Scheper-Hughes+Reading

Scheper-Hughes+Reading - lassachusett . A} ‘Before’...

Info iconThis preview shows pages 1–6. Sign up to view the full content.

View Full Document Right Arrow Icon
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Background image of page 2
Background image of page 3

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Background image of page 4
Background image of page 5

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Background image of page 6
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: lassachusett . A} ‘Before’ Society i-x (.10 . z '4: the Prise: alishers. 'tbouse. New; anyway. The opposite of love is not hate, but indifference. Forebodings ,Why do the church bells ring so often?” I asked Nailza de Arruda soon after I had moved into a incomer of her tiny mud~walled but near the top of Alto do Cruzeiro. It was the dry and blazingly «hot summer of 1964, the months following the .. “bells of Nossa Senhora das Dores Church, an i eerie quiet had settled over the town. Beneath the quiet, however, were chaos and panic. “It’s nothing,” replied Nailza, “just another little igangel gone to heaven.” Naiiza had sent more than Sher share of little angels to heaven, and sometimes at night I could hear her engaged in a muffled, yet :passionate, discourse with one of them: 2-year-oid Joana. Joana’s photograph, taken as she lay eyes epened and propped up in her tiny cardboard Coffin, hung on a wall mm to the photo of Nailza 5? ._._.and Zé Anténio taken on the day the couple had eloped a few years before. Zé Antém'o, uncomfort~ able in his one good, starched, white shirt, looked into the camera every bit as startled as the uncanny Wide—eyed toddler in her white dress. . .W, _ I'll. .‘ - . a .a .. fi if- . it. offin: The Social Production of Indifference to Child Death Nancy Scheper—Hugbes ~ A child died today in the favela. He was two months old. If he had lived'he would have gone hungry -- 3'12" i'l‘lé' ' 3‘ n - 4'3” . .‘f ." .'*T.I"{,/ i 3"? fifth-(J. 0‘ .. m = -:.'-«‘vc.-..-‘¢ Carolina Maria de Jesus (1962: 108) Elie Wiesel (1990: 174) Nailza could barely remember the names of the other infants and babies who came and went in close succession. Some had died unnamed and had been hastily baptized in their coffins. Few lived more than a month or two. Only Joana, pr0perly baptized in church at the close of her first year and placed under the protection of a powerful saint, military coup, and save for the rusty, clanging Joan of Arc, had been expected to live. And Naiiza had dangerously allowed herself to love the little girl. In addressing the dead child, Nailza’s voice would range from tearful imploring to angry re- crimination: “Why did you leave me? Was your patron saint so greedy that she could not allow me one child on this earth?” Zé Anténio advised me to ignore Nailza’s odd behavior, which he understood as a kind of madness that, like the birth and death of children, came and went. [. . .] Throughout Northeast Brazil, whenever one asks a poor woman how many chiidren she has in her family, she invariably replies with the formula, “X children, 32 living.” Sometimes she may say, “Y living, z angels.” Women themselves, unlike the local and state bureaucracies, keep close track of their reproductive issue, counting the living along VI I ___ _ ,..-........ ..,.__'._,a n - O. - . . .... __ _,.,_ _W.va—a_v—a.uu—- 276 NANCY SCHEPER—HUGHES FL; \ with the dead, stillborn, and miscarried. Each little angel is proudly tabulated, a flower in the mother’s crown of thorns, each the sign of special graces and indulgences accumulating in the afterlife. There are a great many angels to keep track of. It is just as well that so many women are doing the counting. When I first began in 1982 to try documenting the extent of infant and child mortality in the mum? cz’pio, I was stymied by the difficulty in finding reliable local statistics. I was referred by various public officials of Bom Jesus to the office of the local IBGE, the national central statistics bureau. This was a small rented room across the hall from a local dentist’s office in “downtown” Bom Jesus and was closed each time I went there. Finally, one afternoonl encountered a civil servant sleeping in a chair in the otherwise empty office. There was not so much as a typewriter or a file cabinet. “No,” I was told, “there are no statistics kept here w no numbers at all.” Everything, I was told, was tabu- lated and sent off to the central office in Recife. The application of some local political pressure, however, yielded summaries of vital statistics for the community for selected years in the 19705. In 1977, 761 live births (599 in hospital, 162 at home) and 311 deaths of infants were recorded, yielding an IMR (infant mortality rate) of 409/ 1,000. In 1978, 896 live births (719 in hospital, 177 at home) and 320 infant deaths yielded an infant mortality rate of 35 7/ 1,000. If these Estatis— tics were reliable, they indicated that between 36 percent and 41 percent of all infants in the mane Cipro were dying in the first 12 months of their lives, a state of affairs that was immediately and roundly denied by the mayor as an absurdity. “My municz’pio is growing, not declining,” he insisted, and Sen Felix sent me to the local hospital to corroborate the IBGE statistics with the records on births and deaths kept there. The Barbosa Hospital and Maternity Center is one of three hOSpitals serving the entire region of the zona da mam — aorta of Pernambuco and Para- iba. Although privately owned by, the Barbosa family, the hospital primarily serves the needs of the rural popular classes, many of whom receive medical services without charge. Hence, the hos- pital attracts a large clientele that extends far beyond the limits of the municipality, and its statis- tics reflected a regional, not a municipal, pattern. Nonetheless, the head nurse gave me access to her records. For 1981 a total of 3,213 deliveries were recorded, of which 807 were of indigent, or non- paying, patients. The remaining deliveries We I. 3' covered by the national health care secufity SYStere Line a [f or by therural workers health fund. There We“: v.16 (3.1 percent) stillbirths and 38 (1.2 percent) peri‘ natal deaths in the maternity wing for that War When I returned in 19 87 the figures for the pram. ous year were 2,730 deliveries, of which 68 (2 5 percent) were stillborn and 27 (1 percent) diEd E: I “ C within 48 hours postpartum. Official death cartifiQ we cates were issued in the name of attending phyS‘ ._,;j.}i:,0rf icians, but these were generally filled out by a nurse I take or hospital functionary. And the causes of death, Tl when given at all, were perfunctory: “prematurity” remg and “heart and respiratory failure” were the moss, and common diagnoses. One hospital physician had a mo, disproportionately high number of stillbirths and gain: perinatal deaths in his practice at the maternity L: wing. But no one seemed to be keeping track too MOE closely or carefully. he ‘ After I had begun, through various and some coff times creative means, to assess the extent of child 31:1‘0 mortality in Born Jesus, I made a visit to the first call and newly appointed secretary of health for Bom bacl Jesus. Responding to inquiries about the greatest coff health risks to the population of the municfpio, the disc debonair and energetic Dr. Ricardo offered with we: out a moment’s hesitation, “Stress.” And he began plaj to outline his proposals for a stress-reduction edu- as r cation program that would target the substantial and business and professional class of the community. bet' Heart problems and cancer were, the secretary of 3 health continued, the two greatest causes of death cor in the bustling little metropolis. When confronted mu with the data painstakingly culled from the civil dec registry office in Bom Jesus indicating that almost but a half of all deaths in the municz’pz‘o each year were col of children under the age of 5 and that diarrhea, s not heart disease, and hunger, not stress, were the W1 main pathogens, Dr. Ricardo sighed and raised his pet eyes to the heavens: “Oh, child mortality! If we ml were to talk child mortality. . . an absurdity, surely. if; be: And unknowable as well.” W “What do you mean?” m “When I took over this office last August, the lll’ municipal administration had no figures on child if: an mortality, none whatsoever. I had to send for them i}. fl“ from the state, and they were unusable: an infant pig“ an mortality of 120 percent!” “How can that be?” 3 3 “And why not? It’s quite straightforward. The 31- official figures said that of every 100 infants born 0f in Bom Jesus, 120 of them died before they reached th age of one year! What a disaster! No wonder . x - so underdeveIOped in Brazil ~— more of us die .. .ngr'iiare even born!” Erma}; there are other ways of counting the i1”: ” I suggested. “For example, how many char" :b'gby coffins does the mayor’s office distribute ,C‘h month?” “H‘éOh, there’s no limit there, no limit at all. We '5 the people as many as they want. In fact, the more they want, the better! It’s one of the things we I marks captured both the social embarrassment d the bureaucratic indifference toward child rtality as a premodern plague in a self~con- s'T .“carpenters” for the city are poor people’s , “'éffins, mostly baby coffins. Nonetheless, Moacir ,.:f.‘« of the munic1pal chambers referred to as a is workshop or a casa fzmerciria. And so the ;, «giiliScreet Sign over his door read, «Municipal Wood- :I. - .ktnrw’xh. ' j much cardboard and papier-maché as plywood ‘ pine. His “product,” he told me, cost the city 2 and 8 dollars apiece, depending on size. {EYES}, he was quite busy, Moacir said, but he liliiirial. There were more than twice as many baby 4m? ' fillfins requested as adult ones. February and «Fliflarch were the “busiest” months for his "work. Perhaps it was, he hazarded a guess, because L'Eeeple liked to marry in June after the festas juni- ixi’. ' .95 were over and boys and girls on the Alto had it: style was similar for both — a cardboard top .d a plywood bottom. All adult coffins, regardless of sex, were painted muddy brown (“Earth tone,” said Moacir), and children’s coffins, males and females, to the age .7 were painted “sky blue, the favorite color of eVirgin.” Moacir noted a detail: there were no fasteners on the children’s coffins because parents preferred to put their angels into the ground as unencumbered as possible so that the children’s spirits were free to escape their premature graves. Moacir found it difficult to estimate how many coffins “left” the workshop each week: “Some days as many as five or six will leave the shot}. And then there are days when there are no requests at all.” But, he added, ,...“this doesn’t affect my productivity. I just keep on working steadily so that coffins are never lacking in the municz’pio. I don’t like to fall behind in my work, even on a holiday a comrade can find me, and I will have a coffin in stock that will serve his needs.” I asked Moacir if he would be willing to go over his requisitions for the previous few weeks, and, somewhat reluctantly, he agreed. We moved over to a cluttered desk with slips of paper in small, untidy piles. “Here,” he said picking up one pile, “I’ll read them out to you. But I warn you, things are a little chaotic. Here’s one: baby, female, three months, June 22, 1987.” And he continued, “New~ born, male, June 17, 1987. Female, about six months, June 11, 1987. Male, four months, June 17, 1987.” Then something had him stumped, and he had a hard time reading the slip _ of paper. As I approached him to look at it myself, he put it down abruptly: “This has nothing to do with any thing. It’s an order for seventeen sacks of cement! I warned you that everything was all mixed up here.” When I learned that all the requisition orders were referred back to Seu Joao in the town hall, I approached Joao himself for access to the records on all materials furnished by the prefei— tum. Grumbling, Seu Joan got down the ledger books, but he warned me not to trust any of them: “if you want numbers,” he suggested, “just double everything that’s put down here — our in- ventory is incomplete.” In the books that docu— mented in neat columns the “movement” of all supplies in and out of the prefeitum, the data on baby coffins were there, interspersed with data on Brillo pads, light bulbs, chlorine bleach, kero‘ sene, toilet paper, cement, alcohol, and soap. In a six—month period in 1988 the prefez'tum had distributed 131 free infant and child coffins. When I asked Seu Joao, who was delighted to get his books back so quickly, why the data on baby coffins were not kept separately, he replied, “Be- cause it wouldn’t be of interest to anyone.” The 278 NANCY SCHEPER-HUGHES deaths of these children, like their brief lives,'are Although, with these exceptions, the data 0 invisible and of little or no account. ' infant mortality at the cartdrio civil can be taken Finally, I was referred to the cartérz'o civil of as fairly complete and reliable, there is no possibiin Bom Jesus, a small, airless, and windowless off-ice ity ofascertaining a reliable infant mortality rate privately owned and run by the formidable Dona Although universal birth registration is mandat ‘ Leona and her humorless 20-year~old son. Here, today, there is no way to enforce it at thelocallevel for a small fee, the vital statistics of the community In practice, most poor families delay registration — births, deaths, marriages, and (since 1986) di- until the child has to confront the “state” for the vorces were registered by hand in one of several first time — usually on registering for primary large ledger books. I was invited to borrow one of school. Otherwise, an individual may not be regis, the two chairs and a small space at a desk to count tered until he or she'wants to enter the work force the entries for selected years, an occupation that marry, join the military, or receive some medicalmi took the greater part of many mornings in Born social benefit from the state. Moreover, although Jesus da Mata in 1987 and later again in 1988 and all registrations of infant deaths (to age one) also . a 1989, require birth certificates, registrations of child Dona Leona has maintained the cartério for 30 deaths older than one year do nor require that the .: years, and she worked in “cooperation” with the. births of the children also be registered. Somewhat ' mayor’s office. The town hall furnishes a space in more reliable, then, is a calculation of the proper. . the municipal cemetery and a charity coffin only to tion of child to adult deaths for the community as a 01‘}; those who haveregistered a death at the cartorio civil. Consequently, the data on child deaths-since 1966 are fairly complete, with the exception of stillbirths and perinatal deaths, many of which whole for the years selected for study. I selected the three years advisedly: 1965, the year following the Brazilian military coup and, as Irecalled it, the year of the great die out of Alto babies; 1985, 20 years later and following the crash of the great economic miracle; and 1987, the period of democratization and preparation for the transfer of authority from military to civilian rule, also the year of the cruzado novo and significant fiscal reforms aimed at re- structuring the economy with respect to inflation and the debt crisis. Public records, whether official censuses, birth or baptismal certificates, marriage or divorce records, or death or burial certificates, are obvi- ously not “neutral” documents. They are not in any sense “pure” sources of data. Censuses and other public records count only certain things, not others. They count some things better than others, as in this instance they count infant and child deaths better than births. They reveal a society’s particular system of classification. So they are not so much mirrors of reality as they are filters, or “collective representations,” as Emile Durkheim might put it. It is just those images and collective representations —~ in this case, of the child and of child death — that I am after. How are the. records kept? What events are kept track of? What is thought hardly worth noting or counting at all? And what can this tell us about the collective invisi— bility of women and children in particular? " Those relatives who arrive at the cartorio civil to register the death of a child in Born Jesus are briefly interviewed by Dona Leona according to are neither registered nor buried in the municipal graveyard. Late abortions and stillbirths, many of them occurring at home on the Alto do Cruzeiro, are buried privately in the mato or in the backyard, , and there is no question of a medical record or a .2 death certificate. Moreover, until relatively re cently, the deaths of unbaptized babies of any age went unregistered. As “pagan” infants they were stigmatized creatures and were buried covertly by their parents at a crossroads in the country, the place where Exu, the Afro-Brazilian deity, and his host of unbaptized spirit infants congregate to serve as messengers for good and ill in the world. in addition to these, about one-fifth of all Alto births today still take place at home, keeping the half dozen elderly midwives (called partez’ras or cariosas) fairly regularly employed. The parteiras .. .1 who work today in virtual isolation from the med- _ ical institutions of Born Jesus (following years of Q unsuccessful attempts to regulate them and to in- corporate them into the extension work of the state health post} especially fear rhnning afoul of the “bureaucracy” and the medical profession in . 'fo 4: Bom Jesus. Consequently, the parteiras do not en— " - courage registration of infant births or deaths in which they were involved. Moreover, stillbirths I and perinatal deaths are rOundly denied by the I. .I , I" . midwives, who actively compete with each other f- .- for an ever-constricting market. I I u . I , .. i . .~ .‘lu '. z. ,5 . was 25lace-cHelfii‘aiflkflieilxilfi/J-Vé «Nitraokx/N' 2N3! “fi‘b’l‘rfi :4.worize‘f/a.~:3e\:z=.<<{o is .w,I.f-.¥r/-::<.>'{~New”. , ._..,-,¢,.,.....,_._,-t- UV...—taH-pWu.”umWamWwwh-m-cu-.p.w-v-<l.\umvmain-can: :s—Ihmnunhw‘vhw-lem: -:-, ~..w —| ’J—l—\ v—Ffi—Iltb-\MM.IJJI\‘APN—hm—IMAUAM£A vxI-h-wl-M-Mvuv - m ....,_ _._._u-_ . _,,, . .. . _ ', .... L-._...._'_ H \ -\ .9,,,,....... .-~.- -..-_».~.w.a- TWO FEET UNDER AND A CARDBOARD COFFIN 5 following formula. They are asked to testify, data built their homes on the Alto do Cruzeiro. Living )e ta their honor,” to the time and date of the death, arrangements were often informal, and couples 3038i. place of death (usually the home address}, frequently did not know each other’s surnames. ity r .l sex of the child, the child’s “color,” the name On one occasion, when a father could not produce ' .Eg“-ithe child’s mother and father, the father’s (but the full name of his common~law wife, his com- f the mother’s) birthplace, the father’s (but not i mother’s) profession, and the name of the cem— , eta-y, The reporting relative is then asked to sign ll form or to affix his or her mark (an X), and two Wfi V- ‘jfiher individuals are asked to testify as “witnesses” the accuracy of the account. " r, What we can learn from this particular record is padre whispered to him, “Well, just let it be Araujo da Silva, then” and so “married” the couple on the spot. Dona Leona was not amused by these “lapses” of memory in her clients, and she was not above giving them an occasional dressing down. As the end of the day approached, Dona Leona could be testy; her work kept her busy, and she _, he following: the sex, age, name, and “race” of the liked to have her books in order by 4 p.m. so that me) 315 :_ ,; Ehurl; the marital status of the parents; the neigh- she could go home early. Those who rushed in at )f " ' rhood or street in which they live; the father’s the last minute, as did Dona Aparecida of the Rua that cupation; and the place of death. In those few dos Magos, could face an impassive and bureau- newh'gt mstances where the child died in the hospital and cratic wall of resistance. Aparecida had just run pIOpor. as also issued a death certificate, Dona Leona from the Barbosa Hospital at one end of Bomlesus airy as'a , ted the name of the attending physician and his to the cartdrio civil at the other end to register the cted the. her diagnosis. death of a premature grandson who had been born ring thé’ While copying the birth and child death data at and who had died earlier that day. Her daughter, the yeai :‘;-.the registry office, I was able to observe many the infant’s mother, was doing poorly in the hos- tizatio'ri' Z", i 3.;u1teractions between Dona Leona and the people f Born Jesus, especially the poor of the Alto, who .~_.;._appeared each day to register the death of a child. pital- and had begun to hemorrhage. The baby’s father was away working on a distant plantation and knew nothing of the events that had tran~ ty from ' iMost often it was the father of the child who spired. It fell to Aparecida to bury her grandson, :ruzadqt iffi‘a'ppeared, but occasionally it was a grandmother, but in her anxiety over her deathly ill daughter, she l at reéf l grandfather, an aunt, a godparent, or even an had forgOtten to register the death earlier in the lflatiOIl ihlder sibling. Mothers, however, never appeared in day, and now Seu Moacir refused to give her the lithe carrdrio to register the death of one of their little coffin until she had done so. 5, birth.,--:;‘-:' -;';,own children. The registration and burial of the “But where is the marriage certificate?” Dona divorcefiigi :jChild usually took place within 12 to 24 hours of Leona inquired, as the older woman attempted to 'e obvi- 35?; not in {i} rifthe child’s death. Dona Leona was generally distant and officious; register her grandson as the “legitimate” son of her daughter and son-in-law. “And how would I know ses and Fin-if provoked, she could be gruff and dismissive, where my daughter keeps such things?” replied the 1gs, notii; '{_'especially if the relative was uncertain of basic grandmother, who was sent away in search of the otherS, 'jifi ii.“details,” such as the name of the, child, the com— document and told to return with it the following :1 child if}: :‘plete names of the child’s parents, the marital status day. And so Dona Leona got to go home early, as aciety’s Ed the parents, or the exact time and location of the usual. The infant, meanwhile, wrapped in its mor- are not ters, or rkheirn llCCt‘iVfi ,fifdeath. Many of these seemingly obvious and neces- jo'sarily bureaucratic details were anathema to the ipeople of the Alto and had little relevance to their fgi'everyday lives. “Name of the deceased?” Dona tdlia (winding sheet), lay overnight in a hospital storage room that served on occasion as a morgue for indigent patients. Dona Leona tried hard to run a tight ship, but and of 5i Leona snapped. And I saw a father turn anxiously she was often frustrated. “Color of the deceased?” records .f; jto his sister-in-law to ask her, “Whatever is the she "asked. And here the relatives were often E’hat is sf g.name of our little Fiapo [a common nickname puzzled. Some fathers pointed to their own skin, at all? :invisi- f0 CIT/Ill - 3.; meaning little bit of nothing]?” Explaining where 3,; one lived in response to the bureaucratic question “Street and house number?” could be taxing. There “were no official house numbers and only descrip~ saying, “Well, she was my child.” In other words, “Judge for yourself, if you wish.” Another young father, when asked the color of his deceased 4~ month-old infant, replied, “it was just a baby — it 3118 are ftive and informal nicknames for many of the dirt didn’t have any color yet.” Usually Dona Leona ling t0, .- paths and hillside ledges on which moradores had simply designated the color of the infant based on . . .1 .. \ /,.\.\ .u x . i l . . NANCY SCHEPER-HUGHES a local cultural category: poor equaled “brown.” She never asked the parents to supply the missing “cause of death,” however. In the absence of an official death certificate and a medical diagnosis, there was, she said, no way to know, and she was content to leave that space blank on most of the forms. The state, then — represented in the personages of minor civil servants such as Moacir and Dona Leona — contributes to the routinization and normalization of child death by its implacable opacity, its refusal "to comprehend, and its conseu quent inability to act responsively to the human suffering that presents itself. Bureaucrats and civil servants. respond to pain and difference with a studied indifference — la belle indifférence. Nor- mally, this is expressed in the bureaucracy’s ‘deaf ear,” its interminable off—putting delays and post- ponements, its failure to note the dire conse- quences of its indecisiveness. But there is another side to bureaucratic indifference that is more char- acteristic in this instance: the rapid dispatch. It conveys that nothing of any consequence, nothing worth noting, has really taken place. Two or three minutes to “process” each dead infant or child should suffice. “But look at this,” I spoke out of turn) from my perusal of the death registry books in the cartdrz'o on one occasion. “Here is the name of a woman on the Rua dos indios of the Alto do Cruzeiro who has —D a,- lost three small chiidren within the space of a few months. What do you think could be going 0n; Shouldn’t someone look into it?” I “I wouldn’t know,” Dona Leona replied coo “My job is only to record the dead, not to hold inquest once they’re gone.’ was sufficiently abashed to go quietly back to my “clerking” of the records, scratching away in my copybooks, a moderndday Bartleby the Scriv- ener, refusing to leave where I was decidedly um wanted and just barely tolerated. In 1965 a total of 497 child deaths (of those born live through age 5 were recorded. Three hun~ dred seventy—five, or 78 percent, of the deaths were of infants in the first 12 months of life. These infant deaths came from a total of 760 recorded births for 1965, a figure that included all children born in that year and registered in that year or born in 1965 but registered in subsequent years. Even if we assume that some born in that year escaped registration altogether, 1965 with an infant mor. tality rate of 493/ 1,000 live births was a year the bells of Nossa Senhora das Dores tolled inces santly. And when they tolled, it was for the “ho innocents” of Bom Jesus and its rural surrounds, the most immediate victims of Brazil’s “quiet and bloodless” military coup. Quiet, indeed, but per- haps not quite so bloodless after all. Of all deaths in Born Jesus in 1965, 44.5 percent were of chil- dren younger than 5 years. ly. an I’—H—f. t .i l i i n .—~ w-O-u'Mu-‘Am u-’ u-w. . > 5 - .._,.r .\ \H.'.>-h.‘ ' \sf .' I ‘s'HI-D:JJ- v u! _ MW“ We“, .. NM. - _ ,._ IIbuzr-xl-‘a- \In$l'.l-I'J-§-l r. ...
View Full Document

Page1 / 6

Scheper-Hughes+Reading - lassachusett . A} ‘Before’...

This preview shows document pages 1 - 6. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online