|Essays on Food, Hunger, Nutrition, Primary Health Care and Development (AVIVA, 280 pages)|
|9. Multidisciplinarity, paradigms and ideology in development work|
131. We tend to forget that a scientific approach is not necessarily always a democratic approach. Actually, it often even hides behind quite reactionary premises.
132. The basic causes of widespread ill-health and malnutrition in third world countries, we had said are seldom addressed in sufficient depth by many of our colleagues; this distances their analyses from actual reality. Class issues are traditionally absent in most sets of analyses, as are the overconsumption habits of the bourgeoisie causing at least in part, the imbalances observed in the equation that leads to unequal access to the benefits of development.
133. The basic causes or macro-causes, as depicted in Fig. 1, set the constraints that make more technical interventions hopeless. Real, long-standing solutions, therefore, depend on the identification and subsequent tackling of these basic causes (21, 22).
134. The message between the lines is that the problems will not be resolved by some "technological fix" or by improved management. A much more fundamental system change will be required. The basic premise of an increased faith in reason, guided by deep intuition, does not work anymore (if it ever did....). It is by no means obvious that the Western development paradigm, in its present form, is viable in the long run or that it leads toward a satisfactory resolution to the plight of the poorest. Moreover, the world is changing and those who had for so long accepted the role of privation, inferiority, and servility are less and less willing to do so (and we should primarily be there to help them articulate their grievances....). Therefore, it is understandable that a path to socialism becomes attractive to some underdeveloped countries, but totally unacceptable to the major capitalist donor nations. The present signs of the inadequacy of past (and present...) thinking should not be surprising. There is no reason to expect the old concepts to fit the new situation(s). Development praxis, as we see it today, has evolved pretty much empirically. Theories have come later. So now, we seem to need to promote changes in our value perspectives to bring about a system change of consummate proportions. We need to adopt an entirely different mode of thinking, although rethinking is not always a comfortable exercise (72).
135. Innovations are not, as a rule, socially neutral, though; they benefit mostly those who can take advantage of them. Therefore, specific patterns of thought and behavior in development work need to be seen in the context of the specific institutions and political forces they serve. So, when technical change brings disadvantages for some individuals, political compensation mechanisms need to be used to even out any serious social disadvantages (90) (e.g.. when the stubborn repayment of the foreign debt or IMF conditionalities lead to cutting down government budgets, health and nutrition programs for the poor should be upheld or upgraded rather than cut-off). This is not done, though, and our multidisciplinary teams have kept silent about it...
136. What this means is that commitment is sought from us development workers not only to the end, but to the means of achieving real long-standing development. The fact that nothing much of note is happening or has happened in the past in so many development projects is precisely the problem that should shake us up and force us to reconsider our role in them. We are just too often lured into getting involved in actions with short-lived success and with a grim future...
137. Poverty conditions have to be constantly generated and regenerated for hunger and malnutrition to persist and grow in a society. It is under these circumstances where society's superstructure - the laws and the institutions that implement its laws - acts as a major constraint (See Figure 1). Hunger may appear to be caused by the inadequate food intake of a sector of the population, but this phenomenon is only the tail end of a process that very importantly has its origins even outside the country. Understanding the basic causes of hunger, thus, requires an understanding of the basic causes of underdevelopment (25).
138. Sneaking up and writing about how important these basic causes are has clearly not been enough. Collectively, as development workers, we simply have not done as much as is needed to correct these underlying causes. We have left unexploited many potentially successful alternative interventions such as working on peasant unionization schemes in some ripe contexts, or on minimum wages (e.g.. indexing one hour of salaried work to the cost of 1 kg of staple food or of some mixed consumer food basket), or working directly on employment generating strategies, or on alternatives to the distorting effects of urban consumer subsidies given at the expense of food producers, thus transferring wealth from the rural to the urban populations.
139. The difficulty in identifying basic causes of underdevelopment with a potential for corrective action has been argued by some as being the bottleneck for starting more meaningful interventions in this domain. This certainly, is a poor excuse for inaction. Arriving at alternative options for action that can tackle basic causes may be more difficult at the national or international level, but not necessarily at the local, village or community level where interventions usually remain more manageable.
140. The challenging questions that come up at this point of the analysis, then, are: Can we at all measure, quantify and rank basic causes? If yes, how most effectively? Is it possible to conceive and put together a cook-book-type checklist of data needed at the village and national levels to evaluate the basic causes and their impact? In a previous paper I tried just such an approach based on my experience in two African countries where I worked on the subject. In short, the list of questions presented in that paper allows the reader to zero in on the major constraints in the economy and in other sectors that are responsible for the state of underdevelopment ill-health and malnutrition in a given society (91).
141. Once the basic causes are identified and even perhaps tentatively quantified and ranked according to their relative weight we must ask ourselves what objectively are the chances of doing something about them. especially about those that seem to offer the more promising chance for successful removal (partial or total). I think it is a fallacy to argue that the alternative is to do nothing - in health, nutrition or any other sector of development - until the major contradictions behind the basic causes are resolved. Rather, we should get involved in actions that will primarily directly affect, say, health and nutrition, but that are also ultimately related to some of the basic causes. In other words, the problems we observe in health and nutrition or any other area of development should all be eye-openers, or act as points of entry, to quickly lake us to the underlying socioeconomic determinants of all these problems. We should start making it part of our paradigmatic consensus that technical interventions that attack only the immediate and underlying causes as depicted in Fig. 1 are worthwhile only if used together with actions addressing the basic causes or if used as vehicles for conscience-raising, mobilization, and consolidation of movements in the population (88). Such an approach obviously makes the objectives of most development projects, as we presently see them by the dozens, obsolete.
142. One final interesting observation that has been made in this context is that catastrophes (either natural or man-made) have often been quantum-leap opportunities to attack basic causes (92). The reasons for this are not always very clear, but sometimes catastrophes are the last drop in the bucket in the patience of people who decide to lake a part of their future into their own hands and thus wipe out some of the long-standing injustices and inequalities at a lime when authorities may still be shaken and in disarray. These situations should thus also be seen as opportunities for us development workers to gain new momentum in our efforts to get more substantial changes under way.
143. So far, we have explored, first, what happens in periods of normal science when scientist are reasonably happy with what they have. Then, we explored what happens when doubts about the validity of the paradigm creep in and subsequently deepen. Next, we described how a crisis comes about and how practitioners are left with no direction for a while having to choose whether to jump forward or stay behind. Assuming they chose to accept the new paradigm, there is then a whole host of things practitioners should begin doing differently. This topic - of whether we are actually beginning to do these "new" things - is what we are going to explore next.