Death Without Weeping

by Nancy Scheper-Hughes

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American medical anthropologist Nancy Scheper-Hughes both explores the subject of infant mortality in Northeastern Brazil and reflects on her position as a foreign researcher, including the ethical dimensions of her involvement. The community of Bom Jesus da Mata (a pseudonym) where she conducted this research in the 1980s was the same place where she had gone as a Peace Corps Volunteer two decades earlier. Her introspective analysis of her own role is closely connected to the changes in the discipline of anthropology during those decades. She describes her thoughts as she decided if it would be wise to work there again.

I squirmed at the thought of returning to a place where I had been so actively and politically engaged as one of the remote intellectuals I had arrogantly dismissed years before. Could one be both antropóloga and companheira? I doubted that this was possible.

When she finally does return, the women she had known as girls challenge her on this doubt, accusing her of not caring about them and basically giving her the ultimatum that if she wanted to do research there, she would have to find a way to help them with their problems.

I have had to occupy a dual role ever since 1985, and it has remained a difficult balance, rarely free of conflict.

One of the most serious problems that Scheper-Hughes identified, which she aims to explain in this book, was high infant mortality. This book became quite controversial because the anthropologist argues that in the Alto Cruzeiro neighborhood of Bom Jesus, mothers have come to see infant mortality as a routine part of life; they even believe that “some infants are born ‘wanting to die.’” Her interpretation of this “routinization” narrowly avoids an accusation of neglect based in fatalism. She says that the conditions placing infants at “high risk” are connected to

the routinization of infant death in . . . an average expectable environment of child death . . .

Scheper-Hughes’s approach to “medical” anthropology includes close attention to the structural position of different people, not only in terms of their access to medical care but in all aspects of their daily lives. As the book’s subtitle indicates, she calls this “everyday violence.” Beyond physical violence, she expands on the concept of structural violence as the cumulative set of disadvantages and discrimination with which poor people must contend.

Many of the poorest people had recently arrived from the rural plantations and forested lands. They have been denied the opportunity to partake in the rapidly developing “modern” society—what she calls “the street”—that includes technological advances through the globalized wealth network. The author sees them as confined to another, almost feudal era.

Although the people of the forest . . . come to Bom Jesus to partake of a better life on the street, a life of the rua, they are not really of the street. They are the little people, the no-account people, those whose features, clothing, gait, and posture mark them as anachronisms . . .

The author places her examination of maternal attitudes toward children, and in particular, newborns, within the context of overall attitudes toward the body. Both their actions—what she terms “praxis”—and their understandings of their bodies are conditioned by that all-encompassing everyday violence.

[A]ll the mundane activities of working, eating . . . and getting sick and getting well are forms of body praxis and of dynamic social, cultural, and political relations . . . [T]he structure of individual and collective sentiments down to the feel of one’s body is a function of one’s position and role within the technical and productive order . . .

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