Science in Christian Perspective

Malnutrition and People

D. GARETH JONES
Department of Anatomy and Human Biology
University of Western Australia
Nedlauds, Western Australia 6009

From: JASA 30 (September 1978): 103-116

The Experience of Malnutrition

"No one in the hospital appeared to be unduly concerned when four-year-old Sonia Enamorado died of starvation. No mother waited tearfully by the cot. The doctor was busy attending to the rasping wailing from the other wasted bodies in the tiny ward. Only one nurse seemed interested: she laid a small muslin square over Sonia's once pretty face, to keep the flies back for her last few moments".¹

"I remember Jobeda who was sitting in the shade of a tattered lean-to in a refugee camp in Dacca. A small withered form lying close beside her whimpered and stirred, instinctively, she reached down to brush away the flies. Her band carefully wiped the fevered face of her child. At six years of age, acute malnutrition had crippled his legs, left him dumb, and robbed him of his hearing. All that was left was the shallow, labored breathing of life itself-that, too, would soon be gone ".²

"The other day a Zambian dropped dead not a hundred yards from my front door. The pathologist said he'd died of hunger. Its his shrunken stomach were a few leaves and what appeared to he a halt of grass. And nothing else".³

I have just quoted the plights of three individuals, three of the many victims of malnutrition. All three instances occurred within the past few years, the first in Honduras, the second in Bangladesh and the third ill Zambia. The three people involved were ordinary human beings, two were young children and one was a young adult. Apart from their malnutrition and certain cultural differences, they would have been just like you and me. And yet they were so very different from you and me-they were malnourished, and even had they been alive today their lives would have been hard, limited and tragically deprived.

How easy it is though to lose these three individuals in the midst of an array of accurate, objective and yet
lifeless statistics. There are hooks galore on malnutrition, oil its economic spectrum, its morbidity and its consequences in educational terms. How easy it is to write about the Third or even the Fourth World, the disadvantaged and the underdeveloped (or more acceptably the developing) nations. However much we need these studies, they are emasculated to the extent that we lose sight of the human face of malnutrition.
Malnutrition is personal; it affects individuals. The individuals are you and I; you who are reading the paper and I as the one who is writing it. They are also those who are hungry, those who are malnourished, and those who are on the verge of starvation. They are those children who are no longer curious; they are those 30-year-old women who look at least 50; they are our children who are healthy and fun-loving and' they are we who have every opportunity in this life. We are all individuals and we are all affected by malnutrition, either as the wellnourished who prosper at the expense of the malnourished or as the malnourished whose only hope depends upon the concerted efforts of the nutritionally privileged.

Whatever approach we adopt towards this issue therefore, we cannot afford to overlook the personal aspects of the malnutrition in today's world. Moberg⁴ has expressed this point very succinctly: "all social problems are intensely personal to the individuals who are their victims." Neither can we afford to underestimate either the global or the historical dimensions of malnutrition

Global Malnutrition

Famine is no new problem to the peoples of the world. One has only to read the Bible and other chronicles to realize how frequent and devastating were famines throughout the Middle East and Europe in ancient times.⁵ Likewise, medieval Europe was repeatedly gripped by famines while even this century has seen people driven to cannibalism in the face of relentless hunger.

Famine is practically integral to the life of humanity, so much so that Jesus Christ in describing the signs which would usher in his return at the end of time foresaw famine as one of these.⁶ In spite of such gloomy (and perhaps realistic) forecasts, the late 1940's were characterized by an upsurge of optimism-the battle against hunger was almost concluded. Bumper harvests in the United States and the development of "miracle seeds" would vanquish this dreaded foe and the densely-populated countries of the Third World would attain selfsufficiency in food stuffs.

Alas, history was not to be so easily overturned! The 1970's have been accompanied by malnutrition of plague proportions, as well as by an avalanche of cries of doom and despair. In 1972, for instance, the world's harvest was some 3% short of meeting demands, while by 1974 the world's reserves of grain reached their lowest level for 22 years. This corresponds to a 26 days' supply compared with one of 95 days in the early 1960's.⁷ It is estimated that at the present time anything from half a billion to a billion and a half people are suffering from some form of hunger, and of these about 10,000 die of starvation each week in Africa, Asia and Latin America.
Such figures are well beyond our comprehension and tend to leave us numb and unmoved. Even worse perhaps is the plight of the children. At any given time there are approximately 10 million severely malnourished preschool children, with very many more suffering from moderate and mild forms of malnutrition. All told, about 3% of children under five in low income countries suffer from severe protein-calorie malnutrition, their body weight being lower than 60% of the standard. Another 80 million preschool children are probably suffering from moderate malnutrition (60-75% of the standard) and 130-160 million from mild malnutrition (75-90% of the standard).⁸

The Context of Malnutrition

It is far more accurate to view malnutrition as part of a much larger constellation of deprivation.⁹ Malnutrition itself is just one aspect of poverty, and it frequently accompanies other traits of poverty such as high infant mortality and prematurity rates and high levels of mental deficiencies.¹⁰ Its severity appears to be related to differences among some of the following factors: total number of siblings, number of siblings under the age of  2 years, family income, food expenditure per person per month, schooling of mother and father, number of marital separations at the time of birth, and the likelihood of being the product of an unwanted pregnancy.¹¹ An additional factor is illiteracy, which merely serves to augment the more strictly biological aspects of malnutrition.
In more general terms, malnutrition has a number of dominant contexts. These include and revolve around poverty which itself may be a manifestation of a host of other contexts such as ignorance, adverse climatic conditions, dispossession, urbanization and the economic and commercial structure of the contemporary world.¹² These in turn constitute the interrelationship of perspectives in which population levels, food production and food consumption need to be viewed.

Poverty
But what of poverty which is so essential to any appreciation of the world of the malnourished? Mooneyham¹³ has made the telling remark: "Poverty is relative but total poverty is absolute, and total poverty is the only term that adequately describes masses of people in the Fourth World". Unbelievably, this fourth world of absolute poverty applies to some 40% of the people living in the underdeveloped countries.

Poverty is the pivotal point of more than one vicious circle. In the words of Heilbroner: ¹⁴

It is not just a lack of capital, or just backward ways, or just a population problem or even just a political problem which weighs upon the poorer nations. It is a combination of all these, each aggravating she other.
The troubles of underdevelopment feed upon themselves.

Although the impact of poverty is on the deepest aspirations and expectations of people as individual human beings, the easiest way of expressing poverty is in financial terms. While the average per capita income in developed Western nations is of the order of U.S. $2,400 (in North America it is well over U.S. $4,000), it is only U.S. $200 in the underdeveloped world. What is more, this differential is rapidly increasing. These figures tell its something about the inequality of wealth at the international level. This unfortunately is only the beginning of the inequality saga, as inequality is even more devastating at the national level. For instance, in Latin America as a whole 60% of the population have incomes of less than U.S. $50 a year, 40% earn up to U.S. $190, while of the remaining 10%, 9.9% cans over U.S. $500 leaving just 0.1% with incomes in excess of U.S. $27,000.¹⁵ And the inequality in these countries is becoming more marked with the passing of each year.

The plight of many in the underdeveloped countries is appalling. And once poor, there appears little that can be done to break out of any one of the vicious poverty circles. There is growing disparity in the face of growing need, and one of the cogent reasons why this should concern us is that, as Alfred Marshall¹⁶ put it many years ago, "the study of the causes of poverty is the study of the causes of degradation of a large part of mankind." If those words were true in 1890, they are just as true and many times more pressing today.

Poverty dominates the underdeveloped nations, what ever its cause; and poverty brings in its wake ill-health. Malnutrition, as we have already seen, is well nigh endemic in some countries. In some areas 30-50% of all children die before reaching their fifth birthday. Poverty also means that doctors are scarce, particularly in rural areas, while overall some countries cannot afford to spend more than 60 or 70 cents a year on the health care of each of its people.¹⁷

Malnutrition therefore, is an integral part of the lives of a majority of human beings today. It is one of the most potent forces in our world, and its presence will be increasingly felt in coming years. Indeed, it may be no exaggeration to suggest that it will prove the major factor in revolutionizing the life styles, social values and political systems of underdeveloped and developed nations in the not-too-distant future.

Definition of Malnutrition

A number of terms are pertinent to any discussion of nutritional deprivation: malnutrition, undernutrition, hunger and starvation.

Malnutrition has the broadest coverage, including as it does undernutrition and, at the other end of the scale, overnutrition and obesity. In ganeral therefore, it is a manifestation of any form of nutrient imbalance. Undernutrition describes the more specific condition of an inadequate intake of food.

Hunger is simply a symptom expressing a craving for food and as such is an essential physiological phenomenon common to all human beings. It must not therefore, be equated with undernutrition, although it is obviously far more of a problem in areas of the world subject to undernutrition.

Starvation is the extreme of undernutrition and leads to a number of well recognized conditions on the road to death. Wasting of muscles, loss of body fat and wrinkling of skin are manifestations of a general deterioration in which the body, in a desperate attempt to find fuel, is burning up its own body fats, muscles and tissues. Inability to resist infection leads to disease, while a shortage of carbohydrates affects the brain and the person's ability to comprehend his plight. Alongside starvation is a whole host of deficiency diseases which are almost endemic in some of the developing countries. The main deficiencies involve proteins, vitamin D, thiamin and niacin, with rickets, beri-beri, pellagra and osteomalacia being the sad end-results.

The must common of the deficits is a lack of proteins and calories, leading to protein calorie malnutrition. Although it is unwise to isolate protein and calorie deficiencies two syndromes are recognized in severe malnutrition. These are marasmus and kwashiorkor. Marasmus is usually confined to children less than one year of age, the principal deficiency being one of inadequate calories. Kwashiorkor, by contrast, occurs
more frequently in the second year of life and principally involves a protein deficiency. In spite of this apparently simple separation of the two conditions, there is considerable clinical overlap between them, marasmus describing a child without oedema and less than 60% of its weight for age and kwashiorkor referring to an oedematous child falling within the 60-80% range of weight for age.¹⁸

Many eases of malnutrition are undetected in the

Malnutrition is personal; it affects individuals. The individuals are you and I. They are also those who are hungry, those who are malnourished, and those who are on the verge of starvation.

early stages. This is because they are sub-clinical, and it has led Broek¹⁹ to propose his iceberg analogy. According to this, the tip of the iceberg represents the minority of obvious eases where malnutrition is readily apparent while the submerged portion corresponds to the majority of cases which are the sub-clinical ones.
Even if this analogy is only partially true, its relevance is all too apparent if it does emerge that relatively mild nutritional insults have irreparable consequences for brain and mental development. It also brings into perspective the potential importance of relatively mild malnutrition, as opposed to the dramatic and all too obviously tragic episodes of extreme malnutrition in its guise of starvation. This, in turn, illustrates a phenomenon that is being increasingly widely recognized in the contemporary world: the almost universal presence of malnutrition. The impact of malnutrition is not confined to the Third and Fourth Worlds. While it is, of course, seen in its direst forms in the underdeveloped regions of the world, its influence extends from Harlem to Ethiopia, from the inner areas of our big cities to the parched rural areas of India and Bangladesh.

Some Consequences of Malnutrition

Malnutrition affects people; malnutrition kills. For instance in Brazil, children under five form less than 20% of the population but account for 80% of all deaths. Beyond this, it converts otherwise minor ailments into killers while even more subtly it leads to prolonged illnesses, chronic infections and a variety of forms of permanent handicap with an accompanying irreversible loss of opportunity in life.²⁰

The impact of the relationship between infection and malnutrition is to transform what would he incidental infections into chronic disabling diseases. Opportunities are lost, education is wasted and the mediocre product of one generation becomes the non-productive, dependent member of the next.²¹ All ton rapidly undernutrition assumes transgenerational proportions with the perpetuation of inefficiency, lack of productivity and enhanced impoverishment. ²²

Malnutrition interferes with a child's motivation as well as with his ability to concentrate and to learn. Such a child is apathetic and listless, and lacks the curiosity so essential to normal development. Not surprisingly he is unable to cope adequately with the demands of schooling, mental and physical fatigue as well as frequent bouts of nutrition-related illnesses together contributing to pour performance, limited aspirations and a high drop-out rate.

It is into this arena that discussions concerning the impact of malnutrition on behavior patterns, intelligence and the brain have intruded. While this is a difficult and in many respects a confused area, it is a pertinent one for all who are concerned with analyzing the possible effects of malnutrition on the individual's capacity to develop optimally as a responsible and responsive person.

The basic data stem from the fact that approximately 80% of the growth of the human brain occurs between the end of the second trimester of pregnancy and the end of the second year of life. This period coincides with the growth spurt of the brain, during which time many brain parameters are undergoing rapid change. Hence any interruption to this growth spurt will, it is argued, affect a number of parameters including the establishment of synaptic connections between the nerve cells, the multiplication of the glia or supporting cells and the formation of myelin which is the insulating material of the nerve cells. From this it follows that, if physical growth processes occur at specified ages throughout development, any insult disrupting this chronological sequence of events during the brain growth spurt may be expected to result in long-term structural and neurological deficits.²³ These ideas are central to the concept of the growth spurt as the vulnerable period of brain development.²⁴ Comparatively mild nutritional restriction during the period of the brain's growth spurt may lead to permanent deficits of the adult brain, both in its physical configuration and in the resulting behavior patterns of the individual .²⁵
This concept of vulnerability has a number of repercussions. In the first place it pinpoints the last trimester of pregnancy and the first two years of postnatal life as a critical time for human development. Second, even a minor insult applied at this time may have major consequences, which may prove to he permanent. The evidence on which this idea of vulnerability is based is derived from all the areas that have been used in malnutrition studies: structural, functional and behavioural fields. These, in turn, have been carried out on a range of experimental animals, while they also draw on observations of underprivileged human groups.

As an example of one of the human studies, consider those carried out by Cravioto and enworkers²⁶ in Mexico. They found that those school children who had suffered from severe protein-calorie malnutrition before their 30th month of life scored consistently lower in psychological tests compared with equivalent children who had not experienced malnutrition.

In another study Cravioto looked at the effect of early malnutrition on auditory-visual integration by comparing school children of shorter stature with their taller companions of the same age. The shorter children showed poorer intersensory development, a factor more closely connected with malnutrition than with environmental influences.

In animal investigations protein malnutrition inflicted during the growing period of the brain has been found to result in an apparently irreversible deficit in indices such as brain weight, the thickness of the cerebral cortex, the number of brain cells, and the amount of brain lipids and hence the degree of myelination.²⁷ In addition there is evidence to suggest that the development of some transmitter systems is delayed, while there is a decrease in synaptic connectivity and a retardation in the maturity of the synaptic junctions themselves .²⁸

Even if these and related data are accepted as evidence in favour of the concept of brain vulnerability to nutritional deprivation, there is still the possibility that the deficits may not be permanent. It may be possible to subsequently rectify these deficits. Experimental evidence on the extent of possible rehabilitation is sparse and confused, suggesting that while a limited amount of "catch up" may take place, the distinction between retarded brain development and abnormal development is a tenuous one. ²⁹

Evidence favouring catch-up amongst human groups is, once again, of a conflicting nature. Cravioto and Rubles,³⁰ in a study of twenty children undergoing nutritional rehabilitation after severe protein-calorie malnutrition, concluded that children over 15 months of age at the time of the malnutrition showed improvement over a 6 month period. By contrast, children less than 6 months of age may he permanently affected. Even here however, one must he careful, because the apathy and unresponsiveness of the severely protein malnourished child,³¹ itself leads to the critical stages of cognition being missed. Other environmental factors of potential significance include the effects of hospitalization and the decreased response of the mother to an unresponsive child.

Chase and Martin,³² in a study of children suffering from undernutrition during the first 4 months of life and later nutritionally rehabilitated, came to the opposite conclusion. According to their data, these children 3 years later had developmental quotients equal to those of control children.

The overall confusion of these investigations is symptomatic of many others, with their pointers on the one hand to various permanent psychological deficits following early malnutrition and regardless of later efforts at rehabilitation³³ and on the other to a marked degree of improvement in a number of physical and mental parameters. ^{34, 35}

What then can we conclude, at present, from these investigations? There can be little doubt that malnutrition is integrally involved with environmental and social factors in depressing the cognitive development of previously malnourished children. Perhaps only academics would be concerned with the relative contributions to this appalling state of affairs of malnutrition as distinct from environmental factors. Most academic commentators however, are forced to conclude-albeit tentatively-that malnutrition probably does play a role apart from factors related to social status. ³⁶, 37 It must never he forgotten though, that almost invariably malnourished infants are exposed to poor housing, low levels of educational achievement, high infection rates and all sorts of taboos.
An interesting, if unproven, idea having a bearing on the interrelationship of malnutrition and general social deprivation is that of Dobbing.³⁸ According to him, permanent intellectual deficit occurs only in malnourished children where the non-nutritional environment is also poor. This has some support from animal investigations³⁹ and, whatever its validity, reiterates once again the overall interdependence of the components of human growth. Each is important and probably contributes to the optimal functioning of the others .⁴⁰

The Inequality of Malnutrition

One thing is self-evident: we are no longer living in one world. We are living in at least two worlds, the worlds of the rids and the poor, the haves and the have nots. The world of need and the world of plenty. The hungry and the full.⁴¹ And there is no doubt to which one we belong.

Just consider a few comparisons. In England and Wales there is one doctor for 900 people; by contrast, the ratio in rural Kenya is 1 for 50,000. In rural Senegal in 1960 the death-rate of children aged 2-5 years was 40 times higher than in France. A teenager in Tanzania has about 1% of the educational opportunities of a teenager in North America. The G.N.P. per person in Malawi is approximately one-fiftieth that found in Sweden.⁴² And so one could extend the list. The end result of these and similar statistics is best summed up perhaps in the life expectancy in different countries, varying as it does between more than 70 years in most rich countries to as little as 25 years in some poor countries.

This is the epitome of inequality, and this is the foundation on which the inequality of malnutrition has been built. This in turn has devastating effects upon life styles and aspirations, and indeed is central to determining what we are as human beings.

In the 1970's we in the Western world are repeatedly confronted by problems that are the making of our technological expertise. Me have been given immense control over our lives and destinies as biological and spiritual beings. We are in the midst of a revolution that has its origin in what man is and in what he is going to he. It is a revolution with profound repercussions for each one of us, as it may well force us to revise our ideas of man and of his role and status on this planet.⁴³

Part and parcel of this revolution are the many techniques implicit in genetic engineering, psychosurgery, drug induced control of moods, family planning and contraception. In other words, techniques aimed at controlling not only the quantity of life, but more significant perhaps its quality as well. We are in the realm of what Joseph Fletcher ⁴⁴ refers to as quality control. While he uses this term with regard to genetic engineering, we need to remind ourselves that we in the Western world have been governed by this concern for many years under the aegis of our medical care, obstetric services, public health programmes and many other medical and paramedical services. We have been free to concentrate on quality, and have done so with spectacular success.

Our success in this direction has actually modified our view of the nature of man; it has certainly led us to stress the value of health over against ill-health and it has dramatically altered our expectations of what constitutes normal human experience. So radical has been this revolution that we must now very seriously ask the question whether we are not in danger of equating biological excellence with human fulfillment. ⁴⁵

This however, is a question which has meaning only for modern, scientific man. It is only he who is able to ask such questions, because it is only he who has experienced the transforming power of technological expertise. Modern, scientific man is rich; he has the means and the leisure to indulge in scientific experimentation and the development of scientific ideas. He has the financial resources to bring concepts to fruition and then apply them to his own life as a human being.

Man is an enquiring animal; he is creative and inventive, and his ever-increasing technological prowess has brought the environment within the realm of his

One thing is self-evident: we are no longer living in one world. We are living in at least two worlds, the worlds of the rich and the poor, the haves and the have nots.

creative talents.⁴⁶ This is true to any significant degree however, only where man is rich and where he has the leisure and the opportunities to develop these abilities.

Poor man is not just poor; he is impoverished as a human being, and in this sense poverty can be defined as that condition which restricts the development of roan's creativity and resourcefulness. Here again then, we meet the two worlds-the poor world with its cultural impoverishment and the rich world with its opportunities for cultural enrichment and control of the environment. These worlds are made up of different kinds of human beings, differences which are manmade rather than God ordained.

Mooneyham⁴⁷ asked a 7 year old boy in the Sahel what he wished for more than anything in the world. His answer was striking and stunning: "For today, I would like a meal, arid for the future, an education". Alas, there are many in the poor world for whom such simple aspirations are mere fantasies.

Cohn Morris⁴⁸ made the pungent observation that only the well-fed play at Church. The rest are too busy raking dustbins and garbage heaps for a morsel to feed their children." In similar vein, we may say that only the well-fed play at science and quality control and the ethical dilemmas that are currently emerging because of these frontiers. This is not to decry quality control any more than Morris was decrying the church in its essence. Nevertheless, it does highlight the inequality of the rich and the poor, the well-fed and the malnourished.
Our two worlds are worlds of unequal human beings; those with hope as human beings and those with little or no hope. Those capable of living life to the frill, and those whose horizons are limited by the need to acquire fond and stave off the next death in the family. To the one world, quality control is a reality; to the other, it is a mocking charade.

Well-nourished Christians in a Malnourished World

It is tragically easy to approach the world food crisis in an unduly objective and observer-like fashion. With little difficulty, we illustrate the reality of our two worlds-we, the rich, sitting in gastronomic splendour as we describe in minute detail the impoverishment and squalor of the other world out there, the poor world. The ease with which we do this is not diminished simply because we are Christians. Indeed, there is some evidence to suggest that theologically conservative Christians may be more inclined to act in this manner, upholding the status quo, than those with a more liberal theological position or with no specific Christian presuppositions at all .⁴⁹ While this position has been energetically challenged and substantially modified by others,⁵⁰ the status quo has a peculiar attraction for Christians in the rich world.

Moberg,⁵¹ in writing of the relationship of Christians to social issues in their widest perspective, has this to say:

In regard to most social issues of this century, evangelicals are known for their negative positions. . . They have worked for changed lives of individuals but not for changes in society . they have described social conditions as going from bad to worse without recognizing that their own lack of social action to correct the structural evils of society - . . were major factors contributing to the deterioration of social conditions.

Their ready acceptance of the social status quo and their inability to understand the relationship between evangelism and social action ⁵² have been two major contributing factors to the supposed "neutrality" of Christians on social issues.

As a consequence of this trend, an increasing number of forthright criticisms are being made of the Church at large, criticisms that are desperately relevant for evangelicals. Mooneyham,⁵³ writing from an evangelical standpoint, is forced to exclaim:

The church which bears the name of the Man who lived for others is more and more living for itself. In 1971-72, sixty-three church denominations in the United States and Canada reported contributions in excess of $4.5 billion. About $1 billion of that was spent on new church buildings . . . . There is no way to know how little of that went into programs that would relieve the sufferings of humanity. . . There is something unbelievably immoral about Christians who still demand to be convinced of the biblical mandate for . . . active involvement in the world hunger crisis.

Morris,⁵⁴ in his fervent polemic Include Me Out!, states quite emphatically that: "we are a rich Church in a hungry world". "But", he argues, "you cannot have a rich Church in a hungry world. And wealth in this context is a single penny more than it costs us to keep body and soul alive".

Bonhoeffcr⁵⁵ expresses similar sentiments in more directly theological language; "To allow the hungry man to remain hungry would be blasphemy against God and one's neighbour... it is for the love of Christ, which belongs as much to the hungry man as to myself, that I share my dwelling with the homeless."

A church satisfied with the status quo of riches implicitly denies the radicalness of Jesus Christ. It denies his concern for the poor and the outcasts, for the dispossessed and the downtrodden, in both spiritual and material realms. A complacent church in a rich world cannot he sufficiently concerned for the poor and the needy. At the basis of so much New Testament teaching is the call to love others, to put others first, to bear the burdens of others, to live for others and to give ourselves for them. But what do these injunctions imply for a rich church and rich Christians in a world of poverty and destitution?

Why Should Christians be Concerned for the Malnourished?

This question is one facet of a much broader one: Why should Christians be concerned for the social welfare of others?

An adequate answer to this question would take us into the relationship between social concern and evangelism, and thus into the tension often felt between the great commission on the one hand and the great commandment on the other. Such an examination is outside the scope of the present paper and has been forcefully tackled in recent years by Carl F. H. Henry,⁵⁶ David 0. Moberg,⁵⁷ Sherwood Eliot Wirt,⁵⁸ John H. W. Stott⁵⁹ and Klaus Runia⁶⁰ among others.

The Lausanne Covenant⁶¹ expresses the Christian's social responsibility in these terms:

We affirm that God is both the Creator and the judge of all tarn. We therefore should share his concern for justice and reconciliation throughout human society and for the liberation of men from every kind of oppression. Because mankind is made in the image of God, every person . . . has an intrinsic dignity because of which he should he respected and served, not exploited. . - We affirm that evangelism and socio-political involvement are both part of our Christian duty. For both are necessary expressions of our doctrines of God and man, our love for our neighbor and our obedience to Jesus Christ.

What is evident in this statement is that the Christian's responsibility for the social well-being of his fellow man stems from the relationship of God to those he has created, and from the nature of man as a being created-in-the-image-of-God. All men are of equal worth in the sight of God, all men have an intrinsic dignity because of who they are and therefore, those who are Christians are to view them in the same way as God views them.

We can go further than this, however, and state that God is concerned with justice and compassion in human society, a concern so eloquently and movingly brought out by Amos⁶² when he stresses the importance of human rights, freedom, obligations, compassion and the integrity of the individual. And insofar as God emphasizes these traits, we are to follow and emphasize them also.

Man's relationship to Cod in creation implies, therefore, that each man has a responsibility to his neighbour. In other words, intrapersonal relationships are important; man lives in community and the manner in which he lives out these relationships is important in the sight of God. This, in turn, points to the importance of relationships between groups of individuals, a point which is amply illustrated in the Old Testament⁶³ by the repeated denunciations of the perversion of legal structures to the detriment of underprivileged groups in the community.⁶⁴

None of this, of course, in any way belittles the importance of evangelism. It simply stresses the wholeness of man. As John Stottt⁶⁵ so eloquently phrases it: "God created man, who is my neighbour, a body-soul-in-community." He continues, "if we love our neighbour as God made him, we must inevitably he concerned for his total welfare, the good of his soul, his body and his community." And the reason why we should be concerned for the social welfare of others is quite simply compassion, the compassion of Christ himself.

As Christians, we are to respect others as people and are never to use them as things.⁶⁶ Put in biblical language, we are to love our neighbours;"⁶⁷ and everyone else-friends, enemies, those close to us, those unknown to us-are our neighbours." We have therefore, a social responsibility for other people and a responsibility for the whole person.

Applying these principles to malnourished people is all too obvious. They are our responsibility, because not only are they our neighbours but they are underprivileged. We are, therefore, doubly responsible for them. If we are still unconvinced about this, we should remind ourselves of God's concern for the hungry. For instance, in Isaiah 58:6-10 we read:

Is not this what I require of you as a fast . . . . Is it not sharing your food with the hungry, taking the homeless poor into your house . . .? If you feed the hungry from your own plenty and satisfy the needs of the wretched, then your light will rise like dawn out of darkness

Then again, in Psalm 146:7 we are reminded that "The Lord feeds the hungry and sets the prisoner free," Moreover, in Proverbs 25:21 we are exhorted to give bread to our enemy when he is hungry and water when he is thirsty, while in Ezekiel 18:7 one of the marks of the righteous man is that he gives bread to the hungry. In the New Testament, quite apart from the many injunctions relating to the poor, the needy and the hungry, Mary⁶⁹ in extolling the wonderful works of God exclaims: "the hungry he has satisfied with good things, and the rich (he has) sent away empty."

It is little wonder that today there are some to whom hunger is an obscenity. For Larry Ward⁷⁰ hunger is "an ugly, six-letter obscenity". For Cohn Morris⁷¹obscenity is the deadly ease with which I and all ecclesiastical word-mongers can write of hungry little men when our hands ought to tremble and refuse to do our bidding". Perhaps this is an emotional response; it may however, be a prophetic one and one also in tune with many of the biblical writers.

Rationale for Action

Christians should he concerned for the plight of the malnourished. Given this basic premise, what follows? Where do we go from here? What specific principles do we need to help us put into practice these very general principles?

(a) The love principle

Concern for the malnourished must start from the great commandment. We are to love our neighbours as ourselves. Jesus linked this obligation with our duty to love God will all our heart, soul, mind and strength.72 Love therefore, is the essence of the moral law.⁷³ What is more, Christ taught that we are always to treat others as we would like them to treat us.⁷⁴

In no sense was this a departure from Old Testament teaching, as we read in Leviticus 19:18: "You shall not seek revenge, or cherish anger towards your kinsfolk; you shall love your neighbour as a man like yourself." It was this that served as the starting point for Christ's own position. Note at this juncture that our neighbour is a human being, a created man, a being in the image of God, in exactly the same way as we are beings in God's image. There is no distinction between us in God's sight; the malnourished and the well nourished are on equal footing as beings of concern to God.

But what of our reaction as individuals to the malnourished and the underprivileged? It is all too easy to look upon our own social group with favour and other groups with disdain. Christ however, allows for no such distinction. Love of those to whom we are

God is concerned for social justice, and he is concerned that his own people put justice above everything else within society.

naturally drawn, that is, our neighbours in the narrow, parochial sense, and hatred of our enemies, has no place in the ministry of Jesus.⁷⁵ According to him, we are to "love our enemies, do good to those who hate us, bless those who curse us, pray for those who treat us spitefully. . . We are to treat others as we would like them to treat us."⁷⁶

There can be no escape from this principle of selfeffacing love. And if this is the governing principle in our response to our enemies, the extreme situation at the individual level, this must also be the principle by which Christians respond to groups of individuals with whom they have no natural affinity.

It is hardly surprising that self-giving of this degree is the essence of Christ's standards, as Christ himself gave without expecting any reward. This is precisely the nature of the love demanded of Christians. We are to give of ourselves for the malnourished; we are to give so that we lose and they gain, thereby restoring the balance of opportunity that should exist between human beings. This is love as exemplified repeatedly in the life of Christ and as underlined by the leaders of the early church.

To John it was axiomatic that the Christian exemplified the love of Christ in his relations with those around him. And so, if a man has enough to live on he must, because he is a follower of Christ, help his brother who is in need. Otherwise, "how can it be said that the rhyme love dwells in him?" After all, John continues, "love must not be a matter of words or talk; it must be genuine and show itself in action."⁷⁷

To ignore the plight of needy fellow human beings is to withhold from them the love of God. It is to refuse to do good, and in Christian terms this is sin.⁷⁸ This responsibility of love is a fundamental requirement of Christian service even when the emphasis is placed no the alleviation of material need. It is equally applicable to the need for evangelism, but this is not a more pressing cause when there is genuine material need. Love should compel us as Christians to feed the malnourished and an restore them to their full dignity as human beings.
Love, as we have seen, is inseparably linked to action and hence is the only satisfactory startingpoint for an approach to the malnourished of the world. Mooneyham⁷⁹ has expressed a similar thought with regard to caring. He writes:

Caring is the crux of the matter. Knowledge will not produce change. It won't make any difference for you to know that ten thousand people die every day from starvation and diseases related to malnonrishment unless you care . . . action is horn out of caring.

(b) The 'our neighbour' concept

In his letter⁸⁰ James rebukes those who would pay especial attention to a rich man attending their church but scant attention to a poor man. Such discrepancy, argues James, demonstrates their own inconsistencies and the falseness of the standards by which they regard the rich and the poor. It is an insult to the poor man, and it flies in the face of the realities of their society, as it is the poor who are rich in faith and the rich who are the oppressors.

Beyond these inconsistencies however, lies the basic one. By elevating the rich at the expense of the poor, these people were abrogating what James calls the sovereign law of God: 'love your neighbour as yourself." Their snobbery was just the opposite of this; it was a transgression of God's law, because it was showing partiality by valuing a person according to his possessions and not according to his intrinsic worth as a human being.

This illustration brings into focus the importance of our attitudes towards the rich and the poor, the well nourished and the malnourished. Our attitudes quite simply demonstrate the degree to which we are conforming to the "our neighbour" concept. It is far too easy to respect the successful business man or the influential academic and yet ignore the starving peasant or the underfed ghetto mother. Here, just as elsewhere, however, the standard set by Christ starts with attitudes and motives; it is never content with superficial conformity to accepted social mores.⁸¹ It is far too radical to equate our neighbour with those who are the rich and respectable in the eyes of society.

Whatever our attitudes to the poor may be, they will manifest themselves in actions. This is the burden of so much of the letter of James and also of the first letter of John, and it is equally the burden of Our Lord's parable of the good Samaritan.⁸² "Who is my neighbour?", asked a lawyer, to which Christ replied by way of this parable "anyone you see who is in need." In this, Christ made explicit what was implicit in all his teaching on the "our neighbour" concept. Our neighbour is anyone anywhere, everyone everywhere; the only criterion is his need of help. There are no geographical, religious or racial boundaries.

It is also instructive to note that Jesus did not answer the question "Who is my neighbour?" By contrast, he implied that a more appropriate question would have been "Do I behave as a neighbour?" As Marshall⁸³ has commented: "Jesus does not supply information as to whom one should help, for failure to keep the commandment does not spring from lack of information but from lack of love." Perhaps this is a relevant comment for the Christian Church confronted as it is by deprivation on an unprecedented scale. Georg Borgstrom,⁸⁴ author of the book The Hungry Planet, came to a similar conclusion when he wrote; "In order to bring health and restore vitality to the whole human species, nothing less is required than a global will to act.."

The "our neighbour" concept brings us back to the importance of the welfare of all people everywhere and of their total welfare. Paul⁸⁵ reminded the Christian congregations at Galatia that, as opportunity offered, they were to work for the good of all, a sentiment echoed by Columbus Salley and Ronald Behm⁸⁶ in their hook on Christianity and race in America. They write:

Christians should therefore he taught to do those actions which promote the good of all men . . . . The example of Christ means that Christians must be involved in ministering to the whole man. It is totally inconceivable for a Christian to say that he loves men if lie does not attack those forces which destroy men themselves.

Our neighbours are being destroyed daily by lack of adequate nutrition. The destruction may be total; it may he partial, cnnervating and demoralizing. No matter what the extent of its severity, it remains and will continue a reality. The overall welfare of our neighbours is at stake each day, but does the Church (do we) behave as a neighbour?

(c) The demand for justice and righteousness

Writing about social needs in general, Paul Schrotenbocr⁸⁷ has written: "The gospel will dispense healing only when the harmonious biblical norms of love and righteousness are built into . . . societal structures.
Christ works through his people in bringing balm to festering societal structures." Justice and righteousness are foundational, therefore, for the health of society and must constitute the goals to which Christians aspire in their work within society.

Time and again throughout the Old Testament we are brought face to face with the lack of justice within society, and God's forthright condemnation of this state of affairs. In Amos' time, for instance, the injustice within Israelite society was an essential ingredient of the people's rebellion against God. Bribery, inequitable real estate deals, oppression, dishonesty, crime and violence were all characteristics of that society.58 Evil and injustice were so deeply rooted in the society and were so characteristic of the actions of the people, that nothing less than a moral reformation of the whole society was required. "Seek good and not evil, that you may live . . . hate evil and love good; enthrone justice in the courts" was Amos' plea to them.
In commenting on this Motyer⁸⁹ writes:

Can God do other than stand aloof from people who claim to know His name but refuse to imitate in life the very things the name stands for-human and humanitarian concern, good social order, even-handed justice, the dignity and well-being at men and women?

Our treatment of our fellow human beings in society is vital, because they are human beings like ourselves. The Israelites among whom Amos was living were very religious, even if their religion was far from pure, and yet it made little difference to their social attitudes. And it is significant, I think, that their social misdemeanors were the first reason quoted by Amos for God's condemnation of them.⁹⁰

God is concerned for social justice, and he is concerned that his own people put justice above everything else within society. The Israelites, by turning justice upside down, brought righteousness to the ground.⁹¹ The two are inseparably linked, demonstrating the interrelatedness of social and religious ideals.

Much earlier in the history of the Jews the concept of social justice was unequivocally written into their way of life. In Leviticus,92 among the rules about conduct, they were instructed thus: "You shall not pervert justice, either by favouring the poor or by subservience to the great. You shall judge your fellow-countryman with strict justice." Interestingly this was closely linked to the "our neighbour" concept. A man must be treated
as a man and this entails scrupulous justice.

It may seem as though I have strayed some distance from the theme of malnutrition. Justice however, is not an abstract concept to be viewed idealistically. It is a basic ingredient of equitable societies and of an equitable world; if societies are not equitable, justice is at a premium because lack of justice is closely associated with greed.

This association surfaces repeatedly in the Old Testament. In Jeremiah,⁹² for example, we read:

Think of your father: he ate and drank, dealt justly and fairly, all went well with him. He dispensed justice to the lowly and poor; did not this show he knew me? says the Lord. But you have no eyes, no thought for anything but gain.

The gain referred to here is "greedy wrongdoing." It is unjust gain, as is brought out in other passages.⁹³ John Taylor, ⁹⁴ in discussing this greed, expresses the idea that at the heart of it is "a narrow-minded obsession with one's personal desire and ambition." Where such exists, there can be no justice, no righteousness and no social stability.

Social justice is not therefore, a matter of legal ordinances, although it inevitably involves these. It is just as much a matter of personal life-style. Where individuals at large live selfindulgent, greedy, unjust lives, there will he other individuals who will lose out and will he unjustly treated. Where injustice serves the greed of sosue individuals, it leads to the deprivation of others. Where injustice leads to excessive overdevelopment of some nations, it leads to the gross underdcvelopment of others. Injustice is central to the well-nourishedmalnourished paradigm, and at the heart of injustice is the excessive covetousness of individuals.

Injustice should be anathema to Christians, not only because of the human suffering that follows in its wake, but also because Christ came to demonstrate the reality and nature of justice. This is the evocative picture painted by Jeremih⁹⁵ with these words: "The days are now coming, says the Lord when I will make a righteous Branch spring from David's line, a king who shall rule wisely, maintaining law and justice in the land." And this is, to use Jeremiah's phrase, "the Lord is our Righteousness."

The "our neighbour" concept demands standards of justice and righteousness. Nothing less is consonant with the dignity of man and the character of God. And implicit within this framework is the equal worthwhileness of all human beings, and the right of all people to be treated as individuals of value. This, in turn, should lead to the realization that individuals are of greater value than possessions, people are more important than things. And this is where the crunch so often comes.

The Christian, however, must cling to those words from Isaiah so deliberately quoted by Jesus⁹⁶ himself: "He has sent me to announce good news to the poor to let the brokers victims go free, to proclaim the year of the Lord's favour." Wide as the orbit of this task was, it included the alleviation of socio-political injustices. Carl Henry ⁹⁷ is insistent on this point,

The Christian is morally hound to challenge all beliefs and ideologies that trample man's personal dignity as a
hearer ,,f the divine image, all forms of political and economic practice that undercut the worth of human
beings 

Social injustice, and hence malnutrition, are more than legitimate concerns for the Christian. They are integral to his standing as a Christian. They are marks of his Christian character.

(d) The danger of riches

The dangers associated with amassing wealth are brought out on many occasions in the New Testament, where riches are seen more often than not as the consequence of greed. We may consider this another aspect of the greed-justice dichotomy stressed by so many of the Old Testament writers.

Jesus,⁹⁸ when discussing greed, introduces the idea of "enough", a concept developed in theological and social terms by Taylor⁹⁹ in his book Enough is Enough. According to Jesus, anything in excess of enough fails to provide satisfaction or depth to life. In all probability it is a symptom of self-destroying greed, in which the individual's own selfish desires are elevated at the expense of an understanding either of God or of the needs of other people.

Each of these possibilities is taken up by Jesus. On the one hand he demonstrates¹⁰⁰ that a love of things
simply demonstrates that our fundamental concerns are confined to that realm, In other words, materialism is the outward expression of an inward secularism. In Christ's own words: "For where your treasure is, there will your heart be also." The emphasis here is once again no storing up treasure on earth. It is the active attempt to amass possessions and wealth, with the aim of providing for oneself, one's own enjoyment and pleasure and one's own satisfaction. The wealth in these illustrations is misused; rather than serving others by enhancing their wellbeing, its inward direction destroys its rich owner and ensures its own sterility.

The other consequence of greed brought to the fore by Jesus¹⁰¹ is this neglect of other people's needs. The rich man in Christ's parable of the rich man and Lazarus is condemned for his total neglect of Lazarus' basic nutritional requirements. Indeed Lazarus is the epitome of the "little man with the shrunken belly" of Cohn Morris' saga. He was hungry, he lived with the dogs, and he died in penury. The rich man, meanwhile, ignored him.

The danger of excessive wealth lies here. It is not so much what can be acquired or built with the money; such things are neutral. The danger exists in the transformation wrought in the attitudes of the rich. The greed underlying these attitudes leads to neglect of God and neglect of his fellow men. Both results however, are aspects of the same problem-neglect of the world outside the rich individual himself. Concern for the poor, the hungry, the diseased, the deprived, the malnourished has no place in the limited world of the rich individual. They lie outside his self-indulgent frame of reference.

This is the antithesis of the epic promulgated by Jesus. It has nothing to do with the compassion of Jesus, or with the "our neighbour" concept, or with the justice and righteousness so actively put forward by the Old Testament prophets. Perhaps James¹⁰² in his New Testament letter best sums up the fate of the greedy rich. In sarcastic terms he concludes: "You have lived on earth in wanton luxury, fattening yourselves like cattle-and the day of slaughter has come."

The Christian stance amounts to concern for the poor, the despised and the malnourished. Anything in excess of enough is to be available for distribution as appropriate.¹⁰³ Those who are rich in material goods are also to be rich in good deeds. ¹⁰⁴ They, after all, are the ones who have this privilege. They are the ones able to mobilize financial and personnel resources. It is therefore, their responsibility. And so we find Moberg¹⁰⁵ writing,
I have concluded after years of reflection upon this subject that the weight of Christians usually should be thrown behind the poor, dispossessed, outcast, strangers, and minorities of society.

Our concern is to be directed towards those unable to protect and fend for themselves, and poverty replete with its undesirable social overtones must feature large in any such concern.¹⁰⁶

Another biblical justification for this stance is found in Christ's parable of the sheep and the goats,¹⁰⁷ where the righteous are equated with those who have provided food, drink and hospitality for people in need. Moreover, the righteous in acting in these ways directly minister to Christ himself. This reinforces the importance of social concern, although whether or not this parable has the extremely wide application sometimes given to it is a matter for debate. Nevertheless, we can readily say that ministering to human need has a direct hearing on our service of Christ.

(e) The perspective of Christian responsibility

It is important that the responsibility that Christians have for the malnourished should be seen in a Christian perspective. This is provided by some words of Jesus himself,¹⁰⁸ words of remarkable aptness for this topic. After dealing with some of man's chief causes of anxiety, such as his daily requirements of food and his need for essential material provisions such as clothes, Jesus reminds his disciples that God is aware of these needs and will provide for them. He then continues with this general principle: "Set your mind on God's kingdom and his justice before everything else, and all the rest will come to you as well."

Eller,¹⁰⁵ in his book The Simple Life, argues that this is the "essential premise upon which thought, faith and practice must build if the result is to qualify as the simple life in any Christian sense. There is a "first", and there is an "all the rest." He goes on to argue that a person is living the simple life when his ultimate loyalty is directed solely to God, with every other concern following on and flowing out from this central loyalty."' Hence, concern for food, clothing, pleasures, satisfactions-whatever "all the rest" may encompass-are good only "if they are used to support man's relationship to God rather than compete with it.¹¹¹

This gives us some clues about the perspectives for the rich, well nourished Christian, who has the freedom to consider and make such choices. What help does it give to the poor, malnourished Christian, who cannot choose but can ask only whether there actually is life before death?¹¹²

The poor Christian canbe assured of his essential food and clothing requirements, only insofar as the rich Christian shares with him his riches. It is precisely at this point that Mooneyham,¹¹³ finds what he terms a "food ethic" in the Bible. According to him this food ethic is encompassed by the "all the rest." Rich Christians should realize that a fundamental obligation placed upon them, in their brother's keeper role, is to give of their resources in compassion and in respect for the dignity and worth of man.

Christians everywhere pray the Lord's prayer: "Give us today our daily bread.¹¹⁴ This is a communal prayer by God's people world-wide. It is a recognition by Christians of their oneness in Christ and of their mutual obligations to serve each other. No Christian can he satisfied with his supply of food, while a brother in Christ lacks food. Indeed, on a broader front, no Christian can be content as long as anyone, anywhere lacks food.

Both poor and rich Christians are confronted by the same principle of primary dependence upon God, with the expectation that the essential requirements of life will he forthcoming. The poor Christian may well find himself thrust upon the former, with all too little knowledge of the latter. The rich Christian, by contrast, living in a world of super-abundance may find it all too difficult to appreciate that dependence upon God for his material needs is a reality.

The relationship therefore, between our dependence upon God and the provision of our material requirements is an intimate one, and this relationship holds for all Christians wherever they are placed on the wealth-nutrition scale. The nature of our response to this relationship will depend on our position on the scale, the criteria for action being our acknowledgement of the primacy of God in our lives and our desire in the light of this that our resources be used to serve both him and others.

Realization of his dependence upon God should lead the rich Christian not only to gratitude for the food and clothes he enjoys, but also to a way of life satisfied with "enough". This is the beginning of Christian social concern, a beginning that enables the well nourished to take seriously and respond enthusiastically to the world of malnourished individuals.

Actions Required by the Well-Nourished

In this paper my emphasis has been on the principles underlying the response of Christians to the malnourished world, emphasizing that it is individual people who are suffering and not simply anonymous societies. My stress therefore, has been on the attitudes essential to a Christian response, rather than on the particular programmes rich governments should adopt towards the underdeveloped nations. We are individuals who have to make our own response to the deprivation of our world. Individual initiative must come first; individuals must be motivated by the plight of other individuals, because it is only in this way that meaningful cooperative action will emerge.
As I turn to look more specifically at actions, my emphasis will still be on the responsibilities of individuals. Furthermore, it will soon become obvious that the actions urged on Christians by the biblical writers are implicit in the principles previously outlined. There is no rigid distinction between our attitudes and actions; the latter are merely the external aspect of the former.

Before I turn to the specific areas themselves however, one general point should be mentioned. This concerns the readiness with which Christians conform to the political status quo of the society of which they form a part. Moberg,¹¹⁵ in discussing the American situation, comments:

Americans selfishly assume that whatever is best for their own subculture, their own occupational group, their own neighbourhood, city, state, or county, will obviously be best for the entire nation-indeed, for the entire world.

This is not the place to enter either into the reasons behind this assertion or into their general validity. Suffice it to say, that this description of Americans and of American Christians could be applied to many other groups of Western Christians.

Working outwards from this assertion, Moberg¹¹⁶ proceeds to elaborate a concept of collective or social sin. In his own words:

(Many Christians) are conformed to their culture and this world age, participating in its unrighteousness, condoning its social evils, and cooperating in its collective sin . . . . Such sins may be individual acts, or they may he acts indulged in by . a nation, or even a church.

This condition Moberg terms "fractional conversion." What this means in practice is that Christians who, as individuals in their normal environments, may be loving, honest and kind people, may at the same time be implicated in evil through their roles as citizens or employees. More than this however, they appear to see no evil in the actions of their nation or employer and hence are willing participants in the evil. This is a major issue demanding rigorous debate and discussion. Nevertheless, Moherg's examples of social sin, including slavery, child labour, maltreatment of the mentally retarded, and exploitation of the poor and racial inequalities, have much to say about the nature of Western societies and raise poignant questions for Christians.

Another example of social sin is the scant attention paid by the rich nations to the poor nations. This may well he a conglomeration of social sins, of which our lack of concern for the malnourished of the world is just one component. Illustrations of these social sins are many, including the way in which so much aid is "tied" and the feeble attempts made by most rich countries to give even 0.7% of their gross national products annually as overseas grants and loans to developing countries.¹¹⁷

The question confronting its as individuals is whether we readily concur with such official attitudes or whether we believe a radical reversal of policies is desirable, given the political implications of such radical action. Are our attitudes-personal and political-radical in this area, or are we content to he a part of the prevalent social evils of our societies?

(a) Spurn excess

This is the corollary of the principle of "enough." Taylor,¹¹⁸ in working out a theology of enough, finds repeated instances of it in the Old Testament. In particular,

Realization of his dependence upon God should lead the rich Christian not only to gratitude for the food and clothes he enjoys, but also to a way of life satisfied with "enough."

he looks to the laws of gleaning,¹¹⁹ limited cropping¹²⁰ and tithing,¹²¹ each in its different way being a device for setting limits to selfish excess. The goal of these laws was the establishment of what Taylor calls an equipoise society, one characterized by right relationships and in which there was a balance between interdependence and responsibility. For the individual there was moderation, a readiness to fit his needs to the needs of others.

Implicit in this idea is the rejection of individualism and stark independence. So too is there a rejection of striving for excess, excess in one's own life at the expense of sufficient in another person's. The needs of a balanced community are brought into focus, a community in which each person receives and is satisfied with enough.

The imbalance of our world stands out in sharp relief against this picture of harmony and equality. The rich nations are overdeveloped; they are immersed in excess. The poor nations, by contrast, are just sufficiently developed or alarmingly underdeveloped; their resources are insufficient to meet the demands of a healthy, vigorous community.

The situation looks so hopeless that despair is frequently the order of the day. The principle of spurning excess is not however, a call either to pessimism or reluctant poverty. It is a matter of willingly sharing our abundance. This is brought out in relation to tithing, and is repeatedly met in the New Testament both in the teaching of Jesus¹²² and in Paul's letters. For instance, Pau1¹²³ on one occasion synthesized excess and equality with these words:

There is no question of relieving others at the cost of hardship to yourselves; it is a question of equality. At the moment your surplus meets their need, but one day your need may be met from their surplus. The aim is equality.

Here is the balance we need today. It is however, a balance that can he achieved only by the ready distribution of excess. Sharing is the indispensable fulcrum of a balanced society.

(b) Share riches

Of the many reasons that could be elicited for sharing the resources we have, perhaps the foundational one for the Christian, stems from the fact that everything created by Cod is good and is not to he rejected when used within a God-structured frame of reference. 124 Riches fall within this framework when viewed positively'. Paul's advice ¹²⁵ to the rich is therefore: "Tell thesis to do good and to grow rich in noble actions, to be ready to give away and to share, and so acquire a treasure which will form a good foundation for the future."
Sharing is repeatedly recognized as the prerequisite for a life of value, simply because the one who shares recognizes his dependence upon God, his creator, the worthwhileness of other human beings and his intimate relationship to them. Excess, on the other hand, emphasizes the converse-one's own autonomy in a closed universe, the lesser value of other human beings and one's independence of them.

Sharing of one's abundance is as much a religious necessity as a social or economic one. The task of justifying it in a malnourished world is a double one for Christians-the necessity of sharing at a national level and its possibility at an individual level through the example of their own lives. It was Jesus himself¹²⁶ who advocated that the man with two shirts must share with him who has no shirt. In exactly the same way, a person with excess food must share his excess with the person who is hungry. What greater justification could a Christian want than that?

(c) Support the needy

This pinpoints those who are to be recipients of the sharing of the rich. For those in the early church the needy in their midst were orphans and widows,¹²⁷ and considerable emphasis was placed on their support. In spite of this, help was not indiscriminate, care being taken to ascertain that there were no family sources of support and that the support was not likely to result in idleness and irresponsibility.

Material support was however, indispensable in certain instances and indeed was evidence of genuine Christianity. So it is today, although the needy from a Western standpoint may be largely outside Western churches and may also be largely outside the rich developed nations. The principle of support still holds; its application however, has to take different forms.

A Radical Response to a Revolutionary Situation

Were the Church of Jesus Christ to adopt the teachings of Christ and the teachings of the Scriptures relating to social justice, it would he far more radical than any extant political organization. While I have purposely confined myself in this paper to the level of individuals, even individual action along the lines I have suggested would have far-reaching social repercussions.

In the end the plight of the malnourished can he alleviated on a massive scale only by a major redistribution of power and wealth, between nations and also within nations.¹²⁸ Whether this is feasible politically and economically, or whether it is the pipe-dream of idealists is a question beyond my competence to answer. Neither am I in a position to judge whether such a redistribution of resources will he brought about by violent means. Suffice it to say that this is a possibility which should not he lightly dismissed.

That such questions are even being discussed highlights the gravity of the malnutrition issue, and it is essential for all of us to ask just where we begin. What should have emerged from this paper is that "the people of God have a radical and unique contribution to make toward the restructuring of the old systems and the creation of new ones.¹²⁹ This follows from the Christian view of man as a creation of God's arid as a person imaged after God's likeness. This is the basis of respect and concern for all men everywhere, regardless of their beliefs, colour, social status or aspirations. This is God's world and all people are God's people. Such is the dynamic of the Christian ethic, and yet unfortunately it is far easier to conform to the sub-Christian social ethic of the societies of which we form a part than launch out with a radical, truly Christian social ethic. In spite of this, the potential is there and the challenge of the malnourished world is an ever-present reality for the church today-in the rich and the poor nations alike.

A revolutionary situation demands a radical response. Such appears to have been provided in a few countries. Of all the preindustrial nations, three have eliminated malnutrition-North Vietnam, Cuba and the Peoples' Republic of China.¹³⁰ In these instances, revolutionary measures have achieved marked gains in this area. Whether these gains outweigh losses in other areas of life, such as the loss of personal freedom, is an issue worth pondering.

If Jesus was the revolutionary he is frequently said to he, Christians should he in the vanguard of social change working for the sort of social equality which will lead to the diminution of malnutrition. If malnutrition is a man-made disorder, such a goal is feasible.

Christians however, insist never forget that Jesus was principally neither a social reformer nor a political activist. While his teaching led to radical social changes, his message also warned of apocalyptic judgment on the world in the wake of man's rebellion against God."' Man therefore, is not only in need of social healing; he also needs the forgiveness of God and newness of life in Jesus Christ. Hence Christians have the task of presenting Christ as Saviour, as well as being salt and light in the present world, thereby bringing hope to society. This is the twofold, radical element of Christianity, and both aspects are required if the malnourished are to be helped back to wholeness of life.

©1978

REFERENCES

¹Winchester, S., The Australian, January 1976
²Mooncyhssrn, W. S., What Do You Say to a Hungry World?, p. 17, Word Books, Texas, 1975.
³Morris, C., Include Me Out!, p. 17, Collins/Fontana Books, Glasgow, 1975 edition.
⁴Moberg, D. 0., The Great Reversal: Evangelism versus Social Concern, p. 99, Scripture Union, London, 1973 edition.
⁵Genesis 41. This famine occurred around 1700 B.C., since which time there have been at least 375 documented famines throughout the world.
⁶Mark 13:8
⁷Time, p. 62, November 11, 1974.
⁸Berg, A., The Nutrition Factor, p. 5, The Brookings Institution, Washington, 1973.
⁹Jones, D. G., The vulnerability of the brain to undernutrition, Sci Prog., 63, 483-503 (1976).
¹⁰Shneour, E., The Malnourished Mind, pp. 6, 7, Doubleday/ Anchor Press, New York, 1974.
¹¹Cobos, F., Malnutrition and mental retardation: conceptual issues. In CIBA, Lipids, Malnutrition and the Developing Brain, pp. 227-248, Elsevier, Amsterdam, 1972.
¹²Mooneyham, op cit, part 1. 
¹³Ibid^.p. 27 see also Mooneyham, W. S., Ministering to the hunger belt, Christianity Today, 19, 326330 (1975).
¹⁴Heilbmoner, B., The Great Ascent: The Struggle for Economic Development in Our Time, p. 59, Harper and Row, New York, 1963.
¹⁵Mooneyham, op cit, p. 45.
¹⁶Marshall, A, Principles of Economics, MacMillan, New York, 1890.
¹⁷Billington, R., The Third World, p. 6, Inter-Varsity Press, London, 1972.
¹⁸Lancet (editorial), Classification of infantile malnutrition, Lancet 2, 302 (1970).
¹⁹OBrock, J. F., Ann. Int. Med., 65, 890 (1966).
²⁰Berg, op cit, p. 4.
²¹Jones, D. G., The Brain and Its Environment, Chapman and Hall, London, in preparation.
²²Robson, J. B. K., Malnutrition: Its Causation and Control, Vol. 1, p. 29, Gordon and Breach, New York, 1972.
²³Jones, op cit. p. 490.
²⁴Dobbing, J., Vulnerable periods in developing brain. In Applied Neurochemistry (ed. A. N. Davison and J. Dobbing), pp. 287-316, Blacksvell Scientific Publications, Oxford, 1968.
²⁵Dohbing, J., The later growth of the brain and its vulnerability, Pediatrics, 53, 2.6 (1974).
²⁶Cravioto, J., Dc Licardie, E. R. and Birch, H. C., Nutrition, growth and neurointegrative development: an experimental and ecologic study. Pediatrics, 38, 319-372 (1966).
²⁷For a summary of these points, see Jones, op cu, pp. 492, 493.
²⁸ ibid, pp. 494-497.
²⁹ibid, p. 499.
³⁰Cravioto, J., and Rubles, B., Evolution of motor and adaptive behavior during rehabilitation from kwashiorkor. Amer. J. Ortlsopsychiat. 35, 449-464 (1965).
³¹Craviotn, Dc Lieardie and Birch, op cit.
³²Chase, H. P. and Martin, H. P., Undernutrition and child development, New England J. Med., 282, 933.939 (1970).
³³Stoch, M. B., and Smythe, P. M., The effect of undernutrition during infancy an subsequent brain growth and intellectual development, S.A. Med. J., 41, 1027-1030 (1967).
³⁴Lloyd-Still, J. D., Hurwitz, I., Wolff, P. H. and Shwaehman, H., Intellectual development after severe malnutrition in infancy. Pediatrics, 54, 306-311 (1974).
³⁵Stein, Z. A,, Susser, M. Saenger, C. and Marolla, F., Famine and Human Development, Oxford University Press, New York, 1975.
³⁶Coursin, D. B. (for Subcommittee on Nutrition, Brain Development and Behavior), The relationship of nutrition to brain development and behavior, Ecal. Ed. Nutr., 2, 275280 (1973).
³⁷Barnes, B. H., Nutrition and man's intellect and behavior, Fed. Proc., 30, 1429.1433 (1971).
³⁸Dobbing, J,, Food and human brain development, Proc. 3rd lot. Congr. Jut. Org. Study of Human Development, Madrid, 1975.
³⁹Barnes, op cit.
⁴⁰Jones, D C., op cit.
⁴¹Mooneyham, op cit, p. 26.
⁴²Billingham, op cit, p. 1.
⁴³Jones, D. C., Making new men-a theology of modified man, JASA, 26, 144.154 (1974).
⁴⁴Fletcher, J., The Ethics of Genetic Control, Doubleday/Anchor Books, 1974.
⁴⁵Junes, D. C., The new man: have we the right to create him?, Ark, 3, 17-18 (1975).
⁴⁶Jones, D. G., What is man?-a biological perspective and Christian assessment, JASA. 28, 165 (1976).
⁴⁷Moonyham, op cit, p. 76.
⁴⁸Morris, op cit, p. 71.
⁴⁹Rokeach, M., The Paul H. Douglass Lectures for 1969: Past I. Value systems in religion. Part II. Religious values and social compassion, Review of Religious Research, 11, 3-39 (1969); see also Stark, R. and Glock, C.Y., American Piety: The Nature of Religious Commitment, University of California Press, Berkeley, 1969.
⁵⁰See for instance Moberg, op cit., pp. 61-63.
⁵¹ibid., p. 177.
⁵²Stott, J., Christian Mission in the Modern World, Falcon, London, 1975; see also Moberg, ibid.
⁵³Mooneyham, op cit, p. 29.
⁵⁴Morris, op cit, p. 80.
⁵⁵Bonhoeffer, D., Ethics, p. 137, MacMillan, New York, 1955
edition.
⁵⁶Henry, C. F. H., The Uneasy Conscience of Modern Fundamentalism, Eerdmans, Grand Rapids, 1947; Aspects of Christian Social Ethics, Eerdmans, Grand Rapids, 1964.
⁵⁷Moberg, D. 0., Inasmuch: Christian Social Responsibility in the Twentieth Century, Eerdmans, Grand Rapids, 1965; The Great Reversal: Evangelism versus Social Concern, op cit.
⁵⁸Wirt, S. R., The Social Conscience of the Evangelical, Harper
and Row, New York, 1968.
⁵⁹Stott, J. R. W., Christian Mission in the Modern World, op cit. 
⁶⁰Runia, K., Evangelical responsibility in a secularized world, Christianity Today, 14, 851-854 (1970). ⁶¹Stott, J., The Lausanne Covenant, p. 25, World Wide Publications, Minneapolis, 1975. 
⁶²Amos 1:1-2:3. 
⁶³E.g. Isaiah 10:1 if.
⁶⁴EIliott, C., The Development Debate, p. 87, 88. SCM Press, London, 1971.
⁶⁵ Stott, J., Christian Mission in the Modern World, op cit, p. 30. 
⁶⁶Gcisler, N. L., Ethics: Alternatives and Issues, pp. 178-180, Zondervan, Grand Rapids, 1971. 
⁶⁷Matthesv 22:39. 
⁶⁸Matthew 5:43; Luke 10:29 ff. 
⁶⁹Luke 1:53 (all Scripture quotations are from the New English Bible). 
⁷⁰Ward, L . . . . . . . . . And There will be Famines, p. 29, Regal, Glendale, 1973. 
⁷¹Morris, C., op cii, p. 57. 75Loke 10:25-28; Mark 12:28-34. 72Matthew 22:40. 7tMstthew 7:12. ⁷⁵Matthew 5:43; at. Rum. 12:20. 
⁷⁶Luke 6:27-31, 
⁷⁷1 John 3:16-18.
⁷⁸James 4:17. 
⁷⁹Mooneyhans, op cit, p. 27. 
⁸⁰James 2:1-9. 
⁸¹ Matthew 5:27, 28. 
⁸²Luke 10:25-37. 
⁸³Marshall, I. H., Commentary on Luke. In The New Bible Commentary Revised (ed. D. Guthrie, J. A. Motyer, A. M. Stibbs and D. J. Wiseman), p. 905, Inter-Varsity Press, London, 1970. 
⁸⁴Borgstrom, C., The dual challenge of health and hunger-a global crisis, 1968, quoted by Mooneyham, op cit, p. 24. 
⁸⁵Galatians 6:10. 
⁸⁶Salley, C. and Behm, R., Your God is Too White, p. 119, Lion Publishing, Berkhamsted, 1973 edition. ⁸⁷Schroteuboer, P., What is!?, Inside 2, 26-27 (1971).
⁸⁸Amos 2:6, 7; 3:9, 10; 5:7.20.
⁸⁹Motyvr, J. A., The Day of the Lion, p. 83, Inter-Varsity Press, London, 1974. 
⁹⁰Amos 3:9-4:5. 
⁹¹Amos 5:7. 
⁹²Jerensinh 22:13.17. 
⁹³Exodus 18:21; Habakkuk 2:9.11. 
⁹⁴Taylur, J. V., Enough is Enough, p. 44, SCM Press, London, 1975. 
⁹⁵Jeremiah 23:5, 6. 
⁹⁶Luke 4:18. 
⁹⁷Henry, C. F. H., A Plea for Evangelical Demonstration, pp. 111, 112, Baker Book House, Grand Rapids, 1971. 
⁹⁸Luke 12:13-21. 
⁹⁹Taylor, op cit. 
¹⁰⁰Matthew 6:19-21. 
¹⁰¹Luke 16:19-31. 
¹⁰²James 5:1-6. 
¹⁰³John 3:17. 
¹⁰⁴Timothy 6:17-19. 
¹⁰⁵Maberg, The Great Reversal; Evangelism versus Social Concern, op cit p. 134; cf. Proverbs 31:9.
¹⁰⁶see for example Luke 14:13, 14; Luke 18:22; Luke 19:8; Galatians 2:10; Romans 15:26; Acts 11:29; Leviticus 19:9; Leviticus 25:35; Proverbs 19:11; Psalm 41:1. 
¹⁰⁷Matthcw 25:31-46. 
¹⁰⁸Mattlsew 6:25-34.
¹⁰⁹Ellcr, V., The Simple Life, p. 20, Eerdmaus, Grand Rapids, 1973. 
¹¹⁰Ibid, p. 28. 
¹¹¹Ibid, pp. 28, 29. 
¹¹²Moonsyham, op cit, p. 33. 
¹¹³Ibid, 1). 178. 
¹¹⁴Matthcw 6:11.
¹¹⁵Moberg, The Great Reversal: Evangelism versus Social Concern, op. cit, p. 126. 
¹¹⁶Ibid, p. 127.
¹¹⁷Billingtnn, op cit, pp. 7, 8; Moneyhan, op cit, pp. 116-131. 
¹¹⁸Taylor, op cit, pp. 40-62.
¹¹⁹Leviticus 19:9, 10; Deuteronomy 25:19-22. 
¹²⁰Deuteronomy 22:9; Exodus 23:10, 11; Leviticus 25:1-7. 
¹²¹Deuteronomy 14:22-29. 
¹²²Loke 6:38.
¹²³E.g. 2 Corinthians 8:12-15. 
¹²⁴1 Timothy 4:4, 5. 
¹²⁵1 Timothy 6:17-19. 
¹²⁶Luke 3:10, 11.
¹²⁷1 Timothy 5:3-16; James 1:27.
¹²⁸Hatfield, M., quoted by Mooneyham, op cit, p. 131. 
¹²⁹Mooneyham, ibid, o 123. 
^13OWatts, G., The ecology of hunger-a portrait of Professor Joaquin Cravioto, New Scientist, pp. 388-390, 19 February, 1976. 
¹³¹Henry, A Plea for Evangelical Demonstration, op elf, pp. 123, 124.