People Who Get Rubbished
From the streets of Recife to the nursing homes for the aged in Baltimore.
A personal account by Nancy Scheper-Hughes.
‘What makes genocide possible?’ This question has guided social science ever since the Holocaust made it impossible to deny that a great many people have been capable of perceiving and disposing of designated ‘Others’ as despicable and dirty things. In short, as ‘disposable rubbish’.
This human capacity to reduce ‘Other’ humans to ‘things’ has motivated much of my anthropological work on ‘everyday violence’. It seems to me essential that we recognize in ourselves a genocidal capacity. And to guard against it we need to be hyper-vigilant, hyper-sensitive to the less violent – though far more common – practices of social exclusion, dehumanization, depersonalization.
For example, how many more new, improved prisons are we to have in the US to contain an ever-growing population of young Black men? What can it possibly mean when jails become the ‘normative’ socializing experience for a certain category of young people? Ordinary, peace-time violence – like the steady evolution of US prisons into alternative Black concentration camps – are the ‘small wars’ and ‘invisible genocides’.
A pre-requisite of dehumanization and genocide is denial. Over a 20-year period, I explored the normalization and social indifference to staggering infant and child mortality in shantytown favelas of North East Brazil.1
Local political leaders, Catholic clerics, coffin-makers, and even shantytown mothers would casually say: ‘Well, they themselves wanted to die.’ The babies were described as having no ‘taste’, no ‘knack’ and no ‘talent’ for life. Perceived as already ‘doomed’, sickly infants were described as less-than-human creatures, as ghostly ‘angel-babies’, inhabiting a terrain midway between life and death.
Common medical practices such as prescribing powerful tranquilizers to fretful, hungry babies dovetailed with Catholic celebrations of the death of ‘angel-babies’ and the indifference of political leaders who were happy to dispense free baby coffins but not food to hungry families. Mothers would radically reduce food and liquids to severely malnourished and dehydrated babies so as to help them, they said, to die quickly and well.
Now, Latin Americans – and Brazilians in particular – are known for their love of children. But they do not love so-called ‘street children’, who have multiplied in great numbers following the transition both to open-market neo-liberal economies and to more democratic structures. Suddenly – or so it seemed to a great many people in Brazil, Venezuela and Guatemala – the favelas, shantytowns and poor barrios ruptured. ‘Homeless’ and ‘dirty’ street children seemed to be everywhere displaying their ‘criminal’ needs.
In Brazil my studies have focused on police and death-squad attacks on ‘street children’ who are often described as ‘dirty vermin’ so that metaphors of ‘street cleaning’, ‘trash removal’, ‘fly swatting’, ‘pest removal’ and ‘urban hygiene’ have been invoked to garner broad-based public support for police and death-squad activities against them. Most blatant was the Candalaria Massacre of 23 July 1993 when a group of off-duty plain-clothes police opened fire on 50 street children who were lying in a huddle near Candalaria Church in elegant downtown Rio. Eight died, six on the spot and two at a nearby beach where they were taken and executed. Opinion polls published in local news-papers showed considerable support for the police. Many ‘ordinary’ citizens reported being ‘fed up’ with the criminal, dirty and disorderly behaviour of street children.
The term ‘street child’ itself represents a kind of symbolic apartheid as urban space has become increasingly ‘privatized’. As long as poor children on the loose are confined to the slum or the favela they are not viewed as an urgent social problem about which something must be done. From the point of view of people in the favelas there is nothing extraordinary about their children flowing over into the main streets of the town which are primary sites of employment and economic survival.
The real issue is the preoccupation of one social class with the ‘proper place’ of another social class. Like dirt which is ‘clean’ when it is in the yard and ‘dirty’ when it is found under the nails, ‘dirty’ street children are simply poor children ‘out of place’. In Brazil ‘street’ and ‘home’ designate more than social spaces; they are moral entities, spheres of social action, and ethical provinces. Home is the realm of relational ties and privilege which confer social personhood, human rights and full citizenship. Street is an unbounded and dangerous realm, the space of the ‘masses’ (o povo) where one can be treated anonymously. Rights belong to the realm of the ‘home’.
‘Street children’, typically barefoot, shirtless and unattached to a home, represent the extremes of social marginality and anonymity.
But we need go no further than our clinics, emergency rooms, public hospitals and old-age homes to encounter other classes of ‘rubbish people’ treated with as much indifference and malevolence as ‘street kids’ in South America. The following painful vignette should suffice.
A few weeks ago I stepped outside ‘Happy Valley’ Nursing Care Center near Baltimore, Maryland to take several deep breaths before returning inside to face what was left of (and left to) my impossibly dear and impossibly frail parents, both in their nineties. A ‘late-in-life’ child, I can only remember my father with grey and then with white hair. No other five-year-old I knew cried themselves to sleep after reciting bedtime prayers, certain that their parents would surely die before they woke. But my parents fooled everyone and outlived their much younger siblings, joining that small cohort that sociologists refer to as the ‘oldest old’. With myself living 3,000 miles away and a more local sibling who nonetheless spends a good part of each year travelling, the once unthinkable idea of a nursing home crept up on us after all else – short of taking them home with one or the other of us – failed.
Today, both are almost completely physically dependent, immobile and incontinent, but only Dad, at 95, is painfully conscious of his condition. Mom is maintained by a plastic sack of nameless brown liquid, suspended from a moveable pole and dripped by tubing into her abdomen. A victim of Alzheimer’s, she has lost language and she communicates by howling, though true to her reserved character, always gentle and lady-like. When not thrashing about she seems resigned but with the hopeless, open-eyed and desperate stare of a hooked rainbow trout. When Mom sees me, and when – ignoring the nurse’s rules – I release her from her hook and line and wheel her into the sunny courtyard, she smiles and is attentive to the birds overhead.
Around the corner, virtually trapped in his semi-private room which he shares with a more robust but ill-mannered bully who steals his socks and shirts, Dad is maintained by three or four tins of milky liquid protein-calorie EN-SURE. At every given opportunity he spills the sticky stuff into his wastepaper basket into which he also occasionally urinates and defecates because he cannot, he complains, get to his bedside porter-potty on time. And so the wise man who taught me courage under fire – ‘Nil Desperandum!’ was his lifelong motto – the organic intellectual who introduced me to multiple ways of seeing and knowing the world now disparagingly calls himself ‘Little Jack Horner’ – that is, ‘stuck in his corner’.
Just as I steel myself to return inside Happy Valley, sirens announce the arrival of emergency ambulance and fire engines. The engines are killed in front of the entrance and several young men, dressed in white and in blue, jump from their trucks carrying a stretcher, oxygen tank and other heavy-duty medical equipment. I am frozen with fear, but not of my parents’ timely deaths. Rather, it is the fear of their untimely rescue. But it is another bird-like fragile creature who is carted away under an oxygen tent as she claws at the plastic tent flaps like a startled tabby cat. Her body is handled efficiently, even gracefully, by the boys in white who, nonetheless, ease their work by making sport of the absurdist drama of rescue into which a resistant Ms Kelly has been recruited.
As ever-increasing numbers of the aged are both sick and (in the US, at least) poor due to the astronomical cost of late life and chronic medical care, they are likely to spend much of their remaining time in public or in less expensive private institutions for the aged like ‘Happy Valley’. In nursing homes ‘care’ for elderly residents is delegated to grossly underpaid and mostly untrained workers who protect themselves by turning the persons and bodies under their protection into objects that can be dealt with at shorter and shorter intervals by cutting corners. Here the practical ‘nursing’ staff mirrors the goals of the private home where pressures are strong to operate on a shoestring budget, especially toward those residents, like my parents, whose limited savings have already been used up by the institution and who are now supported by the state under Medicare. Like me, the staff too need to duck away as often as possible – for a smoke, a snack, or a breath of air.
But other work-survival tactics are less defensible. The personal names of residents are dropped and they are often addressed as ‘you’. Little or no account is taken of expressed wishes so that sooner or later any requests or expressions of personal preference – to turn up or down the heat, to open or close the window, to bring a cold drink, to lower the TV or change a channel – are extinguished. Passivity sets in. When the body is rolled from one side or the other for perfunctory cleaning, when the body is wheeled conveniently into a corner so that the floor can be more easily mopped, when cleaning staff do little to suppress expressions of disgust at urine, faeces or phlegm out of place – on clothing, under the nails, on wheelchairs or in wastepaper baskets – the person trapped inside the failing body may also come to see themselves as ‘dirty’, ‘vile’, ‘disgusting’, an object or a non-person.
The destruction of personhood is aided immeasurably by graphically material means. Although individualized laundry baskets are supplied for each resident, the staff refuse any responsibility for lost clothing. Several times I arrived as late as 11am to find my Dad in bed and under his sheets and completely undressed because he had ‘no clothing’ to wear. Arguments with staff are counter-productive and if anything increase their passive hostility toward the complainant. When all personal objects – toothbrush, combs, glasses, towels, pens and pencils – continue to disappear no matter how many times they have been replaced, the resident (if he or she knows what is good for him or her) finally accepts the situation and adapts in other ways.
Eventually, one is compelled to use other objects which are more available, for purposes for which they were never intended. And so the plastic wastepaper basket becomes the urinal, the urinal becomes the wash basin, the water glass turns into a spittoon, the hated adult diaper is used for a table napkin, and so forth. And so, up and down, face and buttocks, are reversed and staff express their disgust. Meanwhile, the institutional violence and indifference are masked as the resident’s own state of mental confusion and incompetence. And everything in the nature of the institution invites the resident to further regression, to give up, to lose, to accept his or her inevitable and less than human depersonalized status.
How can I write this without screaming? I am screaming. But still I cannot do the only thing that could reverse this mad system: to run down the halls of Happy Valley Nursing Home, pull out the tubes, detach the liquid bags, knock over the porter potties, pick up my ancient and still beloved old ones and take them home to live with me. But this – God forgive me – I am as yet unable to do.
Nancy Scheper-Hughes is professor of anthropology at the University of California, Berkeley.
1. See Death Without Weeping: The Violence of Everyday Life in Brazil, by Nancy Scheper-Hughes, University of California, Berkeley, 1992.
© Copyright New Internationalist Magazine 1997