“The space between: Biocultural examinations of gut health and child growth in highland Peru and the Galapagos Islands”
While the role of nutrition and infectious disease in early child growth are well understood, nearly 30% of child stunting remains unexplained by these two factors. In the last 15 years, gut function has emerged as a likely explanation for this additional growth loss. Environmental enteric dysfunction (EED) is a subclinical disorder resulting from chronic exposure to unsafe water which is known to increase gut permeability and reduce nutrient absorption. In this talk I explore EED as a mechanism through which water quality may influence child growth. Because EED arises from chronic exposure to unsafe water and does not present with overt symptoms such as diarrhea, its effects are often overlooked in water–health research. In this talk, I draw on data from two field sites, Nuñoa, Peru and San Cristóbal Island in the Galápagos, to explore the relationships between water quality and early growth and illustrate how EED may help explain this relationship using endotoxin core antibodies, a relatively novel, minimally invasive dried blood spot–based biomarker of EED. In the Nuñoa case, I utilize ethnographic insight to think about the importance of mothers’ “gut feelings” about the health of their infants and the ways in which claims of clinical illness can be deployed to make up the space between expectations of growth and children’s actual growth.