Perfect pitch: Rio de Janeiro, 2011. Photograph: David Alan Harvey/Magnum
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Golazo! by Andreas Campomar and Futebol Nation by David Goldblatt: the football myth behind Brazil's World Cup

The Brazilians have won five World Cups, more than anybody else. So why was there rioting last summer when teams arrived for a warm-up? Brazil's relationship with football has never been an easy romance.

On 12 June, the World Cup will kick off in São Paulo. Until recently, there’s been an assumption that, certainly by comparison with the two World Cups to follow, in Russia and Qatar, this would be a fun tournament, a month-long carnival in the home of Pelé and “the beautiful game”. What, after all, is Brazil other than football, and who has ever played the game better? Then came the Confederations Cup, the eight-team warm-up event for the tournament, last summer. Matches came to be preceded by a familiar ritual of street protest – sparked by a proposed increase in bus fares in São Paulo, but soon encompassing a range of issues, from corruption to fury that so much has been spent on the World Cup when so many public services are in disrepair. With a sense of shock, the world realised that Brazil is not universally supportive of the tournament and there is a very real prospect of chaos. As these two books demonstrate, though, Brazil’s relationship with football has never been the easy romance of stereotype.

That is not to deny the importance of football to Brazil, especially in terms of generating the nation’s self-image and self-esteem. Brazil is the fifth-largest nation on earth, both by land area and population, statistics which signal, as David Goldblatt points out, that, in terms of an influence on the global culture, it punches significantly below its weight. Its cuisine has raised barely a ripple alongside Indian, Chinese or Thai and, for all the coffee Brazil produces, we drink cappuccino rather than cafezinho. Samba has some global reach, but nothing compared to its Caribbean or African equivalents. In cinema, literature, architecture and visual arts, Brazil’s impact bears no relation to its size. No Brazilian has ever won a Nobel prize. Only in football has it really excelled.

The Brazilians have won five World Cups, more than anybody else, while the country is by some margin the world’s greatest exporter of players – a snapshot of which is given by a glance at the quarter-finals of the Champions League. Of the eight sides involved, only Borussia Dortmund do not have a Brazilian player in their squad, while the others total 19 between them (or 20, if you count Atlético Madrid’s Diego Costa, who was born in Brazil and played for Brazil before becoming a naturalised Spaniard this year). The sums that Nike pays to produce and market the yellow national shirt show what a powerful global brand Brazilian football has become.

The very existence of these two books says much for the increasing recognition of football’s significance. It’s remarkable how little attention was once paid to what is, in terms of participation, attendance at events and general discussion, the world’s pre-eminent cultural activity. For years, most of those academics who considered the sport were sociologists researching fan behaviour, while the few football books that were published were overwhelmingly stultifying player autobiographies.

That began to change between 1990 and 1994 as Pete Davies’s All Played Out, Nick Hornby’s Fever Pitch and Simon Kuper’s Football Against the Enemy proved that the sport was a rich subject for literature, and that the examination of a nation’s football culture said much about its culture as a whole. Since then, the Uruguayan journalist Eduardo Galeano’s line “Tell me how you play and I’ll tell you who you are” has become a mantra for a host of football writers – so much so that Goldblatt took it as one of the epigraphs for his 2006 global history of football, The Ball Is Round, while Andreas Campomar uses it as an epigraph for Golazo!.

In the case of many South American nations, Brazil included, the idea that footballing style is representative of national character has a direct significance because of the part football played in nation-building. That’s why the playwright Nelson Rodriguez described Brazil’s defeat to Uruguay in the final game of the 1950 World Cup as “our Hiroshima”. The comparison is tasteless, but his point was that this weighed on the Brazilian psyche like a national tragedy. The World Cup was supposed to be the consecration of Getúlio Vargas’s Estado Novo (the “new state”), the victory achieved in the Maracanã, the biggest stadium in the world and a modernist monument echoing the work of Oscar Niemeyer in Brasília – Goldblatt is particularly good on the symbolic properties of stadiums.

Brazil only needed to draw against Uruguay and such was the assumption of victory that newspapers on the morning of the game hailed them as world champions. They even took the lead, but lost 2-1. Scapegoats needed to be found, and they were, in the three black players on the team: after Moacyr Barbosa, blamed for letting in the winner at his near post, it would be almost half a century before Brazil selected another black goalkeeper in Dida.

As Campomar points out, given that Uruguay’s captain and inspiration, Obdu­lio Varela, was himself of mixed race, the illo­gical nature of the racism was obvious: “in the moment of truth, a racist stain, a baleful legacy of slavery had revealed itself.”

Football had always reflected the changing social and political environment. In the early years of the 20th century, clubs were often organised on ethnic grounds – Grêmio of Porto Alegre, for instance, were proudly German, while the São Paulo club Palmeiras was founded by Italians and, until 1942, was known as Palestra Italia. Much of the appreciation of the sport had an uncomfortably racist tone, inspired by the eugenic strand of Comtean positivism that underlay the old republic: poets, as Goldblatt put it, were intent on “casting players as the new Hellenic gods of the south”. By the 1920s, though, the poet Antonio Machado was describing incidents in games in terms of an “engine” or “a water tank”: metaphors of the industrial city. Modernisation undermined the amateur ideals – playing not just to win, but to represent your community – of Brazilian football just as surely as it undermined the patrician orthodoxy of the old state.

After Vargas, who had seized power in a coup in 1930, retained it with a pre-emptive coup in 1937, he needed to legitimise his power. A skilled negotiator rather than a demagogue, he lacked the charisma needed to establish a cult of personality, and so sought expressions of Brasilidade, looking, Goldblatt said, “to mobilise and shape the nation’s popular cultures for nationalistic ends”. Football played a key part in that: pretty much the only thing Brazil’s extra­ordinary mix of people had in common was that they all supported the national football team. Portuguese was imposed as the national language which, together with a general antipathy towards Germans and Italians after the war, eroded the ethnic identities of many clubs. The 1950 World Cup was the centrepiece of Vargas’s policy of national unification and of projecting an image of modernity.

By 1958, Vargas was gone, having committed suicide, and Juscelino Kubitschek had been elected to replaced him. He was just as aware of the propaganda potential of football, though, and the state invested heavily in the 1958 World Cup campaign, doing everything it could to give Brazil a chance of winning: the squad underwent extensive medicals, for instance, while 25 venues were scouted as potential training bases in Sweden before one was chosen – and even then all female staff were replaced for the duration of the tournament. With the emergence of Pelé came the birth of the popular conception of the Brazilian game, all fluid passing and individual flair. They won that World Cup, and the next one and, after being physically bullied in 1966, returned to win again in Mexico in 1970, producing three weeks of football that enraptured the world. The Jornal do Brasil compared Brazil’s 4-1 victory over Italy in the final to the moon landing the previous year and, as Goldblatt points out, in the sense that this was a triumph for all humanity, a glorious fusion of art and science, watched – thanks to satellite television – all around the world, the comparison wasn’t entirely fanciful.

For the military government that had taken over following a coup in 1964, the victory was an enormous stroke of luck and one that the junta was quick to seize on. Campomar cites various slogans that sought to link footballing success with economic prosperity, and quotes the efforts of the president, General Médici, to make the victory his own: “I identify the success . . . with intelligence and bravery, perseverance and serenity in our technical ability, in physical preparation and moral being. Above all our players won because they knew how to . . . play for the common good.”

Once football had fallen into the hands of the generals, it would never fully escape. The military appointed technocrats to oversee the economy and to run sport. Although the world continued to imagine that Brazilian football represented the same values as it had in 1970, from the 1970s onwards it became far more pragmatic, concerned more with physicality and the elements that can be measured – pass completion rates, tackles made, kilometres run – than with the artistry of Tostão, Rivellino and Jairzinho. There was a brief return of the old style in 1982 and 1986, when Sócrates, who insisted his club, Corinthians, be run on democratic lines, was captain, but o jogo bonito, the beautiful game, has essentially been a marketing myth for 40 years.

Goldblatt makes clear that the idea of Brazil as a nation wholly in love with football is also a myth, something not helped by often dire organisation. The government introduced a national championship in 1971 to promote a sense of unity, but for years it was a bloated farce, beset by mystifying regulations and a habit of fiddling promotion and relegation for political ends. By the 1990s, hooliganism was rife and attendances had dropped to shocking levels. Even now, the average attendance for a top-flight game is under 15,000: around 50 per cent lower than in Argentina, lower even than the English second flight.

Brazil’s relationship with football has always been more complicated than outsiders have perhaps realised. What’s striking about Golazo!, which attempts the extra­ordinarily ambitious task of summarising the whole of Latin American football history, is the sense that Brazil is far from unique: that across South America, new nations without common bonds of ancestry ended up defining themselves by football, and that successive governments, recognising this fact, sought legitimacy through the sport.

Futebol Nation is focused purely on Brazil and specifically on the socio-economic history. There’s little dwelling on games or personalities. Heleno de Freitas, for instance, the brilliant but tragic striker of the late 1930s and 1940s who died aged 39 in an asylum – a player who with his womanising, his drinking and his addiction to ether seemed to symbolise the excesses of Rio – doesn’t get a mention in Goldblatt’s book, while Campomar gives him a page. But that in a sense is the strength of Futebol Nation. Goldblatt acknowledges that his book is “an introductory essay” but that seems to downplay the immense discipline he must have exercised not to be sidetracked from the central thrust. The result is a breezy, readable and nuanced primer to the centrality of football to Brazilian life.

It ends with the protests and riots that surrounded the Confederations Cup last summer, which Goldblatt witnessed first-hand. The government’s response was to announce a security budget for the World Cup of more than $1bn. “There might still be victories to be won on the field,” Goldblatt writes, “but it is hard to imagine they could unite the futebol nation the way they have done in the past, for they have been bought at the cost of making Brazil’s divisions and its injustices starker than ever.”

Jonathan Wilson edits the football magazine The Blizzard. His most recent book is “The Outsider: a History of the Goalkeeper” (Orion, £8.99)

This article first appeared in the 14 May 2014 issue of the New Statesman, Why empires fall

Flickr/Michael Coghlan
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Why does the medical establishment fail to take women in pain seriously?

Women with mesh implants have been suffering for years. And it's not the only time they have been ignored. 

Claire Cooper’s voice wavered as she told the BBC interviewer that she had thought of suicide, after her mesh implant left her in life-long debilitating pain. “I lost my womb for no reason”, she said, describing the hysterectomy to which she resorted in a desperate attempt to end her pain. She is not alone, but for years she was denied the knowledge that she was just one in a large group of patients whose mesh implants had terribly malfunctioned.

Trans-vaginal mesh is a kind of permanent “tape” inserted into the body to treat stress urinary incontinence and to prevent pelvic organ prolapse, both of which can occur following childbirth. But for some patients, this is a solution in name only. For years now, these patients – predominantly women – have been experiencing intense pain due to the implant shifting, and scraping their insides. But they struggled to be taken seriously.

The mesh implants has become this month's surgical scandal, after affected women decided to sue. But it should really have been the focus of so much attention three years ago, when former Scottish Health Secretary Alex Neil called for a suspension of mesh procedures by NHS Scotland and an inquiry into their risks and benefits. Or six years ago, in 2011, when the US Food and Drug Administration revealed that the mesh was unsafe. Or at any point when it became public knowledge that people were becoming disabled and dying as a result of their surgery.

When Cooper complained about the pain, a GP told her she was imagining it. Likewise, the interim report requested by the Scottish government found the medical establishment had not believed some of the recipients who experienced adverse effects. 

This is not a rare phenomenon when it comes to women's health. Their health problems are repeatedly deprioritised, until they are labelled “hysterical” for calling for them to be addressed. As Joe Fassler documented for The Atlantic, when his wife's medical problem was undiagnosed for hours, he began to detect a certain sexism in the way she was treated:

“Why”, I kept asking myself, when reading his piece, “are they assuming that she doesn’t know how much pain she’s feeling? Why is the expectation that she’s frenzied for no real reason? Does this happen to a lot of women?”

This is not just a journalist's account. The legal study The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain found that women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. 

An extreme example is “Yentl Syndrome”. This is the fact that half of US women are likely to experience cardiovascular disease and exhibit different symptoms to men, because male symptoms are taught as ungendered, many women die following misdiagnosis. More often than should be acceptable, female pain is treated as irrelevant or counterfeit.

In another significant case, when the news broke that the most common hormonal birth control pill is heavily linked to a lower quality of life, many uterus-owning users were unsurprised. After all, they had been observing these symptoms for years. Social media movements, such as #MyPillStory, had long been born of the frustration that medical experts weren’t doing enough to examine or counter the negative side effects. Even after randomised trials were conducted and statements were released, nothing was officially changed.

Men could of course shoulder the burden of birth control pills - there has been research over the years into one. But too many men are unwilling to swallow the side effects. A Cosmopolitan survey found that 63 per cent of men would not consider using a form of birth control that could result in acne or weight gain. That’s 2 per cent more than the number who said that they would reject the option of having an annual testicular injection. So if we’re taking men who are afraid of much lesser symptoms than those experienced by women seriously, why is it that women are continually overlooked by health professionals? 

These double standards mean that while men are treated with kid gloves, women’s reactions to drugs are used to alter recommended dosages post-hoc. Medical trials are intended to unearth any potential issues prior to prescription, before the dangers arise. But the disproportionate lack of focus on women’s health issues has historically extended to medical testing.

In the US, from 1977 to 1993, there was a ban on “premenopausal female[s] capable of becoming pregnant” participating in medical trials. This was only overturned when Congress passed the National Institutes of Health (NIH) Revitalisation Act, which required all government funded gender-neutral clinical trials to feature female test subjects. However, it was not until 2014 that the National Institutes of Health decreed that both male and female animals must be used in preclinical studies.

Women’s exclusion from clinical studies has traditionally occurred for a number of reasons. A major problem has been the wrongful assumption that biologically women aren’t all that different from men, except for menstruation. Yet this does not take into account different hormone cycles, and recent studies have revealed that this is demonstrably untrue. In reality, sex is a factor in one’s biological response to both illness and treatment, but this is not as dependent on the menstrual cycle as previously imagined.

Even with evidence of their suffering, women are often ignored. The UK Medicines and Healthcare Regulatory Agency (MHRA) released data for 2012-2017 that shows that 1,049 incidents had occurred as a result of mesh surgery, but said that this did not necessarily provide evidence that any device should be discontinued.

Yes, this may be true. Utilitarian thinking dictates that we look at the overall picture to decide whether the implants do more harm than good. However, when so many people are negatively impacted by the mesh, it prompts the question: Why are alternatives not being looked into more urgently?

The inquiry into the mesh scandal is two years past its deadline, and its chairperson recently stepped down. If this isn’t evidence that the massive medical negligence case is being neglected then what is?

Once again, the biggest maker of the problematic implants is Johnson&Johnson, who have previously been in trouble for their faulty artificial hips and – along with the NHS – are currently being sued by over 800 mesh implant recipients. A leaked email from the company suggested that the company was already aware of the damage that the implants were causing (Johnson&Johnson said the email was taken out of context).

In the case of the mesh implants slicing through vaginas “like a cheese-wire”, whether or not the manufacturers were aware of the dangers posed by their product seems almost irrelevant. Individual doctors have been dealing with complaints of chronic or debilitating pain following mesh insertions for some time. Many of them just have not reported the issues that they have seen to the MHRA’s Yellow Card scheme for identifying flawed medical devices.

Shona Robison, the Scottish Cabinet Secretary for Health and Sport, asked why the mesh recipients had been forced to campaign for their distress to be acknowledged and investigated. I would like to second her question. The mesh problem seems to be symptomatic of a larger issue in medical care – the assumption that women should be able to handle unnecessary amounts of pain without kicking up a fuss. It's time that the medical establishment started listening instead. 

 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman

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