Then in 1942 in the early days of Franklin Roosevelt’s Good Neighbor policy, Major General George C. Dunham, the author of a famous textbook on public health, was sent down from Washington to help Latin America set up a health program. He had experience in the Philippines in inducing local governing bodies to come in on public health programs and was convinced that a health organization to be effective had to be based on the cooperation of the people themselves. That was the genesis of the Sespe idea. Most of the Brazilian staff obtained their practical education in the field under the Rockefeller organization and their theoretical training at public health centers in the States.
We were standing in the empty office looking at a map of the valley tacked up on the wall with glassheaded pins in various colors indicating the different services.
“To produce an island of public health in each place we work,” said Dr. Penido, “first we have to build privies for the people. You see we start from zero in this country. Then we give them pure water.”
Monty Montanare pricked up his ears at that. Monty was a lanky young American engineer with a long North Italian nose, a graduate of the Seabees in the Aleutians and on Guam. Building water systems was his business. “Don’t touch the water in Vitória” he admonished me gruffly. “Once we get in the valley you can drink all you want.”
Monty seemed to be executive director of the expedition. After a glance at his wrist watch he announced it was time to eat; he’d ordered the linecar for three. After a tremendous Brazilian luncheon, which started with salad and coldcuts, and proceeded through steak and rice and chicken and beans to culminate in roast pork smothered in fried eggs, Monty shepherded us into two automobiles and we were driven across the iron bridge to the railroad station on the mainland.
The linecar of course hadn’t arrived yet, though it was after three, so we roamed around looking at the old wood-burning locomotives with their funnelshaped stacks, like the locomotives in prints by Currier and Ives, that were shunting the cars in the freightyard, and at the great piles of wood along the tracks. I wondered how many manhours of work it took to cut all that wood up in the hills and to bring it down by oxcart or on the backs of burros or of men to the railroad.
At a church on the shore a ringing of bells had started. The steamboats at the docks across the harbor were blowing their whistles. Down the middle of the stream in the sparkling sunlight came a long string of launches and rowboats decorated with green and yellow streamers. From the shore came cheers and the popping of rockets. Foguetes are part of the Portuguese heritage. It was from China, probably, the early navigators brought home a taste for fireworks. Somewhere a brass band was playing. It was the procession of some saint being carried by water from one shrine to another. Before we had time to find out the name of the saint the line-car had backed in beside the platform.
It was a big green stationwagon sort of vehicle mounted on railroad trucks and driven by a diesel engine. We had to hurry to get off in order to meet the passenger train coming down the singletrack line at the proper siding. First we circled the conical mountain on the track the oretrains used. We stopped over the oredocks. Walter Runge, another American, who worked for the company that was repairing the line, stepped out and picked up a piece of heavy blue and red rock.
“Sixtyeight per cent,” he said. “Just about the richest iron ore in the world. The railroad’s still sketchy. It comes a long way, and it takes a long time, but it gets here. These ore-docks could have been better designed but the ships somehow get loaded. There were times when we wondered if they ever would.”
At the edge of the yards the bucktoothed mulatto driver had to stop the car suddenly to send his black assistant running back to the station to get his orders. The railroad was operated on the old English block system; only one piece of equipment allowed at a time in a block. At last the boy arrived panting with a green slip in his hand and we went off rattling and lurching over the newlaid rails, past bamboo fences and small thatched huts with mud floors and yards planted with scrawny papayas where a few skinny chickens pecked about and dirty children black and brown and grayish white, naked or dressed in rags that barely covered them, rolled and played in the thick dust.
One set of houses, freshly built for railroad workers, stood out along the track neat and white with scrubbed tiled floors.
Immediately the town fell away and we were crossing sunseared savannas that had once been planted in sugarcane and where occasionally the ruins of a stone and adobe fazenda crumbled under a bristling mat of vegetation. The abolition of slavery had made them uneconomical.
Scattered white and gray zebu cattle with big humps grazed on the plain. The railroad swept into bare rocky hills. The hills were scorched and smoldering because this was the season when they burned over the land to plant it when the rains began.
In the valleys there was an occasional ranch house with mud walls and tiled roofs set in a bunch of tattered banana trees. As the evening began to thicken in smoke and dusk the line wound in endless curves up a rocky valley. In the distance blue humped mountains rose from dark rock faces into fantastic cones against the sky.
Walter Runge was a hefty young man from New Jersey who had studied his engineering at Rutgers. He pointed out with a craftsman’s pride the work his outfit had done, straightening curves, eliminating grades, laying new rails, reballasting. He made you feel that this rickety singletrack line into the wilderness was an amusing and capricious toy to be coddled and petted and gradually babied out of its errors and vices.
Night came down on us suddenly. As the car came to a stop on a siding he pointed up into a barely visible tangle of matted trees. “We had a camp up there … All over here is swamps … The place is full of wonderful orchids … Before DDT we had to keep a double payroll because half the men were always down with malaria.”
“Any wild animals?”
“There might be some deer. They claim Espírito Santo is a great place for jaguars but I never saw one … Ticks and chiggers keep you so busy you don’t worry about other wild life.” He started scratching at the very thought of them.
We were waiting for an oretrain to come down. The night was dead silent. A few grasshoppers made a rasping noise in the trees. From away up the line we heard the whistle of the engine and the rattle of the trucks of the orecars coming round the curves.
The doctors were talking about jungle yellow fever that had been found to be carried by the Haemagogus mosquitoes that bred in the little pools of water in the forks of high forest trees. Now that the standard type had been eliminated, the jungle type was the next enemy to be vanquished. People called it the bridegroom’s disease because it was often contracted by young men who went out to clear themselves a piece of land when they married. The yellow fever inspectors kept track of it by watching for the bodies of the little animals that lived in the highest level of the rainforest. If they found a lot of dead monkeys it meant that there was yellow fever about.
The oretrain went slambanging past. After that the line was clear. We crossed the divide and went lurching and jangling through the night round long curves over singing rails until we roared with siren hooting into the main street of a place called Colatina.
There were creamcolored stucco housefronts and stores and cafés lit up theatrically by a string of electric lights.
The local doctors had come to meet us at the station. Abraços and felicidades. We walked to the hotel beside flatcars piled with immense logs of peroba wood. Now this hotel, Dr. Penido was explaining, was an example of how public health worked. I should have seen it a year ago. Now at least the kitchen was clean and the bedrooms and the dining room and bar. I’d be distressed by the toilet but he was working on that. Gradually. Gradually … Keeping a toilet clean was the result of years of education. In the Rio Doce Valley a privy was a monstrous novelty five years ago.
Next morning we were out early walking round the town. Rosy mist hung low over the broad sluggish puttycolored river. The bridge had been built f
or a railroad that never got completed; battered trucks were coming across it into town and occasionally a cart with whining wheels of solid planking drawn by a majestic pair of humped zebu oxen.
We walked down the cobbled street toward the Health Center. On the way Dr. Penido and Dr. Lavigne, the local chief of public health operations, proudly showed off the market. No rotting piles of garbage as in Rio. The stalls were clean. The vegetables looked freshwashed. The butchershop was screened and the marble tables had just been scrubbed. To be sure somebody had left open the little window in the screen through which the sales were made. Dr. Penido noted the fact philosophically. The next time it would be closed. “Education,” he said in a tone of infinite patience.
The Health Center had an air of quiet gaiety about it. It was an airy little building of gray stone and white stucco, designed I was told by Peter Pfister in the States, with a cool covered patio between the two rows of offices and consulting rooms, where people could wait out of the sun and in the breeze. At one end there was a playground for children. You could see that people enjoyed coming here. Varicolored children were scrambling around on swings and seesaws. People had brought their dogs.
In back was a sample vegetable garden with vigorous rows of lettuce, beets, dill, chicory, carrots, turnips, magnificent tomatoes. Dr. Penido explained that the people of the Rio Doce Valley had forgotten about growing vegetables. Beans and rice and occasionally a small gourd named chu-chú cooked with a strip of sundried beef constituted the daily diet, sprinkled plentifully with dry manioc flour so that you could make the mess into a ball with your fingers and shove it into your mouth. Now, in the town at least, the Public Health Service was cultivating a taste for vegetables among the people. If somebody proved that he could raise a garden he was given free seeds. Education.
The doctors tried to get the schoolchildren into health clubs so that they would interest their parents in sanitation and a wellbalanced diet. If they educated the children, the children would educate their parents. The trouble was that not all the children went to school and, of those who did, the great majority dropped out after the first three years.
In the offices they showed me their filing system. A simple and usable filing system was the crux of the problem. To produce an island of public health where there had been not the faintest notion of it before, you had to keep a record. That was the best thing the Americans had taught them, the Brazilian doctors agreed; a method of keeping a simple and adequate record without bureaucratic clogging. There were cards for every family in town showing its health record and the results of the visits of the district nurse. There were cards for individual patients. There were cards for every butchershop, bakery, bar, restaurant, hotel and boarding house, showing its sanitary record, recommendations made, improvements if any.
“Always,” said Dr. Penido in his quiet drawling voice, “we try to use persuasion … We try to get people to feel they want to improve things themselves. Then when they feel the benefit they become interested.”
As we walked out we passed a row of humble beatenlooking women waiting in line to get free boiled milk or made up formulas for their babies. Some of them had shoes but many of them hadn’t. Their skimpy dresses were none too clean.
“Five years ago,” said Dr. Penido in his low voice, smiling his sad disdainful smile, “they were drinking polluted water out of the river and depositing their excrement in the bushes … We can isolate the lepers. We can cure yaws with about ninety cruzeiros’ worth of penicillin, we can cure hookworm … DDT has malaria on the run. We can vaccinate for diphtheria and smallpox but to have really universal public health in this country we have to produce models that people will copy … sanitary islands.”
As he went out into the street a dark look came over his face, as if somebody had said something that had hurt his feelings. “Now we face tuberculosis,” he said solemnly. It seemed as if TB increased with civilization. When people lived in huts in the crannies of the mountains they didn’t have so much TB. “As we clean up other diseases TB seems to spread.”
Across the street from the Health Center was a very much larger building ornamented with a great deal of carved stone in pompous Manueline style.
“What is that building?” I asked.
Dr. Penido had walked on scowling up the street. Somebody else answered the question. That was the lying-in hospital built by the state of Espírito Santo some years ago. A fine building but the trouble was it never opened. Funds ran out … Another Brazilian project.
We walked back to the station down the main street between stucco walls that glowed in the failing sunlight. At one corner in front of a drygoods store stood a sallow man of middle age with the respectable paunch of a father of a family. All he wore was a fake Indian feather girdle and a feather headdress. He carried a bow and arrow in his hand. Now and then he emitted hoarse fake Indian noises and made wardance steps inside of the drygoods box he stood in. As we passed we noticed that he was barefooted and that the box was full of broken glass. It was some wily Syrian’s idea of how to advertise his cotton prints.
The Triumph of the Oldtime Privy
The valley was murky and hot that morning. Brush fires burned on the mountains on either side. Clearing land for new coffee plantations. The ranks of shrubby shinyleaved dark-green trees I’d been looking at in the hollows of the hills were coffee, the doctors said. In the lower part of the valley the planters were doing very well with cacao; up here it was all coffee. New plantings. Many of the trees were just about to come into bearing. In a few years the Rio Doce would be a great coffeeproducing region … if the world market didn’t glut with coffee. “Brazil is the land of the future,” one of them broke in bitterly.
The linecar jerked and jounced over the rails. At every station teams of zebu oxen, four, five, and six yokes pulling in line, were hauling up the logs of peroba wood from the water’s edge. They strained forward in slow unison in a swirl of red dust. Alongside ran barefoot men and boys the color of the dust steering the oxen with shouts and groans and the touch of their long slender wands.
The river wound broad and sullen under a glaze of heat between rocky islets. Now and then we waited on a siding for a long oretrain to grind heavily past.
We were out of the malaria belt. The chief enemy of man in this upper part of the valley was a clever little fluke known as a schistosoma that spent part of its lifecycle in a watersnail. From out of the watersnail came millions of microscopic wormlike creatures that joyfully sought out the feet of a man wading or the hands of a woman washing and made their way through the pores into the blood stream where they hatched out eggs and produced a highly disagreeable disease known as schistosomiasis. The preventive measure was oldfashioned privies. The way the schistosoma got back into the streams and ponds to infect the snails was through the human feces.
“In Aimorés we’ll show you the snails … On my way back from the States I stopped off in Venezuela where they are making progress in poisoning the snails. We are experimenting with that method, but meanwhile,” said Dr. Penido with his ironical smile, “the answer seems to be privies. Here I spent twelve years of my life studying medicine, in Brazil and in the United States” he exclaimed in a tone of mock deprecation, “and I spend my time building privies.”
In the freight yard at Aimorés we found the health service’s sleeping and laboratory car. The sleeper was in charge of a shrewdlooking brown steward named Joaquim. Joaquim had some sort of a rising on his chin which was swathed in an immense wad of bandages and adhesive tape like the false beard of a pharaoh. He served us lunch in the tiny dining section of the car. Dr. Penido announced, laughing his soft sarcastic laugh, that it was just as well the car was there because the Aimorés hotel had turned out so hopelessly unsanitary that he had induced the owner to pull it down entirely and start all over from scratch.
In spite of the loss of its hotel Aimorés was a busy little town full of dusty traffic and new building. House building offers few problems in these part
s. A carpenter makes around twenty cents an hour. The valley is full of sawmills and every tiny hamlet has a brick kiln. Everybody complains of the expense and scarcity of cement but they have an abundance of cheap tile and brick. On every street we saw new brick houses going up with tiled roofs, and wellfinished woodwork and beautifully laid parquet floors. From the top of the hill we climbed to visit Monty’s waterworks, about half the roofs of the town straggling out over the valleyfloor beneath us looked new. Right at our feet were the new tiny shacks, some of brick and some of the common mud and wooden frame construction, of the workingpeople’s suburb which in Brazil is known as a favela.
This favela was the best we had seen on the trip. The houses were in row and each had a yard and a solidly built brick privy. “Look at all the privies,” Dr. Penido burst out waving his arms with humorous pride, “An orgy of privies.”
“This is such decent housing,” said Monty, “we shouldn’t call it a favela.”
The Favela: Symbol of the New Brazil?
The word favela as usual set off an argument. Everybody started talking at once.
Favela in Brazilian Portuguese means slum. A favela is a particular type of recent slum that takes its name from the hill near Rio where the first one appeared. The favela is the sign and symbol of the population explosion which has resulted from the success of just the sort of public health measures Dr. Penido and his associates were showing off with such pride.
With the growth of industry, and the caving in of the scanty rural economy, people came crowding out of the back country into cities and towns. In the back country they had lived a barefoot life as ungarnished in every aspect as the little huts with dirt floors they were born in and dwelt in and died in, but at least they had space about them and air to breathe. Except in very bad droughts the rural economy had furnished sufficient food. People lived according to certain standards of civilized rustic behavior. The landowner was feudal lord. Feudalism, when it works, is far from being the worst form of human organization.
Brazil on the Move Page 3
