Killing the Doctors When They Refused to Cry Uncle


Last week the world lost a brave war correspondent, Marie Colvin, when she lost her life covering the strife in Syria. Marie was first an anthropologist before becoming a journalist, graduating with a Bachelor’s Degree in the field from Yale in 1978. During her undergraduate years she attended a seminar with John Hersey, a Pulitzer Prize winning journalist who’d written about the aftermath of the atomic bomb on Hiroshima. So impressed was Colvin that she abandoned the Ph.D. quest for the rigors of reporting the world’s troubles. I told her story to my anthropology undergraduates last week. They struggle, as did young Colvin, with how to apply their critical skills after graduation. “You need to add Colvin to your reading list,” I said, “learn everything about her.”

Coincidentally this semester I am teaching about another war correspondent and anthropologist, Sandy Smith-Nonini. Like Colvin, she risked her life on the front lines, documenting military attacks on rural clinics in Nicaragua and El Salvador as a health rights activist and journalist in the mid-1980s. Her daily reality included day-long hikes across war zones, being detained by soldiers, and police raids on her house and office. Only in late 1989, after death threats to herself and her young son, did she leave the region and return to the U.S.

Unlike Colvin, Smith-Nonini did it backwards. She was first a journalist and then became an anthropologist, going all the way to the Ph.D. She’s just written a book about her war experience , Healing the Body Politic, El Salvador’s Popular Struggle for Health Rights from Civil War to Neoliberal Peace (Rutgers University Press, 2010). I interviewed Sandy in early February to learn more about her strange trajectory as an activist-anthropologist, and what lessons she had for us.

BMcK: Why did you decide to go to graduate school in anthropology after a decade working as a war correspondent and a health activist?

SSN: To understand what just happened.

BMcK: You mean over the previous decade?

SSN: Yes, I knew politically what happened, but I wanted to delve into the deeper cultural issues. I needed to understand how something like health care for poor peasants could so threaten military authorities that they would actually target clinics and kill health workers.

BMcK: That must have been a culture shock, going from the front lines to the seminar room.

SSN: Definitely. My experience in graduate school was excruciating. I had the bad luck to re-enter the academy right after the fall of the Berlin Wall, at the height of Postmodernism and the “culture wars.” Here I was fresh out of a civil war in a place where class struggle held great resonance, and I was being told by professors that the notion of solidarity was out of date. For years anyone who studied political economy was stigmatized. Then around 1998 many academics discovered that some training in political economy is actually pretty helpful if you want to understand neoliberal economics.

BMcK: Tell me about your first experiences as an activist.

SSN: It was an inauspicious beginning. After taking up running in high school in the 1970s, I began my freshman year at Duke in 1974, only to learn that there was no women’s track team. Title IX, a law which required women’s parity in college athletics, was new on the books. It seemed straight-forward. I went to the head of the athletic department and asked them to start a team.

He said no, that first there needed to be evidence of women’s interest in a sport. So I  acquired a list of all freshman girls who had run track in high school, wrote them letters and organized a voluntary club. We got permission for them to train with the men’s team under Coach Al Buehler, a former coach of the US Olympic cross-country team. Our “Duke Track Club” began independently competing against official college women’s teams . . . and winning. Each year I’d go back to the officials and ask, but they kept stalling on hiring a women’s coach. Then I graduated, but less than two years later Coach Buehler, who was now promoted to athletic director, asked the men’s team to give up funds to establish a women’s track team.

The truth is: I wasn’t even remotely political at the time. I was acting in my own interest, and we’re all experts at that. But I was impressed that we had made a difference. Years later, in graduate school, I learned a name for that.  Albert O. Hirschmancoined a term for the seldom noted long term impacts of social action. He called it “the principle of conservation and mutation of social energy.” Isn’t that a neat term?”

BMcK:  Yes, it is. Speaking of the mutation of energy, you graduated just before Central America exploded into imperial madness. The Sandinistas defeated US supported Nicaraguan dictator Anastasio Somoza in 1979. Then in 1980 President Reagan began sending massive support to El Salvador’s military government to defeat the Farabundo Marti National Liberation Front (FMLN). No matter that the rightwing military was supporting Death Squads who killed liberation theology priests. 

SSN:  Yes. I was taking graduate courses in journalism at the University of North Carolina and I attended a candlelight vigil to commemorate the first anniversary of Archbishop Oscar Romero’s assassination. While there I struck up a conversation with Jose Siman, a visiting Salvadoran professor, who had dined with Romero just days before his murder. He told me he feared for his own life. It made an impression on me.

I moved to Washington, DC and got a job as a medical writer. One night I went to a meeting where doctors and nurses fromBoston and New York talked about sending medical aid to Central America. I joined them and we ended up founding the National Central America Health Rights Network (NCAHRN), which grew to over forty committees across the U.S. So I began spending all my vacation time traveling to Central America with small delegations delivering medical supplies. Then we learned that the health promoters we were training were getting murdered, and the clinics we were helping in both countries were being burned by counter-revolutionary forces. It was a violation of international law, but none of the media was covering these attacks. So I decided to try and write about it.

BMcK: So you felt you could be most effective functioning as a journalist rather than as an activist. 

SSN:  It galled me that it was my own government arming the Contras in Nicaragua and the Salvadoran death squads. What happened was NCAHRN and the San Francisco health rights committee had begun co-sponsoring a Public Health Colloquium each November in Managua. So I would go, but instead of attending the seminars, I went with a small group of doctors and nurses in jeeps to the countryside to gather evidence on recent Contra attacks on clinics.

BMcK:  You title Part II of your book “War against Health.” Explain how your health rights reporting led you to the concept of the “body politic?” 

SSN: Let me give you an example. In 1988 I was in a jeep with two doctors and a nurse near San Jose de Bocay in Nicaragua’s far north, the night after 600 contras had crossed the border and mounted a small attack on the town. We had spent the previous week documenting their atrocities against health workers. When we stopped in villages that day, Nicaraguans warned us to get out of there. As we fled south we debated what we would tell the contras, if indeed they stopped us, and if they asked questions before shooting. Our debate was over whether we should we call ourselves doctors or journalists. 

BMcK: That should be an easy one. So many journalists were murdered. An anthropology friend of mine, a photo-journalist named Richard Cross was blown up on the border in 1983 along with an LA Times journalist Dial Torgerson. Which did you choose? 

SSN: We decided to call ourselves journalists. 

BMcK: Really?  Why?

SSN:  Because it was more dangerous to be a doctor. Can you imagine?  Our data clearly showed that health workers in remote areas were not caught in the crossfire, they were being targeted. The same thing was true in El Salvador, where doctors and clandestine hospitals in rebel-held areas were considered prime targets, second only to a rebel command post. Who knew humanitarian efforts could so threaten a military state?” Now that is power. Soft power. The body politic is about social materiality, or how humanitarian narratives challenge political authority.

BMcK: Did your fact-finding draw attention to the crimes?

SSN:  Not at first. But we kept at it. We distributed reports on our findings in Congress, and the American Medical News, the newspaper of the AMA, which I wrote for, published my articles on this in 1987 and 1988 on the front page. They issued a press release on our findings that got picked up by the UPI wire and NBC News. The coverage finally prompted the Washington Post to report on the attacks. By then I had moved to El Salvador to try my hand at free lancing for U.S. papers.

BMcK:  I imagine it was a jolt to go from reporting on terror to an academy where scholarship had been redefined as discourse analysis and deconstruction. Your ethnography on the popular health system in Chalatenango during the 1990s peace process documented the government’s effort to regain control over health from dissident peasants in a former war zoneHow did your alienation with social theory shape your research questions?

SSN:  I was struck by the fact that the activism over health continued long after the war, during a period when the government, backed by the World Bank, was trying to privatize portions of the health system. In 2002 the anti-privatization struggle, led by many of the health activists who had built the popular health network, erupted into the largest street protests since the war. So my theorizing came to focus on how “soft-power” gains authority and challenges existing hegemonies. What impressed me was the “taken-for-granted” aspect of solidarity in precisely those areas where citizens had survived intense scorched earth policies intended to eradicate the civilian presence.

BMcK:  Where did the body politic concept originate?”

SSN:  Well I had read the classic “Mindful Body” paper by Nancy Scheper-Hughes and Margaret Lock,(1987).  Their “lived body” (which foregrounded the experiential) and the “social body” (in which the body is a social metaphor) generated a great deal of academic attention. But it seemed to me that the “body politic,” which is about the relations of political power and coercion with the body, had not been fully explored. My work was greatly aided by theoretical writings on embodiment by John O’Neill, Bryan S. Turner and Andrew Strathern. One of the problems of work on embodiment is the lack of a dualistic comparative structure. In the introduction to my book I write that as cultural scientists we yearn to wrest the injured body back from medical science, so we can exercise our craft of meaning-making. But in doing so we marginalize materiality (both experience and practice), in order to foreground representation.

The body politic serves as a hedge against dualism. We are taught this concept in introductory courses and one sees criticisms of Cartesian metaphysics everywhere, but it is very hard to put a holistic perspective into practice. Here in the West, especially, we are dualistic thinkers despite ourselves, not only because of problems interpreting experience, but because we have convinced ourselves there is something called the social which is separate from the material. Denial of the interdependent nature of the social is at the base of individualism. In the capitalist world, it is this conceit that leads us to consider the notion of  ”moral economy” as an ideal, rather than as fundamental to any theory of governance.

BMcK: The Christian base community which shaped so much peasant resistance to militarism in Central America was informed by Paulo Freire’s notion of a liberating pedagogy. How does the “body politic” relate to Freire’s ideas?

SSN:  My theorizing arose from my experience with grassroots efforts by the Salvadoran peasantry to build new forms of community which have moral economy at the center. When I asked peasants to tell me about their struggle, they tended to invite me to spend time with them and see for myself. Freire’s message was all about practice, and the processual or experiential nature of learning. His approach to adult education was to acknowledge the concerns of daily life that occupy poor people’s consciousness and build the lessons around those priorities.

BMcK:  Yet as you make clear in the book, neoliberal policies have undermined so much of what the civil war was fought to achieve. I work on issues of medical education, and it’s hard sometimes to remain hopeful. Here in the United States, what little progress has been made toward health reform seems in danger of being rolled back. 

SSN: Interestingly, Freire was a man who felt himself to be fulfilled when he was engaged in struggle. When he was put in charge of public education for a poor province of Brazil he was once asked how he could avoid despair given how intractable the problems of poverty were.  And he replied to the interviewer that when the need was greatest, was when he felt most useful as an activist. I remember a poster I brought home from Nicaragua of a revolutionary soldier teaching a peasant to read and write. The caption said, “The duty of a man is to be in that place where he can be most useful.” Now, despite the sexist reference, I’ve always thought that is a pretty good measure of effectiveness. So when I get engaged in a new activist project, I always ask myself, “Am I doing something that makes a difference?  Or would someone else be doing what I’m doing if I wasn’t here.  If so, maybe I should go elsewhere where I can be more useful.”

BMcK: So you see struggle as both a means for making change and a mode of being.

SSN: Being in struggle, to me is not about being a warrior but about finding a way to apply your skills most effectively while being of service. It’s actually really hard to do that well. But lots of people – students, applied anthropologists, health workers – make service to others their personal code, which I find inspiring.

BMcK:  Conventional thinking attributes service to altruistic motivations, as opposed to self-interested market transactions. 

SSN: The body politic is a theory of solidarity that also considers the pragmatic side of moral reasoning and the desire to work in concert with others. It is not about altruism in opposition to a market mentality. We are not driven solely by self-interest when we engage in economic relations. And we likewise engage in solidarity for all kinds of reasons, including self-interest, to have adventures, out of curiosity, to learn a skill, and to build a career. And it’s a good thing!  Often those are the things that keep us going!

BMcK: And the notion of community participation is so central to sustainable and just development.

SSN: We’re social scientists, for God’s sake, it’s time we learned to think better about such a fundamental thing as how to do community well.

Brian McKenna lives in Michigan. He can be reached at:mckenna193@aol.com

A version of this article was originally published in the Society for Applied Anthropology Newsletter, Vol. 23:1, February 2012. Tim Wallace, editor. http://www.sfaa.net/newsletter/feb12nl.pdf


Chomsky, Noam and Herman, Ed (1979) The Washington Connection and Third World Fascism (The       Political Economy of Human Rights – Volume I)

Freire, P. (1970). Pedagogy of the Oppressed.  New York: Seabury Press.

McKenna, Brian (2010) Take Back Medical Education, The Primary Care Shuffle. Invited Editorial for      Medical Anthropology: Cross-Cultural Perspectives in Illness and Health 26(1) 6-14.

Scheper-Hughes, Nancy. And Margaret Lock (1987) The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology. Medical Anthropology Quart. 1:6-41.

Smith-Nonini, S. (2010) Healing the Body Politic, El Salvador’s Popular Struggle for Health Rights from        Civil War to Neoliberal Peace. Piscataway, NJ: Rutgers. 

Brian McKenna is an anthropologist who teaches at the University of Michigan-Dearborn and can be reached at mckenna193@aol.com

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