Learning from the past to improve nutrition today – history of pellagra in Lesotho
The setting is Lesotho, the small mountainous country surrounded by South Africa and formerly known as Basutoland under British colonial rule. In 1963 the colonial Department of Health reported 8154 cases of pellagra, resulting in five deaths and untold suffering. Physiologically, pellagra results from a deficiency of niacin (Vitamin B3) and has emerged amongst populations where people consume refined maize meal and little else. Sufferers are usually poor or institutionalized, or both. Pellagrins experience dermatitis, diarrhea, dementia, and sometimes, death. By 1963 pellagra was a memory for those who had known it in the past such as polenta-eating peasants in northern Italy and American southerners subsisting on hominy and hog fat. But in Basutoland, after fifty years of colonial agricultural and nutritional interventions, pellagra was getting worse. How could this be?
My research thus far shows an array of variables that drove this trend between 1933 and 1963. Ecological changes, economies, and policies intersected. The drought of 1932-33 devastated crops and livestock in southern Africa. Because more Basotho (people of Lesotho) sought periodic wage work in South Africa than in the past, there was less available labor for agriculture. Increasingly, people used cash to purchase refined maize meal: the cheapest foodstuff available in local shops. To boost exports of wool, which officials argued would enhance purchasing power, the Department of Agriculture promoted woolen Merino sheep while eliminating the mutton producing, ecologically appropriate local sheep.
In response to the increase in nutritional diseases after 1946, the Departments of Education and Agriculture in Basutoland drew on international nutrition science being circulated via the Food and Agricultural Organization (FAO) to encourage new practices for farming, gardening, cooking, and eating. Ordinary people responded too. For instance, a local farmer named James Machobane developed an intricate system for mixed-cropping potatoes, vegetables, and grains that would enable people to grow and eat food in ways that made FAO experts blush with envy.
What can this story, with its local and global dimensions, tell us about current relationships between agriculture, nutrition, and health, and furthermore, about the possibilities for mitigating malnutrition? As an historian, I use a wide lens to see how these factors fit together in the past to help us understand how similar factors are coming together now, and might come together again in the future. As I begin field research in January, I am thinking about how to interrogate the abovementioned phenomena by using new analytical tools. In my recent readings on the political ecology of health, I have found the multiscalar approach especially germane. From this perspective, social and biological processes are inseparable. Health and nutrition are examined as spatial webs of relationships within which processes in individual bodies are linked to those at the village, national, and international scales. To this spatial analysis, I will add a detailed narrative of change over time.
For example, a key question for looking at local responses to broader changes is how did papa (maize porridge) become the undisputed staple in Lesotho? We know that maize had some advantages over the indigenous sorghum and non-native wheat, but we know less about how people came to prefer refined white maize meal over other ecologically viable and nutritious grains. Part of the answer may lie in what it meant to be nourished within this specific social and ecological context.
While historical evidence about drought, economies, and development appear in government records, FAO nutrition surveys, and agricultural reports, it is more difficult to find evidence of how people understood the nutritional contexts in which they lived. From January 14th to April 29th, I will be looking for answers to my questions in archives in Lesotho, South Africa, and the United Kingdom. Among other sources, Sesotho language newspapers, which published columns on agriculture and nutrition, will provide a sense of how people engaged with nutritional challenges in the past. In addition to archival research, I will be interviewing Basotho farmers, cooks, nurses, government officials, and teachers. These oral sources will shed light on the language that people have constructed and used to discuss and deal with nutritional challenges on their farms, in their classrooms, in their kitchens, and in their bodies.
Pellagra and malnutrition are not just history. An article in the Lesotho Times reported that in 2009, after another dry year, some Basotho suffered from pellagra. “We have been surviving only on papa,” explained one woman, “that is not the kind of food that keeps a person healthy.” The writer claimed that 42% of Basotho children under five suffered from chronic malnutrition. The 2015-2016 drought, southern Africa’s worst in living memory, brought similar circumstances. But drought alone cannot explain these crises. A look at historical nutritional contexts, I believe, will bring the broader constellation of factors into sharper focus to help us measure and assess policies and possibilities for addressing these crises.
Contributed by Christopher Conz, holder of an IMMANA Felowship. His IMMANA project is called (Un)Cultivating the Disease of Maize: a history of pellagra in Lesotho, southern Africa, as a metric for rethinking agricultural policy.