MUAC: A Talisman / Darryl Stellmach

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Image credit: Luis C. Diaz (CC BY-SA 2.0) https://www.flickr.com/photos/luiscdiaz/3189218916

I never saw it myself, but I heard it from the medics in the hospital where we worked in Marere, Lower Juba, that when receiving treatment for wounds, Somali patients might plaster a small piece of paper with a Quranic verse into the open face of the injury, before the gauze and dressing were laid overtop. In the following days, the paper and verse would incorporate into the wound, word and line becoming one with the patient’s body.

Years later, reading “The Art of Memory,” I would be struck at Dale Eickleman’s account of the “Quranic Presence” in Islamic education in Morocco. A father gave permission to the Quranic teacher to use force, if needed, to get the Quran into the boy. The verse was the word of God and the word of God was transmitted through the teacher’s intervention into the vessel of the boy’s memory (Eickleman 1978:494). Through memorization and appropriate recitation of verse the boy—and by extension his family—came to embody and carry the power of the Quran itself.

The body was a vessel. It seemed to me it was not so much the object (the book, the inscribed scrap of paper) that was sacred, as the words themselves. If those words could be incorporated into the body—through ink mingling with bodily fluids, or through memory—they imbued the body with moral power.

In the same way as words can charge bodies with power, bodies can do the same for words and numbers. The MUAC tape is a simple device, deceptive for its bright colours and unassuming manner. The Measure of Mid-Upper Arm Circumference is a diagnostic tool for childhood undernutrition. In children under 5 years of age, circumference of the triceps and biceps is a good indicator of nutritional wellbeing and a predictor of mortality. The colourful plastic MUAC tape, a purpose-built measuring device, is designed to easily read and interpret upper arm circumference. Like the Quranic verses written on scraps of paper, this small, inscribed piece of plastic is a talisman, but of a different sort. Where the scrap paper Quranic talismans charge the body with spiritual force, the MUAC uses the weight of the body to charge numbers with moral force.

To be encircled by the MUAC is to be counted. Used almost exclusively in the context of aid programs to combat hunger and undernutrition, to be MUACed is to be numbered among the thousands of small bodies that lend their weight, in grams, to statistics. It is to add the fibre of one’s being to a moral argument: children should not starve.

But children do starve. The MUAC can tell us if the child in front of us is starving. And it does more: when the MUAC’s numbers are aggregated, through epidemiology, it shows us where and approximately how many children are starving. On individual and population levels, the MUAC implies the need for action; it brings historical, social and moral power to bear.

To be encircled by the MUAC is also to be assessed, and if found worthy, to be delivered into care. The MUAC invokes the protective sphere of the clinic, the power of the practice of therapeutic nutrition, where medicine, in the form of clinically-engineered food, is made to work upon bodies, to imbue strength and restore health.

In these ways the numbered MUAC and the Quranic verse on crumpled paper are both talismans: objects infused with a vast complex of moral, historical and social expectations—that when employed in the right context, with a certain understanding, can exert and extend protective force upon the bodies they contact.

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References:

Eickelman, D.F. (1978). The art of memory: Islamic education and its social reproduction. Comparative Studies in Society and History, 20(4): 485–516.

Redfield, P. (2013). Life in crisis: The ethical journey of Doctors Without Borders. University of California Press.

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Darryl Stellmach spent ten years as a field manager with the international emergency medical organization Médecins Sans Frontières. A 2012 Commonwealth Doctoral Scholar, he is currently in the third year of his doctorate in Anthropology at the University of Oxford. Follow him on Twitter.

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