At first blush, Tell Me Why My Children Died appears to belong on the shelf alongside the growing number of what might be called ‘epidemic mysteries’. In such mysteries, figures like Charles Briggs and Clara Mantini-Briggs, an anthropologist and public health doctor, respectively, tend to play the role of ‘disease detectives’. The book opens by recounting the deaths of two children in the Delta Amacuro state of Venezuela. These were two of an eventual 38 victims of an epidemic that indigenous healers and leaders in the Delta could not explain, and that doctors and epidemiologists from the Venezuelan health service didn't seem to want to explain. In a conventional epidemic mystery, this is where the disease detectives swoop in, marshalling expert medical knowhow and liberal compassion, alleviating the bereaved parents’ misery and shock with a neat, orderly causal explanation.
But Briggs and Mantini-Briggs refuse to reproduce this trope. They are reluctant detectives. Indeed, they begin the book, which chronicles what turns out to be a rabies epidemic, by admitting that they did not want to write it. In 2008, they found themselves enveloped in the chaos, first as friends and acquaintances to the dead and bereaved, and only later as anthropologist and physician. As the mysterious deaths raged, Enrique and Conrado Moraleda, two leaders associated with the Union of Indigenous Warao Communities, invited the authors, along with several political leaders, to devise a plan ‘to ensure that knowledge about the disease would be mobile – that it would reach officials and journalists in Caracas’ (p. 48).
This attempt to make knowledge mobile provides both the narrative driver of the book and its central theoretical contribution, the concept of ‘health/communicative inequities’. Too often, Briggs and Mantini-Briggs claim, anthropologists and other social scientists have limited ‘health communication’ to interactions between patients and healers, or between expert health authorities and lay publics. This approach, they write, risks leaving the impression that care is something that happens only at the bedside or in the exam room. In response, Briggs and Mantini-Briggs attend to other sites and practices, including the collection and dissemination of epidemiological records, newspapers and television, and the word-of-mouth spread of ideas and news known in the Delta as ‘Warao radio’. The political and technological authority of these media varies depending on context. The authors argue that to understand a health crisis, we must recognise that ‘forms of health and communicative labour are deeply entangled’ yet ‘fundamentally out of sync, simultaneously crucial for enabling the work of care and constituting one of its fundamental obstacles’ (p. 7).
So the authors mourn alongside the bereaved, but, at the invitation of the Moraledas, they also collaborate in their search for justice. In the Delta, as we find out, mourning is collaboration. Forming what they self-consciously call a ‘team’ (equipo), the Moraledas, the authors, and others work to turn narratives born out of collective mourning into mobile knowledge: to enact health/communicative justice.
Though the book should be read in its entirety, Part I will likely be particularly interesting to a Latin American studies audience. In these chapters, the authors move stepwise through the epidemic, starting with the stories of the deaths and the mourning. They next place the halting, uncertain responses of clinicians and epidemiologists labouring in the regional outpost of the Ministry of Popular Power for Health (MPPS) alongside those of local Warao healers. The examination of the print, television and radio coverage of the epidemic that rounds out the section is particularly vivid. Here, we see how health/communicative inequities take shape on the pages and airwaves of the local Delta newspaper, as well as in the pro- and anti-Chávez press in Caracas. Briggs and Mantini-Briggs – both sympathetic to the Bolivarian project – find themselves torn between their political loyalties and the team's desire to have the deaths recognised and explained. This brings them into uncomfortable proximity with anti-Chavista journalists. When the MPSS declared an end to the epidemic without ever really explaining it, those journalists deferred to the authority of the state and not to the indigenous activists. Thus the anti-Chavista media ended up propping up the government it claimed to oppose.
Over and over again in Part I, the equipo faces the challenge of making the team's knowledge about the epidemic mobile without erasing either the ‘collaborative process that produced [it]’ or ‘the work of mourning in which it unfolded’ (p. 222). In Part II, the authors situate that challenge within a dizzying sweep of theory, from Peirceian semiotics, to psychoanalysis, to science and technology studies, to multispecies or ‘more than human’ anthropology (this form of rabies, likely spread by bats, implicates a variety of creatures, spirits and other beings).
There is, in other words, such a wealth of analytical ideas and references in Part II that you might feel overwhelmed, save for the fact that the authors do an amazing job of putting theorists from disparate generations and disciplines into conversation with one another. The authors’ own previous work on communication and health plays a bridging role here, connecting these well-trodden (and largely Anglophone) ideas with those of Latin American theorists. Still, once so many ideas start floating around, you might find yourself, as I did, starting to ask about what's missing (in my case, Kim Fortun's work on the emergence of ‘enunciatory communities’ in the context of disaster kept coming to mind). In the end, though, the book's two-part structure is a success. Its division of a gripping multi-perspectival narrative from an equally polyvocal analysis will likely make the book more useful as a teaching tool.
Indeed, it is in this combination of ambitious scope and gut-wrenching intimacy that Tell Me Why My Children Died really shines. This book is a model not just for anthropologists interested in epidemics (Ebola and Zika were frequently on my mind while I was reading, and they are occasionally invoked in the text), but, just as importantly, for readers interested in a first-hand account of the messy, frustrating and ambivalent work of communicating calls for justice.