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October I am at the regional hematological clinic in the northeastern Brazilian city of Salvador da Bahia, sitting in the corner of the blood sampling ward, where assistant nurses take blood samples from patients to be sent for analysis. He seems to be a regular patient, since he greets all the assistant nurses by first name. He nods, takes a seat and extends his left arm while holding his fist tight. She proceeds to take the blood sample while chatting vivaciously with him. After the blood sample had been collected, the patient leaves, while the assistant nurse puts the blood vial on a tray for collection.
They asked these patients to take a brisk walk or run around the block because empirically they had realized that this raised their white blood cell levels enough so that the values fell within normal ranges 1. In spite of having been disavowed by mainstream genetics, race has proven to be an enduring category to characterize and classify bodily differences, both in everyday life as well as in diverse specialized fields, such as biomedicine.
This is particularly relevant in the context of the ever-growing popularization of low-cost biomedical technologies. At the same time, we should be attentive to how these truths often co-exist with other readings of bodily difference. These other ideas include ideas about race, often having multiple meanings and disguised in related ideas of bodily difference, be it in terms of individuals or populations M'charek, This multiplicity of notions about difference often results in ambiguous and at times conflicting narratives regarding the link between race and disease, with other categories, such as nation or population, appearing intertwined.
This very adaptability and capability to incorporate other ideas about difference has been pointed out as being central to understanding the enduring presence of race, both in biomedicine and in everyday life Pollock, In this article, I want to explore how the notion of normalcy in biomedicine, by facilitating the association of general ideas about difference and race, can contribute to the durability of race as a classificatory concept for human diversity.
Police Violence and Public Security in Rio de Janeiro and São Paulo
Using ethnographic material drawn from the northeastern Brazilian city of Salvador, I explore how ideas about normalcy are invoked in the local use of low-complexity diagnostic biomedical technology, using as a case study the measuring of white blood cell levels within a complete blood count. As several authors, notably Canguilhem , have reminded us, normalcy, a statistical norm defining a pathology or a deviation for which a medical intervention should be applied, is necessarily embedded in its social context, from which it cannot be separated.
Hence, for Canguilhem, health itself must be defined within the specific context of an individual and her relation with the environment in which she lives. The different notions that the concept of normalcy encompasses, of which Canguilhem reminds us are those such as ideal, average, and common type, were also central in how ideas about race were crafted in 19th century scientific racism. Each racial group was seen as having a common type, with the features that defined each of them obtained through measuring characteristics such as skull size and shape, nose width and length, lip and teeth size, and other bodily features such as arm to body length ratio.
Scientific racism was also already permeated by the idea that the deviation of other races from the white norm expressed itself and, in turn, could be gauged by the varying prevalence and expression of diseases, be they physical or mental Stepan, Measuring and comparing bodies to established ideals of racial normalcy was incorporated into biomedicine's everyday practices, in processes that entangled notions of heredity, population, and nation 3.
This association would prove persistent, and even when the hierarchical aspect of race was eventually abandoned, its use as a legitimate concept to characterize and classify human biological diversity was maintained.
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Most biomedical diagnostic technologies provide objective measurements of bodily parameters, that are then set within scales of normal and abnormal. Some of these parameters can be directly or indirectly racialized, both when establishing different reference values for certain groups and in biomedical discourses regarding morbidity and choice of treatment. In this process of racialization, normalcy appears not only related to an ideal about what a healthy body should be, but also to narratives about the nation and its population history, thus easily taking over or, at the very least, acting alongside other ideas about bodily difference.
By analyzing ethnographically how complete blood count, a relatively simple, cheap, and widely used technology, mobilizes and re enacts notions of race, I aim to contribute to a wider field of anthropological studies about biomedicine and technology. Brazil's history of race relations has certain particularities of which the reader should be aware before I go further into the ethnographic details.
With a much smaller European population when compared to other colonies, such as British enclaves, Portuguese settlers soon started to establish informal unions, first with indigenous women, and later on with the enslaved workforce brought to replace indigenous slavery. The result of this process was the widespread occurrence of mixed-unions, with their offspring often being incorporated into the slavemasters' houses, raised away from the slavequarters.
With the independence of the country and the need to establish a project for the nation in-the-making, which coincided with the formulation and spread of scientific racism in Europe and the United States, the present and future racial composition of the country became a heated topic of debate amongst the country's intellectuals and politicians. International discourses of scientific racism propounding the superiority of the white race and the evils of miscegenation were interpreted and reshaped by Brazilian intellectuals to fit the local history of widespread mixed unions. This realization, alongside the impact of cultural currents such as vanguard modernism, that celebrated local cultural specificities, facilitated a shift in intellectual discourses in the s.
This was particularly so with the publication of Gilberto Freyre's Masters and Slaves in Freyre considered miscegenation as the key defining feature of the country and its population. The historical experience of Portuguese settlers with mixture in their own country and other colonial enterprises meant, according to Freyre, that social relations between masters and slaves, although still conforming to the patriarchal system of domination imposed by the Portuguese colonists, also presented a degree of social proximity which facilitated close contact, including sexual, between these two groups.
So was the contrast between the US system of race relations, based on an evaluation of ancestry that places anyone with any degree of African ancestry in the Black group, with the Brazilian system, in which an individual's race is based on an assessment of the absence or presence of physical traits deemed to be of non-European origin, such as skin color, hair texture or facial features, alongside markers of social status such as educational level, demeanor, or clothing. In this manner, two people with a similar physical appearance could be classified into different racial categories, with the person holding higher status marks being classified in a lighter category, with social status offsetting, to a certain extent, the presence of physical features seen as marks of African ancestry Nogueira, Some of the research projects developed under the UNESCO initiative reached conclusions that directly contradicted the depiction of Brazil's race relations in idyllic terms, uncovering the existence of racism and racial prejudice, or the strong correlation between class position and race Pinto, The condemnation of persistent racial inequality and racism within Brazilian society would intensify in the s, both within activist and academic circles.
Organized social movements, siding with Degler's arguments, also highlighted how the ideology of Brazil as a racially admixed and harmonious country meant the weakening of a stronger Black identity. After the , Durban conference and the acknowledgment by the Brazilian government of the existence of racism in the country, several tiers of government at the municipal, regional state, and federal levels designed and implemented affirmative action policies to reduce racial inequalities.
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While the need to reduce these inequalities was, at the time, accepted by most actors involved in public debates, the adoption of the amalgamated category negro in the implementation of these policies, for example to identify beneficiaries for university entry quotas, was rather controversial 5. In the case of affirmative action in health, the field of so-called Black Population Health, a related concern was that these policies would encourage the reification of race as a biological category.
This is particularly clear in Salvador, where I did my fieldwork. This context certainly affects how race is done locally, for example in the higher number of people, particularly younger generations, who self-identify with the term negro Sansone, , or in the type of physical and status features that lead to an individual being recognized as white. I started my fieldwork in Salvador in the early s, to assess the impact that affirmative action policies in the field of health had on local ideas about race. I initially focused on sickle-cell disease, followed by high blood pressure, so as to include within my research both a genetic and a multi-factorial condition.
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During this research I came to realize that both biomedical professionals and patients alike used, at times concomitantly and at times alternately, several ideas about race, bodily difference, genetics, and historical processes, combining discourses that could be seen as stemming from different moments of Brazil's history reference removed by the author. Take for example one of the cardiologists that I followed during my research. On one occasion, while I was observing consultations with patients, he received a visit from a pharmaceutical sales representative. She handed the doctor, amongst several samples of anti-hypertensive medications, a magazine targeted at medical professionals, which he promptly gave me while he walked her out of the consultation room.
On the magazine cover was a headline for one of the stories inside on race and hypertension. And you saw that nearly all of the blacks whose blood pressure was difficult to control were tall, did you notice that? In spite of these racialized considerations, I never saw that cardiologist, during his clinical practice, employing race as a factor in deciding a diagnosis or treatment protocol. The link he made between disease and race was therefore more of a discursive, rhetorical link between past and present, between contemporary bodies present at the clinic more specifically, patients with a very dark skin complexion , and bodies from within Brazil's history.
In the process, he mobilized ideas about normalcy, not in the sense of establishing a standard for what Black bodies are, but to establish a narrative about what is a normal, as in average, Bahian. As a postdoctoral researcher at the Center for Afro-Asian Studies, of the same institution, I participated alongside another anthropologist, a geneticist, two biologists, two activists from the field of Black Population Health, from within the ranks of the organized Black Social Movement, as well as several students from the Immunology postgraduate programme.
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Police Killings in Brazil: Legalized Violence
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Many of the bodies removed by the responding police officers had severe injuries and were likely dead before being taken away. Human Rights Watch also identified numerous other police killing cases from Rio containing credible forensic evidence that officers had engaged in false rescues of their shooting victims. For example:.
Lethal Force
But what is clear is that those who are subject to purported rescue attempts often arrive for their autopsies naked. The ballistics evidence sometimes found on clothing can be particularly significant. However, Human Rights Watch found a consensus among criminal justice officials other than police , health officials, and community members that the practice is commonplace.
The [bullet] cartridges disappear Everything disappears. The heads of the Regional Medical Council of the State of Rio de Janeiro, for instance, stated that they had sent a formal complaint to the Security Secretariat in the past but had never received a reply. Rosa, former Council president, two cases are emblematic. In one, which took place around , two police vehicles dumped nine bodies at the entrance to the Bon Sucesso Hospital.
In the second, in , police dumped 11 cadavers in the emergency room at the Souza Aguiar Hospital.
Two mothers of victims of extrajudicial executions felt strongly that the practice of false rescues was common. This is to destroy the scene of the crime. Under Brazilian law, officers have a duty to assist injured victims who survive police shootings, and deliberate failure to do so may constitute a criminal offense. They could not. Any lay person could attest to the death. The agreement mandates that officers involved in shootings call for specialized medical assistance for their victims rather than moving them haphazardly from the shooting scene and driving them in a police car to the hospital.
These rescuers should provide, at most, first aid in cases of grave injury. But the guidelines make clear that, in order to avoid injuring victims further, rescuers should not move them prior to the arrival of medical professionals, except when necessary to get them away from dangers like fire or drowning. This corrupt practice represents an extreme form of tampering with evidence and, though not definitive, supports a finding that the killings were unlawful. According to O. Afterwards, they took O. E to a civil police precinct for processing. There, the station chief noticed O.
The practice of planting evidence on otherwise innocent victims of police extrajudicial executions has been proven at trial in at least three cases:. In many of the cases we reviewed, we found that police officers who committed or investigated the abuses threatened witnesses, discouraging them from reporting crimes by police.
In some cases, suspected perpetrators threatened witnesses in an effort to silence them. In other cases, witnesses said they were intimidated or dissuaded by police investigators when they testified about abuses or tried to file complaints. These threats create a pervasive fear among the public of testifying against the police, which ensures that many crimes go unreported and that police abuse remains unpunished.
A police officer was beating J. Others were pointing their guns at us, and three wanted to enter the gate to our house.
I shouted at them and they pointed a rifle at my ear.