Strange place. And the strangest of missions. While the UN warns of famine, I am driving through the Sahara in search of fat ladies. I meet World Vision, a Christian relief agency, on the road and ask their project chief if she’s seen any.
‘Er, I don’t think so,’ she says with a withering look. ‘We’re in a stage three emergency here; that’s one step away from famine.’ Locusts have devoured harvests, rains have failed and as investigations go, this one feels absurd. Yet female obesity, not starvation, is what’s killing the women of Mauritania.
A doctor in the town of Kifa examines a woman in her thirties weighing in at 18 stone. ‘Most of the women here are obese,’ he says. ‘First they become less fertile. Then they get gallstones in their twenties, arthritis, diabetes and heart disease in their thirties and forties. By 50 and 60, if they survive that long, they can no longer walk. They are completely handicapped. They can do nothing.’ He wraps the woman’s arm in a giant blood-pressure sleeve. It is 160 over 120.
A younger woman in the obstetrics ward smiles in protest when Dr Sid Ahmed Ould Megeya, Mauritania’s surgeon general, explains that she has just lost her fourth consecutive baby in childbirth because of obesity. ‘I’m not fat,’ she says. ‘I’m just swollen because of heart disease.’ He smiles back and shakes his head.
‘You won’t see the really severe cases,’ he tells me. ‘They cannot get on to a camel or into a car. I have had women carried in on a blanket and rolled along the floor into my consulting room.’
What has brought this on? Not the junk foods that have fattened Westerners, though they are on their way and will compound the problem once Mauritania’s off-shore oil receipts start flowing this December. Here chronic obesity starts with the tradition of gavage — the force-feeding of girls from seven years old.
‘I was force-fed as a child,’ one woman tells me. ‘We all were. We thought it was good, that we would marry well. Now fashions have changed.’ Why do they do it? Force-feeding in this highly stratified, tribal, Islamic society comes from a mixture of cultural legacies which have conspired to fatten, immobilise and disable the women of Mauritania’s ruling tribes, the White Moors.
This is a country the size of France with fewer than three million people. Mostly desert, it’s where the Arabs once came to trade in the region’s most lucrative commodity: African slaves. Long after the rest of the world had banned the trade, Mauritania’s White Moors refused to give it up. It’s now been officially abolished at least three times, the last in 1980. Old habits die hard and although the word ‘slavery’ is now taboo, little black housemaids still grace many homes. For the women of the ruling tribes, to be fat is still a sign of being rich enough to be indolent and own slaves...
There’s a logic to it. It’s a society of camel breeders, so stocking up in times of plenty seems efficient. But add a little conservative Islam, which confines women to the home, plus the indolence that marks out the slave-traders from the traded, and you have a problem.
Like slavery, it’s all officially in the past, but one in ten Mauritanian girls are still force-fed according to independent estimates. Getting fat without Western food is long, hard work. A small child has to be forced to drink vast, unnatural quantities of milk — three or four litres of cow or camel milk — every night for years. The milk is mixed with couscous and water to swell the stomach. She is given marbles to play with to keep her still, she cannot play sports, ride a bike or run around, and older women supervise, ensuring the milk stays down. They clamp the child’s fingers and toes between sticks to stem the vomiting reflex by distracting the child with a little local pain. Often the girls vomit violently...
Women in the villages keep asking me for ‘cow-pills’, their name for steroids, which pharmacies sell illegally over the counter. I am sold a brand which is usually only for patients with terminal cancer.
‘You can always tell the ones on steroids,’ my driver says, his eyes twinkling. ‘They are large on top but their hips are small.’ ‘Acne and facial hair,’ adds the doctor to the list of symptoms. He isn’t smiling. He lost his own sister to steroid abuse. He looks at my stash of illegally bought drugs and shakes his head. ‘Did you really buy these here? They will kill you, the pharmacy should be shut down. He is a merchant of death. But it makes me sad,’ he says, ‘that a woman would risk her life just to be fat.’
Force Fed will be shown on BBC2 on 16 November at 7 p.m.
In case you're wondering who the White Moors are, here is Gary Brecher's explanation:
And that's the Mauritanian population today: "Moors" from the North [i.e. white Berbers forced out of the mountains of Northwest Africa and down into the Sahara] and "black Africans" from the South in about equal numbers, hating each other, wishing they were somewhere else. Just to make it more confusing, there are "white" Moors and "black" Moors. The black Moors used to be kept as slaves by the whites, but that only makes them even snobbier about their Moorishness. They have a real Moor-ier than thou attitude and go around sneering at the black non-Moors. Snobby slaves -- there's a lot of that going around.