Immediately the town fell away and we were crossing sunseared savannas that had once been planted in sugarcane and where occasionally the ruins of a stone and adobe fazenda crumbled under a bristling mat of vegetation. The abolition of slavery had made them uneconomical.
Scattered white and gray zebu cattle with big humps grazed on the plain. The railroad swept into bare rocky hills. The hills were scorched and smoldering because this was the season when they burned over the land to plant it when the rains began.
In the valleys there was an occasional ranch house with mud walls and tiled roofs set in a bunch of tattered banana trees. As the evening began to thicken in smoke and dusk the line wound in endless curves up a rocky valley. In the distance blue humped mountains rose from dark rock faces into fantastic cones against the sky.
Walter Runge was a hefty young man from New Jersey who had studied his engineering at Rutgers. He pointed out with a craftsman’s pride the work his outfit had done, straightening curves, eliminating grades, laying new rails, reballasting. He made you feel that this rickety singletrack line into the wilderness was an amusing and capricious toy to be coddled and petted and gradually babied out of its errors and vices.
Night came down on us suddenly. As the car came to a stop on a siding he pointed up into a barely visible tangle of matted trees. “We had a camp up there … All over here is swamps … The place is full of wonderful orchids … Before DDT we had to keep a double payroll because half the men were always down with malaria.”
“Any wild animals?”
“There might be some deer. They claim Espírito Santo is a great place for jaguars but I never saw one … Ticks and chiggers keep you so busy you don’t worry about other wild life.” He started scratching at the very thought of them.
We were waiting for an oretrain to come down. The night was dead silent. A few grasshoppers made a rasping noise in the trees. From away up the line we heard the whistle of the engine and the rattle of the trucks of the orecars coming round the curves.
The doctors were talking about jungle yellow fever that had been found to be carried by the Haemagogus mosquitoes that bred in the little pools of water in the forks of high forest trees. Now that the standard type had been eliminated, the jungle type was the next enemy to be vanquished. People called it the bridegroom’s disease because it was often contracted by young men who went out to clear themselves a piece of land when they married. The yellow fever inspectors kept track of it by watching for the bodies of the little animals that lived in the highest level of the rainforest. If they found a lot of dead monkeys it meant that there was yellow fever about.
The oretrain went slambanging past. After that the line was clear. We crossed the divide and went lurching and jangling through the night round long curves over singing rails until we roared with siren hooting into the main street of a place called Colatina.
There were creamcolored stucco housefronts and stores and cafés lit up theatrically by a string of electric lights.
The local doctors had come to meet us at the station. Abraços and felicidades. We walked to the hotel beside flatcars piled with immense logs of peroba wood. Now this hotel, Dr. Penido was explaining, was an example of how public health worked. I should have seen it a year ago. Now at least the kitchen was clean and the bedrooms and the dining room and bar. I’d be distressed by the toilet but he was working on that. Gradually. Gradually … Keeping a toilet clean was the result of years of education. In the Rio Doce Valley a privy was a monstrous novelty five years ago.
Next morning we were out early walking round the town. Rosy mist hung low over the broad sluggish puttycolored river. The bridge had been built for a railroad that never got completed; battered trucks were coming across it into town and occasionally a cart with whining wheels of solid planking drawn by a majestic pair of humped zebu oxen.
We walked down the cobbled street toward the Health Center. On the way Dr. Penido and Dr. Lavigne, the local chief of public health operations, proudly showed off the market. No rotting piles of garbage as in Rio. The stalls were clean. The vegetables looked freshwashed. The butchershop was screened and the marble tables had just been scrubbed. To be sure somebody had left open the little window in the screen through which the sales were made. Dr. Penido noted the fact philosophically. The next time it would be closed. “Education,” he said in a tone of infinite patience.
The Health Center had an air of quiet gaiety about it. It was an airy little building of gray stone and white stucco, designed I was told by Peter Pfister in the States, with a cool covered patio between the two rows of offices and consulting rooms, where people could wait out of the sun and in the breeze. At one end there was a playground for children. You could see that people enjoyed coming here. Varicolored children were scrambling around on swings and seesaws. People had brought their dogs.
In back was a sample vegetable garden with vigorous rows of lettuce, beets, dill, chicory, carrots, turnips, magnificent tomatoes. Dr. Penido explained that the people of the Rio Doce Valley had forgotten about growing vegetables. Beans and rice and occasionally a small gourd named chu-chú cooked with a strip of sundried beef constituted the daily diet, sprinkled plentifully with dry manioc flour so that you could make the mess into a ball with your fingers and shove it into your mouth. Now, in the town at least, the Public Health Service was cultivating a taste for vegetables among the people. If somebody proved that he could raise a garden he was given free seeds. Education.
The doctors tried to get the schoolchildren into health clubs so that they would interest their parents in sanitation and a wellbalanced diet. If they educated the children, the children would educate their parents. The trouble was that not all the children went to school and, of those who did, the great majority dropped out after the first three years.
In the offices they showed me their filing system. A simple and usable filing system was the crux of the problem. To produce an island of public health where there had been not the faintest notion of it before, you had to keep a record. That was the best thing the Americans had taught them, the Brazilian doctors agreed; a method of keeping a simple and adequate record without bureaucratic clogging. There were cards for every family in town showing its health record and the results of the visits of the district nurse. There were cards for individual patients. There were cards for every butchershop, bakery, bar, restaurant, hotel and boarding house, showing its sanitary record, recommendations made, improvements if any.
“Always,” said Dr. Penido in his quiet drawling voice, “we try to use persuasion … We try to get people to feel they want to improve things themselves. Then when they feel the benefit they become interested.”
As we walked out we passed a row of humble beatenlooking women waiting in line to get free boiled milk or made up formulas for their babies. Some of them had shoes but many of them hadn’t. Their skimpy dresses were none too clean.
“Five years ago,” said Dr. Penido in his low voice, smiling his sad disdainful smile, “they were drinking polluted water out of the river and depositing their excrement in the bushes … We can isolate the lepers. We can cure yaws with about ninety cruzeiros’ worth of penicillin, we can cure hookworm … DDT has malaria on the run. We can vaccinate for diphtheria and smallpox but to have really universal public health in this country we have to produce models that people will copy … sanitary islands.”
As he went out into the street a dark look came over his face, as if somebody had said something that had hurt his feelings. “Now we face tuberculosis,” he said solemnly. It seemed as if TB increased with civilization. When people lived in huts in the crannies of the mountains they didn’t have so much TB. “As we clean up other diseases TB seems to spread.”