Starving on a Full Stomach: An Intellectual Feast for the Mind

Do you remember that time in medical school when I pledged to read one book a month? Predictably, the streak didn't last very long, although in my defense, I had joined a year-long Bible study, in addition to reading many other, shorter things. Since then I have published the occasional book review, more out of a need to make me sit down and grapple with than because I think most of you want to know about any one of these books. Residency has kept me too busy to do much blogging, but I looked up the other day and realized I had read five books in the last three months, with 2-3 books scheduled for the rest of my current block of time off from clinic for research. I want to share two books with you that had opposite reactions on me.

The first book is Starving on a Full Stomach: Hunger and the Triumph of Cultural Racism in Modern South Africa (2001). It had been on my to-read list since before I presented a paper at a medical humanities conference in Johannesburg, South Africa, in 2013. Starving on a Full Stomach was Wylie's second book, and it has all the markings of the product of a mature scholar--namely, that it is so well written that it makes me doubt I will ever be able to publish anything half as good. Other scholars agree: it won the Melville J. Herskovits Prize from the African Studies Association in 2002.

Wylie uses arguments about food, hunger, and nutrition in the eastern part of South Africa to track the development of the cultural racism that buttressed the apartheid state for more than 40 years. (It was not biological racism, because scientists had shown that all human bodies were comparable; if Blacks and Whites had different life experiences, then this must be explainable by habits and beliefs = culture.) At first Europeans treated the mostly rural African population with paternalism, using the language of the patriarchal family to justify White rule over Black "children," just as native Chiefs had power over their tribes. However, colonial policies that enriched White miners and farmers at the expense of Black workers--such as artificially low wages, artificially high food prices, and crowded native "reserves"--put more and more impoverished Africans in the position of needing help that the government was unwilling to supply after World War II ended.

She argues that the apartheid state was "modern" in so far as it had scientific backing, such as the nutritionists and social scientists who claimed that Africans could not feed themselves and therefore--implicitly or explicitly--did not deserve political rights. As paternalism gave way to scientism (over-regard for scientific-sounding explanations), the apartheid government formed in 1948 no longer accepted any responsibility for Black health, envisioning separate "homelands," foodways, and "self-sufficient" socio-cultural spheres. One of their favorite hobby horses was that Africans were mismanaging their land and cattle, such they no longer produced enough food to nourish their families. This assertion conveniently ignored the fact that Blacks had been ejected from cities and crowded onto too little land for too many people (and cows). Even most of the politically moderate physicians and researchers examining the question of the nutritional health of native Africans described the problem as one of knowledge instead of one of structures of oppression. Finally, at the bitter end, when these scientistic explanations for Black poverty had lost their luster, the apartheid government justified its continued existence with naked power and brute force.

Things I learned:

• Thomas Malthus predicted that a growing population would outstrip its food supply, leading to famine and a necessary reduction in the population. What he did not account for was the agricultural revolution that increased food production exponentially. While modern societies no longer suffer widespread famine, some of their members do experience hunger. Hunger in industrial capitalism is a problem of food maldistribution rather than one of insufficient food production.*


• Europeans typically held a static view of African culture as "a food-sharing entity" and assumed that Africans preferred private gifts of food among each other to higher wages from their White employers. How conveeeeenient, as The Church Lady might say.


• The word "famine" was thrown about a lot. Africans often thought of "starvation" as a synonym for "poverty," while Whites saw it as a description of Blacks' eternally helpless state. How mind-blowingly aggravating that the government never adopted any of the suggestions Blacks offered for their own betterment.


• It was possible to be "starving on a full stomach" if the person had moved to town and replaced their milk, grain, and vegetable-heavy rural diet with processed foods and sugar. To want meat but not be able to afford it was another kind of hunger.

Look out for Part II of this series, a review of Feeding the Nation: Nutrition and Health in Britain before World War One (2010) by Yuriko Akiyama.


*I am now in the middle of Modern Hungers: Food and Power in Twentieth-Century Germany by Alice Weinreb; when I get to the last chapter, on obesity, I hope she talks about how an abundance of food encourages over-consumption, which in our health-conscious western culture typically leads to dieting = voluntary hunger.


Editor's Note: If you liked this post, Frau Doktor Doctor has previously reviewed a book about German measles and birth defects; a book of essays by historians of medicine who are also practicing physicians; and a number of audiobooks she listened to while driving around the Eastern United States for residency interviews.