I am pleased to begin a two-part series on maternal and infant health in Brazil. Cari Maes is an assistant professor of History at Oregon State University. She earned her Ph.D. in modern Latin American history at Emory University. Her research focuses on the rollout of Brazil’s first national maternal and infant health system during the era of Getúlio Vargas. She has recently written about the connections between infant mortality discourses in this period and rhetoric surrounding COVID-19 mortality. Her current book project took her to the IFF/BibSMC where she investigated the history of the institute and its role in Vargas-era maternal and infant health programming.
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History in the Hospital (Part I): Exploring Brazil’s BibSMC Archive
On a tree-lined avenue across from Rio de Janeiro’s picturesque “Sugar Loaf Mountain” (Pão de Açúcar) lies a rich archive focused on infant and maternal health in Brazil’s past and present. The Biblioteca de Saúde da Mulher e da Criança (Library of Women’s and Children’s Health) occupies a small corner on the second floor of a bustling public hospital. Known by its acronym, BibSMC, the archive is part of a wider network of archives and libraries operated by the Oswaldo Cruz Foundation (Fiocruz), Brazil’s leading public health educational and research hub. The archive dwells inside an almost century-old hospital, the Instituto Fernandes Figueira (IFF), which today offers specialized medical services ranging from neonatology to occupational therapy. The hospital also coordinates the world’s largest and most complex breastmilk bank network that comprises more than 200 outlets across Brazil.
On an average weekday, women and children crowd into the lobby awaiting services. Adjacent to the main entrance, a stone statue of a mother cradling her infant welcomes patients (see Figure 1). Forged and placed at the location permanently during Brazil’s Estado Novo dictatorship period in 1944, the so-called “Monument to Maternity” transmits both the history of the archive, the hospital, and a key period in the development of modern infant and maternal health.1 The history of the BibSMC began in 1939 when Brazil’s Divisão de Amparo à Maternidade e Infância (Division of Maternal and Child Protection) opened a small library.2 Owing its initial organization to a team of doctors, technicians, and other departmental staff, the library’s collection expanded greatly in its first years of operation. In 1940, then-president Getúlio Vargas inaugurated a new federal department known as the Departamento Nacional da Criança (National Children’s Department). This new entity focused more robustly on education and public outreach and, as a result, the library transformed into a space for teaching, occasional health and hygiene exhibits, and film screenings.3 The hospital-based library became the research nucleus for National Children’s Department, indexing all of their educational pamphlets and institutional bulletins.4 Another expansion came in 1970 during Brazil’s military dictatorship period, when Fiocruz absorbed the IFF, making it part of the foundation’s web of public health and scientific education and research. Through these transitions, BibSMC remained committed to collecting reference and research materials related to infant, child, and maternal health.
Figure 1: Maternity Monument at the IFF entrance
Today, the library serves the interests of both practitioners and researchers from a variety of medical, public health, and social scientific disciplines. The materials range from books and periodicals to archival documentation and an interdisciplinary collection of dissertations and theses. Some of these resources are available in electronic formats through the online catalog. In 2007, the BibSMC inaugurated a videoteca, or a collection of educational videos used in public outreach, teaching, and practitioner training. As a part of the Fiocruz library system, the BibSMC’s catalog is easily accessible online with user-friendly search functions. The library also contains materials in multiple languages, including English, French, and Portuguese; however, some familiarity with the latter is necessary to navigate the catalog’s search platform. While users can access the main Fiocruz website in English, Portuguese, or Spanish, the library catalog functions only in Portuguese. Impressively, Fiocruz’s entire portal uses Vlibras, a system that translates webpages into Brazilian Sign Language.
Figure 2: Screenshot of BibSMC’s online catalog.
For historians, the repository offers a rich collection of medical and scientific journals that trace the evolution of specialized fields like obstetrics and gynecology in modern Brazil. The collection possesses historical documentation dating to the late 19th century. For example, researchers can consult scientific journal collections, like the Anais Paulistas de Medicina e Cirugia (Annals of Medicine and Surgery-São Paulo) published from 1913 to 1994, as well as the Anais Brasileiros de Ginecologia (Annals of Brazilian Gynecology) published from 1936 to 1969. BibSMC also holds multiple decades of the Anais Nestlé, a journal focused on child nutrition and published by Brazilian arm of the Nestlé Corporation beginning in 1944. While some of these resources are available in other repositories, the BibSMC offers a number of specialized materials not found elsewhere.
On site, visitors can utilize the catalog and consult materials directly. The library stores materials in compact shelving to maximize access within a space the size of a small café. Researchers must register at the main desk, where helpful staff members provide assistance. Unlike many other public archives in the city, the BibSMC allows visitors to retrieve materials independently, take photographs, make copies (for a fee), and use personal laptops (see Figure 3). I have also found that the BibSMC allows for an iterative research process, which I find useful for the early stages of a project. The ease of access and small size of the space allows researchers to explore the available resources by simply browsing shelves or “chaining” materials through cross-references and shared citations. Researchers can also utilize the BibSMC’s collections as a starting point before casting a wider net across Fiocruz’s other local archives and libraries. With the suspension of travel and in-person archival visits due to COVID-19 closures, the BibSMC and the Fiocruz catalog allow for online research from the comfort of home.
Figure 3: Author’s laptop view inside BibSMC
However, the in-person research experience at the BibSMC offers much to the historian by bringing investigation of maternal and child health in the past into conversation, quite directly, with the present. Historians of Brazil and other Latin American countries might be accustomed to finding present-day archives and museums housed within the walls of bygone institutions, like convents, hospitals, and orphanages. BibSMC, however, presents a different interface between historical research and health care delivery in the present. As such, researchers utilizing this repository must consider the ethical and political implications of undertaking archival work in a functioning hospital where the human dramas of the past comingle with those in the present. In my next post, I will consider the co-localization of the hospital and the archive using the BibSMC as a case study.
1 The monument became a sort of public-facing totem representing federal maternal and child health programs. The Departamento Nacional da Criança used it as a centerpiece for its annual public exposition known as “Children’s Week.” Boletim Trimensal do Departamento Nacional da Criança (Rio de Janeiro: Imprensa Nacional, 1943), 19.
2 Dr. Olinto de Oliveira, a prominent Rio de Janeiro-based pediatrician and future director of the National Children’s Department, first introduced the vision for a library annex to the Arthur Bernardes Hospital during its remodel in 1935. See Correspondence from Olinto de Oliveira to Gustavo Capanema, Ministério de Educação e Saúde. CPDOC: Arquivo Gustavo Capanema. GC Rolo 60 (1935.05.27), foto 408.
3 Boletim do Departamento Nacional da Criança (Rio de Janeiro: Imprensa Nacional, 1957), 20.
4 The remnants of these collections are now archived at Brazil’s National Library.