the crowded conditions of urban slums and the general breakdown in traditional socioeconomic systems. Outstanding examples of the first situation can be seen in the Pacific, where some of the most successfully developed native peoples are found. In Micronesia, where development has progressed more rapidly than perhaps anywhere else, between 1958 and 1972 the population doubled, but the number of patients treated for heart disease in the local hospitals nearly tripled, mental disorder increased eightfold, and by 1972 hypertension and nutritional deficiencies began to make significant appearances for the first time (TTR, 1959, 1973, statistical tables). Although some critics argue that the Micronesian figures simply represent better health monitoring due to economic progress, rigorously controlled data from Polynesia show a similar trend. The progressive acquisition of modern degenerative diseases was documented by an eight-member team of New Zealand medical specialists, anthropologists, and nutritionists, whose research was funded by the Medical Research Council of New Zealand and the World Health Organization. These researchers investigated the health status of a genetically related population at various points along a continuum of increasing cash income, modernizing diet, and urbanization. The extremes on this acculturation continuum were represented by the relatively traditional Pukapukans of the Cook Islands and the essentially Europeanized New Zealand Maori, while the busily developing Rarotongans, also of the Cook Islands, occupied the intermediate position. In 1971, after eight years of work, the team’s preliminary findings were summarized by Dr. Ian Prior, cardiologist and leader of the research, as follows: We are beginning to observe that the more an islander takes on the ways of the West, the more prone he is to succumb to our degenerative diseases. In fact, it does not seem too much to say our evidence now shows that the farther the Pacific natives move from the quiet, carefree life of their ancestors, the closer they come to gout, diabetes, atherosclerosis, obesity, and hypertension. Prior, 1971: 2 In Pukapuka, where progress was limited by the island’s small size and its isolated location some 480 kilometers from the nearest port, the annual per capita income was only about thirty-six dollars and the economy remained essentially at a subsistence level. Resources were limited and the area was visited by trading ships only three or four times a year; thus, there was little opportunity for intensive economic development. Predictably, the population of Pukapuka was characterized by relatively low levels of imported sugar and salt intake, and a presumably related low level of heart disease, high blood pressure, and diabetes. In Rarotonga, where economic success was introducing town life, imported food, and motorcycles, sugar and salt intakes nearly tripled, high blood pressure increased approximately ninefold, diabetes two- to threefold, and heart disease doubled for men and more than quadrupled for women, while the number of grossly obese women increased more than tenfold. Among the New Zealand Maori, sugar intake was nearly eight times that of the Pukapukans, gout in men was nearly double its rate on Pukapuka, and diabetes in men was more than fivefold higher, while heart disease in women had increased more than sixfold. The Maori were, in fact, dying of “European” diseases at a greater rate than was the average New Zealand European. Government development policies designed to bring about changes in local hydrology, vegetation, and settlement patterns and to increase population mobility, and even programs aimed at reducing certain diseases, have frequently led to dramatic increases in disease rates because of the unforeseen effects of disturbing the preexisting order. Hughes and Hunter (1972) published an excellent survey of cases in which development led directly to increased disease rates in Africa. They concluded that hasty development intervention in relatively balanced local cultures and environments resulted in “a drastic deterioration in the social and economic conditions of life.” Traditional populations in general have presumably learned to live with the endemic pathogens of their environments, and in some cases they have evolved genetic adaptations to specific diseases, such as the sickle-cell trait, which provided an immunity to malaria. Unfortunately, however, outside intervention has entirely changed this picture. In the late 1960s, sleeping sickness suddenly increased in many areas of Africa and even spread to areas where it did not formerly occur, due to the building of new roads and migratory labor, both of which caused increased population movement. Large-scale relocation schemes, such as the Zande Scheme, had disastrous results when natives were moved from their traditional disease-free refuges into infected areas. Dams and irrigation developments inadvertently cre-
ated ideal conditions for the rapid imported canned tunafish when abun- health status. Indeed, as tribal peoples proliferation of snails carrying schistose- dant high-quality fish is available in their have shifted to a diet based on imported miasis(a liver fluke disease), and major own rivers. Another example of this sit- manufactured or processed foods, there epidemics suddenly occurred in areas uation occurs in tribes where mothers has been a dramatic rise in malnutrition, where this disease had never before been prefer to feed their infants expensive nu- a massive increase in dental problems, a problem. DDT spraying programs have tritionally inadequate canned milk from and a variety of other nutritional-related been temporarily successful in control- unsanitary, but high status, baby bottles. disorders. Nutritional physiology is so ling malaria, but there is often a rebound The high status of these items is often complex that even well-meaning dietary effect that increases the problem when promoted by clever trade ers and clev rer changes have had tragic consequences. spraying is discontinued, and the malar- advertising campaigns. In many areas of Southeast Asia, govern- ial mosquitoes are continually evolving Aside from these apparently volun- ment-sponsored protein supplementation resistant strains tary changes, it appears that more often programs supplying milk to protein-defi Urbanization is one of the prime mea etary changes are forced upon unwill- cient populations caused unexpected sures of development, but it is a mixed ing tribal peoples by circumstances be- health problems and increased mortality blessing for most former tribal peoples. yond their control. In some areas, new Officials failed to anticipate that in cul- rban health standards are abysmally food crops have been introduced by gov- tures where adults do not normally drink poor and generally worse than in rural ar- ernment decree, or as a consequence of milk, the enzymes needed to digest it are eas for the detribalized individuals who forced relocation or other policies de- no longer produced and milk intolerance have crowded into the towns and cities signed to end hunting, pastoralism, or results( Davis bolin, 1972). In brazil, throughout Africa, Asia, and Latin shifting cultivation. Food habits have a similar milk distribution program America seeking wage employment out also been modified by massive disruption caused an epidemic of permanent blind- of new economic necessity. Infectious of the natural environment by outsid- ness by aggravating a preexisting vita- diseases related to crowding and poor ers--as when sheepherders transformed min A deficiency(Bunce, 1972) sanitation are rampant in urban centers, the Australian Aborigines' foraging ter while greatly increased stress and poor ritory or when European invaders de- Teeth and Progress nutrition aggravate a variety of other troyed the bison herds that were the health problems. Malnutrition and other primary element in the Plains Indians There is ne g new In diet-related conditions are, in fact, one of subsistence patterns. Perhaps the most vation that savages, or peoples liv- the characteristic hazards of progress frequent cause of diet change occurs ing under primitive conditions, faced by tribal peoples and are discussed when formerly self-sufficient peoples have, in general, excellent teeth. in the following sections find that wage labor, cash cropping, and Nor is it news that most civilized other economic development activities populations possess wretched The Hazards of Dietary Change at feed tribal resources into the worle teeth which begin to decay almost market economy must inevitably divert fore they have er The traditional diets of tribal peoples are time and energy away from the produc pletely, and that dental caries is dmirably adapted to their nutritional tion of subsistence foods. Many develop- likely to be accompanied by peri needs and available food resources. Even ing peoples suddenly discover that, like odontal disease with further though these diets may seem bizarre, ab- it or not, they are unable to secure tradi reaching complications urd, and unpalatable to outsiders, they tional foods and must spend their newly Hooton. 1945: xvill are unlikely to be improved by drastic acquired cash on costly, and often nutri- modifications. Given the delicate bal- tionally inferior, manufactured foods Anthropologists have long recognized ances and complexities involved in any Overall, the available data seem to in- that undisturbed tribal peoples are often subsistence system, change always in- dicate that the dietary changes that are in excellent physical condition. And it volves risks, but for tribal people the linked to involvement in the world-mar- has often been noted specifically that effects of dietary change have been cata- ket economy have tended to lower rather dental caries and the other dental abnor strophic than raise the nutritional levels of the af- malities that plague industrialized societ- Under normal conditions, food habits fected tribal peoples. Specifically, the vi- ies are absent or rare among tribal are remarkably resistant to change, and tamin, mineral, and protein components peoples who have retained their tradi- indeed people are unlikely to abandon of their diets are often drastically re- tional diets. The fact that tribal food hab- their traditional diets voluntarily in favor duced and replaced by enormous in- its may contribute to the development of of dependence on difficult-to-obtain ex- creases in starch and carbohydrates, sound teeth, whereas modernized diets otic imports. In some cases it is true that often in the form of white flour and re- may do just the opposite, was illustrated imported foods may be identified with fined sugar. as long ago as 1894 in an article in the powerful outsiders and are therefore Any deterioration in the quality of a Jounal of the Royal Anthropological In sought as symbols of greater prestige. given populations diet is almost certain stitute that described the results of a This may lead to such absurdities as Am- to be reflected in an increase in defi- comparison between the teeth of ten azonian Indians choosing to consume ciency diseases and a general decline in Sioux Indians were examined when they 3
ANNUAL EDITIONS 3 ated ideal conditions for the rapid proliferation of snails carrying schistosomiasis (a liver fluke disease), and major epidemics suddenly occurred in areas where this disease had never before been a problem. DDT spraying programs have been temporarily successful in controlling malaria, but there is often a rebound effect that increases the problem when spraying is discontinued, and the malarial mosquitoes are continually evolving resistant strains. Urbanization is one of the prime measures of development, but it is a mixed blessing for most former tribal peoples. Urban health standards are abysmally poor and generally worse than in rural areas for the detribalized individuals who have crowded into the towns and cities throughout Africa, Asia, and Latin America seeking wage employment out of new economic necessity. Infectious diseases related to crowding and poor sanitation are rampant in urban centers, while greatly increased stress and poor nutrition aggravate a variety of other health problems. Malnutrition and other diet-related conditions are, in fact, one of the characteristic hazards of progress faced by tribal peoples and are discussed in the following sections. The Hazards of Dietary Change The traditional diets of tribal peoples are admirably adapted to their nutritional needs and available food resources. Even though these diets may seem bizarre, absurd, and unpalatable to outsiders, they are unlikely to be improved by drastic modifications. Given the delicate balances and complexities involved in any subsistence system, change always involves risks, but for tribal people the effects of dietary change have been catastrophic. Under normal conditions, food habits are remarkably resistant to change, and indeed people are unlikely to abandon their traditional diets voluntarily in favor of dependence on difficult-to-obtain exotic imports. In some cases it is true that imported foods may be identified with powerful outsiders and are therefore sought as symbols of greater prestige. This may lead to such absurdities as Amazonian Indians choosing to consume imported canned tunafish when abundant high-quality fish is available in their own rivers. Another example of this situation occurs in tribes where mothers prefer to feed their infants expensive nutritionally inadequate canned milk from unsanitary, but high status, baby bottles. The high status of these items is often promoted by clever traders and clever advertising campaigns. Aside from these apparently voluntary changes, it appears that more often dietary changes are forced upon unwilling tribal peoples by circumstances beyond their control. In some areas, new food crops have been introduced by government decree, or as a consequence of forced relocation or other policies designed to end hunting, pastoralism, or shifting cultivation. Food habits have also been modified by massive disruption of the natural environment by outsiders—as when sheepherders transformed the Australian Aborigines’ foraging territory or when European invaders destroyed the bison herds that were the primary element in the Plains Indians’ subsistence patterns. Perhaps the most frequent cause of diet change occurs when formerly self-sufficient peoples find that wage labor, cash cropping, and other economic development activities that feed tribal resources into the worldmarket economy must inevitably divert time and energy away from the production of subsistence foods. Many developing peoples suddenly discover that, like it or not, they are unable to secure traditional foods and must spend their newly acquired cash on costly, and often nutritionally inferior, manufactured foods. Overall, the available data seem to indicate that the dietary changes that are linked to involvement in the world-market economy have tended to lower rather than raise the nutritional levels of the affected tribal peoples. Specifically, the vitamin, mineral, and protein components of their diets are often drastically reduced and replaced by enormous increases in starch and carbohydrates, often in the form of white flour and refined sugar. Any deterioration in the quality of a given population’s diet is almost certain to be reflected in an increase in deficiency diseases and a general decline in health status. Indeed, as tribal peoples have shifted to a diet based on imported manufactured or processed foods, there has been a dramatic rise in malnutrition, a massive increase in dental problems, and a variety of other nutritional-related disorders. Nutritional physiology is so complex that even well-meaning dietary changes have had tragic consequences. In many areas of Southeast Asia, government-sponsored protein supplementation programs supplying milk to protein-deficient populations caused unexpected health problems and increased mortality. Officials failed to anticipate that in cultures where adults do not normally drink milk, the enzymes needed to digest it are no longer produced and milk intolerance results (Davis & Bolin, 1972). In Brazil, a similar milk distribution program caused an epidemic of permanent blindness by aggravating a preexisting vitamin A deficiency (Bunce, 1972). Teeth and Progress There is nothing new in the observation that savages, or peoples living under primitive conditions, have, in general, excellent teeth.… Nor is it news that most civilized populations possess wretched teeth which begin to decay almost before they have erupted completely, and that dental caries is likely to be accompanied by periodontal disease with further reaching complications. Hooton, 1945: xviii Anthropologists have long recognized that undisturbed tribal peoples are often in excellent physical condition. And it has often been noted specifically that dental caries and the other dental abnormalities that plague industrialized societies are absent or rare among tribal peoples who have retained their traditional diets. The fact that tribal food habits may contribute to the development of sound teeth, whereas modernized diets may do just the opposite, was illustrated as long ago as 1894 in an article in the Journal of the Royal Anthropological Institute that described the results of a comparison between the teeth of ten Sioux Indians were examined when they
came to London as members of Buffalo enough in itself, and it certainly under- crops and other food sources that were Bills wild West Show and were found mined the population's resistance to rich in protein with substitutes, high in to be completely free of caries and in many new diseases, including tuberculo- calories but low in protein In Africa, for possession of all their teeth, even though sis. But new foods were also accompa- example, protein-rich staples such as half of the group were over thirty-nine nied by crowded, misplaced teeth, gum millet and sorghum are being replaced years of age. Londoners'teeth were con- diseases, distortion of the face, and systematically by high-yielding manioc spicuous for both their caries and their pinching of the nasal cavity Abnormali- and plantains, which have insignificant steady reduction in number with advanc- ties in the dental arch appeared in the amounts of protein. The problem is in ing age. The difference was attributed new generation following the change in creased for cash croppers and wage la primarily to the wear and polishing diet, while caries appeared almost imme- borers whose earnings are too low and caused by the traditional Indian diet of diately even in adults unpredictable to allow coarse food and the fact that they chewed Price reported that in many areas the quate amounts of protein. In some rural their food longer, encouraged by the ab- affected peoples were conscious of their areas, agricultural laborers have been sence of tableware own physical deterioration. At a mission forced systematically to deprive nonpro- One of the most remarkable studies of school in Africa, the principal asked him ductive members (principally children) the dental conditions of tribal peoples to explain to the native schoolchildren of their households of their minimal nu- and the impact of dietary change was why they were not physically as strong tritional requirements to satisfy the need conducted in the 1930s by Weston Price as children who had had no contact with of the productive members. This process (1945), an American dentist who was schools. On an island in the torres strait has been documented in northeastern terested in determining what caused nor- the natives knew exactly what was caus- Brazil following the introduction of mal, healthy teeth. Between 1931 and ing their problems and resisted--almost large-scale sisal plantations(Gross 1936, Price systematically explored to the point of bloodshed--government Underwood, 1971). In urban centers the tribal areas throughout the world to lo- efforts to establish a store that would difficulties of obtaining nutritionally ad- cate and examine the most isolated peo- make imported food available. The gov- equate diets are even more serious for ples who were still living on traditional ernment prevailed, however, and Price tribal immigrants, because costs are foods. His fieldwork covered Alaska, the was able to establish a relationship be- higher and poor quality foods are more Canadian Yukon, Hudson Bay, Vancou- tween the length of time the government tempting ver Island. florida. the Andes. the Ama- store had been established and the in- One of the most tragic, and largely zon, Samoa, Tahiti, New Zealand, creasing incidence of caries among a overlooked, aspects of chronic malnutr ustralia, New Caledonia, Fiji, the population that showed an almost 100 tion is that it can lead to abnormally Torres Strait, East Africa, and the Nile. percent immunity to them before the undersized brain development and ap- The study demonstrated both the supe- store had been opened parently irreversible brain damage; it has rior quality of aboriginal dentition and In New Zealand, the Maori, who in been associated with various forms of the devastation that occurs as modern di- their aboriginal state are often consid- mental impairment or retardation. Mal- ets are adopted. In nearly every area ered to have been among the healthiest, nutrition has been linked clinically with where traditional foods were still being most perfectly developed of people, mental retardation in both Africa and eaten, Price found perfect teeth with nor- were found to have"advanced "the fur- Latin America (see, for example, al dental arches and virtually no decay, thest. According to Price Monckeberg, 1968), and this appears to whereas caries and abnormalities be a worldwide phenomenon with seri creased steadily as new diets were Their modernization was demon ous implications(Montagu, 1972) adopted In many cases the change was strated not only by the high inci Optimistic supporters of progress will sudden and striking. Among Eskimo dence of dental caries but also by surely say that all of these groups subsisting entirely on traditional the fact that 90 percent of the problems are being overstressed and that food he found caries totally absent adults and 100 percent of the ch the introduction of hospitals, clinics, and whereas in groups eating a considerable dren had abnormalities of the den he other modern health institutions will quantity of store-bought food approxi- tal arche overcome or at least compensate for all mately 20 percent of their teeth were de Price.1945:206 of these difficulties. However, it appears cayed. This figure rose to more than 30 that uncontrolled population growth and percent with Eskimo groups subsisting Malnutrition economic impoverishment probably will almost exclusively on purchased or gov keep most of these benefits out of reach ernment-supplied food, and reached an Malnutrition, particularly in the form of for many tribal peoples, and the interven- incredible 48 percent among the Van- protein deficiency, has become a critical tion of modern medicine has at least couver Island Indians. Unfortunately for problem for tribal peoples who must partly contributed to the problem in the many of these people, modern dental adopt new economic patterns. Popula- first place treatment did not accompany the new tion pressures, cash cropping, and gov- food, and their suffering was appalling. ernment programs all have tended to The generalization that civilization fre- The loss of teeth was, of course, bad encourage the replacement of traditional quently has a broad negative impact
Article 35. The Price of Progress 4 came to London as members of Buffalo Bill’s Wild West Show and were found to be completely free of caries and in possession of all their teeth, even though half of the group were over thirty-nine years of age. Londoners’ teeth were conspicuous for both their caries and their steady reduction in number with advancing age. The difference was attributed primarily to the wear and polishing caused by the traditional Indian diet of coarse food and the fact that they chewed their food longer, encouraged by the absence of tableware. One of the most remarkable studies of the dental conditions of tribal peoples and the impact of dietary change was conducted in the 1930s by Weston Price (1945), an American dentist who was interested in determining what caused normal, healthy teeth. Between 1931 and 1936, Price systematically explored tribal areas throughout the world to locate and examine the most isolated peoples who were still living on traditional foods. His fieldwork covered Alaska, the Canadian Yukon, Hudson Bay, Vancouver Island, Florida, the Andes, the Amazon, Samoa, Tahiti, New Zealand, Australia, New Caledonia, Fiji, the Torres Strait, East Africa, and the Nile. The study demonstrated both the superior quality of aboriginal dentition and the devastation that occurs as modern diets are adopted. In nearly every area where traditional foods were still being eaten, Price found perfect teeth with normal dental arches and virtually no decay, whereas caries and abnormalities increased steadily as new diets were adopted. In many cases the change was sudden and striking. Among Eskimo groups subsisting entirely on traditional food he found caries totally absent, whereas in groups eating a considerable quantity of store-bought food approximately 20 percent of their teeth were decayed. This figure rose to more than 30 percent with Eskimo groups subsisting almost exclusively on purchased or government-supplied food, and reached an incredible 48 percent among the Vancouver Island Indians. Unfortunately for many of these people, modern dental treatment did not accompany the new food, and their suffering was appalling. The loss of teeth was, of course, bad enough in itself, and it certainly undermined the population’s resistance to many new diseases, including tuberculosis. But new foods were also accompanied by crowded, misplaced teeth, gum diseases, distortion of the face, and pinching of the nasal cavity. Abnormalities in the dental arch appeared in the new generation following the change in diet, while caries appeared almost immediately even in adults. Price reported that in many areas the affected peoples were conscious of their own physical deterioration. At a mission school in Africa, the principal asked him to explain to the native schoolchildren why they were not physically as strong as children who had had no contact with schools. On an island in the Torres Strait the natives knew exactly what was causing their problems and resisted—almost to the point of bloodshed—government efforts to establish a store that would make imported food available. The government prevailed, however, and Price was able to establish a relationship between the length of time the government store had been established and the increasing incidence of caries among a population that showed an almost 100 percent immunity to them before the store had been opened. In New Zealand, the Maori, who in their aboriginal state are often considered to have been among the healthiest, most perfectly developed of people, were found to have “advanced” the furthest. According to Price: Their modernization was demonstrated not only by the high incidence of dental caries but also by the fact that 90 percent of the adults and 100 percent of the children had abnormalities of the dental arches. Price, 1945: 206 Malnutrition Malnutrition, particularly in the form of protein deficiency, has become a critical problem for tribal peoples who must adopt new economic patterns. Population pressures, cash cropping, and government programs all have tended to encourage the replacement of traditional crops and other food sources that were rich in protein with substitutes, high in calories but low in protein. In Africa, for example, protein-rich staples such as millet and sorghum are being replaced systematically by high-yielding manioc and plantains, which have insignificant amounts of protein. The problem is increased for cash croppers and wage laborers whose earnings are too low and unpredictable to allow purchase of adequate amounts of protein. In some rural areas, agricultural laborers have been forced systematically to deprive nonproductive members (principally children) of their households of their minimal nutritional requirements to satisfy the need of the productive members. This process has been documented in northeastern Brazil following the introduction of large-scale sisal plantations (Gross & Underwood, 1971). In urban centers the difficulties of obtaining nutritionally adequate diets are even more serious for tribal immigrants, because costs are higher and poor quality foods are more tempting. One of the most tragic, and largely overlooked, aspects of chronic malnutrition is that it can lead to abnormally undersized brain development and apparently irreversible brain damage; it has been associated with various forms of mental impairment or retardation. Malnutrition has been linked clinically with mental retardation in both Africa and Latin America (see, for example, Mönckeberg, 1968), and this appears to be a worldwide phenomenon with serious implications (Montagu, 1972). Optimistic supporters of progress will surely say that all of these new health problems are being overstressed and that the introduction of hospitals, clinics, and the other modern health institutions will overcome or at least compensate for all of these difficulties. However, it appears that uncontrolled population growth and economic impoverishment probably will keep most of these benefits out of reach for many tribal peoples, and the intervention of modern medicine has at least partly contributed to the problem in the first place. The generalization that civilization frequently has a broad negative impact on
tribal health has found broad empirical starve. "As one looked one saw consequences, because where tribals can support(see especially Kroeger Bar- that what had once been a gree retain or regain their status as local ma- bira-Freedman [ 1982]on Amazonia; Re- hill had become a raw red rock jorities they may be in a more favorable inhard [1976] on the Arctic; and Wirsing Jones. 1934 position to defend their resources agains [1985] globally), but these conclusions intruders have not gone unchallenged. Some crit- Progress not only brings new threats to Swidden systems and pastoralism, ics argue that tribal health was often poor the health of tribal peoples, but it also both highly successful economic sys- before modernization, and they point imposes new strains on the ecosystems tems under traditional conditions, have specifically to tribals'low life expect- upon which they must depend for their proved particularly vulnerable to in- ancy and high infant mortality rates. De- ultimate survival. The introduction of creased population pressures and outside mographic statistics on tribal new technology, increased consumption, efforts to raise productivity beyond its populations are often problematic be- lowered mortality, and the eradication of natural limits. Research in Amazonia cause precise data are scarce, but they do all traditional controls have combined to demonstrates that population pressures show a less favorable profile than that replace what for most tribal peoples was and related resource depletion can be enjoyed by many industrial societies. a relatively stable balance between pop- created indirectly by official policies that However, it should be remembered that ulation and natural resources, with a new restrict swidden peoples to smaller terri- our present life expectancy is a recent system that is imbalanced. Economic de- tories. Resource depletion itself can then logical advances. Furthermore, the bene- resources. There is already a trend, g.p phenomenon that has been very costly in velopment is forcing ecocide on peoples become a powerful means of forcing terms of medical research and techno- who were once careful stewards of their tribal people into participating in the world-market economy--thus leading to fits of our health system are not enjoyed ward widespread environmental deterio- further resource depletion. For example qually by all members of our society. ration in tribal areas, involving resource Bodley and Benson(1979)showed how High infant mortality could be viewed as depletion, erosion, plant and animal ex- the Shipibo Indians in Peru were forced a relatively inexpensive and egalitarian tinction, and a disturbing series of other to further deplete their forest resources tribal public health program that offered previously unforeseen changes by cash cropping in the forest area to re- the reasonable expectation of a healt After the initial depopulation suffered place the resources that had been de and productive life for those surviving to by most tribal peoples during their en- stroyed earlier by the intensive cash age fifteen gulfment by frontiers of national expan- cropping necessitated by the narrow con- Some critics also suggest that certain sion, most tribal populations began to fines of their reserve. In this case, certain tribal populations, such as the New experience rapid growth. Authorities species of palm trees that had provided Guinea highlanders, were"stunted"by generally attribute this growth to the in- critical housing materials were destroyed nutritional deficiencies created by tribal troduction of modern medicine and new by forest clearing and had to be replaced culture and are"improved"by"accultur- health measures and the termination of by costly purchased materials. Research ation"and cash cropping(Dennett intertribal warfare, which lowered mo- by Gross(1979) and other showed simi Connell, 1988). Although this argument rality rates, as well as to new technology, lar processes at work among four tribal does suggest that the health question re- which increased food production. Cer- groups in central Brazil and demon quires careful evaluation, it does not in- tainly all of these factors played a part, strated that the degree of market involve- empirIc al generalizations but merely lowering mortality rates ment increases directly with increases in already established. Nutritional deficien- would not have produced the rapid pop- resource depletion cies undoubtedly occurred in densely ulation growth that most tribal areas The settling of nomadic herders and populated zones in the central New have experienced if traditional birth- the removal of prior controls on herd size Guinea highlands. However, the specific spacing mechanisms had not been elimi- have often led to serious overgrazing and case cited above may not be widely rep- nated at the same time. Regardless of erosion problems where these had not resentative of other tribal groups even in which factors were most important, it is previously occurred. There are indica- New Guinea, and it does not address the clear that all of the natural and cultural tions that the desertification problem in facts of outside intrusion or the inequi- checks on population growth have sud- the Sahel region of Africa was aggra- ties inherent in the contemporary devel- denly been pushed aside by culture vated by programs designed to settle no change, while tribal lands have been mads. The first sign of imbalance in steadily reduced and consumption levels swidden system appears when the plant ECOCIDE have risen. In many tribal areas, environ- ing cycles are shortened to the point that mental deterioration due to overuse of garden plots are reused before sufficient 'How is it asked a herdsman resources has set in, and in other areas forest regrowth can occur. If reclearing " how is it that these hills can no such deterioration is imminent as re- and planting continue in the same area, longer give pasture to my cattle sources continue to dwindle relative to the natural patterns of forest succession In my father's day they were green the expanding population and increased may be disturbed irreversibly and the and cattle thrived there, today use Of course, population expansion by soil can be impaired permanently. An ex there is no grass and my cattle tribal peoples may have positive political tensive tract of tropical rainforest in the 5
ANNUAL EDITIONS 5 tribal health has found broad empirical support (see especially Kroeger & Barbira-Freedman [1982] on Amazonia; Reinhard [1976] on the Arctic; and Wirsing [1985] globally), but these conclusions have not gone unchallenged. Some critics argue that tribal health was often poor before modernization, and they point specifically to tribals’ low life expectancy and high infant mortality rates. Demographic statistics on tribal populations are often problematic because precise data are scarce, but they do show a less favorable profile than that enjoyed by many industrial societies. However, it should be remembered that our present life expectancy is a recent phenomenon that has been very costly in terms of medical research and technological advances. Furthermore, the benefits of our health system are not enjoyed equally by all members of our society. High infant mortality could be viewed as a relatively inexpensive and egalitarian tribal public health program that offered the reasonable expectation of a healthy and productive life for those surviving to age fifteen. Some critics also suggest that certain tribal populations, such as the New Guinea highlanders, were “stunted” by nutritional deficiencies created by tribal culture and are “improved” by “acculturation” and cash cropping (Dennett & Connell, 1988). Although this argument does suggest that the health question requires careful evaluation, it does not invalidate the empirical generalizations already established. Nutritional deficiencies undoubtedly occurred in densely populated zones in the central New Guinea highlands. However, the specific case cited above may not be widely representative of other tribal groups even in New Guinea, and it does not address the facts of outside intrusion or the inequities inherent in the contemporary development process. ECOCIDE “How is it,” asked a herdsman… “how is it that these hills can no longer give pasture to my cattle? In my father’s day they were green and cattle thrived there; today there is no grass and my cattle starve.” As one looked one saw that what had once been a green hill had become a raw red rock. Jones, 1934 Progress not only brings new threats to the health of tribal peoples, but it also imposes new strains on the ecosystems upon which they must depend for their ultimate survival. The introduction of new technology, increased consumption, lowered mortality, and the eradication of all traditional controls have combined to replace what for most tribal peoples was a relatively stable balance between population and natural resources, with a new system that is imbalanced. Economic development is forcing ecocide on peoples who were once careful stewards of their resources. There is already a trend toward widespread environmental deterioration in tribal areas, involving resource depletion, erosion, plant and animal extinction, and a disturbing series of other previously unforeseen changes. After the initial depopulation suffered by most tribal peoples during their engulfment by frontiers of national expansion, most tribal populations began to experience rapid growth. Authorities generally attribute this growth to the introduction of modern medicine and new health measures and the termination of intertribal warfare, which lowered morality rates, as well as to new technology, which increased food production. Certainly all of these factors played a part, but merely lowering mortality rates would not have produced the rapid population growth that most tribal areas have experienced if traditional birthspacing mechanisms had not been eliminated at the same time. Regardless of which factors were most important, it is clear that all of the natural and cultural checks on population growth have suddenly been pushed aside by culture change, while tribal lands have been steadily reduced and consumption levels have risen. In many tribal areas, environmental deterioration due to overuse of resources has set in, and in other areas such deterioration is imminent as resources continue to dwindle relative to the expanding population and increased use. Of course, population expansion by tribal peoples may have positive political consequences, because where tribals can retain or regain their status as local majorities they may be in a more favorable position to defend their resources against intruders. Swidden systems and pastoralism, both highly successful economic systems under traditional conditions, have proved particularly vulnerable to increased population pressures and outside efforts to raise productivity beyond its natural limits. Research in Amazonia demonstrates that population pressures and related resource depletion can be created indirectly by official policies that restrict swidden peoples to smaller territories. Resource depletion itself can then become a powerful means of forcing tribal people into participating in the world-market economy—thus leading to further resource depletion. For example, Bodley and Benson (1979) showed how the Shipibo Indians in Peru were forced to further deplete their forest resources by cash cropping in the forest area to replace the resources that had been destroyed earlier by the intensive cash cropping necessitated by the narrow confines of their reserve. In this case, certain species of palm trees that had provided critical housing materials were destroyed by forest clearing and had to be replaced by costly purchased materials. Research by Gross (1979) and other showed similar processes at work among four tribal groups in central Brazil and demonstrated that the degree of market involvement increases directly with increases in resource depletion. The settling of nomadic herders and the removal of prior controls on herd size have often led to serious overgrazing and erosion problems where these had not previously occurred. There are indications that the desertification problem in the Sahel region of Africa was aggravated by programs designed to settle nomads. The first sign of imbalance in a swidden system appears when the planting cycles are shortened to the point that garden plots are reused before sufficient forest regrowth can occur. If reclearing and planting continue in the same area, the natural patterns of forest succession may be disturbed irreversibly and the soil can be impaired permanently. An extensive tract of tropical rainforest in the