Bringing up baby: 1950s maternal and infant nutrition programmes

Introduction

Many studies of colonialism in the Pacific are located in the late eighteenth and early nineteenth centuries, however the late colonial project of the 1950s has not been subjected to the same rigorous attention. This paper examines discourses surrounding child and maternal health and nutrition in various island territories during the 1950s. While these studies reveal some aspects of island life, they arguably reveal more about Australian and international concerns of the time, characterised by a scientific approach to childcare, and studies of nutritional trends, dietary beliefs and practices.

Demographic and nutritional surveillance have played an important role in the health programs of modern states. Scientific enquiry, experimentation and evaluation have become central concerns of modern health practice, underwriting the concerns of governmentality and the state, while a range of sophisticated techniques have been developed for recording and measuring populations. Statistical surveys, demographic details and medical records are routinely used to monitor health and welfare concerns of states. South Pacific Commission (SPC) funded research in the 1950s included reports on specific aspects of cash crop cultivation ('economic plants' – copra grading, cocoa plantation management), education (the village library, the visual library, use of visual aids in education) and diseases (filariasis, elephantiasis, tuberculosis, leprosy). This paper considers the impacts of such projects in the late colonial context of the 1950s Pacific Island states.

Colonial regimes are never complete. They have always been unstable, and while some social and cultural transformation may have taken place, the process was far from coherent, easily manipulated and indeed, provides evidence of "unfinished business" (Burton 2000). In terms of early colonial contacts, the practices of trading and establishment of plantation crops had dramatic influences on traditional agriculture. For women, these changes were often contradictory, particularly when missionaries tried to end barbaric practices such as "widow strangulation, polygyny and bride wealth by diverting women's energies from hard work in the gardens to maintaining households and children" (Jolly 1991, 69). This unfinished business continues to haunt contemporary social and political structures in the region. It is important to situate routines of village life, local consumption patterns and home economics as part of wider debates about domesticity, home science and family life. In addition, the organisational objectives of government planners had a profound impact on community health inputs of the time.

Origins of the South Pacific Commission/Secretariat of the Pacific Community (SPC)

The Australian Prime Minister Dr. H.V. Evatt presided over the United Nations General Assembly meeting at which the Universal Declaration of Human Rights was adopted. In a statement following the official release of the Australian-New Zealand agreement on 21 January 1944, Evatt noted that a very "prominent feature of the Agreement is the method of dealing with the welfare and advancement of the peoples of the Pacific". The Commission was designed to bring together "ideas and experience of those who possess first hand knowledge of South Seas Territories" . Following the organisational form of the Anglo-US Caribbean Commission, the Agreement assumed a duty to advance the welfare of these peoples and to promote their social, economic and political development.

Here we have tried to translate general objectives of the United Nations into the field of practical politics. We have pledged ourselves to the full doctrine of trusteeship and we have given it a positive direction, in relation to native education, medical services, encouragement of the civilizing work of Christian missions, and assistance to island peoples in their difficult task of learning how to handle their affairs (Evatt 1945, 162).

The South Pacific Commission was established on 6th February 1947 after a prolonged period of negotiation on specific forms of assistance. The South Pacific Commission was a regional organisation organised under the Canberra Agreement to "collaborate on problems of medical, social and economic development". Membership comprised six states holding territorial possessions in the South Pacific at the time - Australia, France, the Netherlands, New Zealand and the United Kingdom and United States. It excluded Portugal (with its possession of East Timor) and Chile (with its possession of Easter Island) since it was to be ostensibly "non-political" in its workings . The organisation was to administer the role of welfare or "trusteeship association" for the peoples of the Pacific Islands, and despite an assumption that there should be provision for indigenous inputs "to advise the SPC", they were absent from any initial meetings.

The SPC owed some of its organisational structure and agenda to earlier regional meetings, in particular, the first Pan Pacific Health Congress which met in 1926, and a meeting of administrators from Papua, the Mandated Territory of New Guinea, Norfolk Island and Nauru in 1934 who discussed "problems of public service, trade and commerce, health… forestry, land and education" (Mander 1954, 493-495). The Commission consisted of twelve Commissioners – two from each contributing government with two auxiliary bodies, the Research Council and the South Pacific Conference. The Research Council was staffed by "qualified experts" in the fields of Health, Economic Development and Social Development and the structure was designed to feed details of "work programmes" in the islands back to the Commission.

Basic welfare interests and rights of Pacific people provided a focus for early meetings. Ultimately issues of defence and foreign policy came to the fore and Australia and New Zealand backed a proposal for a regional association of South Seas islands in January 1944 which supported a structure for continued regional dependency. Ongoing assessment of the role of the SPC, particularly around the time of the fiftieth anniversary celebrations in 1997, revealed continuing political, social and economic dependency relationships and the legacy of a colonial structure (Fry 1997).

On the occasion of the SPC's twenty-fifth anniversary celebrations in 1972, Ratu Sir Kamisese Mara suggested that a review of the aims and objectives of the organisation was overdue. He observed that:

The Commission was originally set up by the metropolitan powers in the Pacific to encourage and strengthen international co-operation in promoting the economic and social welfare and advancement of the peoples of the non-self-governing territories in the South Pacific region administered by them. It was therefore basically a colonial project. I say this not as a disparagement but as a fact. It was a child of its era… (Ratu Sir Kamisese Mara 1972, 19).

Australian nutritional surveillance

Government intervention and debate contribute to national symbols and progress while domestic concerns are often firmly located within the nationalist project. It is often stated by various government departments that the health of the nation depends on quality food, cooking and housekeeping which underpin the family structure. The structure of the SPC with its particular regional focus on issues of social development provided a perfect framework for a range of projects and planning exercises in the Pacific. In particular, ideas about nutrition and health formed part of wider programs of social control where dietary surveys provided an opportunity to determine the wellness of a population, who could then be subjected to rational, scientific, dietary modifications through mass education strategies (Crotty 1995).

In the United Kingdom ideas of good nutrition were promulgated by nineteenth century welfare crusades, carried out by benevolent middle classes in working class communities, which provided training for later mission activities in colonial settings. This nutritional "policing" of families was linked to child welfare concerns, and ultimately resulted in the growth of community based medicine (Coveney 2000, 94-95).

Hygiene was also promoted in Europe as part of wider medical concerns (Foucault 1980) while new work on organic chemistry provided a framework for the development of physiology as a science. The body was considered to be an efficient machine, dependent on inputs of fuel (food) to achieve desired levels of performance (health and energy). These approaches to hygiene and health formed part of a wider approach to nineteenth century medicine and conveniently merged concepts of imperialism with domesticity.

From this time, nutrition studies evolved as a concern of the state. Scientists linked the discovery of nutritional elements in the laboratory with evidence of poor eating habits and malnutrition in children in the poorer urban and rural classes in England. Similar studies were conducted in Australia, where they led to the establishment of baby health clinics and more systematic research into eating patterns (Coveney 2000, 19). Nutrition, hygiene and home science was also a concern in other British colonies (Donaldson 1992; McClintock 1996; Hancock 2000).

It is interesting to link the earlier concerns with health and nutrition to later twentieth century developments. Part of the wider regional influence originated with changes in food consumption patterns and shifts in national commodity markets. After the austerity of the war years, the 1950s were a time of rising living standards but also a period of conservatism in terms of family and household stereotypes. This material has been widely surveyed in the content of the "Australian Women's Weekly" and other forms of Australian popular culture of the time. Housewives did not necessarily respond positively to these assumptions about home and domesticity (Johnson 1996).

The modernisation of the Australian home involved a number of contradictory developments. While the invention and use of household appliances were labour-saving, they presented increasing demands for the modern housewife who was now encouraged to spend longer on housework and the preparation of nutritious meals. In this role, the task of working for the family became a challenge for home science. Such knowledge was formalised by nutritional advice which extended to economic concerns (frugal budgeting), along with health and hygiene. At the same time the expansion of industrial food production during the 1950s resulted in a greater range of food products with a subsequent advent of fast foods, convenience foods and their impact on the kitchen (McIntosh and Zey 1998, 90).

The focus on the health of the nation linked quality of meals to issues of home maintenance, reflected in an efficient and scientific approach to cooking and housekeeping. It was assumed that emotional needs and the stability of family life were seen to revolve around the provision of good food and atmosphere (McIntosh and Zey 1998, 127). The mechanics of these activities are useful in locating the wider trends in childcare and nutrition studies.

Administration of the home

At a time when many forms of traditional production were being removed from the home by mass industrial developments, women were called on to introduce scientific principles of management to domestic production. New pressures were placed on women's performance of kitchen duties which extended to the planning, preparation and execution of meals. The influence of science on the labour of food production and consumption paralleled an advocacy of new modern equipment appropriate to each task and the principles of nutrition (Reiger 1985, 74).

Advertising of labour saving devices in the 1950s echoed some of the inconsistencies in the kitchen where cooking could be described as "an interesting, nurturing, and creative pursuit" but one that could be escaped from with the assistance of "new products, technology and packaging (which) would free women from this boring, unpleasant task" (Levenstein 1993, 109)

Various studies of the time concentrated on material and child health and welfare with the League of Nations comparing Australian and British epidemiology, stating that "Australia needs not only a numerous but a virile population and virility is very largely a matter of proper feeding" . In Australia there was now a "team of experts" (medical practitioners, interested professionals from dietetics, domestic science and infant welfare and social work) who combined their talents at a government level: the Advisory Council on Nutrition was set up in 1936 and the National Health & Medical Research Council established in 1937 (Reiger 1985, 75). A series of Royal Commissions and other reviews recorded the amounts of household expenditure and consumption and noted the physical conditions of children in many states.

Producing the model modern baby

This approach to child and maternal health formed part of a new research focus. Mothercraft emerged as a new domain of knowledge under professional control. The Truby King Mothercraft Society was established in Karitane, New Zealand in 1907 after Truby King turned his attention from dairy calves to the management of babies and infants (King 1933). The growth of this society reflected a growing interest of the medical profession in the field of public health and scientific feeding patterns and the ongoing influences of the Karitane nursing centres continue to be evident today. Infant welfare centres, medical in nature but concerned with the promotion of general health, were first established in Adelaide in 1909 by Helen Mayo while William Armstrong established the first Sydney clinic for mothers and babies in 1914. By 1923 all Australian states had infant welfare movements, partly or fully state funded (Coveney 2000, 95).

The teaching of Mothercraft reflected middle class concerns. Mothercraft and infant welfare had become part of a major effort to teach women to mother babies "in a scientifically correct and morally approved manner" (Reiger 1985, 128). All aspects of breastfeeding came under scrutiny – techniques of expressing milk, patterns of irregular and frequent feedings. Timetabling took on a clocklike regularity with a moral significance – from early after birth, babies should be wakened regularly to follow a strict feeding schedule and the clock was used as standard reference. The rational control of feeding was also designed to calculate the amount of milk the baby was receiving (Bennett and Issacs 1931; Mothers and Babies' Health Association 1938). The preoccupation with graphs, charts, and standardised measurement belied the claims that each baby had to be treated as an individual.

The impacts of European home maintenance and domestic science were transported abroad and subsequently documented in several colonies. For example, the introduction of home science in India has recently been linked to a parallel rise of domestic wellbeing in the US. The domestic or "private sphere" of family and home was seen to complement public health and town planning and the application of principles of "civic responsibility, order and cleanliness" (Hancock 2000, 151). It is interesting to consider how some of the underlying assumptions for models of care were then transported to regional colonial territories in the Pacific.

Various experiments with foodstuffs were based on a view of the kitchen as laboratory and new criteria were introduced to evaluate the "goodness" of food in terms of "taste, nutrient content and caloric needs" (Hancock 2000, 155). Missionary wives were able to offer powerful housewife roles in their respective societies, based on a number of new cleaning methods and the regular advice to assist in the prevention of disease. The family continued to be viewed as an institutional base or focus for consumption and leisure activities, along with various forms of socialization.

These values coalesced in the work of Christian missionaries who were convinced of their role in rescuing converts from savagery by providing a work discipline along with new social and political models. Missionaries from Protestant and Catholic denominations provided different examples of community with nuns and missionary wives both "imparting European models of housewifery – teaching cooking, laundry, sewing and infant care"(Jolly and Macintyre 1989, 8-9). In most instances these female activities were shown to be subservient to male endeavours.

Europeans were confused by the structure of Pacific villages where men, women and children often lived in separate dwellings. Missionaries found the whole structure of Pacific villages and society quite a challenge as men, women and children often lived in separate dwellings. However some missions tolerated a wide range of social differences in their dedication to "improvement of women's lives…by promoting models of womanhood based on domesticity" (Jolly 1991) 69.

Mission activities were not always marked by passive acceptance of local conditions. In her case study of Tubetube, Macintyre describes the Polynesian teacher reactions to the heathens they found: "they burned down the clan houses; they smashed the skulls of ancestor and enemy alike, as objects of devil-worship" (Macintyre 1989, 162). When Wesleyan missionaries arrived in 1892 to establish a mission station they built European style house complete with water tanks and galvanised iron on the roof. At the same time the Samoan, Fijian and Tongan teachers introduced new crops including sweet banana, sweet potato, breadfruit, Polynesian chestnut and pumpkin. The long term effects of these changes culminated in divisions in society where implications of different housing and rapid change in cash crops influenced village power and authority (Macintyre 1989, 163-164).

Interestingly, Macintyre finds that senior women were able to retain some distance from missionary interference with enhanced access to land and gardens. This position maintained their role in managing food consumption and agricultural production. Today the new items of consumption recall missionary occupation and the shift in lifestyle from one of production to consumption is closely linked to the impact of these early visitors (Macintyre 1989, 169).

Pacific approaches to childhealth and nutrition

In the second part of this paper I will explore several 1950s descriptions of relationships between family and child nutrition as studied and described in Pacific research on infant and maternal health. Eventually these investigations provided the basis for more detailed reports and supplied basic data which continue to influence further health strategies in the region. The SPC, as a regional organisation, provided the institutional framework in which to test common approaches to child-rearing, nutrition and infant growth patterns. A range of specialist information was mobilised by a range of "experts" who applied scientific knowledge and approaches to the practice of daily household and childcare tasks.

Since European intervention in the islands there has been a parallel medicalisation of health systems and these shifts have reinstated disease as a central feature of concern. Biomedical attention has been concerned with curing rather than preventing disease. "Diseases of modernisation" are generally listed as diabetes, coronary heart disease, and various cancers, however recent research indicates that measures used to determine Body Mass Index (BMI) combine with unreliable figures for mortality or life expectancy to give inaccurate data for the region (Pollock and Finau 1999, 286). Shifts in food consumption and production have also resulted in subsequent revisions to symbolic and ceremonial uses of food.

All of these programmes were administered through top down authoritarian approaches to the application of scientific facts about food as solutions to various health problems. A working definition of community health and good nutrition, developed from discussions on various aspects of community development. These discussions originated through regional workshops, delegations and meetings under the direction of the SPC organisation, rather than the colonial state. The role of the SPC provided (or brokered) "expert advice" to help and guide local communities within a wider regional model. Various research exercises in food and nutrition in relation to infant and maternal health reveal the influences on nutrition at the time.

Missions had earlier initiated social and moral reform and had assumed the role of educational provider (Keesing 1937; Whitehead 1988; Macintyre 1989; Jones 1992). The colonial economy relied on a healthy population, particularly in areas where plantation labourers and other workers were required, both to protect enclaves of Europeans on plantations and other settlements, while the health of wage labourers was often inspected before and after commencing work contacts (Malcolm 1952).

Denoon observes that concerns of medical officers in Papua and New Guinea in the 1920s and 1930s were narrowly focussed on clean water, reliable sewage and pure food – concerns that paralleled the quality of life issues in Western Europe at the time. Tropical medicine involved "the pursuit of a narrow range of tropical medicine rather than pioneering public health measures" (Denoon 1989, 96-97). This gendered focus often overlooked issues of maternal or child health (Jolly and Macintyre 1989).

Approaches to social development in the Pacific openly reflected European or western influences. For example, Camilla Wedgwood's research on the education of women and girls in the Pacific states, published in 1957, states:

The urgent need to improve the health and general living conditions of the islanders has led to a prime emphasis being laid upon instructing the girls and women in domestic skills – cooking, housewifery, the care of children – which in our society are the traditional field of women's activities, and to confining vocational training for the most part to nursing… (Wedgwood 1957, 496)

Wedgwood noted that men's and women's work and interests did not parallel Australian society, and community development and agricultural improvement programmes appeared to be ignorant of the fact that women played a major role in growing food crops in the region (Wedgwood 1957, 497). Missionaries attempted to influence women and move their focus from food cultivation to more domestic concerns, while modernisation and development plans of the time focused on cash crops to the exclusion of traditional foods. Missions were responsible in many areas for the introduction of large copra plantations, dairies and other agricultural enterprises like the production of vanilla and bananas (Thaman 1982, 115-117). Cash crops were often regarded as male concerns and development inputs focussed on men, often at the expense of local food production.

In an extensive review of edible food the in the South Pacific, Massal and Barrau comment on the wide range of geographic conditions which extend the diversity of food varieties and local food habits. At the same time, the impact of European discovery and settlement were noticeably influencing the development of cash crops such as copra, coffee and cocoa. The objectives of the research were broad but the introduction of new food crops was noted as a priority:

To enrich the vegetable food pattern of the South Seas islands by some new staple and complementary food plants, the produce of which will give a better-balanced diet; to find among the traditional food plants, species and varieties which can be kept in the new agricultural patterns which are now based mainly on cash crops; to education the population, both indigenous and European, in the matter of the relative values of local and imported foodstuffs, and in better ways of using, processing and preserving them (Massal and Barrau 1956, 2)

Defining child health services

The SPC played a formative role in the identification of foods and the promotion of nutritional and health information in the region. These nutrition studies provide a range of materials with various research projects and fieldwork carried out in a number of island communities. The commission mobilised various organisational approaches to community development. Technical papers produced by the SPC provided a range of primary research materials and survey details, while visual materials were also produced to supplement these projects.

In reminiscences of her years in the South Pacific, Nancy Phelan describes the preparation of flannel graphs, posters and other material to spread health messages in the region. She notes that the accompanying messages were not always well thought through: Phelan refers to a campaign to encourage the use of soap where two babies, one health and the other sickly, were placed alongside one another with a caption that read "Soap makes the difference". Mothers in some villages interpreted the message in literal terms by feeding soap to their babies. They later complained "that their babies didn't like soap, they spat it out and if they were made to swallow it, they became sick" (Phelan 1996, 42-43). The design of the poster had to be scrapped in favour of images of people lathering their bodies.

The postwar period marked a growing concern with community health and nutrition with various efforts to investigate dietary problems. The agenda for further research was refined by various regional conferences and reflected common international trends, in particular mother and child studies in many countries (Mennell, Murcott et al. 1992, 79). In particular, the Australian Government organised a full-scale nutrition survey in Papua and New Guinea in 1947, and two organisations – the South Pacific Health Service and, on a larger scale, the South Pacific Commission – continue to have long-term research programmes in the region.

Issues of modernisation, development and social change provide an underlying focus for these programmes, as evident in the following summary:

A change-over from subsistence to a cash economy and from traditional practices to European methods of food preparation cannot be avoided. It should be the responsibility of territorial administrations to assist the peoples in the transition, to improve existing nutritional standards where these are not as high as they could be, and to attempt to maintain adequate diets and nutrition (Peters 1958, 1).

The research agenda was directed as follows: firstly, research among traditional food plants for species and varieties susceptible to improvement which could be retained in new agricultural patterns; secondly, development of the production of 'rich' foods; and thirdly, education of islanders in relative values of different foods, local or imported, and in sound methods of preparation. This program parallels changes in nutrition research over the past century: a concern with 'micro-nutrients' which paralleled research on people with disease. During the post-Second World War agricultural boom, this focus shifted to identifying trends in disease occurrence and a concern with adequate diet while more recent nutritional concerns are linked to diet-related diseases of affluence (Lewis and Rapaport 1995; Pollock and Finau 1999; Centers for Disease Control and Prevention 2000).

At the same time, worldwide changes in food security and diet were influencing the delocalisation of food production and distribution. As an increasing number of foodstuffs were made available in industrialised countries, these changes often paralleled a decrease of available foods in non-industrialised countries and subsequent shifts in nutritional inputs and food security (Pelto and Pelto 1983; Franke 1987).

In keeping with their earlier agenda, the SPC forwarded recommendations for two main research programmes: the improvement of the health of the mother and child and general research into the diet and nutrition of peoples of the South Pacific. While acknowledging that both projects would require extensive community participation, there was considerable uncertainty about how to define collaborative strategies. More critical views of the programmes note that this type of collaboration was top down with an avoidance of some key principles of primary health care: now described as community-based; low cost; equitable distribution of resources and co-ordinated inclusion of factors such as education, food supply, nutrition, water, sanitation and child health (Pollock and Finau 1999, 291).

Initial studies involved recording local conditions. An extensive compilation of tables and statistics was designed to provide a record of certain daily foodstuffs in daily use in the islands of the tropical South-West Pacific with the proviso that some attention should be given to how this information could be usefully applied in practical dietetics. However, many of these compilations were far from complete and, despite an interest in maximising the returns from cash crops, there were few analyses of impacts of soil and climate on the composition of food. Buchanan remarked in his introduction to Guide to Pacific Island Dietaries that:

There are few if any complete comparative series of analyses to show the effect that vastly differing conditions of soil and climate has on the relative content of essential constitutions. This… emphasizes the inadequacy of our knowledge of local foodstuffs which results in many blanks in the analytical tables (J C R Buchanan 1947, v)

Miss Sheila Malcolm, Dietitian-Nutritionist

The Second South Pacific Conference in Noumea, April 1953 defined health education as a "process whereby people learn to improve their personal health attitudes and habits and to work together responsibly for the improvement of health conditions in their neighbourhoods, communities and nations (Loison and Keyes 1956, 1). However there was some acknowledgement of the need for local participation reflecting a range of inputs from various community leaders along with differences in territories and cultures, as well as administration.

A framework was put in place to monitor these phases of community integration. The SPC identified a range of social and economic concerns. At the same time, a considerable amount of research was being carried out on cash crops and pests affecting these crops. Teaching nutrition in the village environment involved a range of supports and concerns were expressed with regard to the growing replacement of traditional foods with imported foodstuffs.

The call for doctors and dietitians with tropical experience paralleled earlier missionary zeal in recognition of the important role that could be played with local communities. Obviously an ability to travel and work under hardship required a dedication to the task at hand and a form of "missionary spirit". One of these dedicated workers was Miss Sheila Malcolm, an English dietitian-nutritionist, employed by the SPC from 1950 to 1955, after which time she worked for the FAO of the United Nations where she was contracted to continue similar work in the region . The project brief was to investigate and describe the nutrition and diet of infants and their mothers, note the provision of food resources and make some assessment of the overall subsistence economy. What is interesting is the investigation of populations alongside attempts to monitor various aspects of social and cultural change.

In particular, the influence of approaches to education on child feeding, hygiene and child development paralleled earlier trends in Australia where manuals and textbooks, produced for Australian conditions, expressed the need to scientifically account for the increasing variety of nutrients considered essential for health (Coveney 2000, 101). A number of studies of infant feeding were initiated to investigate the possibility of future links between diet and health problems.

Several tools were developed to assist this research. The first was a food group model where foods were grouped together according to their nutrient content so that a child's food intake '"could be qualitatively and quantitatively measured against recommendations which were based on calculated dietary allowances" (Coveney 2000, 100). The second tool was a growth chart which represented the 'normal' experience of every child whose growth was represented as a series of gently curving lines, judged against a pattern of growth of an assumed healthy population (Armstrong 1991, 396)

Rural and Urban New Hebrides

Sheila Malcolm conducted surveys in New Hebrides during 1952 in the vicinity of Port Vila (Efate Island) and in rural coastal and inland areas on Tanna Island. She prepared lists of foods, both local and imported; and made lengthy descriptions of diet, food habits & preparation/preservation of food along with data on diet and nutrition of infants, breast milk, and other food customs and usages. An investigation of foods grown and eaten in the immediate vicinity of Port Vila provided a number of clues to the changing food patterns. At the time of her study, men from the villages were working in Port Vila on a daily or weekly basis, receiving pay or rations.

Imported foods were in increasing demand with some items such as rice, bread, flour and biscuits being eaten on a daily basis when possible. Other imported foodstuffs included tinned meat and fish, tinned milk, sugar and tea. Analysis of children's diets was based on data from 91 children from the villages, appended with data from the British Hospital records for the period 1943-51. Infant welfare sisters visited each village on a monthly basis and recorded the weight of each child, remarking on various aspects of child development.

Table 1: Curves of Weight

Figure adapted from chart (Malcolm 1952, 17)

While table 1 indicates some variation in weight, particularly as the child grows, the high and low range measurements in Port Vila indicate that while some babies were very much heavier or lighter than their Victorian counterparts, average weights of Australian babies and Ni-Vanuatu babies did not differ greatly. As Table 2 indicates, the weights of Victorian children, compared with children of similar ages in Port Vila were very similar.

Table 2: Curves of length

Figure adapted from chart (Malcolm 1952, 18)

All food consumed by each child over a period of a week was weighed and approximate estimates of calorie and protein intake were computed daily from cooked edible portions. Food intake figures were thought satisfactory up to 8 months; 9-12 months dependent on the amount and variety of other foods eaten; while the 1-2 years diet could be adequate but frequently was not so. Malcolm noted the need to educate local people in how to purchase best foods and use foods suitably prepared in adequate quantities. She observed that despite increased availability of imported foodstuffs, villagers should be encouraged in the cultivation of easily grown vegetables to balance their diet; while being retrained to appreciate the advantages of their traditional cooking methods (Malcolm 1952, 11).

Chemical monitoring of milk quality was taking place along with observation of feeding and weaning techniques. Peters describes a nutritional study to determine the chemical composition of milk in New Hebrides involving a group of children from 18-24 months who were still feeding. Fifty one samples were obtained at strict four-hourly intervals and flown to Canberra for analysis where they were compared with appropriate Australian samples. Seven milk samples collected in Canberra: along with 2-5 months (18 babies), 6-11 months (15 babies), 12-24 months (18 babies). While Peters noted that Melanesian milk was lower in lactose and calcium than European milks, he concluded that insufficient results and faulty collection techniques may have contributed to the lack of variation in samples (Peters 1952, 4).

Malcolm made the following recommendations: firstly, she perceived the need for an education programme that would focus on the preparation and supply of suitable foods; and secondly, the population were missing out on high protein foods such as milk, eggs, fish, meat and beans or legumes.

In making some contradictory conclusions, Malcolm stated that most children appeared to have a reasonable diet. While there was sufficient food, it seemed necessary within actual social and economic conditions to recommend better use of local and imported food. She then suggested a range of educational strategies designed to improve village health which revolved around the use of demonstration and introductory gardens in villages, teaching sessions on the best use of available foods and the distribution of pamphlets and posters to village leaders, schools, missions and planters.

While young babies appeared to receive adequate milk, the diet and nutrition of children between 9 months and 2 years seemed inadequate. This situation was linked to the failure of breast milk, the lack of fresh animal milk, and inadequate use of imported milk. These defects could only be corrected with the introduction of suitable foods, foods rich in protein such as milk, eggs, fish, meat and beans. There was a need perceived for necessary educative material such as books or cards to provide information on themes such as age weight and development, suitable foods and their preparation. Books, pamphlets and posters were suggested for school use with combined information for adults and children about foods, their growing and raising, and their preparation and necessary quantities.

Education about child feeding, hygiene, child development and family welfare became part of a larger and more formalised education process. A number of manuals and textbooks had already been developed by Australians for Australian conditions. In many instances the material developed for the region followed similar prescriptive format with charts, feeding timetables, recipes and menus. Several of these cookbooks indicate compromises and interesting reworking of European recipes to maximise the use of local ingredients, while later incorporating partial knowledge about food nutrients (Girl Guides Association 1939; Hamilton 1957; Hoar 1968).

Following this nutrition survey, a pilot health education project was mounted in the New Hebrides in October, 1955 with the following objectives: firstly, to define responsibilities of administrative departments, missions and people in health education; secondly, to study techniques of health education; and thirdly, to evaluate the use of audio-visual aids and practical demonstrations (Loison and Keyes 1956).

Netherlands and Australian New Guinea

Every region of the island comprises people of different stature, with different languages, customs, resources and degrees of civilization. Add to that the technical difficulties of extracting quantitative information out of a wild, unapproachable, partly known country and then it will be clear that it is exceedingly difficult to make general statements about situations in New Guinea. Though the survey covered both coastal and inland, low and high altitude areas, with either taro, sago or sweet potato as staple foods, many regional variations had to be overlooked… (Oomen and Malcolm 1958, 1-2).

Dr Oomen led the research team and with the assistance of various government agencies, local doctors and missionaries, Sheila Malcolm spent more than 7 months during 1954-55 in various parts of Netherlands New Guinea, staying 4-5 weeks in each region. She also visited certain regions of Australian New Guinea. Eight different regions were visited, all experiencing subsistance conditions to a greater or lesser extent: Waropen Coast, Blak Island, Sentani Lake, Marind Region, Wissel Lakes, Ajamaroe Lake, Sepik River and the Chimbu region of the PNG Highlands.

This report was directly influenced by the report of the New Guinea Nutrition Survey Expedition in 1947, which stated the recommendations as follows. In particular, the Nutrition Survey Expedition led by Hipsley had already identified a number of problems with current social and dietary customs which noted the need for an increased use of protein rich foods along with some education in their use; increased consumption of animal products (goats, poultry, sheep and pigs); increased harvesting of fish; along with the need for extended areas of native gardens in and around plantations. The efficiency of existing agriculture was seen to have limited the variety of foods; with further research required to impacts of diet on the people in the region (Oomen and Malcolm 1958, 145-146).

The Nutrition Survey reported a number of criticisms that possibly reveal more about European perspectives on food and agriculture than existing local conditions. The underlying target for dietary inputs and change were identified as those groups in the population who would be most receptive to new ideas. People who were already working for Europeans were exposed to different foods and other social and dietary influences were extended through the role of the missions and education. The increased use of imported foods was seen as both an asset and a liability while the introduction of protein rich food was suggested without consideration of the impact of these animals on the local environment. Pigs and poultry were already in evidence in many parts of the region while the introduction of animals such as goats, sheep and cattle were more problematic.

Particular attention was to be given to the introduction of first foods to children and the following statement suggests:

The Papuan child of today is the parent in the society of tomorrow; a society much different to the present one; a society facing many problems; and among them dietary problems resulting from and related to changes in cultural and subsistence patterns (Oomen and Malcolm 1958, 3).

While Malcolm wryly observed that it is difficult to briefly summarise the range of nutritional needs across such different areas, she provided extensive details and a sample listing of various foodstuffs in the Sentani region and gives some indication of the mixture of traditional food items with those foods obtained via rations, shops and child health services. (Table 3)

Table 3: Food Intakes - 10-21 months, Sentani (Netar)

Figure adapted from (Oomen and Malcolm 1958, 67).

The impacts of imported foods, particularly the excessive use of sweetened tinned milk in the infant diet was noted. While customs and beliefs continued to influence dietary habits and child care in all of the regions, traditional beliefs were challenged by the growing influence of schooling on wider sections of the population. In 'nutritionally poor' areas, the first foods introduced in weaning were often 'monotonous and unbalanced' and the diet was both low in calories and protein. Food intake was often extremely irregular and caused by a lack of fixed routine for meals and irregular food supply (Oomen and Malcolm 1958, 135).

Particular concerns were expressed with the use of bottle and milk in situations that were far from ideal:

Lemonade, coconut water, coconut cream and weak coffee have been found in bottles of children less than 1 year of age… often milk is put in a beer bottle with an ill-fitting teat. With the only spoon available to the household, one or two teaspoonfuls of thick milk are poured through the neck and then the bottle is filled with unboiled water (Oomen and Malcolm 1958, 71).

There are a number of interesting conclusions about dietary standards. Perhaps Malcolm and Oomen's most interesting observation concerns the non-comparability of the Papuan child with Caucasian children, "because growth is slower and body size and age do not correspond" (Oomen and Malcolm 1958, 133). When comparing local conditions with western dietary standards, the food and nutritional situation in some regions "seems satisfactory". Indeed, the subsistence economy reflects a realistic approach to community food, while the introduction of money and foreign economy tends to favour the men and "usually overlooks the improvement of the existing situation where mother and rapidly growing child are often the most vulnerable links of society" (Oomen and Malcolm 1958, 135-6).

Conclusion

Such projects in the Pacific in the 1950s reveal a number of issues that continue to influence discourses on food and nutritional health. Firstly, what is considered to be nutritionally adequate is socially defined. Australian perspectives on diet and nutrition in the 1950s had limited relevance in the Pacific context. Assumptions of researchers concerning infant health and weaning practices reflected western perspectives and failed to recognise that recommended nutrient intakes might differ over time and from country to country (J Dye Gussow and Thomas 1986).

These nutrition studies presume that knowledge of the nutritional situation of the child is essential to understanding problems of development and subsistence; and that the nutritional status of the child results from food intake modified by environment; by economic and disease conditions prevailing within it, and is influenced in turn by the quality of maternal care (Oomen and Malcolm 1958, 3). However this framework overlooks the problem of using comparable data. For example, comparing growth rates of Australian children with local children in Papua New Guinea or New Hebrides has limited relevance. While these inconsistencies were noted, the tools used for such investigations continued to be European-designed. For this reason, underlying assumptions about food and nutrition continue to impact on nutrition and health programmes in the region as they have often built on earlier base lines.

Research on nutrient values of traditional foods were taking place at the same time but the recognition of the value of local food was often overlooked in preference to the perceived need for high protein imports. Contemporary research has identified a number of problems with this approach. For example, a recent US Department of Agriculture (USDA) review and determination of new nutritional standards has been criticised for the biased composition of the committee (at least 6 of the 11 panellists have "significant ties to the meat, dairy and egg industries") while underlying assumptions of the food pyramid have been challenged as "racially biased guidelines" that ignore special interest needs of minority Americans in listing dairy products as the best souce of calcium. Ninety percent of Asian Americans and seventy percent of African Americans (along with fifteen percent of Native Americans) have difficulty in digesting milk and milk products (Earth Island Institute 2000).

Finally, much of this research on infant and maternal dietary patterns took place under the direction of a medical model which stresses the value of scientific interventions in terms of laboratory-based research, under the direction of medical experts. This paternalistic approach to government-sponsored health promotion is now regularly challenged by a variety of community-based approaches which recognise the impact of broader issues such as life-style factors, beliefs, religion and culture (Pollock and Finau 1999; Westwood and Westwood 1999).

These early dietary and nutrition studies formed the basis of government health programmes and educational strategies. The ongoing impact of this research continues to influence dietary habits and assumptions about food. While these trends can be critically examined as a product of the time, they also have contemporary relevance in terms of nutritional studies and baseline data and a number of assumptions made about correct diet continue to influence such research (Malolo, Matenga-Smith et al. 1999).

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