Diego Armus (2003) Tango, Gender, and Tuberculosis in Buenos Aires, 1900-1940.

Diego Armus. 2003. Tango, Gender, and Tuberculosis in Buenos Aires, 1900-1940. In Diego Armus (ed.), Disease in the History of Modern Latin America. Durham: Duke University Press.

In Argentina, between 1870 and 1950 tuberculosis was one of the main causes of death (though still prevalent in marginal populations such as indigenous people). In this article, Armus focuses in three lines that collide in the first half of 20-century Buenos Aires. He follows the development of Tango, of gender relations and the growth of Tuberculosis in order to show how they not only were entangled but how one was used to think the other. For instance, when waves of immigrants came to Buenos Aires, a city that in 1930 had almost 2.5M people, the relationship between the elites and the newcomers was in many aspects very tense and, thus, it was portrayed in the media and in Tango lyrics. Tensions between the center and the neighborhoods (one of the key spaces of social integration and argentinization according to Armus) of the city (still important today) started to arise when the elites felt threatened by the mass of immigrants slowly but steadily enclosing the center. In this context, metaphorical associations connected TB as a romantic disease of refined and sensible people with gender anxieties. Although most men died of TB than women, women were more visible in the media and literature as having TB than men (men were associated with syphilis). Anxieties that were showing signs of a society with a relatively high social mobility, in which the barrio “becomes the emotional geography of the poor” (106), but in which women were sanctioned for their movement from the barrio to the center. TB was imagined as a disease of excess (of passions, consumption) in a context in which people were over-exploited and worked in very poor working conditions. In these circumstances the figure of la costurerita appeared in the Tango lyrics. She represented the consumptives who contracted TB because of excess of work and difficulties but who did not leave behind the barrio, “the costureritas are protagonists of a journey fed by the desires and dreams of rapid social ascent, which can also end up in tuberculosis” (111).
The other figure Armus brings is the milonguita, a character that kicked off with the explosion of Tango with the help of the mass media through radio, movies and newspapers. Women were the subject (and object?) of Tangos such as “Don’t leave your neighborhood”, which started to portray how women became artists, coperas or queridas. Armus says, “Whatever their status, all these women had bet on a life away from the domestic barrio ideal. Their choice for a more autonomous life led many men to see them as a threat to the ruling gender order” (114).
Ultimately, comparing the milonguita (or milonguerita) with costurerita provides Armus a powerful approach to gender and power issues in the formation of the Argentina “multicultural” nation because it helps to show male fears and the struggles that men and women had when they tried to achieve social mobility within the Argentinean society.

Green (2004) An Ethnography of Nonadherence: Culture, Poverty and Tuberculosis in Urban Bolivia

Green. 2004. An Ethnography of Nonadherence: Culture, Poverty and Tuberculosis in Urban Bolivia. Culture, Medicine and Psychiatry 28: 401-425.
Working with five patients on a clinic in a suburb neighborhood in La Paz, Bolivia Green tries to understand how Aymara people (before the very radical changes brought by Evo Morales) although confident of biomedical diagnosis and treatment of Tuberculosis could not keep up with the long treatment due to structural poverty and lack of government aid. Normally a TB treatment would take up to 6-8 months with the first 2 having to go everyday to the hospital for the medicines. In the last decades a specific form of treatment arise, a short-course directly observed therapy (DOTS) in which patients must be present every day for as long as 4 to 6 weeks (then would be once every week) in order to take their pills. TB is the first cause of death in adults in Latin America, but in Bolivia within indigenous people the rate is 5 to 8 times higher than the national average. Nonadherence is considered when a patient doesn’t or can’t finish his or her treatment. At least four causes explain the widespread of TB, the correlation with HIV/AIDS, the relation between TB and adverse social conditions, the rise of drug resistant and multi-drug resistant traits due to nonadherence to treatment, and the incessant risk of contagion of inadequately treated patients. These four causes are enhanced by four more common factors: the blaming on the patient; the patient’s psychological structure; demographic factors such as gender, sex or income; and cultural and linguistic differences produced by the lack of knowledge about the local culture. Citing Farmer, Green considers that the “structural violence” is what can explicate how “poor adherence within an ethnically marginal group is often better explained by economic or political constraints than by folk-cultural constraints” (403). Some of this socio-economic-political constrains are “structural variables such as geographic and temporal availability of health care, hidden costs of treatment, and quality of available care” (404). The informants have to make a big effort to go everyday to the clinic to receive the medication, sometimes they could not afford to pay the bus so they would walk for 1 or 2 hours each way to the clinic and back home. They also have difficulties to keep up their job if they have one, or to look for one if they were unemployed, because going to the clinic would take a big chunk of time (they would be waiting and waiting for a whole morning). So when they could not carry on with the treatment for any reason (always very logical) then they were afraid of the reprimands by the doctors and social workers who would treat them, sometimes, discriminatorily. If social workers would complain that patient are putting their life in risk, patients would say that they need to support their families and can’t afford not to work. Although patients do feel sometimes that guilty for having “abandoned” treatment and this further complicate the decision to go back to the TB control program. All the patients were using both traditional and biomedical medicine, and they all agree that for TB biomedicine was better suited to cure it instead of the palliative treatment provided by traditional healers. I think this article is interesting to see how patients were using multiple forms of care and cure, and although they wanted to be treated by biomedicine for curing TB, they could not keep up with the treatment due to structural constrains such as hidden costs of the treatment (transport and additional costs such as X-Rays) and professional discrimination against Aymara population.

Rubel and Moore (2001) The contribution of Medical Anthropology to a Comparative Study of Culture: Susto and Tuberculosis

Rubel and Moore. 2001. The contribution of Medical Anthropology to a Comparative Study of Culture: Susto and Tuberculosis. Medical Anthropology Quarterly 15(4):440-454.

In this article the authors want to re-think different approach to the study of both susto and tuberculosis via cross-cultural comparisons. They’ve found three types of cross-cultural comparisons, one that compares different groups sharing the same region, another that compares within a society, and a third one that find worldwide comparisons. In relation to susto, or the state of being asustado, they’ve found that “among Latin America’s indigenous peoples” (a little bit too over-encompassing) susto appears when an essence is “thought to be captive because the patient, wittingly or not, has offended the spirit guardians of earth, a river, a pond, the forest, or collectivities of animals, birds, or fish” (442). I think that this explanation excludes other forms of susto according to indigenous peoples in which certain forms of witchcraft or even torture can trigger it. For the authors, in the case of non-indigenous peoples the cause of susto is a fright. In both cases the therapeutic effort is concentrated in returning the spirit essence to the body. In any case, the authors concluded that susto should be considered more as a syndrome caused by profound stress and with a high rate of mortality.
In relation to Tuberculosis the authors (with the help of more researchers) developed a study in which they could compare variations among gender, gender roles, and health knowledge in a single society (Mexico). They’ve found that, in comparison with the widespread symptoms of susto, tuberculosis is a very confined condition. The common symptoms are constant cough, bloody sputum, night sweats, weight loss, and fatigue. The research they’ve conducted was designed to understand how working-class Mexicans understand and react to respiratory disease. They wanted to understand people’s knowledge of the disease, they defined knowledge as “understanding of the causes, implications, and treatments of respiratory conditions that result from everyday experience with them, regardless of their biomedical acceptability” (446). They used “humoral” characteristics because they’ve found that in Mexico “hot and cold humoral dichotomy” is still very important to explain ill conditions. What I do not understand of this study is that at the beginning they’ve found that humoral characteristics were important and they used them in the surveys, and then in their conclusions they say that “these working-class Mexicans do, indeed, share a humoral model of respiratory health conditions” (447), but wasn’t this what they exactly went to look for!? Another conclusion they’ve made is that women have a stronger understanding of respiratory conditions through humoral qualities than men. I don’t quite understand the need to made so many surveys to come up with conclusions that were already included in the hypothesis. Perhaps they could have done more qualitative studies and come up with new information and not information they already pre-filtered.