India, Pakistan, Mali, Maine... You Know... Everywhere

When I got to India the first time, having driven my VW van across Asia, I was just getting out of my teens. I entered in the Punjab, drove to Delphi, Bombay, Goa, through Kerala, took the ferry across to Ceylon for a few months, then drove to Pondicherry, Madras, north through Andhra Pradessh and Orissa (where Tom Wolf, probably the next governor of Pennsylvania was serving in the Peace Corps at the time), on to Calcutta, Benares and up into Nepal for a couple months, Oh, and what fun it was! I'll spare you the unsavory details of what the Kabul Runs entails, but I can still remember the first time I realized that the slab of dead animal hanging from a hook in every (unrefrigerated) marketplace across Asia was black because it was covered in flies.

Around a decade later, one of my closest friends, at least in part inspired by my stories of India, the painter Eveline Pommier, traveled to India, contracted cholera and died, not yet 30. India has never been-- and never will be-- at least not in our lifetimes-- a walk in the park. Anyone who forgets this a trip to India is a serious undertaking, vacation, business trip, spiritual pilgrimage or what-- is putting their health and even their life in jeopardy.

Years later, Roland and I were driving around Rajasthan when we stopped for dinner at a high-end restaurant in Jaipur. Yum, yum. Afterwards we were walking around town and we wound up back behind the restaurant, where we saw some small boys filling up the bottled water they had been serving from a hose. I keep traveling to the Third World-- we were back in India last Christmas, for example-- and the hygiene everywhere is... spotty. On our way to a wonderful restaurant in Bamako a few years ago, perhaps the only really "wonderful" restaurant in the whole country, we counted a number of people using the public sidewalk to squat down and... well... #2. You get used to it. Or you go to Disneyland or, maybe, London and Paris, instead.

A couple days ago I was driving around L.A. listening to Terry Gross interview Pakistani author Mohsin Hamid about his new book, How to Get Filthy Rich in Rising Asia. Hamid isn't some Pakistani bumpkin or, despite his previous book, The Reluctant Fundamentalist, a fundamentalist, a movie version of which opens next month. He spent a lot of his childhood in Palo Alto and earned degrees from Princeton and Harvard. How to Get Filthy Rich seems to be set in his hometown (and where he lives now), Lahore, a city I first visited in 1969 (when it had a million people; today it has 10 million). Wonderful place!

The main character in Filthy Rich, which is actually written like a weird How-To book, feels his best way to get rich is through a series of scams, a tried and true tradition across cultures, as we've seen in the History Channel series, The Men Who Built America. Hamid's character doesn't seem all that foreign when he takes goods that have expired and makes labels for them with longer shelf lives. Eventually he strikes it rich by boiling tap water and selling it as expensive mineral water. When I mentioned it to Roland, he seemed relieved. "At least," he said, "he was boiling it."

"[T]he marketization of water, the sort of application of a kind of uber-capitalism that you see really all over the world and certainly in Pakistan, is in some senses you can see it most clearly in water because water used to be almost free. You could get water, you know, from a river, from a canal, from a well, from wherever. And now, of course, we're running out of clean water in most of Asia and much of Africa and much of Latin America. And so people don't have clean drinking water. And we can live for a month without food, but we can't last more than a couple of days without water. So people are selling water, and both at the luxury level, where you have these high-end mineral waters and also at the level of just poor people needing something to drink. So his scam is to take mineral water bottles that have been consumed at high-end restaurants, buy the empties, take tap water, boil it a little bit, pour it into these mineral water bottles and reseal it so it looks like it's an authentic water bottle and sell it back to the exact same restaurants, who probably suspect that it's a scam product, but because it's so much cheaper than the water they buy normally are happy to take it on." The book, Gross explains in her introduction "is both a satire of self-help books and an examination of life in an Asian city with a growing middle class and an infrastructure that can't support it, except for the crime infrastructure, which is thriving."

This book is a self-help book. Its objective, as it says on the cover, is to show you how to get filthy rich in rising Asia, and to do that, it has to find you huddled, shivering on the packed earth under your mother's cot one cold, dewy morning... I originally didn't want to write it as a self-help book. I was trying to write this as a straight novel, and as usually happens with me, I did that for a couple of years and failed and eventually stumbled across this self-help book form. And what I liked about the self-help book form was I started to realize that in a way I actually do write novels to help myself.

...I think it's a story that is a type of story that is common in Pakistan, but more than Pakistan in the entire world, because something like half the world's people now live in cities for the first time in human history. But in the course of the next generation, 25, 30 years, that number is going to go to 80 or 90 percent, which means a couple billion people are going to move to cities in Asia and Africa and Latin America, all over the world. And I think there's a lot of similarity between going from a poor countryside to a Third World megacity, which is a journey that these billions of people are on. So in a sense this is a story of that mass migration in Pakistan but also elsewhere.

Gross mentions the rotting water pipes and how "the contents of underground water mains and sewers mingling with the result that taps in locales rich and poor alike disgorge liquids that while for the most part clear and often odorless reliably contain trace levels of feces and microorganisms capable of causing diarrhea, hepatitis, dysentery and typhoid." Hamid's wife was diagnosed with hepatitis the day after their wedding. "And it was the second time she had had it," he said. "Virtually everybody in my family has had either hepatitis or typhoid or something of that sort. You know, water-borne illness is everywhere. It affects the poor, and it also affects the affluent in a place like Pakistan... [Y]ou get it from either drinking water, you know, brushing your teeth with tap water, or perhaps somebody prepared your food, and they had washed their hands in that water or touched the water or hadn't washed their hands at all. I mean it's-- the mode of transmission is what's called oral-fecal, and that sort of unsavory term really sums up how you get it." His character, the bottled water scammer millionaire had hepatitis too.

[H]e has it as a boy, and so many of us had it, and it's a strange situation. You know, living in America, where in most cities you can drink tap water, and even so, people do have bottled water, but the tap water is perfectly safe to drink almost all the time, there is an enormous difference in a society where you can do that and a society where you cannot do that. And most of the world actually you cannot do that. So the government, the state, hasn't performed the basic, basic service of taking this most common of all commodities that we use and making it safe for everybody to drink as they please.

Not even in Poland Springs, Maine.

Low wage workers at the Poland Springs Bottling Plant in Maine, which is owned by Nestlé, are so angry with the way the company treats them that they're doing pretty disgusting things to pollute the water-- not that Nestlé gives a damn. Nestlé settled a law suit accusing it of using water under a former trash and refuse dump, and below an illegal disposal site where human sewage was sprayed as fertilizer for many years. Nestlé paid $10 million in the settlement but continues to sell the same Maine water under the Poland Spring name.

And they make a lot of money selling that crap too. People are trying to get their hands on money now... everywhere. And many will do anything to get it. If you listen to the whole NPR interview, you can see that Hamid is clear that he was painting what everyone assumes is Lahore as a prototype for any big 21st Century metropolis. Saturday's Michael Mudd OpEd about food ethics in the U.S. doesn't compare Lahore to New York City, nor selling fake bottled water to what American AgriBusiness does but... don't let that stop you. And Mudd, a former high ranking Kraft Foods executive, wants to see governments step up their efforts to protect the public health by limiting the marketing tactics of food companies, despite Bloomberg's failure in NYC this month. "Anyone," he writes, "who believes these interventions are uncalled-for doesn’t know the industry the way I do."

I was part of the packaged food and beverage business for more than 20 years. As the national waistline grew, the industry sought refuge in the fact that the obesity epidemic has many causes. It has insistently used that fact to fight off government regulators and justify why it should not have to change what it sells or how it sells it.

With tobacco, the link between product and disease is direct and singular. But it is less clear with food: the rise in obesity is the result of multiple factors. Suburban life discourages walking. Escalators have replaced stairs. Schools have eliminated gym class. Kids play video games now, not kickball. Even the vast increase in two-income households over the past 40 years has had an impact, discouraging cooking and increasing reliance on packaged foods and chain restaurants. It all adds up.

So when it’s time to pick the guilty party out of the police lineup, the food industry cries foul whenever critics point to it. “Hey,” the industry complains, “why pick on us when everybody in the lineup is guilty?”

But that’s not true. Everybody in this lineup of cumulative social and environmental changes may have played a role in the growth of obesity, but none are culpable the way the big food processors and soft drink companies are.

The industry is guilty because it knew what the consequences of its actions might be. Large food processors employed a flock of Ph.D. nutritionists and food scientists. The connection between calorie consumption and weight gain was always as plain as the number on the bathroom scale. But instead of acknowledging this and taking corrective action to sell a better product more responsibly, food processors played innocent by blending in with the crowd of causes. It’s time to end the charade and mandate the needed changes that the industry has refused to make.

...Even as awareness grew of the health consequences of obesity, the industry continued to emphasize cheap and often unhealthful ingredients that maximized taste, shelf life and profits. More egregious, it aggressively promoted larger portion sizes, one of the few ways left to increase overall consumption in an otherwise slow-growth market.

All this tells us two very important things. First, the food industry knows it has a problem, potentially a very big one if the forces against it ever do coalesce effectively. So, in maneuvering for protection by managing public opinion and policy formation, the industry will always try to camouflage itself as just one of many causes in the growth of obesity. Just as the National Rifle Association points to mental illness and violent video games as a way to deflect attention from the inherent dangers of guns, food processors will wring their hands about physical activity and, yes, video games. We shouldn’t fall for it.

...The needed changes could take many forms. Here are some of the most promising:

Levy federal and state excise taxes on sugared beverages and a few categories-- snack foods, candy, sweet baked goods-- that most undermine health. These taxes could help pay for education programs, subsidize the healthiest foods for low-income individuals and, maybe, discourage consumption.

Make mandatory the federal guidelines for marketing food to children that were proposed in 2011. These guidelines-- written jointly by the Federal Trade Commission, the Food and Drug Administration, the Centers for Disease Control and Prevention and the Department of Agriculture-- were only to be voluntary, and still lobbyists for the food industry persuaded Congress to block them.

Communicate more actively with people about their food choices. Require prominent disclosure of calories for every item on the menu in chain restaurants and vending machines. And create a front-of-the-package labeling system to encourage healthier food choices. Finally, the government should back community-based campaigns to inform and inspire better eating and more exercise.