Child Survival: Anthropological Perspectives on the Treatment and Maltreatment of Children

392 Pages·1987·15.88 MB·English

by  Nancy Scheper-Hughes (auth.)

CHILD SURVIVAL
CULTURE, ILLNESS, AND HEALING
Editors:
MARGARET LOCK
Departments of Anthropology and Humanities and Social Studies
in Medicine, McGill University, Montreal, Canada
ALLAN YOUNG
Department of Anthropology, Case Western Reserve University,
Cleveland, Ohio, U.S.A.
Editorial Board:
LIZA BERKMAN
Department of Epidemiology, Yale University,
New Haven, Connecticut, U.S.A.
RONALD FRANKENBERG
Centre for Medical and Social Anthropology, University ofK eele,
England
ATWOOD D. GAINES
Departments of Anthropology and Psychiatry, Case Western Reserve
University and Medical School, Cleveland, Ohio, U.S.A.
GILBERT LEWIS
Department of Anthropology, University of Cambridge,
England
GANANATH OBEYESEKERE
Department of Anthropology, Princeton University,
Princeton, New Jersey, U.S.A.
ANDREAS ZEMPLENI
Laboratoire d' Ethnologie et de Sociologie Comparative,
Universite de Paris X, Nanterre, France
CHILD
SURVIVAL
Anthropological Perspectives on the Treatment and
Maltreatment of Children
Edited by
NANCY SCHEPER-HUGHES
Department of Anthropology, University of California, Berkeley
D. REIDEL PUBLISHING COMPANY
A MEMBER OF THE KLUWER ACADEMIC PVBLlSHERS GROUP
DORDRECHT / BOSTON / LANCASTER / TOKYO
Library of Congress Cataloging-in-Publication Data
Child survival
(Culture, illness, and healing)
Bibliography: p.
Includes index
1. Child abuse - Congresses. 2. Child welfare - Congresses.
1. Scheper-Hughes, Nancy. II. Series
HV6626.5.C497 1987 362.7'044 87-23519
ISBN-13: 978-1-55608-029-6 e-ISBN-13:978-94-009-3393-4
00I: 10.1007/978-94-009-3393-4
Published by D. Reidel Publishing Company,
P.O. Box 17, 3300 AA Dordrecht, Holland.
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In all other countries, sold and distributed
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All Rights Reserved
© 1987 by D. Reidel Publishing Company, Dordrecht, Holland
Softcover reprint oft he hardcover 1s t edition 1987
and copyrightholders as specified on appropriate pages within
No part of the material protected by this copyright notice may be reproduced or
utilized in any form or by any means, electronic or mechanical
including photocopying, recording or by any information storage and
retrieval system, without written permission from the copyright owner
Dedication
To mothers and children at
risk, at home and abroad
TABLE OF CONTENTS
ACKNOWLEDGMENTS ~
NANCY SCHEPER-HUGHES / Introduction: The Cultural Politics of
Child Survival 1
PART I: POPULATION, FERTILITY, AND CHILD SURVIVAL
SULAMITH HEINS POTTER / Birth Planning in Rural China:
A Cultural Account 33
SARA HARKNESS and CHARLES M. SUPER / Fertility Change,
Child Survival, and Child Development: Observations on a
Rural Kenyan Community 59
MARIA LEPOWSKY / Food Taboos and Child Survival: A Case
Study from the Coral Sea 71
PART II: INFANTICIDE: CULTURALLY SANCTIONED CHILD
ABUSE
BARBARA D. MILLER / Female Infanticide and Child Neglect in
Rural North India 95
DOROTHY S. MULL and J. DENNIS MULL / Infanticide Among the
Tarahumara of the Mexican Sierra Madre 113
PART III: SOCIAL TRAUMA: THE EFFECTS OF POVERTY,
SOCIAL DISRUPTION, AND CATASTROPHE ON CHILD
TREATMENT
LUCILE F. NEWMAN / Fitness and Survival 135
LIZABETH HAUSWALD / External Pressure/Internal Change:
Child Neglect on the Navajo Reservation 145
M.W. de VRIES / Cry Babies, Culture, and Catastrophe: Infant
Temperament Among the Masai 165
vii
viii TABLE OF CONTENTS
NANCY SCHEPER-HUGHES I Culture, Scarcity, and Maternal
Thinking: Mother Love and Child Death in Northeast Brazil 187
PART IV: CHILD ABUSE: DEVIANT AND IDIOSYNCRATIC
CHILD MALTREATMENT
NELSON H.H. GRAB URN I Severe Child Abuse Among the
Canadian Inuit 211
MARCELO M. SUAREZ-OROZCO I The Treatment of Children in
the "Dirty War": Ideology, State Terrorism, and the Abuse
of Children in Argentina 227
JILL E. KORBIN I Child Sexual Abuse: Implications from the
Cross-Cultural Record 247
1.S. LA FONTAINE I Preliminary Remarks on a Study of Incest in
England 267
PART V: CHILD SAVING: PROBLEMS AND DILEMMAS IN
SOCIAL INTERVENTION
CLAIRE MONOD CASSIDY I World-View Conflict and Toddler
Malnutrition: Change Agent Dilemmas 293
NORA J. KRANTZLER I Traditional Medicine as 'Medical Neglect':
Dilemmas in the Case Management of a Samoan Teenager
with Diabetes 325
NANCY SCHEPER-HUGHES and HOWARD F. STEIN I Child Abuse
and the Unconscious in American Popular Culture 339
DON HANDELMAN I Bureaucracy and the Maltreatment of the
Child: Interpretive and Structural Implications 359
D. MICHAEL HUGHES I When Cultural Rights Conflict with the
"Best Interests of the Child": A View from Inside the
Child Welfare System 377
LIST OF CONTRIBUTORS 389
INDEX OF SUBJECTS 391
ACKNOWLEDGMENTS
This volume grew out of an all day, two-part invited symposium on child
treatment and child survival held during the American Anthropological
Association meetings in Denver in 1984. In addition to the original panelists,
several other scholars were invited to contribute to this book, and I am
thankful to all of them for their patience, steadfastness and even tempers
during the many revisions of their papers. Susan Scrimshaw, Margaret Clark,
and Patricia Draper were incisive discussants during the original symposium.
Susan Scrimshaw communicated at length with several of the contributors
who benefited from her astute readings of their papers and from her experi
ence and expertise in this field. Grace Buzaljko lent a deft hand in copy
editing the manuscript at a most precarious moment. Finally, a University of
California Research Fellowship and a grant from the Wenner-Gren Founda
tion for Anthropological Research allowed me to take a leave of absence
from teaching during the fall of 1985 which made the completion of this
project possible. Royalties from the sale of this book will go to the women
and children involved in UPA C, the Uniiio para 0 Progresso do Alto do
Cruzeiro, a twenty-year-old grassroots self-help movement in the interior of
Northeast Brazil (see Scheper-Hughes, this volume) that has worked continu
ously to decrease the infant mortality of that community through a combina
tion of political activism and ethno-medical ingenuity.
The poems 'Limbo' and 'Bye-Child,' from Poems 1965-1975 by Seamus
Heaney, copyright © 1966,1967,1969,1972,1975,1980 by Seamus Heaney,
are reprinted here by permission of the author and Farrar, Straus, and
Giroux, Inc.
The cartoon, 'The Far Side,' by Gary Larsen is reprinted by permission of
Universal Press Syndicate, and the cartoon, 'Cabbage Patch Doll Accesso
ries,' by Tom Meyer is reprinted by permission of the New York Times
Syndication Sales Corporation.
The American Anthropological Association granted permission to repub
lish the article, 'Culture, Scarcity and Material Thinking: Maternal Detach
ment and Infant Survival in a Brazilian Shantytown,' which first appeared in
ETHOS, winter 1985, Volume 13(4): 291-317.
IX
NANCY SCHEPER-HUGHES
THE CULTURAL POLITICS OF CHILD SURVIVAL
Oh, children, children, how fraught with peril are your
years!
Fyodor Dostoevsky
The dialectic between fertility and mortality, reproduction and death, survi
val and loss, is a powerful one in the lives of most people living outside or on
the periphery of the "modern," industrialized world. The pressure that
biology exerts on human history is strong throughout much of the "peri
pheral" world, where disease epidemics and famines consign millions to an
early grave, and where the "life of the species" is only marginally under
human control.l In the world in which most of us live, however, the dialectic
between fertility and mortality has lost its edge, become buried in the
consciousness of most North Americans and Europeans, for whom each
birth signifies new life rather than the threat of premature death, and for
whom some control over fertility is assumed. Yet it was not long ago in our
own "western" world (barely more than a hundred years) when reproduction
was as unpredictable, and death as random and chaotic as in the contempo
rary Third World. In many remote rural areas and in the squalid urban slums
of the 19th century, there was hardly a family that had not experienced
firsthand the death of an infant or small child. Public health and sanitation,
child and adult labor laws, and social welfare legislation had yet to vanquish
the great uncertainties of individual human existence. A walking tour through
any New England churchyard with its symmetrical rows of infant tombstones
gives silent but powerful testimony to the fickleness of the natural and social
orders to those people who lived and died on the threshold of modernity.
The mundane ness and ubiquitousness of child death - a fairly permanent
feature of the western history of childhood until quite recently - contributed
to a plethora of individual and collective defenses. Historically, one of these
has been the failure to recognize childhood morbidity and mortality as a
significant social or medical problem. Consequently, childhood mortality
rates are often difficult to discern up through the 19th century for Europe and
North America; often they were not separately tabulated from adult rates?
As late as 1855 the British Registrar General introduced a new subclassifica
tion of death - diseases from growth, nutrition and decay - under which adult
deaths from old age and degenerative diseases were counted along with infant
and childhood deaths from prematurity, congenital diseases, and from "wast
ing" (deaths from malnutrition, consumption and from what might be diag
nosed today as "failure to thrive").3 As Cassidy [this volume] points out,
childhood malnutrition, still one of the greatest social pathogens affecting
childhood survival throughout the world, was first identified as a pediatric
1
Nancy Scheper-Hughes (ed.), Child Survival, 1-29.
© 1987 by D. Reidel Publishing Company.
2 NANCY SCHEPER-HUGHES
"disease" in 1933, and the more specific diagnoses of marasmus, kwashiorkor,
and protein energy malnutrition (PEM) have come into clinical use only since
the 1950s. Meanwhile, pediatrics, as a clinical specialization, is also of recent
vintage. The British Pediatric Association was founded in 1928, and in the
United States pediatric medicine developed only when women began to be
accepted into medical schools and into the medical Academy at the turn of
the century (Morantz-Sanchez 1986: 272).
In short, the social construction of child survival as a medical problem
about which something can and should be done is fairly recent.4 In many
pockets of the western world up through the mid- to late-19th century
childhood mortality tended to be viewed as an unfortunate but altogether
predictable natural occurrence, and a 15% to 20% morality rate during the
first year of life was not regarded as intolerable or unacceptable. For one
thing, childhood mortality had a clear social class reference which allowed it
to remain masked for many generations. The pernicious living and working
conditions of the urban proletariat during the first half of the 19th century
corresponded to the lack of social and medical concern for the mortality of
working-class and underclass children. As Foucault writes, "It was of little
importance whether these people lived or died, since their reproduction was
[thought of] as something that took care of itself in any case" (1978: 126). The
improvident and slovenly "Malthusian couples" who propagated without
restraint, without foresight would have that devil, Nature/Biology, to pay. It
would take political conflict and economic emergencies (such as the new labor
requirements of an advanced phase of industrialization) to provoke state
interest in the regulation and control of population,including a concern with
child survival, which has recently achieved the status of a "master" social and
political problem in the "modern" world.
Given the relatively recent perception of child survival in advanced indus
trialized nations as a social-medical problem in which the state has a clear and
vested interest, it should not be surprising that this public consciousness is
absent in many societies undergoing a rapid and early phase of industrializa
tion or mired in a relatively crude form of industrial capitalism. In these Third
World contexts, so often characterized by a high pressure demography of
untamed fertility and high mortality, individuals themselves approach repro
duction and parenting with a range of sentiments and practices rather differ
ent from our own. Parents in much of the so-called developing world (like
parents in early modern Europe) understand a baby's life to be a provisional
and undependable thing - a candle whose flame is as likely to flicker or go out
as to burn brightly and continually. There, child death may be interpreted less
as a tragedy than as a misfortune, one to be accepted with equanimity and
resignation as an unalterable fact of human existence. Following from a high
expectancy of loss, reproductive and child-rearing strategies may be based on
a kind of thinking in sets, on the presumption of the interchageability and
replace ability of offspring (Imhof 1985). Reckonings of the social, moral and
economic value of the infant and small child may be measured against those