Slavery and the African diaspora in the public health of Brazil
Work in progress – by Kaori Kodama and Tânia Salgado Pimenta
It is estimated that Brazil received about 5 850 000 Africans during the centuries when the slave system existed in the Luso-American world. During the 19th century around 2.5 million people were transported from Africa to Brazil, where slavery only ended in 1888. The African influence on the Brazilian population is enormous, justifying the strong tradition of slavery studies in the country.
Despite the importance of the Afro- descendant presence in the Brazilian population, academic attention to slave health and the health history of Afro-descendant populations was minimal for most of the 20th century, limited to a few doctors interested in writing the history of their discipline. This began to change in the final decades of the century, though only very recently has the history of slave health started to become a fruitful field of investigation. The renewed interest in the history of slave health and Afro-descendant populations is the result of several factors, notably recent public policies emphasising the need for the country to deal with racial questions, such as the creation in 2003 of the Secretariat for the Promotion of Racial Equality, and the higher level of specialisation of historians themselves.
For public health historians, the development of more in-depth studies related to slave health helps to elucidate the living conditions of Africans brought to the American continent by force, as well as allowing a critical review of what doctors in the past understood as ‘slave diseases’ or diseases imported from Africa. It was common for doctors to believe that some of the diseases they observed were typical of blacks, or that some of the principal endemics and epidemics in Brazil originated in Africa. The diseases considered as ‘black illnesses’were dysenteries, hookworm, scabies, ophthalmia, smallpox, ‘piã’ (yaws), maculopapular rash (gangrene of the rectum), tetanus and Arab elephantiasis (filariasis). The slave trade was also linked in the discourse of doctors to specific diseases, such as scurvy (also known as Luanda disease) and ‘nostalgia’, an illness of the spirit that led many slaves to commit suicide. It was common to associate the occurrence of epidemics, especially of smallpox and different ‘fevers’, with the growth of the slave trade during times of epidemics. Doctors’ ideas about the ‘importing of diseases’ could signify a discourse that condemned not only slavery but also Africans and their continent. It also preserved a positive image of Brazil, stating that the diseases present in the country had an exogenous origin.
Diseases linked to Africans were also discussed in investigations of their living conditions. Classifying these diseases is complex: a disease which now has a specific known cause may have been identified by different names in the past; conversely, illnesses caused by different agents may have been identified as the same disease because of similarities in symptoms. Despite this, studies have made advances by relating diseases to more general questions about the daily conditions faced by slaves and freed slaves, such as poor alimentation, lack of care and excessive work, taking into account specific contexts referring to rural and urban areas, fluctuations in traffic, customs and beliefs, family and community organisation, social relations and legislation.
Another important point is related to healing practices exercised by Africans and their descendants and the healthcare to which they had access. Research about the origins of enslaved Africans gives us a better understanding of their shared cosmological visions. Among these was often the idea that disease was caused by the actions of malevolent spirits or by people using witchcraft or sorcery. Thus, investigating the concepts of health and disease and related therapeutic practices during the 19th century can help to explain the preferences of a considerable part of the population for popular healers to the detriment of official medicine.
Furthermore, it has also been possible to identify solidarity networks created by slaves and freedmen that provided some protection and care in the case of disease, as well as allowing an improvement in living conditions and even the purchasing of freedom by captives. These networks may have been created through various criteria as well as belonging to the same African ethnicity. For example, most of the bloodletters were slaves or freedmen, whose wisdom and experience were passed onto other individuals in this condition. They carried out a fundamental activity in the universe of the arts of healing in Brazil, showing how the understanding of public health and medicine has been enriched by the questions raised in studies of the history of slave health.
Kaori Kodama is a Visiting Researcher at Casa de Oswaldo Cruz/Oswaldo Cruz Foundation, where Tânia Salgado Pimenta is a Researcher and Associate Professor on the Postgraduate Programme in the History of Sciences and Health.