Wednesday, May 18, 2016

The spirit of the social sciences: Speaking truth to power

The social sciences offer insights into social, cultural, political, economic phenomena through empirically-driven work.

The quest for empiricism essentially means that the social scientist has to pay close attention to data in drawing her conclusions. Good social science is not simply about running an equation or generating a simulation on the basis of assumptions, but actually putting these observations and assumptions to test.

For instance, mathematically drawing out how two players may make specific choices in a game based on a rational actor model is perhaps irrelevant unless tested through empirical observations.

The observation of social phenomena thus is grounded in a commitment to generating truth claims, however contingent and incomplete.

It is possible that some or many of these truth claims that emerge from honest social science scholarship disagree with the broader assumptions or foregone conclusions of the dominant power structures in a given social-political-economic system.

For instance, when a social scientist observes the poor health effects of large-scale inequalities in systems, the conclusions drawn may not really be palatable to the political-economic plutocrats that govern many universities today.

Yet, the commitment of good social science lies in speaking these very truths, drawn from close study of data.

Speaking truth to power in this sense is quintessential to the integrity of social science.

Wednesday, May 11, 2016

Addressing Diabetes and Regulating the Food and Beverage Industry: Misplaced Stigmatization of Rice




Culture is integral to how we live our everyday lives, how we experience health and illness, and how we negotiate our health seeking behaviors. Cultural context is a salient aspect of our everyday experiences of health, giving meaning to our negotiations of health.

Yet, culture is often either neglected in health promotion efforts emanating from the West or deeply ingrained in Western values. Even more problematically, these Western-based ideologies of health promotion often work to precisely turn culture as a barrier to healthy behavior, instead working to change cultures elsewhere based on Western scripts, values, and concepts.

Culture thus emerges in health promotion efforts as backward and as the object of Western-style health promotion campaigns, using the narrative of health thus to disseminate Western-style values of health. What we have as a result often in the name of health promotion is a Western hegemony of health, pushing behaviors that are deeply Western, dressing these behaviors up in the name of science, and thus strategically obfuscating the Western cultural values underlying the proposed behavior.

Paradoxically, as I have noted in my work over the last fifteen years, the Western behaviors being promoted as healthy are often fundamentally unhealthy, and in other instances, are deeply embedded in value-driven notions of what is health. Nations such as the US and the UK are deeply problematic in terms of their unhealthy lifestyles and behaviors, thus witnessing the epidemics of diabetes and heart disease.

The role of culture in health is salient when considering diabetes, its prevention and treatment. Diabetes as a lifestyle disease, is a disease of globalization, the global movement of the unhealthy lifestyles of the West that have been projected as symbols of prosperity and upward mobility. Consider for instance, the global diffusion of the Pepsi and Coca Cola lifestyle that is attached to youth and symbols of upward mobility and modernity (unfortunately equated with Westernization).

It is another example of a paradox then when Western-imported knowledge claims are offered as solutions to a health problem that is in many ways a product of the "ways of the West."

Given the recent emphasis on addressing the diabetes epidemic in Singapore, it’s worthwhile to consider the cultural context of diabetes and the way in which culture may be taken into account in addressing the risks of diabetes as well as in developing potential solutions.

A nuanced understanding of culture and cultural context is however missing from most top-down health communication efforts that fail to take into account the lived experiences of people. In these interventions, culture is often treated as a barrier that needs to be transformed in order to diffuse the health solution.

Culture gets in the way and should be changed so that the health behavior can be disseminated among the target audience.

Consider for instance the recent coverage of diabetes prevention that has appeared in the mainstream media in Singapore. The "War on Diabetes" takes on rice, an unfortunate example of turning local cultural  practices into pathology and uncritically circulating Western knowledge claims. The targeting of rice by the Health Promotion Board's recent diabetes campaign apparently is based on meta-analyses published by the Harvard School of Public Health. An introduction to the campaign makes the following reference to the studies:

"A meta- analysis of four major studies, involving more than 350,000 people followed for four to 20 years, by the Harvard School of Public Health - published in the British Medical Journal - threw up some sobering findings. One, it showed each plate of white rice eaten in a day - on a regular basis - raises the risk of diabetes by 11 per cent in the overall population."

The reference to the study is not available in the references to it, and the study therefore is not accessible for analysis to the lay public. When I started looking for the study through targeted literature searches based on the description, I came across the following study published by Hu et al. (2012) in the British Medical Journal (BMJ) (this is probably the study the HPB is referring to but it is difficult to be certain given the lack of citation).

When the Hu et al. study was published, it came under criticism for its methodological drawbacks and a debate ensued in the May 2012 issue of the BMJ. These articles, published by Naqvi et al. (2012), Hu et al. (2012), and Kadoch (2012). Unfortunately, this debate is inaccessible to the public because it is located behind a firewall.

The Naqvi et al. article questioned the methodology adopted by the Hu et al. (2012) study, noting the limitations of self-reported measures of diabetes used in the study. In their response, Hu et al. (2012) acknowledged the unrepresentativeness of the study participants in comparison to the general population in those countries, thus limiting the generalisability of the findings.

In his response to the BMJ article, noted Dr. Michael Kadoch (2012, p. 28) of the Mount Sinai Medical Center: 

"White rice has been the staple of the Asian diet for thousands of years. For most ofthat time it produced some of the most slender people in history. Western diseases such as diabetes and coronary artery disease were almost unheard of in this region. Only after the comparatively recent adoption of high fat Western dietary habits, focused primarily on animal products and highly processed junk foods, have these illnesses become more prevalent in Asia."

Acknowledging the presence of White rice in the Asian diet for thousands of years, Dr. Kadoch draws attention to the rise in diabetes in Asia corresponding with the globalization of Western lifestyles to Asia more recently, accompanied by the rise of high fat Western dietary practices focused on junk food and animal products. Certainly as an anchor to the debate on lifestyles and diabetes, he draws attention to the unhealthy effects of the global diffusion of Western-style lifestyles.

He then goes on to note:

"Diets centred on white rice have, in fact, produced some of the most dramatic health benefits reported in the medical literature. The rice diet, as pioneered by Walter Kempner, has repeatedly been shown to drastically reduce hypertension, insulin resistance, and obesity. Low fat diets emphasising starch have reversed diabetes and coronary artery disease. These remarkable studies were all inspired by the traditional Asian cuisine. Encouraging patients to choose intact whole grains such as brown rice is certainly warranted. However, to rescue the Asian population from a mounting epidemic of chronic lifestyle diseases, most effort should be focused on removing the cause- the toxic Western diet. This may even justify promoting a return to white rice, instead of condemning it outright."

Note in the article the acknowledgment of traditional Asian cultural practices such as the practice of eating white rice as a potential solution to Western-induced lifestyle diseases. This debate in the pages of the BMJ draw attention to the questions that remain about the viability of the simplistic claim "White rice causes diabetes." Moreover, the debate attends to the important role of culture and cultural practices within the broader context of health outcomes. 

Let's then situate this debate in the backdrop of the Health Promotion Board's "War on Diabetes."

The lead Straits Times story on Diabetes prevention that appeared online on May 6, 2016 sought to hit home the point that Singaporeans needed to reduce their intake of rice. The story compared rice with sugary drinks, noting that eating a bowl of rice is equivalent to eating two cans of sugary sweet drinks.

The brief story description on FB summarized: “ICYMI: Starchy white rice can overload Asian bodies with blood sugar and heighten their risk of diabetes. It is even more potent than sweet soda drinks in causing the disease.”

The juxtaposition, while may be accurate when comparing carbohydrate content, does not take into account the everyday lived experiences of Southeast Asians with rice and the history of eating rice across various parts of Asia. Rice has long been a part of Southeast Asian cultures, a staple to most meals. 

Southeast Asian countries such as Thailand have comparatively lower diabetes prevalence rate and yet are mostly rice-consuming.

In Singapore, rice is a part of everyday culture, integrated into the ways of life of Indian, Malay, Chinese communities. In each of these cultural contexts however, rice is never eaten by itself. It goes along with some combination of vegetables, fish, meat etc.to make up what would be considered a balanced Asian meal.

It’s not just about eating the rice but also about how it is eaten and what is the portion of the meal. It is also about understanding the local cultural context, its nuances, and the lived experiences of everyday food habits.

In response to the ST Facebook post, one commenter noted “How to shiam rice in our Asian diet? We are fed rice the day we started to eat solids as a baby. If you go to angmo countries, you still yearn for rice for your meals. There is really no substitute for rice.”

One solution proposed in the story is adding brown rice to the mix. This suggestion, while worthwhile, also needs to take into account the cultural meaning of brown rice, the taste and texture of brown rice in the context of the entire meal, and the cost of brown rice compared to white rice. In the comments section of the Straits Times Facebook story, each of these aspects have been raised by community members. 

To consider culture is to make room for voices of community members in developing solutions that would be meaningful to them and their lived experiences. A culture-centered approach to addressing diabetes in Singapore would begin with understanding local cultural practices of eating and living, cultural understandings of diabetes, and developing culturally situated solutions through partnerships with everyday Singaporeans. Such an approach would celebrate local cultural practices as positive entry points toward developing solutions to health and well being.

Moreover the message foregrounding sugary sweet drinks as the benchmark for rice underplays the health effects of sugary sweet drinks as well as the prevalence of sugary sweet drinks such as “Coca Cola” and “Pepsi” in increasingly Westernized Asian lifestyles. Contrary to how the message might be interpreted as underplaying the role of sugary sweet drinks in diabetes, sugary sweet drinks and other processed foods are indeed key risk factors in the context of diabetes.

The health effects of sugary sweet drinks and processed foods on children and adolescents needs serious consideration. This is especially the case given the large proportion of advertising of sugary sweet and processed foods that is carried on online and offline media targeting children and youth. Policies need to carefully look at ways to regulate the food and beverage industry, particularly its targeting of children and youth through advertising and promotion. Policies might similarly look at raising the taxes on unhealthy foods such as sugary sweet drinks and snacks. Certainly, these are some of the approaches being adopted closer home in Asia.

Unfortunately, the comparison of white rice to diabetes framed in a message "The health authorities have identified one of their top concerns as they wage war on diabetes: white rice. It is even more potent than sweet soda drinks in causing the disease" can be misleading for parents. It might lead them to underestimate the poor health effects of sugary sweet drinks, especially when parents might not even be aware of the negative health effects of sugary sweet drinks to  begin with.

Similarly, the role of processed foods in the context of diabetes need to be carefully examined, simultaneously developing appropriate regulatory tools for processed food advertising and marketing.

Addressing diabetes, just as addressing any other health risk, calls for a deeper understanding of cultural complexities. Bringing community members to dialogues in developing participatory solutions, and understanding their everyday lived experiences are integral to the solutions that are developed. 

Finally, addressing the structural contexts of poor health and developing appropriate regulatory measures targeting the Food and Beverage industry is an important policy component.

In sum, a starting point in addressing diabetes in  Singapore ought to engage the local cultural practices, look at culture as a positive resource, understand the local cultural context, and make available the evidence on the basis of which claims are made for public engagement. Through these open dialogues on evidence that engage local communities and develop culturally meaningful solutions, Singapore's addressing of diabetes can emerge as a global exemplar.

Prof. Mohan J Dutta is Provost’s Chair Professor of Communication at the National University of Singapore, where he specializes on health communication and culture. He sits on the Advisory Board of WHO Europe’s “Cultural Contexts of Health Expert Advisory Group.”

Sunday, May 1, 2016

Elite logics of justification and the lack of transparency

Elitism often survives on the sense of entitlement among the elites.

Thinking that "I am better than the rest" is often offered as a self-justification for a variety of benefits and deviations that elite claim for themselves. New rules and new normative guidelines can be created to justify this sense of entitlement, always operating under the notion "I am better than the rest."

For elites, this heightened sense of self is accompanied by a sense of disdain for the "other," especially for the margins.

The trials and tribulations of the margins are justified by the argument "They are not good enough." This argument therefore results in the conclusion "They are deserving of the way they are treated."

The notion that "they are not good enough" is usually some mix of "they are not hard working enough" and "they are not capable enough."

Both of these judgments about the poor work ethic and the poor ability of the "other" serve as the bases for elite justifications of inequality.

Inequality is thus natural for the elite.

Inequality in rewards and life outcomes are natural products of differences in ability and motivation.

In the elite mind, inequality is a justified order of society. The seduction of neoliberalism lies in its ability to speak to elitism, to nurture a narrow coterie of elites that run modern neoliberal organizations. For these elites, inequality is an accepted part of organizational life and elite privilege is a natural product of the "hard work" and "god gifted ability" of the elites.

It is this very logic then that creates a culture of non-transparency. The sense of entitlement adds as a convenient justification for creating opaqueness into the management of organizations built on elite logics.

"To the extent that I am better than the rest, I can make up the rules of the game and make sure that these rules are not visible to others."

For the elite, rendering organizational processes opaque is a byproduct of not having to respond to people of inferior quality.

"To the extent that I am ordained to lead by virtue of my superior qualities, I can run the organization whichever way I want to run it, retaining the power of decision-making in the hands of my elite network. I don't have to make transparent my processes and frameworks of decision-making."

Elitism thus perpetuates the hegemony of the elites, ensuring that decisions about outcomes, rewards, work distribution etc. are rendered opaque to organizational members.

Saturday, April 23, 2016

The language of meritocracy, the workings of power, and the lack of accountability

One of the challenges of an organizational structure built on the rhetoric of meritocracy is its inability to put checks and balances in place to hold accountable the structures of power that are accumulated through claims to meritocracy.

The logic of meritocracy works precisely on the acceptance of inequality as natural to a structure that is built on merit, with merit standing in as a signifier of capability.

Inequalities are justified to the extent that they are based on differentials in merit.

Inequalities in differential labour, differential assigned workloads, differential pay structures can all be justified to the extent that they can be justified by some claim to merit. The powers that be in meritocratic structures determine the rules of the game to justify these inequalities.

Now all of this would work in a meritocratic system if the system was devoid of the workings of power and the traps to equal access that are put up by structural differences in access to opportunities.

In the concept of a meritocratic structure, once one has achieved the markers of what constituted merit, he/she has an opportunity of being part of the system. This logic would of course work if a meritocracy was based on continual evaluation on the basis of clearly articulated and transparent structures, with checks and balances of accountability built into the system such that those who were once in but have failed to perform to the standards of merit are automatically filtered out, making place for new power players in the system by virtue of merit.

In other words, for meritocracy to work, the rules, processes, and guidelines would have to be transparent to organizational members broadly, and opportunities would have to be extended equally so every organizational member has a chance at merit.

However, meritocracies are not devoid of power. Quite the opposite. Once through some claim of meritocracy one set of actors have been incorporated into the structure, it is of ultimate interest to the power brokers within the system to maintain their power. The maintenance of this power can now be achieved through the changing of rules, creation of new systems and new metrics that would serve the interests of power, and that are overall directed toward servicing the control of the power elite. In many instances in organizations, these rules are not transparent and are not available to all organizational members. This lack of transparency then keeps intact the power structure while keeping those in these structures out of the lens of scrutiny. Inequalities produced by the structures are continually justified without any accountability to organizational members.

Power in a meritocracy thus makes sure that new rules, standards, and arguments are propped up to retain and propagate power, maintaining intact the status quo. In organizational structures, these workings of power retain as intact the dominant modes of circulating power, simultaneously consolidating additional power in the hands of the meritocratic elite. Inequality thus is continually perpetuated in meritocracies that work by perpetuating differentials of access and differentials of labour, opportunities, and rewards.

Accountability in such systems is lost as structures don't really create opportunities for remaining accountable. The logics of the organization and its rules are not rendered visible in such instances, ensuring that inequalities are perpetuated.

Friday, April 8, 2016

Attack on academic freedom across Indian Universities: BJP’s saffronization agenda



In global education, established universities are seeking partnerships with India to build their brand presence in the country. Noting the large market for education in India, multiple international institutions are exploring building partnerships.

For these institutions, while building linkages with India, it is vital to make note of India's most recent round of attacks on academic freedom. Partnerships and collaborative works with Indian universities stands threatened in a climate that is actively seeking to thwart academic freedom, silence thoughts, and turn education into a skills-mill. While the skills-mill approach may sound enticing for a global partnership, the drawback of such a skills-focused approach is its lack of engagement with critical thought.

Education in many ways in India now is being modeled into a factory for producing obedient workers for the global neoliberal economy. Add to this training in obedience an unhealthy dose of nationalism filled with perversions of history, you have a model of education that can hardly be called education.

Since coming to power in 2014, the Narendra Modi-led Bharatiya Janata Party (BJP) government at the center in India has systematically orchestrated attacks on academic freedom across Universities in India. The impetus of these attacks has been on silencing dissent, with an active agenda toward thwarting any critique of the BJP’s narrow idea of a Hindu nation state and its model of growth-driven development.

These attacks have been accompanied by strategic efforts by the BJP to place at the helm of University decision-making individuals who are aligned with the BJP’s Hinduization agenda. These BJP-installed decision-makers are seen by the state as instruments for redoing the curriculum and the research agendas of Universities, turning toward the teaching of Sanskrit, the discoveries of ancient Vedic science, and the reformulation of teaching as practical skills-building to serve the narrowly conceived agendas of economic growth.

Education, reworked in a saffronized imaginary, is seen as an instrument for reintroducing the ancient knowledge of India from its Hindu past. Education, thus, is reworked into a script for investing Indians with nationalistic pride.

In BJP’s strategy of redoing India’s education, Universities as spaces of critical thought are antithetical to the progress of the nation state. The vision of the nation conceived in the image of Hindu growth has little room for critical thought that is seen therefore as anti-national, against the goals of the nation.

Concerted efforts have been carried out in attacking criticisms of India’s regressive caste-based Brahminical culture, interrogations of the increasing saffronization of the country, and criticisms of India’s death penalty or of the oppressions carried out in the hands of the Indian army in spaces such as Kashmir and Northeast India.

Earlier in 2015, a Dalit (meaning “oppressed” in South Asia, a broad category comprising of the scheduled castes, scheduled tribes and other oppressed groups) student leader at the University of Hyderabad, Mr Rohith Vemula committed suicide after having been unjustly treated by a University administration directed by the BJP government at the Center to take action. Rohith was a member of the Ambedkar Students Association, a dalit student group and was protesting the hanging of Yakub Memon, a convict in the 1993 Bombay bombings. The attack on the Ambedkar Student Association reflected the caste politics of the state, mixed in with its impulse to label any critique as anti-national.

The recent round of attacks on the hallowed Jawaharlal Nehru University (JNU) further depict the relentless nature of the efforts to cleanse Universities. On February 9, 2016, a small group of students at JNU had organized a cultural event ‘A Country without a Post Office’ to question the unjudicial hanging of Mr. Afzal Guru, who was allegedly involved in the attacks on the Indian parliament in 2001, and in solidarity with the people of Kashmir.

Accusations of anti-India slogans raised at the event formed the basis for the arrest of the President of the JNU Student’s Union Mr. Kanhaiya Kumar, followed by arrests of students Umar Khalid and Anirban Bhattacharya accused of raising the slogans. Used as evidence for the arrests were doctored videos broadcast by TV channels and circulated on social media. The police are yet to offer concrete evidence that the arrested students had raised the slogans.

How the doctored videos were circulated suggest possible involvement of the BJP in the creation of the story. For instance, investigations reveal that Ms. Shilpi Tiwari, former aide of the Union HRD Minister Ms. Smriti Irani, planted and circulated the doctored videos. Moreover, the BJP spokesman Mr. Sambit Patra played the doctored video(s) on network Television, thus framing the students as anti-national. The attack on JNU students by the state was accompanied by orchestrated media attacks on the basis of the doctored videos that constructed the students as anti-nationals.

The depiction of the accused students as seditious sought to catalyze mass hysteria. Home Minister Rajnath Singh warned “Anyone who raises anti-India slogans or tries to put a question mark on nation’s unity and integrity will not be spared.” Singh then suggested that the JNU event had the backing of the Lahore-based Lashkar-e-Taiba chief Hafiz Muhammad Saeed, following a tweet by an unidentified individual impersonating as Saeed.

Similarly, the Union HRD Minister in charge of Education observed: “The nation can never tolerate any insult to mother India” and went on to deliver an address in Indian parliament attacking the students. BJP-affiliated politician Subramanian Swamy demanded a temporary closure of the University and a complete cleansing of the University. The disproportionate actions of these BJP leaders raise questions about the underlying motivations behind the cooked up controversy.

More recently, arrests have been carried out at the Tata Institute of Social Sciences (TISS) in Mumbai and the University of Hyderabad. The responses by the state point toward a concerted effort to delegitimize the University as a site of thought and to undermine spaces of thinking that interrogate the BJP’s vision of creating a Hindu India. The anti-national propaganda campaign has been strategically directed at portraying students, professors, and their university as a threat to the nation, feeding into a national media and public frenzy to shut down debate, conversation, and difference.

This most recent attack on JNU is part of an ongoing campaign against Universities in India, witnessed earlier in Film and Television Institute of India (FTII), University of Hyderabad, and more recently, Allahabad University.

Across these spaces, thought is in jeopardy.

To think, in the imaginary of Modi’s “Make in India,” is to be anti-national.  

Globally, institutions of higher learning need to think cautiously and carefully when building partnerships in India. To build collaborations in spaces where freedom of expression stands threatened is to give in to the silencing of knowledge and thought, simply because it is inconvenient. Countries and universities that are exploring collaborations in the Indian education sector without giving serious consideration to questions of academic freedom are equally at fault as Mr. Modi's authoritarian regime.