Ailing healthcare

Tell Me Why My Children Died: Rabies, Indigenous Knowledge, and Communicative Justice
Charles L Briggs and Clara Mantini-Briggs
2016, Duke University Press
319 pages, plates, paperback

THIS IS a hard book to read, not least because it recounts the details of an epidemic that claimed the lives of vulnerable people – mostly children – who were existing at the margins of society.

It is also difficult to read, however, because it tests some of the worthy claims of Venezuela’s Bolivarian Revolution, which placed equality at the heart of its promises yet, despite the assistance of Cuban medics, in this case clearly failed to deliver this in some of the poorest sectors that it aspired to represent.

Finally, it is difficult to read because it puts forward complex theoretical arguments and discusses these comprehensively, at times a little too comprehensively, requiring of the reader exhaustive attention to detail.

Nonetheless, as an ethnographic account of health inequality and the role communication plays in that, it is an important book and one that repays careful reading.

The authors recount the circumstances surrounding a spate of deaths among the Warao indigenous people in the Orinoco River Delta at Mukoboina in Venezuela’s Delta Amacuro State in 2007–08.

Baffling to both local healers and healthcare staff, initially the epidemic affected only children, who developed fever, headaches, muscular pains, numbness, paralysis and, eventually, acute anxiety before dying.

The sickness occurred in 14 settlements in total and would claim at least 38 lives. Local leaders sought the help of both healers and professional clinicians, including a Cuban epidemiologist.

Hypotheses abounded, but no one was able to reach firm conclusions about the disease. In 2008, the local leaders recruited the authors – a physician and an anthropologist – to join their search for answers.

What transpired was a unique exercise in indigenous data-collection and analysis that concluded with a report, diagnosing the disease as most likely to be rabies spread by bats, which was finally delivered to the national headquarters of the Ministry of Popular Power for Health in Caracas.

This was a matter of life and death – yet the matter still became politicised, as both government officials and opposition groups vied for points in support of or against the revolution of Hugo Chávez.

Simultaneously, other government officials declared that there was no epidemic, blamed the Warao for their cultural backwardness, and even insisted that the role of the authors themselves suggested this was an imperialist plot. If the socialist ambitions of the revolution were not to blame, those in authority who had allowed it to be bureaucratised certainly were.

It also became evident that locally, health bureaucrats were attempting to discredit the indigenous leaders involved, effectively silencing them simply for seeking answers to the heartrending plea: “Tell me why my children died”.

The authors write: “In the end, officials simply erased the entire affair: Chávez’s socialist government defended a regional administration affiliated with the United Socialist Party of Venezuela (PSUV) rather than standing by its commitment to provide healthcare to low-income Venezuelans and countering discrimination against indigenous people. The parents were forgotten.” [pp 15–16].

There are no easy explanations in this book, but it serves a valuable role by reminding us that lofty ideological claims and even passionate practical commitment are, in themselves, insufficient for eradicating deep structural inequalities, the real solutions to which can sometimes only be found among the people themselves.