In the 1970's I worked as a health planner specializing in developing countries. I sometimes worked in places where on the average, of every four children born one would die before his/her fifth birthday. There are still such places today. It was then, as it is now, possible to cut that death rate by an order of magnitude. Rather than one in four children dying, one in 40 would die. Would anyone suggest that it were not desirable to achieve that reduction in infant and child mortality?
Of course, that is itself a change in the culture. Moreover, the ways we know to reduce child mortality involve teaching mothers to improve the nutrition and hygiene and providing basic public health and medical services. Of course, each such intervention changes the culture, and in fact tends to do so to move the original culture toward the culture of societies in which low infant and child mortality is the norm.
Indeed, breaking the cultural links as to where families seek nutritional and medical advice substituting linkages to new institutions would seem likely per se (if it works in ways that the families can see) will tend to promote more cultural change and less cultural diversity. If getting advice from the government health system works to improve your children's health, maybe getting advice from the government agricultural extension system will work to improve your farm's yield.
I would suggest that the impact of the improved health of children could also be seen as cultural change. We know that improving the survival probability of children leads rather directly to lowered numbers of pregnancies per woman. It has also been suggested that families invest more in children who are more likely to survive, and even invest more emotional attachment to such children. These would seem quite profound cultural changes.
Think also of the effect of a cohort of children growing up better fed, healthier, and receiving more investment of wealth and affection from their parents than did the previous generation. I suggest that there would be an important generation gap, leading to significant cultural change from generation to generation.
So the decision to reduce child mortality by an order of magnitude in a culture of poverty, while seemingly an obviously justified change in that culture, is likely to have repercussions that would lead to rather profound convergence of that society towards aspects of culture typical of societies with low infant and child mortality -- a significant reduction in cultural diversity.
Thursday, September 30, 2010
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