Death Without Weeping Ethnography Review

Ethnography Review: Death Without Weeping: the violence of everyday life in Brazil, by Nancy Scheper-Hughes

As an ethnography, Death Without Weeping describes the way of life of people in a Northeast Brazilian shantytown. As the author herself says, it is an attempt at a "good enough" ethnography: one that seeks to give voice to these people without futilely trying to sweep the anthropologist's personal perspective under the rug (28). Scheper-Hughes considers the relationship between this town, Alto, and colonialism, power, capitalism, religion, and the overall history of hardship and horror. Scheper-Hughes approached her fieldwork with an interesting participatory tactic, which has allowed her to make unique conclusions but which also raises the question of audience.

The author began her relationship with the people of Alto when she was stationed there with the Peace Corps in 1964. In this role she was a community organizer and was very much an actor in the daily lives of the people there. When she came back as an Anthropologist almost twenty years later, it seems she had to confront the disparate characters of community participant and community ethnographer. It is in her fusing of these two roles that she was able to construct Death Without Weeping as a realistic representation of a place and a people.

The first step in this is acknowledgment of the Western Enlightenment tenets which have created a potentially flawed view of what knowledge should be. Scheper-Hughes rejects that knowledge can or should be acquired objectively, and adopts what she calls a phenomenological approach. The world is personal, and that what works in one place does not have to work universally in order to be legitimate practice. There is no "universal and absolute truth" or scientific neutrality; the best solution is to try and look at individual and community aspects of perception of phenomena (24). As an innately non-neutral observer, Scheper-Hughes participated in the political and social movements of Alto (setting up the childcare center and UPAC change group). She essentially combined her actual ethnographic work with a public stance on the living conditions of the people of Alto, resulting in an especially well informed radical action.

With her focus mainly on women and children of the Nordeste, Scheper-Hughes interviewed hundreds of women about their reproductive history, and talked to hospitals, morgues, the Church, politicians, and any person who was a part of a woman's life there. The most in depth of her lines of inquiry was in the lives of a handful of women who were her friends. She had even delivered some of their children while she was in the Peace Corps there, and as an Anthropologist came back to study their families as they survived the luta (struggle) of every single day. Her methods and interactions are ideal for an ethnography as they do not reduce a people to data points and they present more than just a personal diary type of description.

Her research question concerned the ability of women to cope with the loss of so many children. As an American, this seemed impossible and perhaps even loveless at times. As she learned about the full process of getting by in Alto, she developed a sense of what she called "selective neglect" in which the consciousness of the mothers "constantly shifts back and forth between allowed and disallowed levels of awareness" (390). After experiencing the loss of children to starvation and disease, women would not allow themselves to become attached to and care for their new children. The investment was too physically and emotionally costly. They would not do this neglect consciously, but in the end they acknowledged the trade off they had to make to get by with so much loss. Death Without Weeping as a research project is an explanation of the social and economic conditions that can lead to a strategy such as selective neglect of children.

The Nordeste is an area of extreme poverty in the silent shadow of a violent military history, colonialization, and most recently, the sugar industry. Scheper-Hughes describes it as a "satellite of the sugar plantation and sugar mills, and anonymity, depersonalization, and surveillance are used [...] to create a climate of fear, suspiciousness, and hopelessness" (532). Here she acts as a Medical Anthropologist in identifying the cause of an area-wide sickness. The history of oppression and the absolute indifference of the government to its people in Nordeste are the root of what she calls "the diseased tissues of the social body gone awry" (26). The comparison can then be drawn between selective neglect and inflammation in response to infection, say, as both are symptoms of illness because they are both coping strategies.

In rejecting the fly-on-the-wall ethnographic method, Scheper-Hughes does not trip on the fine line between reducing her subjects to purely victims and romanticizing their resistance. The people of Alto are oppressed by the government as well as by the economic environment created by the sugar plantations. This does make every action of the poor Altoans the result of the government or the sugar companies, as they are still autonomous individuals. Exploring the strategies they supply to cope with the oppression, such as their dark humor or cultural practices shows how resistant the Altoans are to the waves of injustice that variably crash over their hill. However, this discounts the suffering and terror they must live through. Scheper-Hughes walks a middle ground, acknowledging "the destructive signature of poverty and oppression on the individual and the social bodies, [...] but also the creative, if often contradictory, means the people of the Alto use to stay alive and even thrive with their wit and their wits in tact" (533). The message is not of victimization or resistance, but of existence. The people are just surviving.

Ultimately, Scheper-Hughes is describing a curse of silence on the Nordeste. The people do not speak out in public due to the fear of imprisonment or shunning, and they have little voice to begin with due to the widespread illiteracy in the community. The fearful and miserable silence of the Altoan citizens is only met with silence from the government and institutions in their complete lack of acknowledgement. The bureaucratic indifference toward the suffering of the shanty-towns creates a wall against which the Altoans must push all their lives. This theme of silence is embodied in the mute little ghost of Mercea, the daughter of one of Scheper-Hughe's friends who died as a surprise (502). Biu, the mother, finally allowed herself to love and invest in Mercea when the girl died suddenly of pneumonia. Her image came to her sister for many years after, silent and searching. Mercea symbolizes the silence forced on the people of Alto, the silence of the fleetingly alive children, and the silent withholding of personal connection that painful loss forced Altoans to embrace.

While her stance as community activist and also careful ethnographer has allowed Scheper-Hughes to beautifully describe the silence and suffering of the people of Alto, this calls forth the question of her audience. If she seeks to give a voice to the silent, who then does she want to listen? Whose ears and eyes are meant to understand this story? Who can take action? If the book is published in English for the academic Anthropological community, how does this help the Nordeste? Will the Brazilian government read Death Without Weeping and build a public school for everyone in Alto? Will the sugar mills read the book and pay higher wages? Understanding the social work of Death Without Weeping requires exploring the role of Medical Anthropology in modern global health.

As Scheper-Hughes describes, she is pointing a trembling hand toward the diseased and ill fabric of society. In this way, she is acting as a muckraker: initiating action simply by describing the horror and hoping whoever reads her words will be surprised enough to act. This can be very effective: in 1906, Upton Sinclair's The Jungle about the meat packing industry shocked Americans so much that the government had to react and ultimately created the Food and Drug Administration, though this did not address the author's main concerns about wage labor (Dawson). In this sense, Death Without Weeping is an expose, one that has the ability to create change by putting knowledge into enough hands.

Is there a more direct job to do for Death Without Weeping and Medical Anthropology in general? Is the role simply to direct powerful eyes towards regions of broken threads and suffering? According to anthropologists James Pfeiffer Mark Nichter, Medical Anthropology must grow a political pair of lungs and not just show everyone interested where to pour their attention, but translate the needs and perceptions of groups of people into a language that the global health arena can understand (2008). That way, whoever may be concerned about a problem can see the bigger picture of what they actually could do to help. Critical Medical Anthropology takes careful awareness of the destructive and confused birth of global health and combines this with the practice of cultural brokering to direct the most effective and wholesome solutions to complicated problems.

The question of just who Death Without Weeping sought to teach is a more general question of who should be the actor of health change. Scheper-Hughes worked on changing the perspective of the people in Alto by setting up open discussion forums, action groups, and communal care centers. She was doing this simultaneously with her ethnographic work. It seems that Death Without Weeping is actually meant to show how communities are the source of social change, and that whoever wishes to enact change must, like her, understand and accept the way of existence of the people whose lives they want to change. Their job has to be giving the people a voice loud enough to be heard by those who hold the most sway over life. In doing so, communities like Alto become a paradigm for other changes. An NGO official can read this book and focus on providing the resources to give their target community a local voice enough that they and their government and surroundings can find their own solution.

Sheper-Hughes was a part of the community she sought to learn about in the Nordeste region of Brazil. That way, she constructed a holistic representation of life in the poor shantytowns. She addressed the historical background of the area, the total institution created by the sugar industry there, and the troubling question of love and personal investment in a community so stricken with death and frantic hunger. Her theme of insidious and thorough silence helped to illuminate the importance of community voice. At first it seems her point is to cast a large net to attract people into the cause of these people. This, however, is not the case. Looking at the ideal future role of Medical Anthropology as described by Pfeiffer and Nichter, it becomes clear that Scheper-Hughes’s actual message is to learn from Alto’s example. Her action there was to give Altoans more of a voice in their area and against the Brazilian government as well. Those seeking to help oppressed communities in the future should do the same.

Works Cited

Dawson, Hugh J. 1991. "Winston Churchill and Upton Sinclair: An Early Review of

The Jungle". American Literary Realism, 1870-1910. 24 (1): 72-78.

Pfeiffer J., and Nichter M. 2008. "What can critical medical anthropology contribute

to global health?: A health systems perspective". Medical Anthropology

Quarterly. 22 (4): 410-415.

Scheper-Hughes, Nancy. 1992. Death without weeping: the violence of everyday life in

Brazil. Berkeley: University of California Press.

A Review of Righteous Dopefiend

Brittany Peters

Ethnography Review Paper

10-14-12

A Review of Righteous Dopefiend

            Suburbanites and inner-city individuals may be separated by area codes but often share a similar lack of understanding and stigmatization towards the homeless populations of cities. In general, the middle class Americans who are the majority of passersby only see the most mundane fact of the homeless: they are without a home. Rarely is there time to sit and talk to the men and women that are panhandling, flying a sign, or quietly minding their own business. In return of this lack of time to devote to talking with these individuals, stale thoughts remain trapped in an ideological box of judgment. Nevertheless, through ethnographic research a better understanding is gained and all facets of the lives of homeless men and women can be given a new light. In this particular ethnography, Righteous Dopefiend, a research team assimilates into a small population of homeless heroin injectors of San Francisco to better understand their narratives, past and present, and how ethnicity, gender, and childhood memories/experiences have shaped it.

            This ethnography was organized in a manner that followed the “analytical themes related to the power relations and historical and institutional forces that shaped their [Edgewater homeless] lives”(Bourgois and Schonberg 2009:21). In the first three chapters of Righteous Dopefiend ethnic, gender, and hierarchal relationships between the Edgewater homeless are discussed. Chapter one specifies the racial divisions present in the encampments surrounding Edgewater Boulevard as well as the almost contradictory mutual dependence connecting all ethnicities present. Chapter one also attempts to dissect the unclear development of homelessness. In the second chapter gender relations are analyzed and the complicated distinction between sex work and romanticism from Tina’s perspective is described. The beginning of the third chapter establishes the hierarchal relationship between the homeless on the Edgewater Boulevard scene. Concluding the third chapter the ethnographic team’s review of both local and governmental programs and institutions and how they affect every facet of the lives of the Edgewater homeless.  

            In chapters 4-6 the relationship between the past and the present are explored through childhood experiences and memories along with the categorization of the Edgewater homeless as adolescents coming of age in an era of “sex, drugs, and rock and roll”. In chapters four and the beginning of chapter five familial dynamics of the Edgewater homeless childhoods and their transitions between teen and adulthood is examined. In the end of chapter five and chapter six, it is asserted that the present economic and familial struggles that are being faced by the homeless are reflections of the past. The main point of these chapters was that the psyche of each individual on the Edgewater homeless scene was shaped by childhood traumas either of a sexual, mental, or physical abuse. This trauma was reflected in their present lives through PTSD type episodes, linguistic styles, overall demeanor, and most importantly it influenced the relationship, or lack thereof, between themselves and their children.

            Chapters 7-9 revisit the topic of gender relations and sexuality through an alternate interpretation as well as discussing everyday problems that afflict the homeless such as sickness and disease. The beginning of chapter seven focuses on the dichotomy between homophobia and homosocial love relationships. The relationship between two of the homeless men, while not described or viewed in a sexualized manner, represents a homosocial relationship on the Edgewater Boulevard scene. This part of the ethnography depicts the complicated aspects of a male running partner dynamic and then necessity of other homeless to define it with a sexual label, but at the same time both men adamantly homophobic. The end of chapter seven assess the biomedical afflictions affecting the Edgewater homeless and how the dysfunctional U.S. medical system allows this group of individuals to fall through the cracks. While offering a critique of the U.S. medical system, the ethnographic team is faced with the stark knowledge that the lifestyle lead by the Edgewater homeless is one leading to death conjointly with immense physical and psychological suffering. Chapter eight takes a “real time” perspective of the everyday accounts given by the Edgewater homeless. A day in the life of a homeless man or woman on Edgewater Boulevard is illustrated through the field notes taken by the team of the accounts three aspects of life: working by conducting licks (stealing items) or flying a sign, fixing (getting high), and dopesickness. In the final chapter, the psychologically and physically painful process of detoxification and treatment is explored through personal accounts of attempts to quit heroin.

An interesting similarity between this ethnography and global health is the concern of HIV/AIDS.  HIV/AIDS has been one of the most developed global health topics which have been discussed around the world in literature, documentaries, and policies. In the blog post written by Molly Reid talked about how the percent of HIV/AIDS infected American citizens in Washington D.C. is higher than in six African nations (2012). This begs the question why are there more American based organizations with a concern for the people of Africa rather than fighting to lower the domestic infectious rates? While there is no answer to this question, it is important to note the differences between public assistance, fighting for the same cause, to foreign and domestic alliances.  Also in the annual publication World Health Watch it was stated that “between 2002 and 2006, 75 per cent of the additional funding to health was allocated to HIV/AIDS” (Shukla, Abhay, et. al 98). Taking ¾ of an additional budget clearly identifies that HIV/AIDS is possibly the largest area of concern in the global health community. It is also important to see that that funding was distributed through the global south on behalf of the global north, still leaving HIV/AIDS prevention in industrialized nations on the rise and/or undertreated. In Righteous Dopefiend there are multiple field notes documenting the discussions about HIV/AIDS and its prevalence in the community (50, 70, 198, 242, etc.) Another common message in relation to HIV/AIDS was opportunities provided by needle exchange programs (41, 106, 11, 118, 222, etc.). This program was the only program that was given positive feedback from the ethnographic team as well as something that they continually reminded the Edgewater homeless about. The slogans of HIV prevention campaigns, although a source of mockery, were being passed by word of mouth around the community. Unfortunately it is important to note that while the Edgewater homeless were aware of the devastation that HIV/AIDS causes, the heroin high was above all physical, mental, and social dangers associated with it, including this terminal disease.  

A connection that was made between the Righteous Dopefiend and some of the readings, videos, and a blog post written is how San Francisco authorities such as the “Caltrans” and Sand Francisco Police officers are depicted as bad guys and how biomedicine is often illustrated as a domineering force over the natural healing/alternative medicine practices of third world nations. To all others, authorities such as the local police department, DOT officers, and doctors/medical professionals are of no concern and often the heroes, but for the homeless of Edgewater Boulevard this was not the case. On multiple occasions DOT officers known as Caltrans maliciously demolished encampments, took their blankets and clothing all without warning. Some doctors would even unethically perform abscess surgeries without anesthesia (101).  A similar theme of perceived atrocities from a pharmacological perspective was in the movie Clinical Trails Overseas that showed the pharmaceutical market expanding their trial drugs in severely impoverished nations such as India(Fault Lines). These trials were conducted without informed consent along with other unethical practices such as giving Indian citizens the choice between trail health care or no healthcare at all. Another way in which biomedicine can be perceived as an overbearing force is in the general idea of Global Health. To many people global health is the practice that the global north uses through biomedicine, to provide ‘magic bullet’ practices for the global south with little or no regard to the native practices to areas of concern. Carlie Anderson writes of the constant battle between biomedicine and an alternate medical practice of India known as Ayurveda(Anderson). This blog clearly outlines the differences between natural medicines and biomedicine, mentioning the healing of the soul and mind as a major difference. Also this blog asserts that centering healing around the soul and mind rather than strictly the physiology of the patient may create a more devoted patient to healing including a change of mind about certain biomedical treatments(Anderson). I think that this theme of authority acting as a bad guy rather than the hero is prevalent throughout history but particularly offensive in the case of the Edgewater homeless and biomedicine vs. alternate medicine. There is a glaring dichotomy that is present within the authorities in the case of the Edgewater homeless, they take advantage of the fact that their help is sought out by individuals and then in return harm them through a process masquerading as health care.

Finally the most important point worth examining is how the ethnographic team during the twelve years the spent on Edgewater Boulevard acted as public anthropologists that actively helped the lives of the homeless in multiple ways. Along with the work that they did during the research, after concluding the study a bigger question remains: what can be done to help the lives of homeless heroin injectors in the San Francisco area? In the conclusion there are multiple points made about medical and environmental policies that were enacted while they were researching or shortly after their field work had ended(311). These harm reduction techniques included a mobile psychiatric clinic, mobile abscess clinic, mobile needle exchange programs to name a few(303). While these programs could have been in the framework before the ethnographic team started their fieldwork it is also possible that their presence and interest drew to light the need for assistance particularly in the public health sector. As a class the purpose of public anthropology has been discussed the and in quiz section it has been incorporated with almost every topic. While too often public social problems such as homelessness are overlooked because of their deteriorating lifestyle, it is important that necessary programs and institutions are in place in order to help with any affliction they may face including but not limited to drug abuse, mental illness, and alcoholism. By acting as the mediator between all participants, policy makers, local, and federal governments, nonprofit coalitions, public anthropologists can advocate for change for unheard or unnoticed populations such as the Edgewater homeless.

            Reading, reviewing, and analyzing the ethnography Righteous Dopefiend has provided an in-depth understanding of the meaning and purpose of ethnographic research as well as the applications of public anthropology. While this specific ethnography provided context on a sub group of heroin injectors in San Francisco, broader messages within this work can transcend this explicit population. The ethnic, gender, and childhood memories are themes that are factors present whenever you are dealing with people. Righteous Dopefiend made it clear that present situations are not the only common trait between populations, as evident in the shared childhood memories of sexual, mental, or physical abuse. Another important theme was public anthropologists as advocates for the impoverished. This is seen in the continual critiques made by the ethnographic team about the local and governmental policies and organizations that dramatically exacerbate the conditions afflicting the Edgewater homeless. The benefits of fieldwork are numerous and if everyone took time to read the products of this work, such as ethnographies, then in addition to a better understanding about the group of people being studied, alternate ideologies and theories can be applied to outside problems allowing for more holistic approaches and possibly solutions.   

BIBLIOGRAPHY

Anderson, Carlie

  2012 Western v. Indigenous Practices and the Benefits of Both.

Bourgois, Philippe, and Jeff Schonberg

  2009 Righteous Dopefiend. Berkeley: University of California Press.

Fault Lines

  2008 Outsourced: Trials Overseas

Reid, Molly

  2012 DC HIV Efforts: Challenge to what we learned in class, or support for it? 

Shukla, Abhay, et. al.

  2011 Global Health Watch 3: An Alternative World Health Report. London: Zed Books Ltd. 

INFANT MORTALITY BLACK WOMEN

                When it comes to infant mortality we often assume that the cause heavily lies with medical reasoning’s. Extensive ethnographic research shows that there are multiple factors that cause infant mortality. This essay aims to discuss the reasons of why African American women face higher rates of infant mortality compared to other races. Using the ethnographic book, Stress and Resilience: The Social Context of Reproduction in Central Harlem authors Leith Mullings and Alaka Wali, I draw my conclusion that in order to provide better reproductive health for black women we must debunk how factors like policies, racial oppression, and culture cause immense amounts of stress. The author does a great job digging deeper into the issue and making notice of the causes for the disproportion beyond the typical medical explanations. They show that the rising rate of mortality among black women cannot be understood without looking at all aspects of life. I found this ethnographic work to be extremely interesting. I feel like the disparity of infant mortality among African American women is rarely talked about. Reading all the interviews conducted and statistical reports made me relate this to my community to see how much this issue relates here compared to Harlem. I was shock and a little startled when I realized how similar the personal stories in the book related to women of color I know who experienced the devastating loss of their child. I too believe that new public health approaches are needed to reduce infant mortality and improve reproductive care.

 

                Health statistics report that African American women disproportionally face pregnancy mortality rates higher than any other racial group. In the ethnographic book, Stress and Resilience: The Social Context of Reproduction in Central Harlem authors Leith Mullings and Alaka Wali examine how economic/ political factors, environmental injustice, and social contexts affect the reproductive health of African American women. They cover the personal journey of black women living in Harlem and how they face a barrier to accessing proper reproductive health inducing chronic strain and pain leading to accounts of mortality. They conduct their research by interviewing participants, accompanying participants to doctor appointments, and observing the community in which they live in. The author argues three main points. First, the disparity of infant mortality should not be looked at as genetically determined. Second, disparities should be prevented in populations not individually. Lastly, we need to understand how social and biological factors work together to cause stress.

 

                The disparity of infant mortality among African American women is a global health issue because it possesses serious health concerns for women of color not only in Harlem, but all over the world. Mullings argues that public health approaches must cater to the whole population rather than on an individual level. Harlem is a predominately African American community .Compared to other cities in New York, Harlem is associated with higher infant mortality rates (Mullings 12). In the book ethnographers look at the environment in which people live in that contributes to stress.  The ethnographers conducted interviews with the participants asking them about their neighborhood. Most participants complained about receiving poor services. Things like water, intercom, and heat being out of order. In the interviews participants describe having to fight with their landlords and public housing officials to get repairs done. Living in Harlem is described as important to some because it allows them to live comfortably among other blacks free of racial insensitivity. Black women often sacrifice living in poor housing conditions to live in a black community. Others are confined in Harlem simply because they cannot afford living outside of the city. Housing is a critical aspect of life. It provides the foundation for family, safety and support.

 

I Harlem, inadequate access to proper housing conditions, community safety, and police protection put heavy stress on community members. The women living in Harlem also talk about the lack of care they receive in their community in general. The women in the research worried heavily on their safety. They reported sidewalks being cracked dangerous to women in wheelchairs. Another epidemic that women worried about was the abuse of crack cocaine. Often finding empty vials of crack left on the sidewalks, the women shared their concern with the police but were frustrated with their response. They felt like they were discriminated because of the racial stereotypes of blacks. A member of the community explained that she believed police attitude was that drug activity was “normal” in the community and didn’t take them serious (Mullings 36). When troubles erupted the women were hesitant in calling the police. Community members believed that the police made more minor arrests on the young men than actual criminals (Mullings 35). The ethnographer shares the story of a woman named Ruth who a day after being present in a drive by shooting broke her water and had to repeatedly keep calling the ambulance which arrived more than an hour later. Ruth felt like the ambulance wasn’t taking her emergency as serious because of her neighborhood history. Ruth ended up losing one of her twins and expressed that she forever has a hole in her heart. Her story exemplifies how the poor police coverage in Harlem and the perception of racial judgment by ambulatory staff may have contributed to a death of an infant. 

 

                African American women living in Harlem believed social and biological factors to be a high cause of stress. The author provides a framework of the women’s lives in order to understand why black women undergo large amounts of stress. In 1990 in Harlem, 69 percent of households with children under 18 were headed by a woman (Mullings 113). Having a single black female household limits the amount of income and forces black women to play both gender roles. They have a weaker support system and increase feelings of regret and shame. Black women in Harlem also related racial oppression to high levels of stress. Mullings covers the outcry of anger from community members about the way the social media reinforces the negative stereotypes of blacks living in Harlem. The New York Times article, Another America it stated that people of Harlem were “dependent on public assistance, involved with illegal drug activities, and hopeless (44). Viewing the people of Harlem in this manner can affect the way they are treated/ receive healthcare. It further marginalizes them from other areas in New York causing more stress and feelings of alienation which affects pregnancy.

 

                Looking at the gender role difference between white and black women will help us understand the reason behind the racial disparity. The Sojourner syndrome is also used to explain the intersection of gender and racial oppression. The Sojourner syndrome is based off her abolitionist speech And Ain’t I a woman? It conceptualizes the lifestyle of many African American women. The author talks about how black women in Harlem face problems with gender identity. Having to be primary economic providers, head of household, and community activist, black women carrying a significant amount of pressure and stress. In comparison to white women are as many of the people in Harlem view, are protected by their patriarchal system. White women maintain their female gender role with relaxed motherhood and womanhood (Mullings 170). Relating historical events like slavery and colonization will provide a more in depth explanation of why these two racial groups have significantly different health outcomes. Understanding the role that social and biological factors play can allow us create a better framework that more realistically caters to African American women to improve their reproductive health.

               

                The author did great job showing multiple perceptions on the issue of infant mortality disparity. The perception of black women in Harlem feeling that discrimination to social, economic, and political factors limits the amount of resource and health care they receive. He also shows the perception of the doctors, police officers, and housing officials used preconceived notions of Harlem to look at the cases individually. Not realizing the systematic way of institutionalized racism leading to the lifestyle of Harlem. Lastly, he shows the perception of the media referring to Harlem as “Another America” as if they are too far left to be included with the rest of America. The author makes light of the media’s take on the issue to show how the accuracy of the story rather than someone simply observing from the outside. Rather than covering a story in your words, the ethnographic study allows the black women and men’s voice in Harlem to be heard. Allowing the people of Harlem to tell their own story. The author’s purpose in this is to create common bridge between Harlem and the rest of not only New York but America. Understanding the lifestyle of people in Harlem will help others understand the structural problems to reduce individual blame. In addition to allowing public health officials to generate an approach that improves reproductive care for black women. Mullings research relates to Borovoy and Hines article, Managing the Unmangeable in which the authors discuss the story behind diagnosed Russian immigrants not receiving treatment for diabetes. They show both the perception of the doctors believing they are being lazy and telling the actual side of the immigrants and showing how it is a culture difference. Borovoy and Hines work is similar to Mullings because it shows us if we shed light on the different perceptions of the other group we will be able to understand and realize the actuality of the problem. This shows the importance of including different perceptions in ethnographic work to generate a solution.

 

                While Mullings was successful addressing the multiple factors contributing to infant mortality among black women in Harlem, she was failed to include possible public health intervention solutions. After reading all of the different stories in the book, I felt like there was a missing chapter. She focused entirely on showing the frustration in the women’s lives however, didn’t include how we can better progress. The women in the survey were not asked how they think the disparity can be reduced. Or critical areas they believed needed immediate change. Mullings towards the end lightly glosses over how her data can be used to give the people what they want. She stresses that hearing the voices of the women will allow us to make an intervention that benefits the people. She broadly states that the women want to, “take control of resources so they can care (170).” Mullings leaves out how the black women in Harlem believe we should go about increasing the access to the women. Her main focus was to make sure their voices were being heard but, their voice of what/ how they think interventions should take place is silenced. Silencing that information leaves it up to public health and other officials to create a framework they feel will benefit the people, rather than looking at the way the women believe they will benefit and work together to formulate a plan. Mullings research could have been stronger if she extended beyond documenting their personal stories and speaking to them about their opinions on change.

 

We see how the discrimination within the economic, political, and social structure of Harlem city women, contributes to poor reproductive health. In order to improve for better reproductive care we must work on creating a framework for public health interventions that relates to the lifestyle in which these women live in. Taking into account factors like environmental injustice, social and biological factors, and institutionalized racial oppression. Connecting those factors to chronic strain and stress will allow us to improve their care. The rates of infant mortality among black women not only in Harlem but all over the world, is disproportionally high making this a serious public health concern. Mullings research shows that in order to treat someone we have to understand all aspects of the culture they live in. Because infant mortality is confined solely with black women it is not a genetic issue therefore, biomedical intervention cannot be the only solution. Based on the data collected biomedical intervention is not the only answer to this issue. The intervention must include ways in which black women can be able to preserve their gender identity. The solution extends way beyond medical intervention, using ethnographic data we can create a framework that reduces the disparity of infant mortality among African American women.

 

 

Bibliography:

Borovoy, Amy Hine, Janet. (2008). Managing the Unmanageable: Elderly Jewish Emigres and Biomedical Culture of Diabetes Care. American Anthropological Association.

Mullings, Leith Wali, Alaka. (2001) Stress and Resilience: The Social Context of Reproduction in Central Harlem. University of New York, New York.

 

Ethnography Review Paper: Children of Deh Koh

 

          Written by anthropologist, Erika Friedl, Children of Deh Koh is an ethnography about the life of children in a village in the mountains of Southwest Iran. Between 1965-94, Friedl spent accumulatively six years in this village she calls “Deh Koh” (a pseudonym she’s given it for the sake of confidentiality). Living among the villagers with her husband and on some trips her daughters as well, she and her family established personal relationships with the villagers and obtained a competent understanding of the native language, Luri. She has written and co-edited several books based on her studies in Iran, her only other solo work being Women of Deh Koh, which was published six years prior to Children of Deh Koh. She did not originally intend to study children, but as she spent time studying women and the society of Deh Koh, she realized that learning about the life of children was a necessary piece of understanding society, especially considering half the population of the village was under the age of 15. 
         This ethnography could be simply described as a book of recorded observations. Her style is somewhat unique in that there are very few statistics and formal interviews included and thus her account relies heavily on observations and retold anecdotes. This approach differs from many case studies we’ve looked at in class such as “The Case of the Cannibals’ Curse”, and the study on schizophrenia done in south India, which rely on statistics, formal interviews and observations to assist the anthropologist in an in-depth analysis of the culture or issue at hand. While Friedl does an excellent job of giving the reader a very intimate view into the personal lives of the villagers, she aims to keep her own analysis from tainting the information and thus leaves the reader alone to interpret her observations. As an inexperienced reader of case studies, I enjoyed the approachable style of this book and I appreciated the personal lens with which she approached her study. This allowed me to draw connections between what I gathered from these observations and concepts we discussed in class. However, I felt that I could have learned more from the study if she had more openly accepted the inherent bias bound to occur in an ethnographic study, and provided her analysis of the information she shared. Having said that, I was moved by the struggles of the people in this village and inspired to learn more about women’s health.
          Friedl organizes this book so that it generally outlines the development of a child within the society of Deh Koh. However, she focuses less on physical factors of their environment that have changed over the years, such as housing, diet, etc., but more on the “assumptions and rationalizations” (Friedl 1997:xv) they grow up hearing and emulating, that shape them.  She assumes that, “early in a child’s life, habituation establishes concepts as well as patterns for the expression of feelings, even for feelings themselves; for expectations of reactions from others to one’s own bodily or verbal utterances; for the courses of interactional encounters; for the logic of common sense.”(Friedl 1997:xv)  She approaches the study of childhood, by studying how they’re society influences and shapes them, asserting that she aims to answer the central question, “What do children learn from it all?” (Friedl 1997:xvi)
          Friedl begins the book by describing Deh Koh, so that we have some context for what the village is like. Since around 1900, the village has grown from a few dozen to about four thousand people. The village is struggling to keep up with this large expansion and therefore the infrastructure is in a state somewhere between developed and undeveloped. There are urban houses next to huts and telephone lines but no sewers. In the context of the village, Friedl describes children’s sphere of action. While boys are free to roam around and spend their time wherever they want in the village, it is socially unacceptable for girls to be out and about, especially the older they get. Gender inequality is a major theme in this study and Friedl shows us through the observations and stories she chooses, how its implications affect children and life in Deh Koh.
          She dedicates a significant section of the book to describing sex, pregnancy and childbirth, in a male dominant society and thus allowing the reader to see how the nature of reproduction in Deh Koh, affects the children. Because men are allowed to demand sex and contraception is somewhat new and unfamiliar in their culture, women are overburdened with children and are almost constantly pregnant. These cultural practices affect the health of many women and children; Friedl discloses many horror stories of infant and maternal mortalities that occur often. Friedl quotes a women physician who treated patients in Deh Koh, “From a medical point of view, pregnancies in the whole area ought to be treated as health crises.” (Friedl 1997:73) Although biomedicine is practiced there, cultural superstitions and healing practices are often sought first or interrupt biomedical treatment, resulting in a lack of effective treatment.
          However, not only do these practices affect children’s health, but it affects how children are raised in many ways. One, children are taught from a very young age what their roles and worth are according to their sex. Two, mothers are unable to pay very much attention to their children, because they are preoccupied with the tasks of having such a large family, or with taking care of the youngest children. Consequently, children must take on a large amount of responsibility early on, in order for them and their siblings to survive. Third, since children are considered the “property” of their father, they are often left feeling unwanted or literally abandoned by their mother on the occasion that she walks out or threatens to walk out on them when angry with her husband. And lastly, children are shaped by the comments they hear their mothers and fathers make regarding the roles of males and females and reproduction.
          The notion that children are shaped by what they hear, is another central theme of Friedl’s work. She has a whole chapter dedicated to sharing various lullabies that are sang to children and another dedicated to short stories children grow up hearing. However, there is yet one more profound theme in Friedl’s study and that is the common hypocrisy in society between what children are taught in principle and what they know they should do. Since they are often ignored, children learn early on how to get what they need and often times their resourcefulness, even if somewhat ill-mannered, is rewarded. For example, even though children are taught not lie, parents are sometimes concerned about their child’s wit if they haven’t figured out that lying can benefit them. Also, although children are shy around adults and taught not to speak to them, they are often horribly behaved around their parents, in order to get what they need.
          I could continue on summarizing Friedl’s observations, because they are numerous, but I’ve done my best here to extract the main ideas from the study. Friedl has purposely made it difficult to know her own personal ideas about what she’s studied and instead she’s only applied the tool of  participant-observation to this study, applying very little context and no comparison. (Borofsky 2011:3) I liked how this approach allowed me to be completely absorbed in learning about the realities of the people of Deh Koh, without having to try to understand a complicated case study. However, it forced me to analyze the information myself.
          As I was reading the stories of women who had lost, friends, sisters, mothers and children to birth complications, I thought of the article we read in class on maternal mortality in Mozambique. In both cases, “woman reported high maternal reproductive morbidity, frequent pregnancy wastage, and immense pressure to bear children throughout their reproductive years.” (Chapman 2003:1) I thought it was interesting that even though both societies have the capabilities to practice biomedicine, it is of little use in the face of the cultural restraints these women feel. These women are trapped by their role in their society to produce children and consequently their health is suffering. I connected this to the statement made by Professor Ceron in lecture that, “power is the determinant of health,” because in this case, men hold the power. Previously, I had only understood this statement to mean financial, economic and governmental power, but now I understand that this power can be exercised between one another, as a result of inequalities.
          In addition to being affected by their cultural obligation to bear children, women of both cultures still believe in various traditional superstitions, that sometimes prevent them from seeking out biomedical care. In Mozambique, “vulnerability heightens women’s perceptions that they and their unborn infants will be targets of witchcraft or sorcery by jealous neighbors and kin.” (Chapman 2003:1) Similarly, women in Iran believe that their children could be subject to “evil eye” by others. (Friedl 1997:71) These showed me how, though we’ve discussed the possible benefits of medical pluralism such as the availability of multiple types of treatment, there are also great obstacles. The two differing explanatory models won’t always work side by side, and one is bound to stand in the way of the other every so often. By comparing these two situations, I think we can see that the challenges of medical pluralism we see in this study are not isolated to Deh Koh alone, but are common around the world. Thus it is a global health issue that biomedicine professionals and local practitioners must work together to solve.  
          While I can make these connections between certain aspects of this study and my class, I haven’t addressed the point of the study which is how these issues affect children. I very much agree with Fiedl that children are shaped by what they hear and what they experience. I thought it was interesting how she highlighted the paradoxes that children learn to navigate. However, because her observations about children are spread across the board, with little context given and almost no comparison, it is hard for me to start analyzing the work, because it’s almost too broad. While I think she intends for her work to be purely informative, it inherently has biases. For example, there are very few stories recounted that are told by men, almost all are told by woman, causing me to think that she is biased towards the woman’s viewpoint. I feel that instead of trying to remain completely neutral, she could offer some of her own analysis, so that the reader can get the full worth of her work. The reader is in no way forced to accept her analysis, it is merely her interpretation.
          In conclusion, I think that Fiedl provided a unique look into the lives of children, rightfully citing what influences them most, while drawing our attention to health issues and ideological hypocrisies within the society. Fiedl’s style of ethnography could be very useful or not, depending on the reader and what their objective is. I’m not sure if Fiedl intended for this book to be used for anything in particular other than just obtaining knowledge. If one was looking for information with which they could make their own connections and draw their own analysis, this type of ethnography would be very useful. However, if someone wanted to use this study to compare to another, it would be hard given the lack of concrete data and analysis provided by the ethnographer. Having said that, I found this ethnography refreshingly genuine and while it left me wishing I had more guidance, it forced me to make some of my own connections and allowed me to feel like I was learning about this village on a personal level, which is the technically the job of an anthropologist after all, to share culture. In fact, unlike any of the other case studies we’ve read, this inspired me to further study women’s health.

 -Carlie Anderson

Works Cited

Borofsky, Rob

2011 Why Public Anthropology?. Hawaii Pacific University: Center for a Public Anthropology.

Chapman, R. Rachel
2003 Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk. Social Science and Medicine 57:355-374

Friedl, Erika
1997 Children of Deh Koh. Syracuse, New York: Syracuse University Press.

Ethnography Review: Swaddled in the Cloak of Science

Lynn M. Morgan’s ethnography, Icons of Life, delves into how historical events have shaped American’s view of embryos and fetuses. Morgan discovers a small collection of preserved human fetuses in a dusty science department storeroom at Mount Holyoke College. She is told that the collection is part of a large-scale embryo collecting project based at John Hopkins during the first half of the twentieth century. Morgan then unveils the social, political, and cultural implications resulting from that project. I enjoyed Lynn Morgan’s ethnography. The depth of her elaborations made it easy to follow and understand the connections she drew between the Carnegie Human Embryo Collection and implications that have evolved. It is interesting how this project had valuable scientific contributions, yet it deeply impacted how the American culture views fetuses. Morgan’s reoccurring theme of how the collected embryos were completely alienated from women took me by surprise. Pictures of fetuses typically do not include the mother that carried it. I never realized the severed connection between fetuses and their mothers; yet this is a theme that is easily observed within the American culture. The cultural assumption of how all dead fetuses are immediately linked to abortion was another theme that I had never considered.

  

This ethnography was inspired by Morgan’s anthropological fieldwork in Ecuador during the early 1990s, where she was interviewing rural mothers “about the status of fetuses and the morality of abortion” (Morgan 2009:XII). She discovered how the mothers, who are all Catholic, saw abortion as a sin not because they see it as murder, but because it is an act of self-mutilation, and they are taking God’s will into their own hands. Through her fieldwork, Morgan came to the realization that the link between the status of the fetus and the morality of abortion belonged to her American culture, thus prompting this ethnography.      

Icons of Life deals with the place of embryo and fetal specimens in American history. It draws on the history of a large embryo collecting project based at the Carnegie Institution of Washington’s Department of Embryology, but is not a history of that department. It features the anatomist and embryo collector par excellence, Franklin P. Mall, but is not a biography. It touches on the political and philosophical implications of anatomical embryo collecting, but is neither a political manifesto nor a philosophical treatise. Instead, I argue that the history of human embryo collecting had an enormous unacknowledged influence on how we think, in cultural terms, about what embryos are and what they mean. Collecting practices, in other words, had social, political, and cultural implications. [Morgan 2009:XII]

           

Franklin P. Mall pushed doctors to actively collect any specimens that came into their possession, usually through miscarriages or hysterectomies. These specimens allowed scientists to physically see what was previously hidden within a mother’s womb. “Embryo collecting was born as a collaborative effort between research scientists, clinicians, and pregnant (or formally pregnant) women” (Morgan 2009:6).  Mall and his colleagues successfully established an embryo collecting tradition in the United States. This tradition lead to a shift in culture, for “embryo collecting became thoroughly normalized and unremarkable” (Morgan 2009:9). Normalizing the collection of fetuses and establishing the tradition within the “players” involved made science the “owners” of the collected embryos and fetuses. This collection paved way to “the very concept of ‘development,’ conceived as a cumulative process of unfolding” (Morgan 2009:7). This lead to the embryological view of life as the origin story, rather than an origin story. “The embryological view is told as one of the greatest, oldest human truths. Its legitimacy is enhanced by being linked with other powerful forms of knowledge in our society, especially science and religion” (Morgan 2009:8). In class, we have discussed how biomedicine is strongly weaved into institutions, and therefore our culture. Morgan claims “embryos and fetuses are thoroughly infused with culture, even (or especially) when tightly swaddled in the cloak of science” (2009:8).

In 1933-34, there was a prenatal exhibit of forty specimens at the Century of Progress Exposition in Chicago. This exhibit further illustrates how the embryological view of life penetrated American culture. The exhibit “depicted human development as a seamless trajectory from conception to birth. Curiously, it did this by glossing over the reality that pregnancy is often interrupted, as these bottled fetuses so obviously demonstrated” (Morgan 2009:134). “The 1933-34 exhibit of prenatal development proffered a biological basis for what was more accurately the cultural production of embryos and of the embryological view of development” (Morgan 2009:135). The exhibit deflected attention from the women who were connected to the fetuses.

Science as the “owners” of the embryos and fetuses uncoupled the connection between the mother’s and their fetuses. Morgan states, “Women’s lives and stories were never the embryo collector’s concern, any more than the love letter inside the envelope might matter to a stamp collector” (2009:107). This analogy effectively exposes how women were not given credit for their contribution to the embryo collection, and therefore science. Sarah Franklin argues how the embryological view of development can be particularly hard to apprehend reflexively, because it tends to obscure the social aspects of reproduction at the same time that it becomes the basis for their cultural production (1991:197). “This double move, of displacing and replacing the social with the biological…enables a woman’s pregnancy, the work of nurturing a child, the meaning of motherhood, the social meaning of personhood (in terms of kinship, identity, naming, reciprocity, interdependence, etc.) all to be reduced to one dimension… biological life” (Franklin 1991:200). Morgan connects Franklin’s argument with the Carnegie Human Embryo Collection, “In the way that specimens were culturally defined and collecting was practiced, embryos were made to be absolutely alienable from women and absolutely inalienable from the embryologists” (2009:89).

Morgan explains how currently, “images of embryos and fetuses speak−loudly−on a range of contentious topics including gender, abortion, and reproductive technologies” (2009:187).  I agree with Morgan’s statement; American culture adheres various topics with embryos. Morgan elucidates how “as embryologists materialized the embryonic body and claimed it for science, they authorized themselves to control and shape the interpretations that would be made of it” (2009:188). On the contrary, embryologists claimed that the embryonic body spoke for itself (Morgan 2009:188). Acknowledging that the embryologists’ interpretations were based on a rational, unemotional examination of biological evidence, Morgan goes on to explain how “we can see the lasting social consequences of the knowledge they [embryologists] produced. They helped to construe the human embryo as an autonomous actor, detachable from women’s bodies and motivated solely by biological forces” (2009:188). Embryologist, therefore, introduced the embryos into political debates by allowing the embryos to take sides in the culture wars over topics such as evolution and women’s suffrage (Morgan 2009:188).

Fetal images then began to seep into popular culture as symbols of life (Morgan 2009:197). Embryos and fetuses began to move out of the laboratory, and into magazines, advertisements, and books. After the 1960s, it was rare to admit that the fetal images used to represent life were actually created from dead specimens, specimens that were likely a part of the Carnegie Human Embryo Collection. As embryo collecting fell out of fashion, a shift in the view of embryos occurred. In 2002, a popular book titled From Conception to Birth by Alexander Tsiaras depicted brightly colored visualizations of embryos and fetuses. During this time, birthing books to inform younger mothers of the development of their unborn child depicted images of embryos and fetuses as various stages of the gestational period. These books are an example of how embryos and fetuses began to symbolize life. Morgan points out how “ironically, most of the images in the book are based on scans of ex utero dead embryos and fetuses” (2009:220). As lifelike, animated embryo and fetal images were “becoming ubiquitous, they [were] increasingly juxtaposed against another set of images that depicts dead embryos and fetuses (including specimens) as tragic, threatening figures. Lifelike versus lifeless” (Morgan 2009:228). The latter imagery is used heavily in anti-abortion propaganda. This juxtaposition lead to a general connection within American society that all dead fetuses are the result of abortion.

            Since this ethnography was inspired by fieldwork in Ecuador, most of the research was conducted in archives and libraries. Morgan’s own curiosity fueled this work, and therefore she has a prominent influence on the work. Morgan wanted to uncover why the culture in the United States automatically linked dead fetuses with abortion. This prompted her discovery of a small embryo collection at Mount Holyoke College. She learned that “the heyday of embryo collecting took place between 1913 and 1944, although the earliest efforts began around 1890 and the project lasted into the 1960s and beyond” (Morgan 2009:3). While completing this work, Morgan was limited to the remnants of the era, what she could dig up in the archives and libraries. She was limited to what she could decipher from Mall’s handwriting, for she could not directly interview him. Morgan did not have access to a first-hand perception of the era, such as the information she would get from directly interviewing Mall himself, which is a weakness of this work.

On the other hand, the decades that have passed since the embryo collecting was done also plays into a strength of the work. The time that has passed allows the implications of the project to surface, which allows Morgan to expose insights on the long-term affects of the project. Morgan also had access to historians, librarians, archivist, and embryologists who have done specific research that Morgan was able to build upon. For example, Morgan draws upon Sarah Franklin’s argument of how the embryological view of development obscures the social aspects of reproduction at the same time that it becomes the basis for their cultural production, and then further elaborates on that theme. Morgan had access to other respected professionals, and that helps strengthen her work. Having various professionals in different fields allows more perspectives to be represented, and thus widening the scope of relevance.

The Carnegie Human Embryo Collection was done in America, and although other embryo collections have been done in other countries, this project directly affected the fetus’ role in American Culture. Morgan gives an example of how she was giving a presentation at the University of Washington, where a foreign student voiced how she did not find Alexander Tsiaras book (From Conception to Birth) “fascinating, but vulgar. The whole idea of such as book, she said, showed extremely bad taste. Her reaction reinforced my [Morgan’s] impression that fetal displays condensed cultural assumptions, in this case about fetus-obsessed Americans” (Morgan 2009:221). This ethnography contributes to how the American public views embryos and fetuses, as well as the associations specific to this culture.    

This ethnography has various practical uses. Morgan presents multiple insights on the unseen implications of science. Morgan’s observations can be used as case study of how medical knowledge shapes social representations, a theme that has been discussed in lecture. In this case, Morgan shows how medical knowledge gained through the Carnegie Human Embryo Collection lead to the embryonic view of life, and how that view resulted in several alternations in the American culture. Prior to the project, Americans pictured a tiny human growing inside its mother’s womb. After the project, Americans are able to tie a picture of specific embryo or fetus with each week of the gestation period. The project expanded the medical knowledge of embryos and fetuses while also shaping their representations within the American society. Birn defines global health as transcending borders, for it considers the health needs of the people of this planet above concerns of particular nations. With that in mind, I do not think that Morgan’s ethnography is about a global health issue. The implications that Morgan explores solely affect American culture, and therefore this issue is confined to one country. As someone who grew up within that culture, this ethnography raises several questions, such as if our cultural view of embryos and fetuses is disastrous? Does uncoupling a mother and her fetus allow us to legitimize the legality of abortion in our society? Since it was an election year, I noticed both parties discussed abortion and reproductive technologies. One main difference between the two prominent parties in the United States is their view on abortion. This politicization of abortion leads me to wonder if it is related to the cultural assumption of how all dead fetuses are the result of abortion. Natural miscarriages are generally unacknowledged within our society, and that may leave women with uncertainty on how to cope with a miscarriage. Although this ethnography leaves me with a few questions, Lynn Morgan does an exceptional job of dissecting the historical events that lead to American society’s current representations of embryos and fetuses.

Franklin, Sara

1991 Fetal Fascinations: New Dimensions to the Medical-Scientific Construction of Fetal Personhood. London: HarperCollins.

Morgan, Lynn M

2009 Icons of Life: A Cultural History of Human Embryos. Berkeley, CA: University of California Press.