The Introduction begins with an account from 1965, in which Scheper-Hughes frantically helps to deliver a newborn child in the town of Alto do Cruzeiro. The mother is a 16-year old girl named Lordes who works in a tomato field; the delivery is brief, yet the attitude for everyone present seems to accept that the newborn will die. This is common, and even normal. The author describes the staggering deprivation of these communities she witnessed as an aid worker from 1964 to 1966.

In recounting her work as an aid worker in these communities, she describes some of their political and economic history. While in her role as an aid worker, the author is involved in the creation of a community center, and efforts to support "local action."Life in Alto, as the town is called, is dominated by sugarcane production. Most of the men of Alto primarily work in the sugarcane fields and factories, while women supplement this income with paid and unpaid domestic labor. Child-rearing adds to the precarious balance of life in Alto; infant and early childhood mortality is especially high in these regions. Understanding how this high infant mortality affects society, with respect to notions of womanhood and motherhood, is the author's primary task.