So Part III in the Female Genital Mutilation Saga


A Skepchick writer has come out in favour of the Lisa Wade’s article in one specific way

No one likes to be told what to do? Especially by people outside the culture if they are using language condemning a practice that is harsh.

The problem is Lisa Wade poisoned that one point with the rest of her post. “With Therapy” women will have a normal sex life doesn’t excuse protecting a practice. With therapy a broken leg will heal, doesn’t mean running someone’s leg over with a car is harmless. She covers up harm and uses language legitimising a practice and treats it as a medical procedure.

The piece in from Heina refers to Ophelia’s and Zinnia’s pieces on the topic mentioning that they are facts of FGM light. And to be fair I had just run my “primer” on FGM earlier so I figured they didn’t go into the details about it because if people asked they could just go “Look at Avi’s Stuff” rather than hammering out the same primer. That’s my defence of why they didn’t really go into the details of the subject.It does ask a question though and I think the problem is at the crux of the issue where Lisa Wade failed in her argument. It is not a strength.

Neither, however, address what I find significant in Wade’s piece. In response to Wade’s claim that “people don’t appreciate being told that they are barbaric, ignorant of their own bodies, or cruel to their children,” the latter said:…

While it is true that Wade’s piece does not discuss many of the harms of FGM, that particular point made in the Sociological Images post is not as much of a platitude as one might think. Most conversations about FGM among Westerners not had by sociologists and other such academics indeed center around some version of “Ugh, that’s so horrible and disgusting! Who would do that to children?!” at best, and, at worst, a variant of “Let’s kill the monsters that do this!” This corroborates some of what Wade initially posits: Westerners’ reactions are highly informed by their particular perspectives in ways that they might not fully comprehend. To them, it’s clear and unquestionable that FGM is bad and that its practitioners should feel bad.

To understand the problem of this I will have to tell you an anecdote. An anecdote which is at the heart of another quackery movement of the Natural Home Birth.

Majority of Indians still live in rural sectors away from the technology and wealth of big towns and cities. Around 700 million Indians are considered at or below the international poverty line. For most Indians the city is a dream, which explains Indian movies (They aren’t aimed at the city dwellers) where often laughable achievements for us are considered massive ones for the hero because the people who love these movies are not the pampered kids of the city but the hardened people of the villages who often go watch a movie as a treat or as a massive event. The ownership of a expensive phone, fighting injustice and of a car are power fantasies that best appeal to the under dog. It explains the fairy tale quality to Indian movies, because the people who love them want a little escapism. They have enough tragedy in their life without having to deal with the themes behind Schindler’s List.

The majority of childhood mortality in India is in this sector. Today roughly 5% of children born in India will die before their first year. This is a remarkable achievement. When I was born close to 10% would die before their first year. If I was born in India there would be a 1 in 10 chance I wouldn’t be here to bore you all.

So what’s the fall in part due to? A revolution in home birth. 70% of Indians undergo home birth. Naturally this is something that the average home birth advocates love to mention. That the Dais (traditional midwife) who dropped the Infant Mortality Rate (IMR) in India without answering the question as to what Indians used to do before the Dai? Dais dropped the IMR rates because the tradition behind the Traditional Midwife was destroyed through education and equipping them with modern technology and some education. The Dai just changed.

The Indian Dai is probably closer to a Nurse Practitioner Midwife than a Certificate Practitioner Midwife in the west. They are paramedical personnel given crash courses in modern obstetrics and given medical kits that they can easily use to reduce neonatal and infant mortality rates as well as maternal mortality rates. They encourage vaccination, breast feeding and often help with the supplementation of the mother’s diet through various schemes such as the ICDS and in the fight against anaemia in addition to midwife duties. This causes an effective fall in deaths. The traditional midwife despite being called that is anything but.

But in order for them to do this they had to destroy the culture of traditional midwifery. Such as the practice of anointing children with cow dung which is a Hindu religious practice that died out in the cities because we know about bacteria and other septic practices we know to be unsafe. This is a western piece of knowledge. Indians thought “fuck this noise, culture be damned, we don’t want 10% of our babies to die for the sake of culture”. So they fought the practice. We still fight the practice because it is still present. Babies fall sick, babies die from it. Priests and holy men still argue for it but the facts speak for themselves. The women who go to the trained Dai have lower maternal and infant mortality than those who go to the untrained dai often by a factor of 50% lower. The women that seek the infamous “medicalised births” as hated by the natural birth fans in the west have the absolute lowest rate with some hospitals matching western standards. Culture and tradition have made way to common sense and the thing is people have gained out of it rather than lost.

But it is a “western” practice that we are doing. These things aren’t native to India. We are “forcing” a new practice and eliminating an old one.

This is where I must point out why we think like this. There is no such thing as western and eastern medicine. That is a misnomer flogged by the alt. med groups to portray Eastern Medicine as a different ethic and science to western medicine when it is really quackery. There are things that are “Asian” in origin that are now part of medicine (Short list? Cataract Surgery, Rhinoplasty, Internal Fixation, Septoplasty, Pleural Drainage, Tracheostomy, Opiate medication, Vaccinations…) but we don’t flog those as eastern medicine. There is medicine and there is quackery.

There is an idea that these notions are solely western. That we are forcing our beliefs on others because we automatically think our culture is superior and that we suffer from sort of white man’s burden. When it is not the case. It is high arrogance that we assume that people cannot grasp the benefits of doing something. Asian, Arab and African people are not infants, we can hear bad news about our actions. It’s incredibly irritating to hear someone say that we are going to get insulted by hearing that we have problems. If you think like that then you are confusing “being insulted” by something with “denying a problem exists”.

Things that are wrong with Indian culture? Caste System. Female Infanticide. Corruption. Sexual Violence. Repression of Women… Plenty of things. Coming out and criticising them may not be what some people want to hear but it is what they NEED to hear. The caste system is older than western civilisation. Greece and Rome fell and Europe was plunged into an age where people we considered advanced for the age started living in hovels in the ruins of civilisations that built arches and domes (Architecturally speaking, to a dark age european the dome would have been akin to witchcraft since it’s construction was not known). It took nearly a 1000 years to get back to an equivalent stage of development. European society fell and rose and all the while the caste system has been there. It pre-dates Judaism but it is evil as evil can be. Calling it for what it is may hurt the feelings of those who believe in it, but it is evil and the damage it causes harms countless millions. And there are people who fight that in India who call it evil. Me going there and saying it is evil will get me called a variety of choice words by people who think caste is important but it will also get people who fight caste to come and agree with me. Me going there and supporting those who think the caste system is important and vital is just a dick move. The equivalent argument Lisa Wade made was like saying “Oh? Untouchables can make more money than Brahmins so we shouldn’t outright portray all the untouchables life as worse than slavery”.

What does this mean with regards to Female Genital Mutilation (FGM)?

You are confusing a knee jerk response of people who see such horrible things. Most of my readers live in a bubble (even in India since city life is so much different from rural) of luxury that they often don’t realise. It is easy to look at something horrific and go “STAHP NAO”. Because that’s what a reaction is. It’s knee jerk. It’s not thought out. I argued as much on the Lisa Wade piece where people didn’t grasp why many countries don’t outright ban a practice citing the binding of chinese women’s feet as an example (and mentioning Sati too) without realising that those bans were enacted centuries ago. I got accused of mansplainin even… You are looking at the end result of a campaign. In addition to call Chinese laws harsh is to understate the fact that the country isn’t a free nation and is a totalitarian state. Not as much now as it used to be but it was once a place where different cultures were not respected. It made it easy for it to solve problems like out of control birth rates and indeed foot binding with incredibly draconian laws. Laws that simply would not arise in a democracy. Let’s take Sati. It took more than 500 years to stamp out and even now the occasional one still occurs. If we look at Slavery in the USA and anti-black racism you still notice that racists are still around. Slavery was halted nearly 160 years ago. It took a little over a hundred years to stop apartheid in the USA. Culture changes slowly and anyone out in the field knows that. FGM is not going to go away and there will be millions of women who undergo the procedure over the next hundred years or so but it will be a smaller and smaller number. The work we do know will create a core of women to fight against the practice and to create the political drive for change and elimination of this practice. We are not going to defeat it in my lifetime. We will probably make my child’s or my grandchild’s world a FGM free one but for that you need to lay groundwork.

But you have to fight it. It is a horrible practice and the reason women do it to each other because women have always done it to each other. Now the problem in fighting the issue is that you need legislative changes in the country where these things happen to go along with changes on the ground. The current problem is that there is very little drive in these nations to stop the practice and in some cases there is a government green light to do these things. You aren’t fighting downhill like against smallpox or polio. You are fighting this fight uphill. You need governments on board to produce systems to stop this kind of thing.

Yes education is vital. Yes I understand, White Man’s Burden was written about my people you know… But education is fantastic. Because education of people works. To treat people in developing nations as somehow incapable of learning is just harmful. They are you, only with a lack of opportunity. Education gives them the tools to know why the things they fight are bad. I noticed a comment on the Skepchic article where someone says that they don’t like the term “education” because it has historical baggage of civilising the savages. Which is why we are going to play a little game. Because this notion is one of the major problems you face when you want to try and spread awareness and information about a disease.

A simple little game. You are denizens of the Internets, your Google Fu is strong which is why we shall not test it. Even medics get some of these wrong. I am going to expose a little lack of education in our privileged upbringings. Just to point out why we do certain things the way we do it and often don’t realise it.

1. What is the most common genetic defect in Humans?

2. How do Shoes save lives?

Please do not Google this. Just answer honestly in the comments what you think it is. It’s vital that you are honest about it and don’t go find out because it demonstrates the point that you don’t honestly know. Pass it onto your friends. See what they say. Let’s get this going and put down some answers in the comments. I will give the right answers in a few days but for now just let’s see what you savages know.

Education is a weapon, it is the deadliest of weapons against this sort of thing. There are people in India who hang themselves from hooks to teach people that the men who con them are nothing more than just men. Education killed smallpox. Education killed polio. It fought leprosy and it will kill it. It is fighting AIDS and every other disease and ailment of mankind. It will kill FGM. It just needs to begin right now. And Lisa Wade’s piece was not education. It actually misrepresented pieces which talked about sexual dysfunction and ignored parts of papers which spoke about known side effects of the procedure. Education is my deadliest weapon and slaughters billions of things that make human lives miserable and short. To claim that sharing it with those who lack it is just painful to hear. It is an elegant weapon for a very civilised age. Maybe it’s my upbringing but in hinduism education is considered divine. Knowledge is the domain of the creator’s wife, you don’t pray to the creator. There are no temples to him. No prayers or rituals. Everything is aimed at his wife whose domain is knowledge (The prime gods are Brahma, Vishnu and Shiva. Brahma is not prayed to. They are the Creator, Preserver and Destroyer. Their wives are Saraswathi, Lakshmi and Parvathi who are the domains of Knowledge, Wealth and Destruction and Rage) Maybe that’s why I think education is awesome and why everyone should be educated… But I know for a fact that people take it for granted. Education will help us fight FGM by telling people the problems with FGM and and the problems with doing it to women and create a understanding that the practice is wrong.

And this is all FGM we are talking about. Not just infibulation. Clitoral stimulation is vital to the sexual health of women. Sure you can lose the clitoris and still have a vaginal orgasm but you have lost a method of pleasure.

Yes I understand that people are frustrated that nothing has changed in our lifetime but remember this. WE HAVE JUST STARTED FIGHTING THIS. We are at stage 0. We are at the beginning. We have just inserted the token, we have just picked out the scotty dog. We are laying groundwork for the future. It is a journey of Snakes and Ladders and we have just rolled the dice. We have a way yet to go but the first roll of the dice is the hardest because sometimes you end up back at square one. There is progress, you just don’t see it yet. We haven’t been fighting long enough to create the kind of change that satisfies us.

When MSF went to Port Sudan and set up their landmark Obstetrics unit that fought against Infibulation women didn’t come in because MSF refused to reinfibulate after the procedure was done. They had almost zero cases. Now they see 300 cases a week and oversee 25 deliveries of women who are not reinfibulated. They also were accompanied by local education schemes where they told women that the procedure was wrong and harmful. Alongside prevention they were out undoing the stitches from infibulation. Word of mouth quickly spread and women who had the procedure now work for them and tell others what they have done and all the changes that have happened. They tell women that they won’t do that to their daughters. They tell their sons that the reason for the procedure is stupid. They are changing the culture by punching at an individual level. Eventually these women will influence the politics and make changes there. Then the avalanche of change will occur. And the speed of change will pick up. For instance? In South India the female foeticide and infanticide rate was as high as the North. Now? Out of 1000 males there will be 980 female babies. Just 20 are aborted. In parts of the north the rate is sometimes as high as a 200 abortions… The change was rapid once the groundwork was laid out. The South had the advantage of more infrastructure since Madras was once the British Capital rather than Delhi or Bombay or Calcutta. So the changes were enacted rapidly while the North lags behind due to the initial infrastructure gap and compounding issues such as corruption, caste warfare, naxalite insurgency and outright religious shenanigans.

And I must repeat this because so many people don’t realise this. The majority of aid workers who work in developing nations are not international. They are local workers. The people who come from abroad are usually skilled workers who are simply unavailable locally. You are not some white hero showing up to Last Samurai/Dance with Wolves/Avatar the situation. You are a technical consultant. A medical mercenary. Your job is to provide a temporary service while they train up the local equivalent of you. You may even train up your own replacement. Your job there is highly temporary. Even during major disasters. Once the situation is under control and there is no threat of escalation you usually go home. EVERY and I mean EVERY medical charity worth anything in this day and age is armed with a host of locals who actually do the heavy lifting. Now in some places there may be no experts but honestly those are rare. They are the exception rather than the norm.

The WHO is a massive international organisation, but it works through grassroots organisations which it trains and equips and provides technical support to. MSF set up grassroots services using it’s colossal technical expertise considering it has the largest pool of doctors, nurses and paramedical staff. Orbis do the same with opthalmology. The Red Cross may have the biggest presence but it’s because it actually is a massive international grass roots organisation where it uses it’s massive international clout and indeed works with bodies such as MSF and WHO to do grass root level aid and train up replacements. Just because you work for one of these organisations doesn’t mean you have no grassroots contact. You are more than likely to BE a grassroots employee. Someone from the culture, the area and often from the villages hired to spread education and the necessary changes. Even kids are involved because I know of a lot of vaccine related education in Africa that is taught to children who put on skits on immunity (Like “RAWR I AM A MACROPHAGE I AM GOING TO EAT YOU! YOU EVIL BACTERIA! OM NOM NOM NOM! skits) that’s devastatingly cute but also informative to their parents.

Change will occur. You can speak of knowledge (The Lisa Wade article was NOT knowledge since it misrepresented some papers. Zinnia read through it a bit more thoroughly than me because I had one of my qualification exams today and I needed to study.) while still condemning a practice. You can call something barbaric and still support a grassroots change. It is a bad practice, it needs to stop. Medically and Scientifically it is a procedure with only disadvantages in every single iteration of it except in some rare cases. Saying so is only insulting if you think you are divinely required to do something or you know that somehow not doing this procedure would do some nebulous and horrid thing to society. There are probably more Africans, Arabs and Asians who fight this than people in Europe and the Americas. It’s just that you notice people in Europe and America because they are the voices you hear since they exist in your monkey sphere. But here is the thing? If you guys didn’t make so much of a fuss about FGM I wouldn’t have had to write my original primer which still condemned the act but informed people about the different types. Now I understand that I don’t have the reach of people like Zinnia or Ophelia because I just moved to the bigger stage but I know a few hundred people will see this and I hope some people will see my way. But these people will spread the word and the way we think will change. We will stop having the knee jerk responses to either say “KILL EM ALL” or “YOU ARE BEING A WHITE SAHIB” and realise that the reality is that change is occurring. It’s just that we are impatient.

[notice]A quick reminder to those wanting to post a comment. Thanks for reading the giant wall of text. Can you please write down your guesses in the comments. I do like reading what you guys say and especially in context of this piece the answers to the two questions I asked are vital to demonstrating that we take things for granted and have an absence of knowledge. Thanks for your time![/notice]

People don’t like being told they are wrong. But you have to tell them. We had to tell people who smoked that their habit was dangerous. We had to tell racists that that their views are bigotry. We have to tell pro-lifers that their views harm women. And we have to tell people that FGM is a terrible practice that only does harm. Just because you don’t like what we say, doesn’t change the fact of what we say. The cardinal rule when responding to anything that raises ire is to count to ten and in that time think about why someone would do this and think of ways to change it.



  1. Ashley F. Miller says

    Shoes prevent parasites like hookworm, but also protect against cuts that can get easily infected and snake bites.

    I think congenital heart issues are the most common birth defect, but I don’t know if they’re necessarily genetic, but I know different populations have different common defects so what is most common in the US isn’t necessarily what’s most common worldwide since Asia makes up most of the worldwide population.

  2. says

    1. Most common birth defects: heart disorders. Second: orofacial clefts. Clefts are the most common visible defect.

    2. Shoes can prevent common parasitic infections.

  3. bobo says

    1) near-sightedness?

    2) shoes protect feet from cuts, scratches (which can lead to infections) and parasites

  4. says

    1) Downs or trisomy 21? Not allowed to Google it so probably wrong about the trisomy bit… Also I suspect that since it is more common with age it might not be so prevalent in places like India and something like achrondroplasia or dwarfism is more common… Now I’ve guessed two and probably spelt them both incorrectly!

    2) Well I was going to say cuts, but that looks popular so I’ll try something else. Shoes allow you to work on your feet for longer, gather more food and travel further so you are more likely to survive with the advantage that affords.

  5. says

    1. My guess is trisomy 21. I remember it being incredibly common, at any rate. I’m curious to find out what the real answer is, though.
    2. Prevention of infections and parasites through small cuts and cracked skin in the soles of feet? It’s easy to forget just how deadly infections from minor wounds can be.

    People don’t like being told they are wrong. But you have to tell them. We had to tell people who smoked that their habit was dangerous. We had to tell racists that that their views are bigotry. We have to tell pro-lifers that their views harm women. And we have to tell people that FGM is a terrible practice that only does harm.

    It seems as though some people from the “we can’t possibly offend people by telling them it’s wrong” camp assume that taking a hardline stance against FGM is equivalent to showing up in a rural community with a bullhorn and screaming at elderly women that they’re child abusers. Yes, there have been efforts that have consisted of little more than foreigners telling everyone how awful FGM is and then leaving with no real impact, but there are other options between that ineffectiveness and refusing to openly condemn it at all.

    Providing international assistance to grassroots movements and spreading genuine education are some of the best options.

  6. says

    Hmm I’d say that shoes protect the feet from cuts etc though I know that people who don’t where shoes get a more callused foot so it might be protected fine that way.

    I have no idea what the most common genetic defect is but I’ll go with Red green colour blindness as all the recessive cases in men present while other problems might stay hidden more often….

    Look forward to be proven wrong ^.^

  7. Cuttlefish says

    Most common genetic defect? Presence of a Y chromosome, which is associated with countless problems, from increased aggression to higher likelihood of color-blindness. Roughly half the population has this defect.

    Shoes? They keep you from tripping over the hair on your toes.

  8. maxdwolf says

    1) I guess near-sightedness. I’m a little biased here, as I’m terribly myopic. I’m told by some that the high rates of it in our society are due to stress from screen time and reading. I suspect however that there is no research backing this up and that the claim is a vast exaggeration, if not entirely false.

    2) I understand some parasites that have evolved to feed on us require entering the skin of our feet as one step in their life cycle. I had not considered the laceration angle that bobo brings up, but it makes sense. I used to go around barefoot a lot as a kid and have the scars to prove it.

  9. Pierce R. Butler says

    Regarding the shoes: schistosomiasis, aka bilharzia, a nasty disease caused by a parasite transmitted by snails and epidemic in tropical river areas, attacks through bare feet: shoes provide a condomoid function.

    Most common human birth defect? My initial reaction was “Y chromosome” – yeah, guess what kind of mood reading about FGM puts me into – and my second was “lactose intolerance”, but both of those are considered adaptational in some circumstances.

    If I hadn’t read Prof. Myers’s comment above, I’d probably have said something about mental handicaps – but that’s a very broad category and useful only to get me classified as a lumper by medical taxonomists. So – what he said.

    As for FGM: I’ve seen it claimed that the practice varies widely, ranging from a sterile and minor trimming of the clitoral hood to a brutal gashing with a broken bottle, and tend to agree with the principle that reactions should vary with the actual harm done. I have yet to see any field-work-based numerical report on the actual extent and variety of the practice, but must admit the subject affects me in such a way that I haven’t looked.

    OT: I really really really hope all the other FTBloggers will do what you did, in their individual ways, with the new mausoleum-themed background “art”…

  10. dandelionc says

    1. No idea. I’m going to guess the most common genetic disorder is… Marfan’s disease? Maybe that’s covered by things that cause heart problems… I think Lincoln had it.

    2. I think the same stuff everyone else said. Shoes prevent cuts, broken toes, infections, parasites, etc.

  11. says

    I think Pierce R Butler wins no matter what for his use of the word “condomoid”.

    Oh and a lot of people didn’t read PZ Myer’s comment because it always shows up as spam and need to be recognised separately. Keep going this is rather good (Some people have got it right BTW…) But it does show that despite the fact we do something really sensible we don’t know why we do it…


  12. bobo says

    Hey, as an analogy, how about toilets?

    I was watching a program, “architects of change’ and apparently many people throughout the world do not use toilets, and are in fact horrified at the very idea. Due to this practise, these people get sick a lot – defecating into their water supply that type of thing.

    Since, ‘culturaly’ they have never used toilets, and are horrified at the very thought of it – couldn’t one, if so inclined, make the argument that ‘snooty westerners are being mean to indigenous peoples by getting them to use toilets. Toilet use isn’t natural for these people, stop being such cultural snobs you sillly westerners, poking your nose into other peoples business!”

    Of course, noone makes that argument, b/c it sounds sillly. But when it comes to a ‘cultural’ practise that involves the mistreatment of women…well suddenly we have to be more accepting- right?

  13. Fred Salvador - The Public Sucks; Fuck Hope says

    1) Ginger hair.
    2) Because tarmac is hard.

    That is to say, I have no idea. Human beings aren’t my field.

  14. says

    @ Bobo They aren’t horrified by toilets, they just don’t see the need to have one in the same way that you don’t really need to worry about fuel prices until you have a car…

    Because they don’t see the link between open air defaecation (don’t look so smug… In the 1940s people in the USA still didn’t have access to proper sewerage) and the diseases they caught because they didn’t understand how bacteria and viruses spread.

    (FYI the position of defaecation for this kind is actually “better” than what we are used to. You can try it with your own “western style toilet”. The next time you feel the need take a stool with you and prop your legs up on it. You will feel much much better because it imitates the natural posture more. There are newer toilets being constructed that come with either slide away leg rests or sunk lower to the ground to give you this posture but you can get it for free by just propping your legs up on a cheapo footstool and going to town…)

    This is an example of a cultural practice that would benefit western society that actually has low uptake because people think the position is not as good because it “looks uncomfortable”. Honestly? Give it a whirl and be surprised…

  15. says

    My first thought on the most common genetic defect was colour blindness. But really that’s just a guess; the true answer is “I don’t know.”

    Shoes prevent life-threatening infections in diabetics, hookworm infestations, broken toes (which really impede mobility over the long term; been there), fatally infected injuries in malnourished people, and bilharzia. Oh, and bites from various insects, spiders, and even rats and snakes. (I like a good boot for hikes in rattlesnake territory.)

  16. felix says

    1. Short eye sight or colourblindness?
    2. Shoes save lives by stopping the penetration of parasitic worms in to the body. (Hook worm??)

  17. lsamaknight says

    My first thought as to the most common genetic defect was: Not a clue. Second thought was: How are we defining defect because there’s at least one mutation (the infamous cause of sickle cell anemia) that is only a defect when there are two copies but an advantage when there’s one copy.

    As for shoes saving lives it would be that the help prevent cuts on the soles of your feet that can then get infected.

  18. jboggs says

    1. What is the most common genetic defect in Humans?
    2. How do Shoes save lives?

    1. I was thinking cleft pallet, but I’m not seeing anyone agreeing :p

    2. Lots of parasites get in through the soles of your feet! This is come folk knowledge imparted to shoeless Kentucky children by their elders. Also, I’d suppose shoes protect you from harsh terrain, resulting in fewer injuries to the skin, and fewer opportunities for infection to creep in.

    Really couldn’t say which is deadlier.

  19. Daniel Schealler says

    1) Most common genetic defect in humans

    No idea, honestly.

    Not even sure what would or would not qualify as a ‘genetic defect’.

    For example: Lighter-skinned people are more vulnerable to sunburn than darker-skinned people. Is lighter skin therefore a genetic defect in that regard? Perhaps, and perhaps not. Depends on what we call a ‘genetic defect’.

    What about lactose intolerance in adult humans? From what I understand, adult lactose tolerance is the norm in as much as the last common ancestors of all living humans would have had adulthood lactose intolerance. The neoteny*-style mutation that allowed for childhood lactose-tolerance to extend into adulthood was the mutation. Is the lack of a beneficial genetic mutation the equivalent of a ‘genetic defect’? Perhaps, and perhaps not. Depends on what we call a ‘genetic defect’.

    Interesting question. I’m interested to hear about the answers.

    2) How do Shoes save lives?

    I’d guess here that it’s protection against infection, particularly in the case of parasites such as roundworms. (But now I think about it, that’s murky as well – I’m pretty sure that clean drinking water is probably the real life-saver in terms of infections from these sources… So yes, hesitant here as well.)

    * Disclaimer: I did a Google search to double-check the spelling of neoteny, because my browser spell checker didn’t know what to do with it.

  20. LF says

    2 Rather than the obvious of shoes stopping damage and protecting the feet. which they do do. Perhaps it is more important that people take them off before going inside a dwelling.
    Particularly important if you live in a slum walk through and past open sewers and your family eats sitting on the floor.

  21. briane says

    1. Most common genetic defect: being born, causes potentially years of pain.
    2. Shoes save lives, especially for short people, because hobbit hunters open fire on bare footed humanoids without further attempts at identification.

  22. says

    Isn’t deafness/impaired hearing the most common congenital defect? But by ‘genetic’, you mean the most common heritably transmitted. Do you thus refer to a (recessive) gene (CFTR?), or a phenotype?

    Shoes? Inexhaustible demand means a (sweatshop) industry providing (meagre) livelihoods for (exploited) people who might otherwise starve.

  23. GregB says

    1. Extra finger/toe

    2. To prevent fungal infection

    Nice article. I’m reminded of the conversation held a few years back over whether or not doctors should allow “ritual cutting” as a way to a) minimize the harm of FGM (the practice involved no real physical damage) and b) getting into communities which would otherwise surely simply ignore the “evil Western busy-bodies” and perform the usual, horrible practice.

    Where is the hard line between patronizing and effective, and when should you cross it?

  24. 742 says

    for the shoes: parasites and/or cuts that are hard to keep clean so prone to infection (both even larger worries w/out sanitation)

    for the genetic defect … … um… ima go with vampirism. could you more clearly define ‘defect’ so i have more time to stall?

  25. eowyn says

    first thoughts:
    1: Down’s syndrome.
    2: if you take shoes off before going inside, you avoid carrying some bacteria inside to the living area.

  26. Second Thought says

    My guesses off the top of my head:

    1. Most common genetic defect: near sightedness
    2. Wearing shoes saves lives: by protecting feet from cuts which can get infected or let in parasites

  27. rhea says

    A lot of factors that contribute to maternal deaths in villagers are due to ignorance and sexism, girls pregnant too young, bad diet, poverty etc. agreed, agreed, yes it can get pretty bad. Sexism is pervasive and it takes a lot of effort for the government get through to them and I laud that. But since you decided to use Indian villages as an example, I’d just like to point out to the people reading this, because the example can give the impression of general ignorance, that we Indians had/have a very rich culture surrounding home-births and and mother/infant care before hospital medical care came along, it’s something that I personally explored and experienced pre and post childbirth, even as a city dweller. A lot of my friends benefitted from this ‘traditional’ therapy, and not all of it is crap. This does not mean I’m dismissing modern medical care, I had mine in a hospital, but I’ve noticed a lot of medical practitioners dismissing traditional recovery processes like diets that speed up post-partum recovery and therapeutic massages that help prevent back pain and also ensure the mother take better care of her baby as hokum. Diets that can also help a mother who is lactating poorly to produce more milk for her baby. Ayurvedic medicine that helped me recover my poor immunity that vitamins tablets did shit for, and my aunts and mother and grandmothers benefitted from. Some of it would be considered valid as a recovery process today. Passed on mother to daughter, to ensure the health of the mother and the baby, from my mom’s village, her mother’s village, her grandmother’s village. Yeah, ‘rural’ India. Perhaps somewhere along the line the mother/daughter chain was broken and ignorance crept in, but back then it was sacred and childbirth being women’s business, it was all they had to go on. Seeing a skinny child I’ve seen plenty of old biddies ask “don’t you breastfeed?” Again, tradition, it was all they had to go on, they had many many children, and they saw good results. Many an Indian mother’s sense of self-worth is ‘traditionally’ directly related to the health of her child, and this includes healthy food made from scratch. Perhaps we someone to do a PhD. on it, then it would validate my experience, but I don’t like the idea of someone painting traditional Indian midwifery and therapy with such a broad brush. This is what Sociological Images keeps insisting on, a balanced look, however the cultural relativism and the selectively produced facts in their FGM piece made them look bad, and here you’re making us look bad. There is another side to this, a good, positive side.

  28. bradleybetts says

    “1. What is the most common genetic defect in Humans?

    2. How do Shoes save lives?”

    1- I have no idea.

    2- I would guess that they protect the feet from cuts etc. which could turn septic and from snake bites and other nasties. But that’s just a logical guess, I don’t actually know.

    Great post Avi, very informative, as usual. I’m with you on the FGM… I couldn’t give a fuck if it’s cultural, it needs to stop. But equally you can’t hate people for being a product of their environment.

  29. bradleybetts says


    No one suggested that all traditional medicine is without merit. Just that a home birth is never going to be as safe as one in a hospital and that Indian traditional midwifery has been improved and enhanced by educating practitioners in modern first aid and trauma medicine. You’re seeing a denigration where there was none.

  30. rhea says

    Then mention it, have a disclaimer, (something that I did when I mentioned modern medicine, by the way, read my original comment again.) Do some research or acknowledge that your references might not be infallible, it one story amongst others. The overall tone is generalizing, and give the impression to someone reading it and doesn’t know anything about India that village=ignorance. That’s why the other side needs to be heard.

  31. says

    Rhea a baby born in a city is sometimes 10 times more likely to die if it were born in a village. The majority of India’s stats are due to the villages rather than the city. 70% of India lives out there and often in “real poverty” with starvation.

    Please don’t romanticise the village, there is a massive tendency for people in India to do so which blinds them to the reality of the village life. It isn’t idyllic it is a way dying out because the majority of villagers in India are not as developed as they need to be.

    And there are a lot of village practices that increase mortality rates. You seem to think that there was some “golden age” of midwifery where Indians lived long and healthy lives. That is simply not the case, the dai are like midwives in western europe prior to the medical improvement of gynaecology.

    In 1940s the IMR in the UK was 44 per 1000. In 2012 India’s is around 50. We are basically at that stage of IMR and we can drop it but that involves medicine.

    Ayurveda works through either minor effect or placebo. Vitamin pills don’t make you feel better. There is medicine and there is quackery and ayurveda is quackery. There is real medicine done by Indians. The neural homunculus was discovered by an Indian (Ramachandran) as were rhinoplasty and the precursor to vaccines… You would ignore real achievements for pride in quackery.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>