More than ten million children suffer from severe acute malnutrition globally each year. In Uganda, longstanding efforts to understand, treat, and then prevent the condition initially served to medicalize it, in the eyes of both biomedical personnel and Ugandans who brought their children to the hospital for treatment and care.

More than ten million children suffer from severe acute malnutrition globally each year. In Uganda, longstanding efforts to understand, treat, and then prevent the condition initially served to medicalize it, in the eyes of both biomedical personnel and Ugandans who brought their children to the hospital for treatment and care. Medicalization meant malnutrition came to be seen as a disease—as a medical emergency—not a preventable condition, further compromising nutritional health in Uganda.
Rather than rely on a foreign-led model, physicians in Uganda responded to this failure by developing a novel public health program known as Mwanamugimu. The new approach prioritized local expertise and empowering Ugandan women, blending biomedical knowledge with African sensibilities and cultural competencies.
In The Riddle of Malnutrition, Jennifer Tappan examines how over the course of half a century Mwanamugimu tackled the most fatal form of childhood malnutrition—kwashiorkor—and promoted nutritional health in the midst of postcolonial violence, political upheaval, and neoliberal resource constraints. She draws on a diverse array of sources to illuminate the interplay between colonialism, the production of scientific knowledge, and the delivery of health services in contemporary Africa.

"“Largely biomedical in orientation and located in the Global North, groups such as the World Heath Organization (WHO), the United Nations Children’s Fund (UNICEF), various nongovernmental organizations (NGOs), and university research centers seek to remedy the health of the Global South through technological fixes with one-size-fits-all protocols. Tappan’s research … challenges the assumptions of global health on a number of fronts and shows the cost to public health when little regard is given to local culture, history, or autonomy…. Tappan’s work makes significant interventions to the emerging field of African historical epidemiology.”" - American Historical Review

"“This is a thoughtful and well-researched book on a subject that has remained outside the global health bubble. It tells the important story of capacity and local initiative, as Ugandan doctors, scientists and community health workers struggled to sustain primary health care against unbelievable odds.”" - Social History of Medicine

"“We try not to pick favorites in the African Politics Summer Reading Spectacular, but I’ve failed this year with this week’s book…Why was it my favorite? I’ve learned a lot and enjoyed reading all of the books in this summer’s series. But Tappan’s excellent and deeply researched book reads almost like a novel: At the end of each chapter, I needed to keep going to learn what happened next.…This book could change the way you think about health interventions.”" - Washington Post online