[COVID-19 Pandemic: Worlds Stories from the Margins] Edges of the Pandemic – Survival Activism at the Peripheries in Brazil

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by Su-ming Khoo and Mayara Floss

At the edges of necropolitics

If the current COVID-19 pandemic has taught us one thing it is that the elephant of widening inequality and basic deprivation is still in the room. A shadow hangs over the struggle to understand the different problems of the COVID-19 pandemic – a shadow of necropolitics that puts some people and risks in the obscure background in the current emergency, while others are in the foreground and the light. On the ground, social activists are working with primary care professionals in everyday struggles to help people stay safe and provide basic necessities like food, water or soap. Meanwhile, far-right protesters, some from the better-off classes who protest from the safety of their cars, but also some daily workers, Uber drivers and street traders are demonstrating against the lockdown, in protests that are reported to be approximating a military coup.  Their objective is getting workers back to work, contrary to public health recommendations. The elites want the economy to be re-opened, so they can get back to making profits and their convenient market freedoms, while the precariously-employed are torn between the need to stay safe at home, and the need to return to work in the absence of alternative means of survival.

The philosopher Achille Mbembe coined the term  ‘necropolitics’ to describe the power of death as the correlate to the power of life in politics and the long shadow cast over the world by the legacies of slavery, apartheid and occupation, shaping how we are to think about terror, sacrifice and the possibilities of resistance. The words ‘necropolitics’ and ‘necropower’ speak of the conditions of life experienced by vast populations that are so cruel as to make it possible to call them the ‘living dead’.

The question of survival marks the ‘edges’ of the pandemic. ‘Edges’ or borders (Bhattarcharya 2018) are where rights and freedoms are differentiated for different groups of people. Bordering is not only about the control of migration, or about the differences between the ‘global north’ and  the ‘global south’. Bordering takes place within states, within public institutions and even within the public sphere.

Brazil is rapidly becoming a front-runner in the horrible reversal of the ideal of justice playing out across the world – the last are coming first in experiencing the brunt of mass ill-being, fear and insecurity, and death. Necropolitical assumptions run through current ‘scientific’ models and conceptions of society, especially the conception of society that is synonymous with ‘economy’. The aggregated statistics of pandemic monitoring offer an impersonal, objective, universal language of a single ‘population’ or ‘economy’. Science, law and ethics are complicit when they universalize in ways that disguise questions about who or what is being kept alive, while others are being let to die.

Some argue the coronavirus puts all of humanity on the same cliff edge, since after all, everyone must die, yet they must also admit in the next breath that the stigmatized and disadvantaged (who are not ‘minorities’, but the numerical majority) will predictably suffer more. The first thought recognises universal vulnerability, while the second understands that this universality has pretty sharp edges as the virus will get to some people at these edges first. Despite quarantine, the poor need to leave their homes to keep working, including the many who improvise their survival daily by the means of informal work. Many people who have been instructed to quarantine live in favelas, sharing cramped housing in densely populated zones. Much of that work is cleaning – cleaning of public and essential facilities, but also rich people’s homes. The same cleaners return to homes that may be a single cramped room, maybe shared with others, or no room at all – just the street. Still, they may count themselves fortunate to be working at all, since unemployment is rising sharply.

Quarantine and ‘lockdown’ measures are especially contradictory for the many people who live on the edge of rural areas and beyond those edges in remote areas. These people depend on precarious and arduous transport routes to get in supplies and medication, and sell the products of their labour. Bolsonaro’s necropolitics refuses to see any of these realities, having long ago rejected evidence-based policies for policy-based evidence. Denialism has been his government’s modus operandi, as it pushes for ‘re-opening’ the economy. A sense of uncertainty, even chaos has pervaded the country as two Health Ministers have come and gone in the space of less than a month.

The edges are not a metaphor  –  care and geographical gradients

On the frontline, the ‘edges’ are not a metaphor, but the real places where workers have to deal with the realities of exposure, illness and survival. On the health services frontline, whether in the urban hospitals or at the remotest rural clinics, we can only describe what workers are doing as survival activism. Society’s survival cannot happen without services. Activism has been required to maintain the health services that exist, but health personnel cannot engage in activism to preserve the health system which was already under huge strain before the pandemic without the survival of their own selves and communities. Survival requires the health systems personnel to keep challenging the government’s science denial and its policies, (which veer confusingly between quarantine and the selective relaxation of restrictions), while working hard on the frontline. Survival requires individual and collective work against the government’s instrumental mode of governing, a mode that Moten and Harney call ‘Policy’. Survival activism requires daily work to construct a micropolitics that resists and counters federal narratives and policies. Survival, by definition, is the act and fact of surviving under these adverse and terrifying circumstances.

Brazil’s first documented coronavirus victim was a cleaner, who lived in a favela. Her employer returned from a trip to Europe, having been quarantined for suspected infection. She neglected to  inform or protect the cleaner who worked for her, a 63-year-old woman who subsequently contracted COVID-19 and died. The mayor of Pará, in the Brazilian North has declared that domestic cleaners are not subject to movement restrictions because they are ‘essential workers’. These workers face a contradiction. Their richer employers feel that it is essential to have cleaners (usually black women), come to clean their houses. But to travel to an employer’s house exposes the cleaner to risks that she could bring home to her own family, and having children in quarantine at home requires someone to be at home to care for them. The pandemic has brought to the fore multifaceted strains of cleaning and care.

The ‘edge’ that marks carelessness from care is notable in the care sector, where many COVID-19 deaths have remained uncounted because of lack of testing. It is not only the patients in the care sector who are at the edge of survival, but the workers who clean places and people. The lack of PPE for health professionals has been denounced throughout the world, but less has been said about the protection of receptionists, cleaners, security guards and others, who are in no less need of protective equipment. Care work tends to be badly paid, precarious, and done by people who have to travel distances to reach their work. Patients are salient in everyone’s consciousness as ‘precious’, vulnerable and needing protection, but many workers caring for them are somehow at the edge, in the peripheral vision of the debates about safety. Many people involved in caring work lack the protection that comes with being noticed, being respected and not-poor. It is not just personal protective equipment that is in short supply. It has been widely known since early on that care settings have a huge risk of becoming a potential source of uncounted fatalities. Too many workers are at the edges of the health system, being barely noticed, even when they are right there. Last week, Mayara saw a patient with flu-like symptoms, whose job is to deliver food to patients in a hospital. The employer had only provided PPE at the beginning of May, when the pandemic was already nearing a peak in Brazil. The patient was afraid, not knowing whether the patients she had delivered food to while unprotected had the coronavirus.

What is clear is all those who do the jobs of feeding, touching and cleaning are very much at risk because work associated with these tasks is both necessary for survival and low-status, thus poorly paid and stigmatized. Such work is usually done by women, especially black women. Early on, epidemiologists stated that food is not a vector of the virus, but hands are and many hands were neglected in that analysis, especially the hands of people performing less visible and low status work. Of course work associated with food is a major vector. Making and delivering food and cleaning up before and after people eat food and cleaning people after food has been digested – all that is someone’s work, and it is work that is essential for survival. The virus reminds us that humans cannot survive alone, and cleaning matters far more than many would like to admit, from the domestic cleaners  who clean the houses of the rich to the cleaners who remain invisible in the discourses of medical and nursing heroism, but are just as essential for battling COVID-19.

Better-off metropolitan Brazilians are, to some extent, observing and benefiting from effective social distancing regardless of government measures and advice. Privilege itself offers the benefits of effective physical distancing, which are not available to people living in favelas and the rural and remote parts of the country. It seems absurd to have to point out that Brazil is a very large country, but in the Northern Amazonas region, the distance between the state capital Manaus and its farthest city, São Gabriel da Cachoeira is 853km. 90% of São Gabriel da Cachoeira’s inhabitants are indigenous, representing 23 different ethnic groups and the area is the gateway to the Yanomami Indigenous Territory, an area of about 10 million hectares that shares  borders with Venezuela and Colombia. This means that the region had been receiving many immigrants before the border was closed due to COVID-19. São Gabriel da Cachoeira’s 45,000 inhabitants’ nearest ICU bed is in Manaus. Air and river passenger transport has been suspended, but this lockdown measure is pushing already remote populations deeper into a very unsafe form of isolation. The closure of riverine and air transport is also preventing the movement of health staff, medicines and PPE. There is very little information getting out regarding  how people are being affected and who can reach the ICU beds in Manaus. The state capital, São Gabriel da Cachoeira is hardly better off as it is also reported to be in a state of systemic health collapse. The oxygen stock is running low for the seven ventilators available in the hospital and no field hospital has been built. The situation in Manaus is no better – the ICU has been reported to have collapsed. The entire region has already been suffering from longer-term environmental health impacts. The biomass and forest burning of the Amazon that was going on long before the pandemic started has already worsened the environmental determinants of respiratory health, making people more susceptible to contracting respiratory illness. The deforestation and burning have not lessened just because the COVID-19 pandemic started. Deforestation is peaking as the Environment Minister, Ricardo Salles announced that that COVID-19 pandemic offers the ideal time to reduce legal protection of the rainforest and  promote cattle ranching. The violently misogynistic language that Bolsonaro uses to describe the Amazon is truly appalling, saying that: ‘Brazil is ‘…a virgin that every pervert wants’’.

Meanwhile, reporters in Manaus have not been permitted to film public burials, but reports have been circulating that gravediggers were working without PPE while drenched by heavy rain. In nearby Tabatinga, Milena Kokama, Director of the Kokama People’s Federation explains that they have been trying to get a patient transferred for three days, but are unable to do anything because there is no aerial ICU in the municipality. By May 12th there were 77 registered deaths and people from 34 indigenous ethnic groups have been exposed to the coronavirus in Brazil.

The shortage of aerial health support units brings up the difficult and sensitive question of what to do about the ‘uncontacted’ peoples beyond the edges of the health system. For the uncontacted living beyond the edges, it is their ‘emergence’ from uncontactedness that could be the real emergency, making the present emergency one that they are unlikely to survive. FUNAI, Brazil’s indigenous affairs agency, has a longstanding policy against contact with isolated groups as a basic measure to ensure their survival. The pandemic may be opening the way for a ‘missionary aviation’ contact plan by evangelical Christian agencies that contravenes the ‘no contact’ policy. Transmission of new diseases to isolated peoples in the remote Western Amazon risks entirely wiping them out under the guise of ‘helping’ them. Under the cover of COVID-19, the government is relaxing the no-contact restrictions while clearly having no consideration for the consequences.

Survival beyond the edges

The edges of the pandemic are a complicated place where healthcare professionals, care workers, local government and communities are trying to pursue various forms of survival activism. The spaces for choices and action are limited, and the immediate aim is just to keep going, as a matter of survival for individual persons and whole communities. People are faced with their own bodily limits – of getting sick, being hungry, experiencing terror and burnout. At the edges of the pandemic, in the shaded lower reaches of the care and geographical gradient, where incomes are low and vulnerability is salient, nobody is safe and there is somehow the feeling that love, important though it is, cannot save you.

A shorter version of this story first appeared in Discover Society.

Mayara Floss is a Family Medicine Resident in a Primary Health Care Unit of SUS in Brazil, she is also involved in the access and care of rural people and Planetary Health. Su-ming Khoo is a lecturer in the School of Political Science and Sociology at the National University of Ireland, Galway. Mayara and Su-ming are working together on a project on ‘survival activism’.

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