DANCING SKELETONS – ETHNOGRAPHY REVIEW
Dancing Skeletons: Life and Death in
West Africa by Katherine Dettwyler is an ethnography
that mainly focuses on how infant feeding and weaning practices, and chronic
childhood malnutrition leads to an increased chance of children being more able
to succumb to life threatening childhood diseases like malaria, tetanus,
diarrhea, diphtheria, kwashiorkor, marasmus and measles in Mali. Furthermore,
the author also talks about how Malian people perceive death and illness, and the
social structure and women’s control over their own reproduction in Mali.
First
and foremost, I really liked this ethnography. At first I was a little
skeptical about reading this ethnography because I had a preconceived notion
that Katherine Dettwyler (a foreigner with an etic perspective), would not
write a good ethnography since she would be very biased and ethnocentric, and
thus judge the Mali people that she was studying, and look down on them. To my
surprise, Dettwyler actually was very open minded, and even though her
epistemology as an American on childhood nutrition made her biased and
ethnocentric in the beginning of her research, she was able to shed her biased
opinions and through cultural relativism, Dettwyler was able to understand Malian
culture and answer her main research question. As a reader with an emic view on
childhood malnutrition and threatening childhood diseases in Africa, this
ethnography confirmed what I already knew about the topic. This ethnography
made me happy to see that anthropology, and biomedicine as a whole is finally
maturing by trying to see things from other cultures point of view instead of
looking down on them, an making them feel that their traditional ways are wrong
by forcefully making them assimilate to western healing practices. Likewise
Dettwyler inspired me to also give biomedicine a chance in my life, and have a
happy medium between my traditional healing practices and biomedicine.
Dettwyler’s
main point in the ethnography is that poor infant feeding and weaning practices
in Mali, leads to chronic childhood malnutrition which in turn results in
increased risk of children dying from life threatening childhood diseases like
malaria and tetanus because malnutrition is the main cause of a poor immune
system. Her research question is on infant feeding and weaning practices in
Mali and how it leads to malnutrition in children and their ability to conquer
childhood diseases. After conducting her research Dettwyler concludes that the
main cause of childhood malnutrition in Mali is ignorance (mothers lack of
knowledge on the appropriate foods to feed children during child growth), and
inappropriate cultural beliefs and practices towards infant feeding and weaning
practices (p.159). It’s funny because at the start of her research, Dettwyler
assumed that the main cause of childhood malnutrition in Mali is overpopulation
which led to lack of food for the people of Mali, most importantly the children.
However, as her research progressed, she noticed that people in Mali have
plenty of food. The main reason their children are malnourished is because the
women, don’t know which type of foods to feed children, and this is shown by
how they feed young children millet rice day in and day out (p.11), which is
evidently does not provide young growing children the nutritional requirements
they need in order to stay healthy and develop a strong immune system. Even
though Dettwyler ethnocentrically judged women in Mali for not caring about
their children’s nutrition, she later on noted that this is just part of their
culture; these women were fed millet rice as kids and they are just using their
predecessor’s knowledge about nutrition that has been passed on to them (p.45).
Evidently,
Dettwyler’s has an etic role on the ethnography. She is an outsider (a
researcher with prior exposure to the Malian culture) looking in and observing
the culture. Her etic perspective as a researcher might affect the research
through ethnocentrism and biases based on her epistemologies (her cultural thoughts
about what is wrong or right). Her role as an outsider of the Malian culture
has pros and cons; she could either be more open minded to understanding the
culture of the Mali people as compared to an anthropologist with an insider
perspective doing the same research who might be tempted to defend some
cultural practices due to ethnocentrism, or Dettwyler could either be
ethnocentric because of her biomedical background, and judge the Malian beliefs
and traditions based on her epistemology. Detwyler’s role as an outsider
looking into the Malian culture was clearly stated as the very beginning of the
ethnography, when she openly admits that she has no prior knowledge of Mali, or
it culture (p.4).
Summary
Dettwyler is an American physical
anthropologist in Mali conducting her fieldwork research in the town of
Magnambougou for her Ph.D. for two years. She left her husband and four year
old son in America, and came to Mali with her nine year old daughter Miranda
for company, and also to make her learn about another less fortunate culture,
so that she can be able to appreciate what she has in America. Her research
involved documenting traditional infant feeding practices and their effects on
children’s growth; she measured the height and weight of infants, toddlers,
teenagers, and adults in Mali, in order to determine the effects of
malnutrition and how it affected children in their adult years. She had to
interact with her informants, ask them about their infant feeding practices, and
learn about their cultural view on weaning and infant feeding practices,
malnutrition, and death of children as a result of life threatening diseases in
their communities like tetanus, malaria, kwashiorkor and diarrhea. She
listened, observed and provided necessary ethical advice on how to improve
malnutrition, infant feeding, weaning, and how to prevent childhood diseases
like kwashiorkor, marasmus, diarrhea, tetanus and malaria. She while conducting
her research she mostly relied on interviewing her informants, and collecting
data about their height, weight and illnesses. She took stool and urine samples
of her participants to test for intestinal parasites, and offered treatment for
the participants who tested positive for intestinal parasites like tapeworm and
schistosoma. Dettwyler also organized a nutritional program that educated
Malian women on the importance of good nutrition especially in the first five
years of a child’s life. Particularly, she was able to show how social
structure and women’s control over their own reproductive health in Mali,
ignorance and inappropriate cultural beliefs and practices resulted in
childhood malnutrition in Mali and mortality of children under five years old
due to poor immunity and increased risk of infection of threatening childhood
illnesses (malaria, kwashiorkor, measles and tetanus).
Discussion
I would really like to talk about
the reasons that Dettwlyer attributes to the cause of childhood malnutrition in
Mali. First of all, she argues that Mali’s cultural concept that children
should not be feed good food because they don’t know its value and that old
people deserve good food because they have worked hard for it and need it more
compared to children because they are going to die soon is one of the main reason
that shapes the kind of food children in Mali are given. Most children in Mali,
especially toddlers, are feed only millet rice and peanut source every day,
which certainly does not meet even half of the nutritional requirements they
need to be strong and healthy(p.13). When Dettwyler tried to educate mothers in
Mali on the importance of giving children a balanced diet in the first years of
their lives because this was the building block for their immune system, most
Malian mothers at first failed to comply and change the way they feed their
children because they felt that Dettwyler was trying to change their culture
(p.29). Dettwyler felt very frustrated when some mothers stuck to their bad
feeding practices even though she had advised them and told them about the
importance of good nutrition for children (p.37). This reminded me of the
discussion we had during quiz section on October 16th about the
consumption of fry bread in the Native American community and the consumption
of pigtails in the African American community. The Native American community
started consuming “fry bread,” when they were taken from their fertile lands
and pushed to reserves by Americans and were only given pounds of corn flour as
their main source of food, by the American government. Native Americans had to
be creative and find means to survive in the reserves, so they decided to mix
the corn flour with water, form dough, and roll it out in the form of a
tortilla and fry it. The fry bread helped Native Americans survive in the
reserves, and this food tradition was passed down to later generation. Unfortunately,
recent studies of obesity and high cholesterol in the Native American community
reveal that consumption of fry bread is one of the main causes of obesity among
the Native American people because it is very high in fat and cholesterol.
Similarly in the African American
community, many of them could not afford the healthier and more expensive parts
of meat during slavery, so they had to consume pigtails, which are very cheap,
high in fat and cholesterol and have no good protein benefit. Even though
slavery was over, these tradition of eating pigtails was passed down to later
generations, and resent research has also shown that pigtails have very little
health benefit. But how are Native Americans, African Americans and Mali people
supposed to just give up an important part of their culture just because
biomedicine says it is wrong? These food practices in these three cultures have
all been imbedded in the culture during colonial times, and have been passed
down to later generations as part of their culture. Mali people fed children
millet rice and soup for years because during colonial days (Mali was colonized
by the French), adults had to work in the farms and factories of their French
colony so the Malians so it fit to feed adults good and healthy food because
they had to work all day, and feed children less nutritional food because all
they did was sit around, and did not really use a lot of energy (p.94). This
shows that colonialism still has a big impact on the customs and traditions of
many people in today’s world. If colonization did not take place, the Native
American people would probably not be eating the fry bread, the African
American society would definitely not be consuming pigtails, and lastly the
Mali people would be providing better nutrition for their children. The
colonial notion that children don’t need good food because they don’t require a
lot of energy, has also affected infant weaning practices in Mali; infants are
only breastfed for the first year of their life and weaned to solid food
(usually millet rice only), which is very little food and thus leads to
malnutrition because a baby requires both food and milk to be satisfied and
healthy (p.15).
Correspondingly, the unwillingness
of Malian mothers to feed their children more nutritious food also reminded me
of Borovoy’s article, “Managing the Unmanageable Elderly Russian Jewish Émigrés
And The Biomedical Culture of Diabetes Care,” which talks about how biomedical
diabetic doctors in America are frustrated by elderly Russian Jewish immigrants
with diabetic conditions because they are stubborn, and lack the will power of
self-control one of the key aspects in successfully regulating
diabetes(p.16-22). American doctors feel that Russian immigrants with diabetes
are stubborn and don’t want to change their bad eating habits (consumption of
their favorite foods which are very high in sugar, cholesterol, fat and
starch), even though they are constantly being told by their doctors that it is
bad for them. In actual sense, Russian immigrants fail to comply and follow the
advice of their doctors because they have certain foods that they hold sacred
and indulge in during their Jewish holidays, and in doing this, it makes them
feel more connected to their culture because they are miles away from home.
Moreover, these immigrants fail to comply and take doctors’ advice on diabetes
prevention because they feel that American doctors are not genuine and
personable, and they tend to be fake (being polite, and putting on fake
smiles), which makes these immigrants miss their doctors in Russia who were more
personal, and hands on with them (p.17). While American doctors view Russian
immigrants as stubborn and require more attention, the truth is that the
Russian immigrants are this way because they are used to doctors being in
charge of their health, and the thought of them being in charge of their health
(diabetes central idea) does not make sense to them because it is not what
happens in their culture because they are used to doctors doing everything for
they; they mainly work on the principle of damage control rather than
prevention (p.16). This article shows that until American doctors understand
the culture of the Russian Jewish immigrants, they will always be ethnocentric
and see them as being ignorant while in actual sense, these immigrants are just
used to a certain way or form of treatment. This just shows that Dettwyler
needs to work with the Malian mother’s in order to achieve her goal of good
nutrition for children in Mali, and likewise American diabetic doctors need to
be sensitive to the culture of Russian immigrant Jews because stereotyping them
as stubborn and non-compliant, and looking down on their culture, does not help
solve the problem.
Another argument in Dettwyler’s
ethnography that stood out to me was her argument about how people in Mozambique
view certain childhood diseases as a normal part of life, and she attributed
this to the culture’s calm acceptance of death as a part of life. She felt that
mother’s and the rest of the Malian community were numb to issue of mortality
in children from deadly diseases because in their culture, they were already
considered diseases like malaria as normal (p.147). This claim reminded me of Scrimshaw’s article
about Culture, behavior and health and how malaria is said to be seen as normal
in Africa because “everyone has it or has had it” (p. 46). In Mali, malaria in
children is considered normal because children always get it, and multiple
infections of malaria in children, make them immune to the disease as adults
(p.48). By the same token, when Dettwyler interview mother’s about their
reproductive history (how many kids they had, and how many had died, and the
causes of their deaths), she was flabbergasted by how mother’s seemed to show
no emotion when talking about their deceased children (p.158). As a mother, she
could not understand why these women acted this way, and for a moment she
thought that maybe they did not love their children or care about them. After
further investigation and research, she learned that some mothers seemed to
exhibit no emotion when talking about their deceased children because they were
unwillingly married off and made to have kids with husbands they did not love,
so the death of the kids they had did not pain them as much (p.159). Women in
Mali have no control over their reproductive choices because most men demand
ten to more children, and the women have no choice but to go by their husbands
desires, since they rely on their husbands for provision of income. It is
culturally held that having a lot of children in Malian culture is essential
because it helps in the provision of labor that is needed in the field and at home
(p.158). Malian women feel trapped in their own culture because their main role
is to rare children, and take care of the household. Most Malian women are not
literate because the society favors boys over girls in terms of education.
Parents in Mali struggle to send boys to school, while girls stay home and help
out with chores and are often married off by the age of fourteen (p.154).
Undoubtedly, social representations
in Mali favor the old to the young (this is shown in the case of good nutrition
for adults, and poor nutrition for children), and men to women (this is shown
by the gender inequality as far as sending boys to school, while girls stay
home and help with chores and eventually married off). Although the above
practices are certainly unfair, they cannot be looked down upon because they
are actually part of the Mali culture, and is what defines them as a group of
people.
Like anything in life, this
ethnography certainly has its strengths and weaknesses. The strength of this
ethnography is that the author made a very big effort in interacting with the
Mali people. Dettwyler, tried to learn Bambara, the native language of the
Malian people, which made her seem friendly and approachable, and made her
informants more willing to participate in her research because they felt that
she was genuine and wanted to know, understand and be part of their culture.
She quickly learned how to say greeting in Bambara which is a very big part of
the Malian culture (greeting is seen as a very essential aspect of respect in
the culture), she put her ethnocentric views aside, and accepted the people’s
food and way of life, which made the people very pleased with her. I also feel
that her research methods were very successful and also her main strength in
her research; she interviewed people by making use of a Malian translator who
was fluent in both Bambara and English, and she did not offer incentives like
money or gifts to her participants which made her work more ethical. In
contrast, the ethnography’s main weakness was that the author did not provide
any data to support her claims. She actually measured children’s height and
weight, but did not publish any numerical data to support her claims, which
made it very hard for me to estimate the level of malnutrition in the children
(numerical data tend to shock people and raise awareness on issues). To make up
for not including numerical data on her research, the author successfully made
use of very elaborate pictures, which really explained what she was talking
about.
The different perspectives that are
seen in the ethnography are the emic and etic perspectives. Dettwyler plays the
role of the outsider which helps shape biomedicine understanding of chronic
childhood malnutrition in Mali. On the other hand, the children, women and the
entire Malian culture play the insider role and helps biomedicine understand
Malian problem of childhood malnutrition by explaining their culture and
beliefs to the ethnographer. The Malian people help the ethnographer answer her
research question of chronic childhood malnutrition in Mali by making her
understand their culture and seeing things from their point of view. This ethnography
shows how the Malian culture operates through social representation, and helps
readers have a feel of the culture and judge it through cultural relativism and
not ethnocentrism; this work presents the Malian community in a positive light,
and strives to understand them for who they are. The possible impact of this
ethnography is that readers and people around the world will be able to
understand childhood malnutrition by learning about a culture’s belief system,
and seeing how nutrition is imbedded in the roots of a culture and its struggle
during colonialism. In addition to this, this ethnography brings light to a
very important global health issue; child malnutrition, and its impact in
conquering life threatening childhood diseases.
Childhood malnutrition is a very
important global health issue, and this is clearly shown in the WHO 2102 World
Health Statistics report which states, “Childhood malnutrition is the
underlying cause of an estimated 35% of all deaths among children under five
years of age” (p.12).
Conclusion
In summary, I feel like this
ethnography is a very strong and insightful piece of work. The author has
written this ethnography like a diary, where she has fully pointed out her
epistemology and biases, and talked about how doing this research has helped
her redefine her perspective on childhood malnutrition in Mali. I feel like the
author went above and beyond to fight and get rid of her preconceived notion,
which greatly helped her successfully mingle and understand her research
subjects. However, I really wish she would have given numerical data and a
little colonial history of Mali in order to make her ethnography stronger. Dettwyler
left out a big chunk of the colonial history of Mali, which would have really
helped readers better understand her research and overall ethnography. All in
all, I feel inspired by this ethnography, and I feel like I have a better
understanding of the Malian culture.
Bibliography
Dettwyler
A. Katherine
1994 Dancing Skeletons: Life and
Death in West Africa. Long Grove, Illinois.
Waveland Press, Inc.
Borovoy
A, Hine J.
2008: Managing the Unmanageable
Elderly Russian Jewish Émigrés And The
The Biomedical Culture of Diabetes Care.
Mar; 22(1): 1-26.
Scrimshaw,
S. C.
2006: Culture, behavior and health.
International Public Health. Diseases, Programs, Systems and Policies.
