The Blind Men and the Elephant

Blindness is in the Eye of the Beholder

“…As one can conclude from our foregoing commen-tary, we embrace the notion that situational factors make "truths" from one setting into "falsehoods" in another. Our agreement with the important principle of geographic specificity aside, however, we disagree with what Nevin Scrimshaw draws as his lesson, namely, that the Bangladesh-based paper "reports that even evaluation of a method in three different countries was apparently not sufficient to ensure its applicability to all countries" [3]. Who tested the applicability?…”

“…The last two International Vitamin A Consultative Group (IVACG) meetings have shown that it has come into frequent use. In poorer countries, it has even been used in national surveys, in Laos [3] and Mozambique [4]. This indicates the need for a simplified method such as the HKI FFM in the study of vitamin A deficiency.…”

“…The appropriate outcome variation is not lactation behaviour, but rather prevalences of low retinol levels in the circulations; blood specimens-not milk samples-are the arbiters in this debate. We thank both Persson and colleagues [2] and this journal's Editor [3] for drawing attention to the HKI method. Moreover, there is no doubt over one set of facts that we all share in common: that further validation of the HKI FFM would be beneficial and that breastmilk is undeniably an important component of nutrition.…”

“…The extent of the applicability of this generic HKI FFM approach is called into question in an article by Persson et al [2], with the title "The Helen Keller International food-frequency method underestimates vitamin A intake where sustained breastfeeding is common," which presented data from Bangladesh. The third element was an erudite editorial by the editor of the Bulletin [3] entitled "The blind men and the elephant. "…”

To the Editor

“…I did not experience much difficulty in recognizing myself as the first blind man in your commentary [1]. The blind and other disabled are frequently misunderstood and misrepresented, so perhaps I might be given the chance to set the record straight.…”