Ohio University Press · Swallow Press ·

The Riddle of Malnutrition
The Long Arc of Biomedical and Public Health Interventions in Uganda

By Jennifer Tappan

“Tappan’s rich study explores how complex health issues in Africa and other regions of the global south have been falsely constructed as problems that can be easily addressed through the application of externally derived biomedical technologies. A must read for public health scholars and practitioners.”

Randall M. Packard, author of A History of Global Health: Interventions into the Lives of Other Peoples

“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.”

Kim Yi Dionne, Washington Post online

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.

Jennifer Tappan is an associate professor of African history at Portland State University. Her research focuses on the history of medicine and health in Africa, and her work has appeared in the International Journal of African Historical Studies and the edited volume Global Health in Africa: Historical Perspectives on Disease Control.More info →


Table of Contents and Introduction


Order a print copy

Paperback · $27.96 ·
Add to Cart

Retail price: $34.95 · Save 20% ($27.96)

Hardcover · $64.76 ·
Add to Cart

Retail price: $80.95 · Save 20% ($64.76)

Buy from a local bookstore


US and Canada only

Buy an eBook

Amazon Kindle Store Barnes & Noble NOOK Google Play iBooks Store

Availability and price vary according to vendor.

Cover of The Riddle of Malnutrition

Share    Facebook icon  Email icon


Desk Copy Examination Copy Review Copy

Permission to reprint
Permission to photocopy or include in a course pack via Copyright Clearance Center


Retail price: $34.95, S.
Release date: June 2017
32 illus. · 238 pages · 6 × 9 in.
Rights:  World

Retail price: $80.95, S.
Release date: June 2017
32 illus. · 238 pages · 6 × 9 in.
Rights:  World

Release date: June 2017
32 illus. · 238 pages
Rights:  World

Additional Praise for The Riddle of Malnutrition

“An incisive and sensitive portrayal of the real implications of the uneven generation of knowledge in East Africa. Tappan locates the history of nutrition not only in a succession of hypotheses tested on the bodies of Ugandan children, but in later community demonstration meals and in the willingness of researchers to recognize and reflect on the unintended consequences of their actions.”

Holly Hanson, author of Landed Obligation: The Practice of Power in Buganda

“By tracing the twists and turns in the epidemiology and treatment of severe acute malnutrition in Uganda into the present, The Riddle of Malnutrition delivers an illuminating analysis of the relationship between scientific research and efforts to provide medical care in Africa over the last century.”

Neil Kodesh, author of Beyond the Royal Gaze: Clanship and Public Healing in Buganda

Related Titles

Cover of 'Preaching Prevention'

Preaching Prevention
Born-Again Christianity and the Moral Politics of AIDS in Uganda
By Lydia Boyd

Preaching Prevention examines the controversial U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) initiative to “abstain and be faithful” as a primary prevention strategy in Africa. This ethnography of the born-again Christians who led the new anti-AIDS push in Uganda provides insight into both what it means for foreign governments to “export” approaches to care and treatment and the ways communities respond to and repurpose such projects.

Anthropology · Religion | Religion, Politics & State · Medical | Health Policy · HIV-AIDS · International Studies · Global Issues

Cover of 'The Experiment Must Continue'

The Experiment Must Continue
Medical Research and Ethics in East Africa, 1940–2014
By Melissa Graboyes

The Experiment Must Continue is a beautifully articulated ethnographic history of medical experimentation in East Africa from 1940 through 2014. In it, Melissa Graboyes combines her training in public health and in history to treat her subject with the dual sensitivities of a medical ethicist and a fine historian.

History of Science · African Studies · Medical | Public Health · Social Science | Disease & Health Issues

Cover of 'Global Health in Africa'

Global Health in Africa
Historical Perspectives on Disease Control
Edited by Tamara Giles-Vernick and James L. A. Webb Jr.

Global Health in Africa is a first exploration of selected histories of global health initiatives in Africa. The collection addresses some of the most important interventions in disease control, including mass vaccination, large-scale treatment and/or prophylaxis campaigns, harm reduction efforts, and nutritional and virological research.The chapters in this collection are organized in three sections that evaluate linkages between past, present, and emergent.

Medical | Health Policy · African History · Anthropology · Global Issues · African Studies · Africa

Sign up to be notified when new African Studies titles come out.

We will only use your email address to notify you of new titles in the subject area(s) you follow. We will never share your information with third parties.