Stories in the Time of Cholera: Racial Profiling during a Medical Nightmare

Abstract

Stories in the Time of Cholera: Racial Profiling during a Medical Nightmare. By Charles L. Briggs with Clara Mantini-Briggs. (Berkeley: University of California Press, 2003. Pp. xxvi + 430, preface, acknowledgments, photographs, maps, tables, illustrations, notes, bibliography, index. $34.95 cloth) In 1992 and 1993 cholera struck eastern Venezuela, killing five hundred in the Orinoco Delta-most of them indigenous known to outsiders as the Warao. In January 1991, Venezuelan authorities had learned from officials in neighboring Peru that cholera had broken out in that country. Rather than mobilizing public health workers throughout the country to begin educating citizens and taking other preventive measures, the Venezuelan Ministry of Health and Public Assistance dispensed carefully controlled information through the media. Moreover, by requiring that each case of cholera be identified through laboratory analysis at the National Institute of Hygiene-a difficult standard to meet when most of the cases were in remote areas, making submission of samples difficult and unlikely-the Ministry assured that only a small fraction of the actual number of cases of cholera in Venezuela would be recorded. In the Venezuelan press, cholera was depicted in geographical terms: A standard line in articles began, 'The epidemic, which first appeared in Peru. . .' (21). Once the disease actually spread to Venezuela from its neighbor Peru-perceived as a more backward nation-the story changed. Reports began to suggest that Venezuelan indigenas were primarily at risk of infection because of where they lived, their (lack of) hygiene, the food they ate, the way they prepared their food. The Warao were seen as primitive who endangered Venezuela's ability to be perceived as part of the modern world. The Warao had their own stories of the origin of cholera and these reflected, to a greater or lesser degree, the official narratives. Some suggested that Trinidadians had, in a dispute over prices, poisoned the crabs that the Warao ate. Others believed that the crabs had been poisoned by a chemical that had seeped into the ocean after the Americans used it in Iraq during the 1991 gulf war. (One official narrative stream also attributed the disease to the consumption of raw crabs.) Clara Mantini, a physician dedicated to ending the epidemic, was director of the Venezuelan Rural and Indigenous Health Program for the Regional Health Office in June 1993 when anthropologist and folklorist Charles Briggs visited the delta to help set up health education and treatment programs. Briggs had been working in the Orinoco Delta since 1986. He had learned of the cholera outbreak during a visit in November 1992, by which time several of his close friends in the area had died. Briggs and Mantini began collaborating on public health programs in Venezuela, undertaking a detailed study in hopes of developing a program that would ultimately help prevent cholera and other diseases. In Stories in the Time of Cholera, Briggs and Mantini-Briggs describe how various narratives constructed by health officials, the media, the Warao, and others influenced, even determined, how the authorities dealt with the epidemic. The authors introduce the concepts of sanitary citizens, who are seen as possessing modern medical understandings of the body, health, and illness, practicing hygiene, and depending on doctors and nurses when they are sick; unsanitary subjects, people who are judged to be incapable of adopting this modern medical relationship . . . or who refuse to do so; and medical profiling, differences in the distribution of medical services and the way individuals are treated based on their race, class, gender, or sexuality (10). Political institutions clearly took advantage of the epidemic, but the authors seem to imply that there was a conscious strategy to exploit the crisis for political gain. Yet weren't the officials simply relying upon received concepts based upon stereotypes? …