Brazil's northeast remains a poor backwater while the rest of the country has steamed forward to become South America's industrial titan.
Nearly half the drought-stricken region's people cannot read or write and industry has never taken hold on a large scale, local officials say.Small farmers till the land as they have for centuries with oxen and plow, while those in the rest of Brazil use some of the most modern equipment in the world.
Officials say they fear the gap between Brazil's poor northeast and rich south is growing wider every day and that the country's current economic crisis is hitting hardest in the nine-state region because of its weak economy.
Poverty is a cradle-to-grave reality in the northeast. The infant mortality rate is 121 deaths per 1,000 births, compared to 87 in Brazil overall, the latest official statistics show.
Forty-six percent of the region's 40 million people are illiterate, compared to 25 percent in Brazil as a whole.
Illiteracy rates have fallen steadily in the northeast over the past few decades, as in the rest of Brazil. But it is still common to find waiters in the northeast who can't read menus and street vendors who can't read the newspapers they are selling.
This town in Piaui, said to be Brazil's poorest state, is typical of hundreds of communities across the northeast's arid, scrubby hinterland known as the sertao.
Many of its 80,000 residents live in shantytowns of dried mud shacks, where children show the bony limbs and bloated, hollow-looking stomachs that spell malnutrition.
Farmers never know when they can count on enough rain to work the land, and few have the money for irrigation systems to counter the fierce sun and dry winds that blow incessantly across the plains.
The land is so unyielding that basic foodstuffs have to be trucked in from afar, keeping food prices high. Industry is close to non-existent.
"In Piaui our biggest disease is hunger. It is the root of all other diseases here," said Jose Soares, a pediatrician at the local hospital which, with only 120 beds, serves a vast area covering parts of three states.
"Nutrition is so poor for most people that they cannot resist illnesses that would otherwise by easily cured, and so mortality rates are very high," he said.
The average lifespan in the northeast is 52 years, compared to 63 in Brazil as a whole.
With the local economy offering so few opportunities, northeasterners have for generations been a people constantly on the move. Searching for jobs, millions spend their lives moving from state to state within the region or migrate to cities in the country's industrial heartland in the south.
In a shantytown on the edge of Picos, no one could be found who had lived in the town for more than 10 years. All of them had migrated from nearby states or elsewhere in Piaui in search of work.
But the most common destination is the south.
In Rio de Janeiro the term paraibano, meaning someone from the northeastern state of Paraiba, has become synonymous with low-salaried construction workers because so many migrants from that state have taken up work laying bricks.
Sao Paulo, Brazil's largest and wealthiest city, is home to about two million northeastern migrants, including Luiza Erundina, the city's leftist mayor-elect, who left her family in the impoverished interior of Paraiba in 1971.
The exodus southward, apart from providing Sao Paulo and Rio with abundant cheap labor, has underscored Brazil's division into two separate and very unequal economic nations.