I grew up in Chile, got my medical degree there, began an academic career in 1970, and left for the USA due to the military coup in early 1974. My first job in the USA was working as a public nutrition professor in the international programme of Meharry Medical College in Nashville, Tennessee.
I started to travel to Africa in 1975, and worked a year in Cameroun in 1980 helping to prepare their five-year nutrition plan. I then moved to New Orleans, to Tulane University’s School of Public Health, and taught in the department of nutrition for ten years, before moving to Nairobi where I was an advisor in the Ministry of Health. Seven years there got me into extensive consulting in Africa, often on nutritional issues. In 1995 moved to Vietnam where I worked for two and a half years in the Ministry of Health as a senior primary health care advisor.
Many years of touching the reality on the ground, in Latin America, then the USA, then Africa and Asia, has made me understand that the real challenge is in the social and political determinants of malnutrition. I have devoted my writings and teaching to that. Over the years, I have found an important shift in my colleagues’ attitude and understanding towards acknowledging the basic causes of malnutrition. But yet I see little happening as a result. I submit that it is our guild’s lack of experience in the political arena that explains this dichotomy. I devote much of my energy to bridge this gap, and am a fervent advocate of empowering claim holders to demand needed changes from duty bearers. Nutrition is a perfect port of entry for that. Equity, social justice and people’s empowerment in a human rights sense is what really will make a difference.
There is no alternative but to deal with nutrition problems as indivisibly linked to social, political and environmental problems. We need to address them as such. The question is: are we all prepared to do that? The answer, in my view, decides whether we are part of the solution or part of the problem. Travelling and living in different parts of the world has reinforced my conviction that we need to get down from our academic ivory towers, and need to change the curricula of our young and upcoming colleagues, to give them the tools to act in such a context. To me, public health nutrition cannot be anything but that.