Biosocial Worlds. Группа авторов
for a healthy child, are raising three or four children with deformities, the most common of which is hydrocephalus (‘water on the brain’) that causes severe retardation. A few women discover very late in a pregnancy that their fetus is not normal, and some opt then for a late termination, to the great discomfort of their doctors.
Gammeltoft’s interviews with affected families make clear that many people choose not to entertain the idea that an anomalous fetus or the birth of a horribly deformed child is due to Agent Orange. They are all too well aware that the stigma attached to Agent Orange families ensures that finding marriage partners for healthy members of the family becomes virtually impossible. Better to claim publicly that the anomaly resulted from a common cold that the mother had, or the heavy work she did while pregnant (Gammeltoft 2014, 47–50).
A range of severe illnesses are associated with dioxin exposure, including deadly cancers, Parkinson’s disease, and spina bifida, in addition to those associated specifically with pregnancy. Vietnamese researchers have reported these findings, but the official US position is that there is no conclusive evidence that herbicide spraying caused health problems among exposed civilians and their children. However, following extensive lobbying over many years, in 2014 the US Congress passed a five-year aid package of $21 million that amounted to a modest sum for each US veteran of the Vietnam War. These cases were settled out of court and no legal liability has ever been admitted. The official position to this day is that the government was in effect prodded into settling these legal suits and that no evidence exists that Agent Orange caused harm, and this position is supported by its principle makers, Monsanto and Dow Chemical companies. Children born to Vietnam War veterans who have birth defects may be eligible for compensation that varies according to the perceived level of disability.1
In Vietnam, officials were reluctant to press complaints about Agent Orange because uppermost were concerns about the economy as a whole, notably a desire not to damage the marketing of numerous agricultural and aquacultural products made in Vietnam today. In the mid-1990s, Vietnamese writers and artists began to express concern about Agent Orange, and eventually Vietnamese citizens filed a class action suit in the US District Court in New York that was abruptly dismissed. However, belated demands for responsibility are increasingly being heard, spearheaded by non-governmental organisations. In summary, local biologies not only persist across generations; they also travel through space.
Food as environment
Globally, nearly 2 million children die from malnutrition each year. Research has revealed significant findings about biological differences between infants who suffer from marasmus as opposed to kwashiorkor2 (Forrester et al. 2012). This impressive study carried out in Jamaica commenced in 1962 and continued for 30 years; during this time over 1,100 infants with severe acute malnutrition were admitted to University Hospital, Kingston. It was found that those infants diagnosed with kwashiorkor had considerably higher birth weights than did infants diagnosed with marasmus. The authors concluded that mechanisms associated with physiological ‘plasticity’ are operative in utero and that these children have distinctively different types of metabolism. Of the two conditions, children more often die from kwashiorkor, associated with edema, although less wasting takes place as compared to marasmus. Children diagnosed with marasmus do not become edematous, but endure much greater wasting of their flesh, although their survival rates are better than those of children with kwashiorkor.
Researchers characterise marasmus as ‘metabolically thrifty’, and kwashiorkor as ‘metabolically profligate’. They propose that in the case of children with marasmus, when the maternal diet is low in nutrition, fetal metabolism in utero in effect ‘anticipates’ a postnatal environment of scarcity, and low birth weights are assumed to be evidence of this process designed for survival. The authors argue that this finding provides the first direct evidence in humans in support of the fitness-enhancing effects in childhood of ‘anticipatory responses’ in utero. Hence, the distinctly different phenotypes of children with kwashiorkor and marasmus are understood as the endpoints of epigenetic activity on genotypes in utero.
Nutritional epigenetics is a field attracting a great deal of attention in part because it is hoped that it will throw light on the so-called obesity epidemic currently affecting many countries, whether affluent or not. The same team that carried out the research reported above argues that growing evidence exists of ‘developmentally plastic processes’ that, in addition to lifestyle and individual genotypes, contribute significantly to obesity (Forrester et al. 2012). No claim is being made that such developmental pathways in which methylation processes are involved cause obesity directly, but that the risk of individuals genetically predisposed for developing obesity in later life is increased.
Based on a hypothesis known as the ‘mismatch pathway’, it is posited that ‘evolved adaptive responses of a developing organism to anticipate future adverse environments’ can have maladaptive consequences if the environment is not what has been ‘biologically anticipated’. In other words, if fetuses and young infants are exposed to nutritionally deprived diets, their bodies may be epigenetically prepared to deal with deprivation as they mature, as the marasmus study suggests, a situation that can cause havoc in energy-rich environments. In addition, maternal diabetes, maternal obesity and infant overfeeding are associated with increased risk of obesity in adult life (Gluckman and Hanson 2006). Clearly this account resembles the thrifty gene hypothesis put forward in 1962 by James Neel, an argument now outmoded in the post-genomic era; discussion about thrifty phenotypes has superseded it (Watve and Yajnik 2007).
Hannah Landecker argues that researchers presently understand food as an ‘epigenetic’ factor that functions in the regulation of gene expression, in turn, linked to several medical conditions including cancer, metabolic syndrome, obesity and diabetes. In other words, food is a form of ‘environmental exposure’ (Landecker 2011, 167) in which the environment is molecularised as food chemistry so that ‘the body’s molecules [are] hung in the same network of interactions as environmental molecules, a network anchored and organised through the temporarily sensitive interface of metabolism’ (Landecker 2011, 176). Landecker argues that this is a model ‘for how social things (food, in particular) enter the body, are digested, and in shaping metabolism, become part of the body-in-time, not by building bones and tissues, but by leaving an imprint on a dynamic bodily process’, namely, the expression of genes (Landecker 2011, 177).
Eliminating stunting
The President of the World Bank, Jim Yong Kim, a physician/anthropologist, has announced that he will ‘name and shame’ countries that fail to tackle the malnourishment and poor growth of their children (Boseley 2016, 1). Kim is clear that ‘stunting’, that is, children with height considerably below the average for their age, is not only a humanitarian disaster but also an economic one. His position is that fetal malnutrition during pregnancy and early childhood leads to serious neurological deficits, particularly in toxic environments, where recurrent infections are common, and when infants are given little or no stimulation. Kim stresses that stunted women frequently give birth to children who become stunted, with the result that ‘Inequality is baked into the brains of 25 per cent of all children before the age of five’ (Boseley 2016, 1). Crude estimates suggest that stunted children in India approach 40 per cent, in Pakistan 45 per cent, and in DR Congo 43 per cent; hence, Kim insists, ‘the most important infrastructure we can invest in is grey matter’. He seeks to rid the world of stunted children by 2030 by donating conditional cash transfers to mothers of stunted children, thus enabling them to feed and stimulate their children through play. It is reported that a trial run in Peru worked well (Boseley 2016, 2).
Jim Yong Kim plans to repeatedly bring up ‘this stain in our collective conscience’ at World Economic Forums in the coming years. Clearly interventions to eliminate stunting are of enormous importance, but key socio/economic variables noted by Kim have been set to one side in his Peruvian project, including unremitting poverty, unequal distribution of land and other resources, and increasingly toxic environments. In addition to which is the violence and counterinsurgency so evident in that country, ably documented by the anthropologist Kimberley Theidon (2013). The horrendous effects of climate change must now be added to this list.