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Frequent child death remains a powerfulshaper of maternal thinking and practice.In the absence of firm expectation that achild will survive, mother love as weconceptualize it (whether in popularterms or in the psychobiological notionof maternal bonding) is attenuated anddelayed with consequences for infantsurvival. In an environment already pre-carious to young life, the emotional de-tachment of mothers toward some oftheir babies contributes even further tothe spiral of high mortality—high fertil-ity in a kind of macabre lock-step danceof death.The average woman of the Alto expe-riences 9.5 pregnancies, 3.5 child deaths,and 1.5 stillbirths. Seventy percent of allchild deaths in the Alto occur in the firstsix months of life, and 82 percent by theend of the first year. Of all deaths in thecommunity each year, about 45 percentare of children under the age of five.Women of the Alto distinguish be-tween child deaths understood as natural(caused by diarrhea and communicablediseases) and those resulting from sor-cery, the evil eye, or other magical or su-pernatural afflictions. They alsorecognize a large category of infantdeaths seen as fated and inevitable.These hopeless cases are classified bymothers under the folk terminology“child sickness” or “child attack.”Women say that there are at least four-teen different types of hopeless childsickness, but most can be subsumed un-der two categories—chronic and acute.The chronic cases refer to infants whoare born small and wasted. They aredeathly pale, mothers say, as well asweak and passive. They demonstrate novital force, no liveliness. They do notsuck vigorously; they hardly cry. Suchbabies can be this way at birth or theycan be born sound but soon show no re-sistance, no “fight” against the commoncrises of infancy: diarrhea, respiratoryinfections, tropical fevers.The acute cases are those doomed in-fants who die suddenly and violently.They are taken by stealth overnight, of-ten following convulsions that bring onhead banging, shaking, grimacing, andshrieking. Women say it is horrible tolook at such a baby. If the infant beginsto foam at the mouth or gnash its teeth orgo rigid with its eyes turned back insideits head, there is absolutely no hope. Theinfant is “put aside”—left alone—oftenon the floor in a back room, and allowedto die. These symptoms (which accom-pany high fevers, dehydration, third-stage malnutrition, and encephalitis) areequated by Alto women with madness,epilepsy, and worst of all, rabies, whichis greatly feared and highly stigmatized.Most of the infants presented to me assuffering from chronic child sicknesswere tiny, wasted famine victims, whilethose labeled as victims of acute child at-tack seemed to be infants suffering fromthe deliriums of high fever or the convul-sions that can accompany electrolyte im-balance in dehydrated babies.
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Alto, Bom Jesus, Cruzeiro, Ze Antonio, Bom Jesus da Mata