Maria Cecília de Souza Minayo is a sociologist who works on several fronts. With more than 60 years of experience as a teacher and three decades as a researcher, she helped introduce social sciences into medical and public health studies in Brazil. She observed specific groups, such as police officers and the elderly, and created methodologies for investigating how different types of violence impact people’s health, pushing the debate beyond public security. Over the course of her academic career, Minayo led more than 40 studies on the relationship between violence and health, as well as supervising approximately 80 postgraduate students studying master’s degrees, PhDs, and postdocs.
Now a professor emeritus at the National School of Public Health of the Oswaldo Cruz Foundation (ENSP-FIOCRUZ), Minayo was chair of the committee that formulated the Brazilian Ministry of Health’s National Policy for Reducing Morbidity and Mortality from Violence and Accidents in the 1990s. The policy outlined protocols for different types of violence that affect health services, such as road traffic accidents and domestic attacks against women and children. Her most recent work, yet to be published, is a survey of the living conditions of elderly people incarcerated in male and female prison systems in the state of Rio de Janeiro.
At 86 years old, Minayo continues to teach, supervise students, and lead research. She is married to chemist and sociologist Carlos Minayo, with whom she has two daughters and four grandchildren. She recently received the International Prize from The World Academy of Sciences (TWAS). The following interview was conducted in her apartment in Aterro do Flamengo, Rio de Janeiro.
Field of expertise
Sociology
Institution
Oswaldo Cruz Foundation (FIOCRUZ)
Educational background
Bachelor’s degree in sociology from Queens College, City University of New York (1979), master’s degree in social anthropology from the National Museum at UFRJ (1985), and PhD in public health from FIOCRUZ (1989)
What is your strongest memory of your childhood?
I was born in 1938, in a small village in the interior of Minas Gerais called Caxambu. I started school at the age of 7, by which point my mother had already taught me how to read. Dona Ruth, my teacher, taught the first, second, and third years all together. I have great respect and gratitude toward her. All the children in that village knew how to read, write, and do math thanks to her. It was so important to me that I received such a good quality education in my early life. However, the rural school only taught children until the third year, and families in the village did not usually encourage their children to continue studying. But my parents were different. My mother was a postal worker and my father was a versatile and intelligent salesman, as well as a well-known local politician. They had a vision of what the future should be like for women, so they decided to enroll my younger sister and I in a school called Nossa Senhora das Dores in the city of Itabira. I was 9 years old and she was 8.
Did you travel all the way to Itabira every day?
From my house to the school was a nine-hour journey back then. Nowadays, you can get there in an hour and a half by car. But in the past, we had to travel on horseback or in a cart, and then take a train. Because it was so difficult to get there and back, we boarded at the school. We only came home twice a year, for the holidays. I quickly became one of the best students in my class. I eventually did my teacher training at the same school. It was a common route for women to take at that time, to give them a profession. I finished my studies in 1955 at the age of 17, and then I became a teacher at the same school, which now would be called a high school.
Why did you move to Rio de Janeiro?
I worked as a teacher at the school in Itabira for 10 years, until 1965. The Catholic group that owned it had another school in Rio de Janeiro, and I was invited to teach there. At the end of the 1950s, due to changes to the Church proposed by Pope John XXIII [1881–1963], the Instituto Superior de Pastoral Católica [ISPAC] was created in Rio de Janeiro. The institution offered courses in philosophy, theology, sociology, ethics, and morality, inspired by the papal encyclicals of Pope John XXIII, which called on Catholics to take action against poverty and misery. I enrolled at the institute and the classes completely altered my perspective. I began questioning the fact that the group I worked for only served middle-class students and did not pay any attention to the poverty all around us.
What changed for you after this experience?
My parents had very few books at home, but they were subscribed to a newsletter called São Geraldo which discussed the issue of poverty and reported on the suffering of people in Africa. I have always been an avid reader, and this newsletter made me dream. From a young age I wanted to become a missionary. The course I studied at Instituto Superior de Pastoral Católica opened my mind, but not to deny Catholicism—I didn’t lose my faith. But I did begin to question the relatively easy life of the group of teachers that worked at the institution, which included myself. In the late 1960s, I got involved in various social movements. At the same time as giving classes at the school, I started working in the Penha favela. I took students and colleagues to see what life was like in the slum and taught popular education classes. I started to do the same in other communities in Rio, such as the Guaporé housing complex in the north of the city.
Was that when you met your husband?
Yes. Carlos came to Brazil from Spain in the late 1960s to head the Chemistry Department at the Pontifical Catholic University of Rio de Janeiro [PUC-Rio]. When he saw the level of poverty in Rio de Janeiro, he too decided to get involved in social work. At that time, there were several popular education courses in Brazil, taught in informal spaces outside universities. In mid-1969, while working in Guaporé, I met Carlos. He told me he was there because of the negative experience he and three of his friends had in the Rocinha favela. They were living in the community so that they could teach there, but with Brazil under the rule of a dictatorship, the police began causing them a lot of trouble. Eventually they decided they could not stay in Rocinha, so they moved somewhere a little more under the radar. But as the months passed, the level of repression became heavier. One of the military’s main targets was popular educators. Many were arrested.
How did the military dictatorship [1964–1985] impact your life?
At the Catholic school where I taught, there was a child whose father was a federal police officer. He liked me a lot, but he didn’t know that I was also working in popular education. One day, when I arrived at school, he was there to pick up his daughter. I asked to speak to him. I was so naive. I told him that several of my colleagues involved in popular education were being arrested, and I asked for his advice. He asked me their names, so I mentioned two people and he told me to stay away from them, calling them “dangerous.” Then he told me I should go into hiding before they arrested me too. I was terrified and decided to do as he said, but I couldn’t go to my parents’ house in Minas Gerais, because I didn’t want to put them at risk.
My research is not about public security. I seek to understand how violence impacts the health of children, women, and the elderly
So what did you do?
A friend of mine was married to one of the sons of the publisher José Olympio [1902–1990]. She also worked in popular education. I called her and explained my situation. She told me she felt like she was being followed at all times. She lived in a big house in Lagoa Rodrigo de Freitas and invited me to stay with her family for a while. I moved in with her and decided to ask the National Conference of Brazilian Bishops [CNBB] for help to free my friends who had been imprisoned. But the political situation only worsened. I left the school I was teaching at and moved to Nova Iguaçu in Baixada Fluminense, where there was a bishop called Dom Adriano Hipólito [1918–1996] who protected people working in popular education that were being persecuted by the authorities. A friend from the school accompanied me on this adventure. We stayed there for a while, under the protection of the bishop, each of us receiving a minimum wage to work as part of a collective movement created by students and intellectuals to educate people in that vulnerable region.
How did you end up going to university?
In 1974, I enrolled in a sociology course at the Institute of Philosophy and Social Sciences of the Federal University of Rio de Janeiro [UFRJ]. Because of the dictatorship, it was an environment where you always had to talk in code, because you could never know for sure what other teachers and students were thinking. Despite this, I learned so much. I got good grades in every discipline and helped my friends read complex books, such as work by the German philosopher Karl Marx [1818–1883].
Were you already married at that time?
No. In 1971, Carlos went back to Spain to take care of his mother, who was very ill and died soon after. He had planned to come back to Brazil, but his friends warned him to stay away. If he had returned, there was a risk he would have been arrested. One of our peers who was in prison had been interrogated and pressured into giving names, and he told them about Carlos because he knew he was out of the country. But as a result, he was in the military’s sights. At around the same time, a lawyer who defended political prisoners warned me that my name was also being mentioned in interrogations. That was when I decided to leave the country to meet up with Carlos, even though I hadn’t finished my degree. We already had a close relationship and in 1976 we got married in New York. We’ve now been married for 48 years.
What was life in exile like?
There were several renowned Brazilianists in New York who supported Brazilians. One of them was historian and anthropologist Ralph Della Cava, of Queens College at City University of New York. He managed to get me a place on a course at the college. At that time, there was a group based in France, comprised of intellectuals and members of the Catholic Church, that was financially supporting people exiled in various parts of the world. This group was chaired by the pedagogue and educator Paulo Freire [1921–1997], who was exiled in Paris. My husband and I would periodically get US$500, which allowed us to stay in the US.
And when did you return to Brazil?
In 1979, when the Amnesty Law was passed. I was already pregnant with my second daughter. We were so scared that we were going to be arrested that Carlos spent the entire plane journey back tearing up documents, worried that the police might find something to incriminate him. But we passed through customs without any problems.
How did you reorganize your life after exile, with two young daughters and no job?
We were in the US for three years, during which time PUC-Rio canceled Carlos’s employment contract. When we came back, I spent 10 years working as a translator and doing some activities with the United Nations Children’s Fund [UNICEF], such as helping create a community center in Rocinha. I also started my academic career. Carlos was rehired by PUC-Rio two years after we got back. He also began teaching at Fundação Getulio Vargas [FGV] and later was invited to work at FIOCRUZ.
Administrations have modernized, but the police continue to follow the same rules of command and discipline
What was the topic of your master’s degree?
I did my dissertation in social anthropology at the National Museum, UFRJ, between 1981 and 1985. My advisor was Victor Vincent Valla [1937–2009], an educator with a PhD in history. I studied the living conditions of workers in the iron ore mining industry in Itabira. After defending my thesis, I started teaching at PUC-Rio and joined a research team that was investigating different situations of poverty that existed in Brazil. The project was funded by Brazil’s Ministry of Planning. For three years, we carried out fieldwork in five poor areas of Rio de Janeiro, including the Rocinha and Roquete Pinto favelas, the latter of which is built on stilts. I finished my master’s degree and started my PhD at FIOCRUZ the same year.
What was it like for a sociologist arriving at an institution that primarily focuses on research in medicine and public health?
When I joined FIOCRUZ, I felt like I had found my place — somewhere I could combine my concern for social issues with my academic ambitions. During my PhD, which I defended in 1989, I created a methodology for qualitative social research in health. The approach looks at subjective aspects of social phenomena and human behavior, through methods such as individual and group interviews, document analysis, and observation. I created it based on my theoretical knowledge of the topic, but also the different things I was working on at that time. At FIOCRUZ, for example, I was teaching sociological research classes to postgraduate doctors who were studying for a master’s or doctorate. They were used to studying epidemiological public health in large groups, but they did not know how to look at people from a more individual perspective. In class, I showed them the importance of more individual analyses and I was faced with questions that forced me to rethink how to explain the impact health problems can have on a person’s social life. Based on these experiences, my PhD thesis addressed theories, methodologies, strategies, techniques, and practical examples for carrying out social research in the field of medicine. It was published as a book, titled O desafio do conhecimento [The challenge of knowledge; Hucitec Editora, 1992], which is now in its 15th edition.
And how did violence come to be the topic of your research?
In the 1980s, renowned Colombian scientist Saul Franco took a position at FIOCRUZ, fleeing the dangers of drug trafficking. Sérgio Arouca [1941–2003] was president of the institution at the time. He and Saul believed that FIOCRUZ needed to establish lines of research investigating how violence affects health, something the Colombian researcher had been studying in his home country. Franco has spent over 40 years researching violence and armed conflict in Colombia and its impacts on people’s lives and health. Violence is a socio-historical phenomenon and is not, in and of itself, a public health issue or a medical problem. But it does impact health in various ways. It causes deaths, injuries, physical trauma, and mental and emotional problems. It reduces people’s quality of life and has consequences in healthcare systems, raising new problems for preventive and curative medical care. Arouca asked me to lead this line of studies at FIOCRUZ. I accepted the challenge, together with two colleagues who remain my research partners to this day: epidemiologist Simone Gonçalves de Assis and psychologist Ednilza Ramos de Souza. They are wonderful colleagues; we support each other in all that we do.
What did you do next?
We began investigating the situation in the municipality of Duque de Caxias, in Baixada Fluminense, which had the highest violent deaths rate in the state of Rio. Back then, very few people were studying violence and health in Brazil. Maria Helena Prado de Mello Jorge, a jurist from USP [University of São Paulo] who specialized in public health, was one of them. Our research in Caxias demonstrated that not only did violence impact people’s health, but the health system itself was often violent. The study served as the basis for the creation of ENSP’s Latin American Center for Violence and Health Studies [CLAVES] in the late 1980s.
Your research on violence and health played an important role in the formulation of several public policies. Can you tell us about any of them?
In 1998, the Brazilian Ministry of Health invited me to chair the committee formulating the National Policy for Reducing Morbidity and Mortality from Violence and Accidents. The policy establishes protocols for different types of violence that affect health services, but it is a difficult initiative to put into practice. Many professionals don’t believe it, don’t like it, or don’t want to know about it. For example, when an injured child arrives at a health center, or a woman with a broken arm, someone needs to identify whether the case is the result of domestic violence. Doctors treat broken arms and other injuries, but rarely do they ask what happened. They need to know when to refer someone to a psychologist, social services, or a police station.
Was this policy implemented in the 1990s?
No. It was only enacted in 2001, and it took a while for it to be formalized by the government, named the National Policy for Reducing Morbidity and Mortality from Violence. The measures related to accidents were adopted first. It was one of the elements that contributed to the creation of the Mobile Emergency Care Service [SAMU] in 2003. Between 2003 and 2016, the policy was established in greater depth. Training centers were set up in major cities to implement the protocols in every state. These training courses, aimed at health workers nominated by state and municipal health departments, are provided by CLAVES in partnership with the Ministry of Health. The objective is to train professionals to properly deal with the problem. However, since 2016, the process of instituting the policy has stagnated.
Violence against the elderly has historically been normalized. Old people have always been mistreated in our society
What is the status of the policy now?
We are seeing a recovery, but there is still a lot to do. At the Ministry of Health’s request, we are currently finalizing a review of the policy. We identified the area that best adopted the policy as primary health care, which is the main gateway to Brazil’s public health system [SUS]. According to the ministry’s definition, primary care encompasses a set of actions that aim to promote and protect health, prevent illness, and diagnose, treat, and rehabilitate patients. But there is still a long way to go before the policy is fully instituted.
Could you tell us about the research bias you have encountered, in terms of looking at violence beyond crime?
I always say that my research is not about public security. What I seek is to understand how violence and aggression impact the health of children, adolescents, women, the elderly, and workers. And this happens both at the individual level, in every person’s life, and in the system as a whole, to the extent that this violence ends up overflowing into health services.
Was it through this approach that you studied police organizations?
Yes. Together with my colleagues, I did two studies of police officers. The first was with civil police and the second with the military police. We showed how they suffer from the effects of the violence they experience on a daily basis. Many officers complained that society tends to generalize the police force, assuming that all of them behave badly. They bemoaned the lack of recognition they receive from society, and from within the institution itself.
What challenges do the police in Brazil face today?
It is a difficult profession all over the world, but the challenges here are even greater than in the USA or Europe. Police officers receive insignificant training on human rights and the salaries are very low. The world has modernized, administrations have modernized, but the police force has not. They continue to follow the same rules of command, discipline, and order as they always have done, especially in the military police, which is the largest branch. In São Paulo alone there are more than 90,000 military police officers. In Rio, there are more than 40,000.
How do these problems impact the mental health of these professionals?
Several commanders told me about how lonely they feel, because they have to give orders and bear the consequences alone, with no support from the institution. Those in higher positions generally have more mental health problems. This is because officers in lower ranks, despite earning less money, generally only follow orders, while higher positions carry the great weight of having to make decisions that can impact the lives of all police officers. They have to attend the funerals of their colleagues, which affects them greatly, often making them feel like they are confronting their own mortality. At the same time, many refuse to seek psychological care. During my research, several of them told me they were neither women nor crazy. Often, the only person they listen to is the chaplain. And if the only person they listen to is the chaplain, then the solution is for the chaplain to also be a psychologist. I follow this issue closely not only in academia, but also within my family. My son-in-law is a shooting instructor and kidnapping specialist with Rio de Janeiro’s civil police. The area of training that police trainees spend most hours on is shooting. He teaches both civil and military police officers, and often says that one of the most important things about being a police officer is learning not to shoot everything you see. But what about the human issues, including their own?
With so many topics of interest in your work, do you have any time for hobbies?
I exercise once a week and I really like reading. In the January holidays, for example, I read five works of literary fiction. I’m also very close to my daughters. I have one grandson, two granddaughters, and another granddaughter due to arrive any day now. They are the joy of my life and they are all so intelligent. One of my granddaughters, who is 9 years old, is writing a book for her little sister who is about to be born.
During the dictatorship, I asked a student’s father, who was a police officer, to help me find some friends who had been imprisoned. He told me I should go into hiding before they arrested me too
What are you researching at the moment?
Lately, I have been studying the issue of dependent elderly people, who are the ones that suffer most in this age group, regardless of social class. Because they don’t have the autonomy needed to lead their lives alone, they often become forgotten. I do empirical research, and I have already seen several cases of people going to work and leaving an elderly person alone, in bed, unclean, and with nothing to eat. I am committed to gathering the data needed for Brazil to create a specific policy for dependent elderly people. Canada, the US, and Europe all have policies of this type, implemented by central governments and coordinating participation by local governments, the private sector, and civil society. This way, the family is not abandoned and left to struggle alone. I am also finishing a study on elderly people in prisons in Rio de Janeiro. My research partner, FIOCRUZ psychologist Patrícia Constantino, collected statements from people in every prison in the state and carried out other fieldwork. Some of her reports and findings are very interesting. The majority of elderly people incarcerated in the state left school before the fifth grade and 15% do not know how to read or write, but 81% of them have positive expectations for their social life in the future. Despite being a very modern research topic, I have been investigating violence against the elderly since 1995. This violence has historically been normalized. Old people have always been mistreated in our society. Decades ago, they were brushed aside and left without food. The idea that they were treated better in the past is a myth. Now, Brazil has the Statute for the Elderly [2003], which was a very important milestone in protecting old people in the country.
And what are your plans for the future?
Because of my research into elderly prisoners in the state of Rio de Janeiro, the Ministry of Health invited me to lead a study on the health conditions of the prison population as a whole in Brazil. It’s a big challenge, but I accepted it. I’m getting older, but I continue to do research, teach classes, supervise students, and publish books. It’s great to have a sense of purpose and gives me hope for the future. I am grateful for the things I have in life and the generosity of those around me.
