Marcia Zanelatto's blog posts

Writer interview

October 21, 2016

B!RTH’s Creative Director, Emma Callander speaks to Brazillian writer Marcia Zanelatto.

 

How did you begin to write plays?

In my hometown, there was almost no theatre. The first time I saw a play, I was about 14 or 15, but I started writing poetry at 11. In my house, I had no books but my mother had notebooks in which she jotted down prose and verse. When I found these notebooks, I fell in love with the poems. I read them every day. So, when my sister Marta was born, I took the book and sat in the garden to read the poems in honour of her birth. By chance, there were white roses in the garden and the buds were opening. I associated the opening of the buds with the birth of my sister and there, I wrote my first poem. I have never stopped.

When I started studying theatre, I was very nervous when I came onto the stage, but I loved the text of the plays. I decided that my job was not to act, but to write for theatre.

My first theatrical text was a lyrical piece called ‘Boy Brazil’. I compared my country to a boy living in dangerous situations, still not knowing how to stand up for himself. At this point, I was 19 and I had already won two awards as a poet – one at my school and one at an academy of poetry in my town.

I don’t just write poetry or plays with strong lyrical parts, but this trait distinguishes my work to date. The most important award I received as a playwright was for a lyrical piece called ‘Shabbiness’. (I’m surprised! I realised that my first poem happened because of a birth!)

How do you feel the Brazilian culture of playwriting is different to other countries’ cultures?

It differs a lot! I, as a member of the Brazilian interior, lower middle-class family, started studying theatre having never had read a script! When I decided I wanted to study theatre, the first thing I did was go to a used books store in my city and buy all the plays there. I still have them and keep them with great affection. The theatre is not a huge part of the average Brazilian’s life – less than 7% of the population attends the theatre. So I realise that Brazilians don’t understand, for example, the difference between the director and the playwright.

For the past ten years here, we’ve started working more in training playwrights. For about five years, I have taught playwriting and my students come from all different areas. Usually, they arrive with no idea of what a text for theatre looks like, but I really like the work of the (few) Brazilians who could really write a play – Plinio Marcos, Nelson Rodrigues and Ariano Suassuna. The three of them are radically different authors and I see very strong aspects of Brazil in them. They are our parents. You cannot write for theatre in Brazil without studying the work of these three.

It is also important to mention that we have a very strong tradition of scriptwriting for TV – the television soap operas or Brazilian novelas, but they obey the logic of TV series and naturalistic realism. The writing for theatre suffers from this influence and, because of it, realism is the most explored aesthetic in the productions made. The classic stories with a beginning-middle-end structure, causal, with a protagonist with a great goal. But a lot has changed in the last 15 years. With public investment in the theatre, experimental pieces have won viewers, have developed to a more mature and more theatre-like… theatre! Less like the TV shows.

How do you see theatre affecting social change in Brazil?

I think that theatre was very active and influential in society during the military dictatorship (1964-1984). After that, society was very battered artistically and intellectually, and the theatre was battered. The repression was so violent we were all traumatized, making it became boring and unpleasant for a play to speak about or touch upon social issues. We spent years making a very aesthetic theatre, in which the text was only there as a pretext for building a beautiful and exciting scene. Some say that this pushed the common viewer away, but I don’t know. We also had a long phase of nonsense in theatre – theatre became a place for a joke, for mockery, for loose laughter.

Today, some 15 years on, we are returning to a more authorial exploration of playwriting. And in recent years, writers have started to talk about the country and about the important issues of our society. The good news is that these plays have increasing audiences. I hope that this will develop further, as we are facing a strong political and social crisis in the country and we have to review a lot.

I feel that we are still preaching to the choir, but there is a growing interest in this kind of theatre. Last year I wrote and produced a play about Hannah Arendt [a German Jewish writer who escaped Europe during the Holocaust, settling in America to write several books, including ‘The Human Condition], and it is still going, a year later, touring and selling out theatres wherever it goes. [I think this is] because the banality of evil is a very present theme in our lives right now. In 1999, I wrote a piece about a family devastated by drug trafficking. This piece was only put on last year, as previously there had been no interest in speaking on this subject in theatre. Today, it is a success, the house is always packed. Recently I produced a piece with 4 LGBT characters, which was a great success. I feel that 15 years ago these pieces may not have been put on. But today, we need to talk about these issues. Brazil is the country that kills the most women and trans people in the world and is among those who commit the most homophobic crimes – just so you have an idea of what is going on.

What have you found interesting about writing for BIRTH?

B!RTH has everything to do with my work, which brings together theatre and social issues. My pieces trigger debate and meetings between different members of society. I have worked a great deal in thematic exhibitions alongside several authors and directors, trying to enable debate where the debate is crucial. I had an immediate affinity with B!RTH for that reason. And I work well in this way, always researching and making links with intellectuals and experts on the issues. That is, this is the kind of process that I know and like very much.

 On the creative side, it was very challenging for me to write a ‘poetic self-documentary’. This is something I have never done before. My personal and family experiences are always behind the characters and stories I write, but never take the main role. It’s like I’m showing the back of the embroidery. It was a very deep and revealing process, which demanded different ethics because I’m starting from real events and people I love. But when I saw my family in the historical trajectory of childbirth in Brazil, I was delighted to make this piece a family inventory.

Childbirth in Brazil is going through a very radical artificiality process. And to expose the writing craft and use it in the scene struck me as a nice feature. To reveal myself as a character, my experiences, memories and even my research on the scene seemed to be a real appeal for the humane, for the beauty of simplicity and craftsmanship of life as that of the scene. It seemed to me to be an aesthetic appeal for a life with fewer devices and more affection.

Researching ‘The Birth Machine’

October 21, 2016

On 11th May 2016, I crossed the city of Rio de Janeiro in an Uber towards one of the units of the vast Fiocruz complex, located in one of the access roads to the city – Avenida Brazil – to meet with Maria do Carmo Leal.

With a medical degree and PhD in Public Health from Oswaldo Cruz Foundation (Fiocruz), and a researcher at the National School of Public Health (ENSP, Fioruz), Maria do Carmo led the research ‘Born in Brazil: National Survey on Labour and Delivery’. She was actually the person who showed me the big picture on the issue, showing me the main points in historical and geographical terms, and pointed me towards the public policies that were implemented to contain the behaviour that led Brazil to be the world record-holder in Caesarean sections.

She met me in one of the research rooms that had access to a computer network, so throughout the conversation we could consult maps and the institution’s database.

Caesarean sections in the public system reach 45%, and 90% in private hospitals, when the recommended amount by the World Health Organisation (WHO) is 10 – 15%.

Maria do Carmo told me that, today, 99% of births in Brazil take place in hospitals – hospital birth is universalized. Caesarean sections in the public system reach 45%, and 90% in private hospitals, when the recommended amount by the World Health Organisation (WHO) is 10 – 15%.

In a long conversation, Maria do Carmo explained how we came to this exorbitant number of caesareans in Brazil, indicating to me the doctoral thesis of Liana Carvalho ‘The meaning of caesarean sections among users of the private sector and public health: the coexistence of biopolitic strategies present in the “giving birth”’ and the ‘Thematic Executive Summary of Research of Birth in Brazil’ which was led by Maria do Carmo, so I could delve into this further. So this report involves mapping done by Maria do Carmo and the study of this material.

The first thing Mario do Carmo did was to deconstruct the idea that the ‘epidemic’ of caesarians in Brazil had a single cause. She showed me how the situation is complex, involving many stakeholders, socio-economic, political and behavioural factors, and fired up, of course, by the medicalisation of childbirth, which was a worldwide phenomenon dating from the 1950s.

One of the factors I had no idea influenced this high number in such a short time is that women who have had one caesarean section have to have a second.
Because cesarean causes a fibrosis in the uterus that prevents the egg to settle, making it attach itself elsewhere and this kind of pregnancy will require cesarean section.

So if you think that a first c-section has become standard, regardless of any necessity for it, you will realise how the two factors combine, dramatically increasing the number of caesarians. Because once a woman has had a first, she has to have a second. And a third…

What made c-sections the norm?

But what made c-sections the norm? Historically, from the medicalization of childbirth during the 1950s, midwives were discredited and associated with the high number of maternal and child deaths, failing to take into account that health in Brazil was still very precarious. Doctors and hospital procedures were seen as the only safe way to deliver a baby. Homebirth fell into disuse.

Instead of a doctor’s presence at a birth only being for mothers at risk, it became standard procedure: doctors now made all hospital deliveries. However, with the socioeconomic development of the country and vertical population growth, the high demand for doctors has become a problem. Even by the 1980s, doctors were no longer interested in leaving their families during late nights, weekends and holidays to attend a delivery. They were no longer willing to cancel their trips and leave their schedules open to wait for 12, 15, 20 hours (or more) for the conclusion of a labour. A caesarian section therefore emerges as a solution to this ‘problem’, regardless of whether it is best for mother and baby, and regardless of whether there’s a need to perform surgery when the body is healthy enough to deliver naturally.

Another problem is that both the public health system and private health plans pay the doctor more for delivery by c-section than a natural delivery, generating a preference for the surgical option. Health plans, then, charge their customers more for categories including caesarean deliveries then those related to normal birth, generating more profit for the medical profession and the health system business men, in addition to substantially driving the pharmaceutical industries.

The demonization of the natural birth process triggered the departure of midwives and turned the pain of childbirth into a sort of dreadful tragedy that must be avoided.

Added to these factors, and driving it all, the demonization of the natural birth process triggered the departure of midwives and turned the pain of childbirth into a sort of dreadful tragedy that must be avoided. This idea disseminates, including with it the idea that women, after vaginal delivery, become less sexually able. Thus, women with more money opt immediately for caesarean sections, and when the public health system integrates women’s apparent preferences for this delivery, it is perceived to be a gift by the community – a privilege that the state gives to its citizens.

The perception women have of the risks of c-section is minimal, because the medical community does not clarify this to them – for example, that during normal delivery, the baby comes into contact with [healthy] bacteria as it comes through the birth canal. That is, the baby absorbs the mother’s bacteria. With a c-section, the baby absorbs the operating room’s bacteria. It is a scientific fact that babies born by caesarian section have more respiratory problems, congenital allergies and even more prone to diabetes. On the contrary, it was found that at least half of women began their prenatal care aiming for a natural delivery. That is, doctors construct the idea of a c-section as a better process with greater safety and comfort for the mother and the baby.

According to data provided by the National Health Agency in 2015, in the private system there were 87,617 natural births against 481,157 caesarian deliveries – 84% were c-sections

When we reached the largest number of c-sections in the world, it became necessary for the State to implement policies to humanize birth – this has happened in more recent years, during the Lula and Dilma governments. Today there is a degree course for the training of midwives at the University of São Paulo. There are now fifteen units called ‘Birthing Homes’, paramedic centres maintained by the Ministry of Health, which aim to reduce caesarean rates, medications and unnecessary interventions and to ensure the rights of the women’s choices, such as the delivery position, their birth companion, wearing their own clothes and doing rituals of their own religions.

In Rio, City Hall keeps open and sponsors the maternity hospital ‘Maternidade Maria Amelia’, which focuses on vaginal delivery, using caesarean sections only on high-risk cases. The deliveries can be done by obstetric nurses and midwives, not requiring the presence of a doctor except in high-risk cases. But the reason no other maternity hospitals like this were founded is because of the heavy lobbies of the pharmaceutical companies and the Regional Medical Boards, preventing the establishment of other projects like this.

Recently, the state equalized the monetary value of normal and caesarean deliveries to prevent the excess amount of caesarean sections in the public system.

However, the rates remain tremendously high. According to data provided by the National Health Agency in 2015, in the private system there were 87,617 natural births against 481,157 caesarian deliveries – 84% were c-sections – which shows that the procedure is most widely spread in the middle and upper classes, despite being the worse option in terms of health for mothers and children.

Zika virus and microcephaly

October 21, 2016

Marcia Zanelatto recently spoke to Professor Debora Diniz of the University of Brazil about Zika virus and microcephaly.

MZ – Firstly, I would like to know if you really think microcephaly to be solely caused by the Zika virus or if you’ve considered the possibility of the link between microcephaly and the use of pesticides or other equally important factors. I read that Zika has also infected many people in Colombia, but there are no cases of microcephaly reported there. In fact, here in Rio, although we have cases of Dengue and Chikungunya in the south of the city, there have been no cases of microcephaly. What do you think and why?

DD – There is already international scientific consensus that the Zika virus is the cause of congenital neurological syndrome in fetuses, which has, as one of its signs, microcephaly. It is true that scientists are still investigating the possible interactions of the virus with other factors, but the most reliable literature no longer questions the effect of Zika virus. That is, the cause of the syndrome is Zika virus, although it cannot be the only cause.

MZ – Another thing that strikes me is that, as you say in an article in the New York Times, most fathers of children with microcephaly abandon the child and the mother of the child. And the state does not allow the woman to abort. Thus the woman is pushed to one of two situations: either she lives a life of suffering with a child who isn’t supported or to commit a crime, visiting a clandestine abortion clinic. You can see the way that microcephaly is treated as some sort of penalty for the woman, as if she has to pay for the misfortune, or as if it were alright for her to pay for her own misfortune. I can see some traces of misogyny in the way that microcephaly has been treated by society and the state. What do you think? 

DD – Yes, you’re right in identifying women as the main victims of the epidemic. But perhaps, put it this way: there is misogyny in the criminalisation of abortion and the imposition of compulsory maternity under any circumstances. In times of epidemics, defencelessness intensifies because the state submits women to the fear and deep anguish evoked by a public health emergency that cannot be reversed or controlled, and at the same time, criminalises abortion or forsakes these women completely, by denying access to social policies to those who are already mothers. That is, the Zika virus epidemic does not create the scheme of defencelessness, but it makes it explicit.

MZ – As you very well know, the State’s interest in eradicating microcephaly seems to be minimal. Microcephaly, it seems, is a disease of poor people who do not meet the mimumum standards of sanitation, for example. Are the two things connected? That is, if it was a disease affecting the middle class, and the children of lawyers and engineers were born with tiny brains, would we be witnessing a different approach to the virus’ treatment? 

DD – Yes, there would probably have been a different reaction. The population most affected by zika have not become invisible after the epidemic; they were always invisible, hidden by class inequality markers and regions. For that slice of the population, public policies are already fragile, and it continues in this time of global emergency, as an effect of persistent inequality regimes.

MZ – I have found reports of natural births with more painful and invasive medical procedures amongst poor women. And then an almost widespread choice for a Caesarian section – as a safe delivery – amongst the middle and upper classes. Does the evidence tell us of some type of institutionalisation of social inequality in hospitals? Can we associate the prohibition of abortion in Brazil to sexism? 

DD – No doubt. The criminalisation of abortion is the materialisation of a regime of gender that makes women’s lives precarious, as they have to submit their reproductive processes to a logic of surveillance and punishment.

Debora Diniz is a professor at the University of Brazil and a research at Anis Institute for Bioethics, Human Rights and Gender. She is a member of the Technical Board of National Research and Ethics of Transplantation for the Ministry of Health and an Advisory Committee Member of Global Doctors for Choice, Brazil. She is the international board vice-chair of the Women’s Health Coalition. She researches into bioethics, feminism, human rights and health.

 

Creative process

July 14, 2016

Márcia Zanelatto gives an insight into the creative process and research that is forming the work she is producing for B!RTH.

“On the day you were born…”

My dramaturgical process aims to create two moments. The first one wishes to bring to the stage a brief history of child birth and labour in Brazil, starting at the beginnings of the 20th Century.

To shy away from it becoming a lecture, or carry the density of information of a documentary as well as being pleasant to act and to watch, I needed emotion and poetry. In other words, I strived to touch people and through it, inform them.

It was after I realized that that a beautiful image had formed in my mind’s eye. I saw myself sitting in a chair before the audience telling them about how I gave birth to my son and, in a juxtaposition of narratives, following my own, would be my mother, occupying the same position I had just previously occupied, telling about how she gave birth to me and after her, the image of my grandmother giving her account of how my mother was born to, finally, end with the image of my great grandmother explaining how my grandmother was born.

As I came back from imagining that, I immediately realized that between my son’s birth, in 1994, to the birth of my great grandmother, in 1898, most of the 20th century had gone by.

“doctors were, sometimes explicitly, saying that natural birth was dangerous”

The research had now given me a new understanding of the child birth and labour in Brazil. What had happened during the 20th Century here was a fast-acting and enthusiastic maneuver to artificialize child birth, placing Brazil in the list of countries with the highest rates of Cesarean birth in the 21st Century.

The determining factors of said maneuver were made possible by a change in the ethical position of some in the medical class who opted for the comfort to control child birth through a projectable schedule of Cesareans, selling the procedure to their patients as the safest technology available. At the same time, said doctors were, sometimes explicitly, saying that natural birth was dangerous and the best way to ensure the child’s and the mother’s safety was to place them in an OR and have them undergo a Cesarean procedure.

This manner of approaching child birth spreads through Brazil like fire through dried grass. It dialogues and acquiesces with the colonizing understanding that all that is foreign – or, more precisely, European and USAmerican, is better than that which is Brazilian. The technology is, therefore, immediately accepted by the Brazilian people as it would an imported high-price commodity. Brazil’s economic ascension is also known to have been a factor in the rise of Cesarean births. Also in Brazil is a culture of the rich and expensive being seen as synonyms for wisdom and quality. The Brazilian common man does not like to spare; to spend money and show off is how they achieve and keep their social status. So, in that logic, the Cesarean surgical procedure, due to its cost, is seen as a commodity, a marketable good. And when the Public Health System begins to make said procedure available to the lower classes and, in some states, reinforce it as the preferred method, it undoubtedly is seen as a great gift from the State.

With a clearer view of the history of child birth in Brazil, I turn to myself once more – now as a Brazilian woman, born outside the capital of Brazil and into an intellectually and culturally humble working class family, of Indigenous and European heritage, who was largely dependent upon the State’s medical and educational public system – and I see myself as a character, as part of the statistics about nativity and child birth in Brazil. In other words, I found within my family’s history all the defining data of the history of child birth in Brazil.

“present within my writing is the desire to achieve an intimate, confessional tone.”

Better informed, I return to my initial dramaturgical proposal and turn myself into a character, while creating through an artisanal structure of storytelling a poetic core through which the words the decreasing affection of the increasingly surgical and cold birthing procedures. Also present within my writing is the desire to achieve an intimate, confessional tone. Therefore, the seemingly unshaped and unpolished play is like so presented to its audience in the hopes it will appeal to their human nature and natural cycles.

I confess to the spectator not to know what the Indigenous chant says, but I allow myself to write a poem inspired by it. I choose to show the lack of details in my mother’s memories, but the clear presence of a midwife and the fact that her baby was delivered at home, as shown in the statistics. I also choose to expose my wish was to have a natural birth and how I let said wish be thwarted by my obstetrician. I choose as well to show how a great friend of mine, in order to have her child the way she wanted – at home with a midwife, much like my grandmother – had to go through an adventure of sorts including being accused by her family and by society of being irresponsible.

“We are the people that make up the statistics.”

The development of the aforementioned ideas resulted in the creation of humane voices – like that of my great grandmother, an Indigenous woman captured by a Spanish colonizer with whom she had twelve children – and the ones made up by the statistical data.

The voices, as documental as emotional, are actualized on stage through a diversity of resources, while constantly pushing for an intimacy between the actress and the spectator, inviting both to inhabit the thin line between fiction and reality.