The main focus of this chapter is how the crisis of infant and child mortality is understood among the communities of the Brazilian Northeast. Specifically, this chapter takes on the profound normalization of and indifference to child death in such communities. The author argues that this indifference―although genuine―is not a personal phenomenon, but instead a social phenomenon. Furthermore, the author argues that this indifference is a function of class status—that the circumstances that predicate rampant infant mortality also predicate the means to normalize it within local culture.

To explore this hypothesis, Scheper-Hughes begins with a personal account of witnessing an infant die while she was a volunteer worker, and being singled out by the infant's mother and family for the "inappropriateness" of her grief. Returning as an anthropologist, the author meets with medical and civil officials, but even accurate figures on rates of infant death are hard to come by. The problem, she claims, is compounded as much by residents' underreporting―due to their reliance on home births and midwives―as much as officials' crude record-keeping practices. These attitudes, the author argues, stem from a cultural and political posture that normalizes the adverse, unequal systems that precipitate child death―systems perceived to be intractable.