“TO FORM A STRONG AND POPULOUS NATION”: RACE, MOTHERHOOD, AND THE STATE IN REPUBLICAN BRAZIL A Dissertation submitted to the Faculty of the Graduate School of Arts and Sciences of Georgetown University in partial fulfillment of the requirements for the degree of Doctor of Philosophy in History By Okezi T. Otovo, M.A. Washington, DC April 2, 2009 Copyright 2009 by Okezi T. Otovo All Rights Reserved ii “T O FORM A STRONG AND POPULOUS NATION ”: RACE , MOTHERHOOD , AND THE STATE IN REPUBLICAN BRAZIL ” Okezi T. Otovo, M.A. Thesis Advisor: Bryan McCann, Ph.D. ABSTRACT Government policies designed to protect families and public institutions dedicated to providing for the health and welfare of women and children are a relatively recent development. Child welfare, particularly high infant mortality rates, emerged as a public concern across the globe in the mid-19th century. In Brazil maternal and infant hygiene reform became part of a larger movement to improve Brazilian society through science, creating a healthy, “progressive” population. With slavery abolished and the Republic founded, Brazil began the 20th century hoping to enter the world stage with a working population strong in quality and in quantity. Reform campaigns of the period sought to improve the physical health of people on society’s margins, attempting to maximize their economic potential so as to benefit the growth of the nation. While maternal welfare advocates campaigned for “proper motherhood,” millions of poor Brazilian women negotiated family life and wage labor within the constraints of a racially unequal and gender-inequitable society. This dissertation analyzes the origins and outcomes of the movement for healthier mothers and babies in the northeastern state of Bahia from the 1880s-1945. It argues that the Bahian movement was a crucial resource for national reform that illustrated the tensions of nation-building and the deconstruction of slavery, building upon continuities and transformations in social understandings of race and gender. It demonstrates that maternal and child welfare were key aspects of the integration of the popular classes into the vision of a modern state. This dissertation iii explores the intellectual and political contradictions as well as the lived experiences of Brazilian families and public health institutions as motherhood was redefined and health became a corollary to citizenship. These transformations rhetorically elevated the poor family as the cornerstone of moral and social change without fundamentally disrupting long-held and carefully guarded social hierarchies. iv ACKNOWLEDGEMENTS Like all dissertations, this one results as much from elbow grease as the invaluable support of various institutions and individuals. While at Georgetown, I was very fortunate to receive generous financial support for my graduate studies and research trips from the Patrick Healy University Fellowship, the Center for Latin American Studies, the Brazilian Studies Program, and the Georgetown University History Department. In addition, the Ford Foundation supported my final year of dissertation writing. I gratefully acknowledge the Ford Foundation and the National Academies fellowship staff as well as these various entities at Georgetown University. I don’t think I could have had a more encouraging group of professors to guide this project and introduce me to the study of history as a scholarly pursuit and a profession. My dissertation committee helped me to think through, contextualize, and deepen my interest in health, motherhood, and social dynamics in fascinating and novel ways. Bryan McCann has always been kind, encouraging, yet critical and challenging in his analysis of my work. I greatly appreciate his guidance as well as that of John Tutino and Meredith McKittrick. I also acknowledge the helpful advice of several professors in the Georgetown History Department, including Erick Langer, Alison Games, Adam Rothman, Judith Tucker, and John McNeill. I also thank Barbara Weinstein who helped to inspire my interest in race and gender history in Brazil. In Brazil, I formed relationships with a number of institutions that aided in completing the research necessary for this dissertation. This project would not have been possible without the generosity and assistance of the administrative staff at the Liga Álvaro Bahia contra a Mortalidade Infantil in Salvador. I gratefully acknowledge the v support of Romilsa Almeida, Elga Sampaio Torres, and Rosina Bahia Carvalho dos Santos. At the Memorial da Medicina of the Faculdade de Medicina da Bahia, I always appreciated the assistance and kindness of the archival staff, particularly Francisca and Vilma. Likewise, I acknowledge the research support provided by the staff at the Arquivo Público da Bahia and the Centro de Pesquisa e Documentação de História Contemporânea do Brasil in Rio de Janeiro. I was extremely fortunate to have two friends in Brazil who also provided research assistance in the public archive and the archive of the Santa Casa de Misericórdia. I appreciate the hard work of Luis Henrique da Silva and Luciana Brito. During my pre-dissertation research trip, Cicinha also provided a wonderful orientation to the public archive along with many helpful tips on living and working in Salvador. I had and continue to have incredible friends in Bahia: Simone Manigo-Truell and Raimundo dos Santos, Adele Ledet, Kobla Osayande, and Mavis Gragg who all served as an almost constant and very welcome distraction. I enjoyed my research year immensely because of their friendship and our various shared adventures. I also thank my colleague in Brazil, Meredith Glueck, for many informal chats while we both attempted to figure out how to do archival research and make sense of the results. Back in Washington, I spent months writing this dissertation in the Hispanic Division Reading Room at the Library of Congress. I extend my appreciation to the research staff: Luis, Tracy, Iêda, Barbara, and Kaydee. At Georgetown, I would also like to thank all of my latinamericanista colleagues who read and commented on versions of several chapters of this dissertation. My years at Georgetown were enriched and enlivened by the friendship and support of Verónica Vallejo, Marisabel Villagomez, vi Elizabeth Chavez, Alejandra Ezeta, Luis Granados, Ben Fulwider, Xenia Wilkinson, Rodolfo Fernández, Fernando Perez Montesinos, Larisa Veloz, April Yoder, and Javier Puente-Valdivia among many others. I will greatly miss our vigorous semi-weekly debates and discussions over sake and shrimp dumplings. I also acknowledge my community of young Brazilianist scholars whose scholarship continues to inspire me in my own work, including Christen Smith, Keisha- Khan Perry, Edvan Pereira de Brito, and Sales Augusto dos Santos. I look forward to many future opportunities to work with and learn from them. Saving the best for last, I extend my heartfelt gratitude to my family and friends who supported me through the long and arduous process of completing this project. I am blessed to have so many people who care about me and cheer me along in my work, including many already mentioned above. I thank my parents, Earnestine Otovo and Benson Otovo, for their love and support and for setting the foundation for this career path many years ago. I thank my good friends Renee Littleton, Jean-Jacques Ahouansou, and Moja Mwaniki. Above all, I acknowledge the patience, friendship, and encouragement of my sister Amelia Otovo. This project is dedicated to her. I thank her for always being my most ardent supporter as I am hers. vii TABLE OF CONTENTS Introduction 1 Section I – Ideas about Health, Race, and Gender Chapter 1: The Birth of Puériculture 26 Chapter 2: From Mãe Preta to Mãe Desamparada 61 Chapter 3: The Science of Motherhood 102 Section II – Institutions, Politics, and Policy Chapter 4: State and Private Partnerships: Supporting Public 145 Health and Social Welfare Chapter 5: Mothering the Abandoned, Rejected, and Impoverished 191 Chapter 6: Maternalism, Getúlio Vargas, and the Bahian Estado 237 Novo Conclusion 277 Bibliography 287 viii INTRODUCTION On October 5, 1933, 22-year-old Maria Magdalena dos Santos entered the 3 rd Health Center in her hometown of Salvador da Bahia, Brazil. She visited the health center to take advantage of their free prenatal services, but Maria also learned that she suffered from syphilis—a feared disease and constant preoccupation of local physicians. Like the overwhelming majority of women of color in Bahia, Maria worked as a domestic in a wealthier family’s household. She lived in the Liberdade neighborhood of Salvador--a largely poor Afro-Brazilian neighborhood named in honor of the “Freedom” from slavery legally established in 1888. In Liberdade , visiting nurses canvassed the streets, knocking on doors and looking for impoverished pregnant women like Maria and those with young children to convince them to register themselves and their infants with the state. 1 Maria was among the first women to get prenatal care at the 3 rd Health Center which only began offering this service in 1932. Though the clinical record cannot complete her story, Maria may have chosen to give birth at the Maternity Center in the center of town if her baby survived to full term. She likely would have returned to the health center for well-baby care like thousands of women did in the 1930s and 1940s. But if Maria were a bit older and had needed prenatal care just 15 years earlier, she would have encountered a very different health care landscape in the state of Bahia. There were no free clinics, or free daycares for working mothers, and the maternity center did not yet exist. Throughout the colonial and imperial periods, women like Maria gave birth and raised their children with the advice and assistance of family members and traditional 1 Secretária de Saúde, Departamento de Saúde, “Registro de matrícula do 3º Centro de Saúde,” 1933/1934, Arquivo Público do Estado da Bahia (hereafter APEB), Caixa 4050/ Maço 56. 1 healers like midwives.