Even before the pandemic hit Brazil’s favelas, residents began organizing to protect themselves — against both the novel coronavirus and the government’s active suppression of effective public health action (Ortega and Orsini, 2020). Seasoned activists began fund-raising, mobilizations donations, distributing food, masks, and hygiene kits, and writing policies and manifestos; volunteers signed up to learn basic first aid and walk door-to-door checking on neighbours and identifying needs, while others drove the streets using megaphones to educate residents about mask-use, social distancing, and handwashing (Fleury and Menezes, 2020). Local journalists have intensified their use of social media to counter fake news and support their activist colleagues in demanding access to hospital care. Residents have converted closed schools into isolation wards and fought for the accurate documentation of Covid-19 deaths. In a feat of highly skilled social mobilization, one favela in Sao Paulo has managed to keep transmission and mortality rates lower than average for the city. 

International media outlets reporting on these actions have noted the resilience, altruism, and ethic of unity, linking these qualities to the pressures of living in conditions of scarcity. While important, the partiality of this narrative needs to be confronted head-on. There is far more to this picture than well-organized collective care — a “more” that is vital to broader discussions on civic engagement, public policy, and democratization in global health. We interviewed several activists involved in grassroots organizing in Rio de Janeiro to learn more about the multifaceted ways they do their work. 

A key overarching concern touched on by all those we spoke to relates the opportunities and pitfalls of social media. Gizele Martins is a journalist with master’s degree in Education, Culture and Communications, who lives in the Favela da Maré, a group of 16 favelas with 140,000 inhabitants, one of the largest conjuntos in Rio de Janeiro. “People believe the fake news,” she told us, “in part because we lack not just information but [real] public debate, political debate. How are we supposed to continue doing our mobilization work when governors relax, do not guarantee health care or the right to testing, or devalue and weaken hospitals, and when the president tells big lies. This shows the limits of elections, and of the state…”

Attempts to counter misinformation, particularly when endorsed by government officials, and the algorithms and political polarization that feed it, have only grown more complex with the state’s neglect and the social isolation created by pandemic lockdowns. Like all activists, favela residents and local journalists have been highly effective in their use of social media, reporting to YouTube channels, building websites, and running Facebook live streams, to mobilize residents and counter misinformation (Leal and de França Filho, 2020). But the social and political implications of internet-based activism are by no means straight-forward. Sociologist Zeynep Tufekci makes the important point that, although today’s grass-roots movements are able to quickly mobilize large numbers of people thanks to viral hashtags, this very capacity is undermining the mobilization of labor and the complex organizational and logistical capacity needed for movements to make tactical decisions and sustain action (Tufekci, 2017).

The solidarity work that favela residents are engaging seems to be avoiding this dilemma.Boosting activists’ media work — and reinforcing the public legitimacy of their media outputs — are old-style communications and interpersonal organizing. Local journalists, street ambassadors, and activists are moving through their streets, engaging in door to door conversations, making new relationships and multiplying volunteer networks. They are collecting data, assessing needs, managing and adding daily to excel sheets, building fact-checking systems and collaborating with local primary care doctors (Fernandes et al., 2020). As conversations unfold around these practical activities, so too do debates about misinformation, politics, gaps in management, social justice, and how best to distribute funds and paid and unpaid labor (de Oliveira Andrade, 2020). 

One of the ripple effects of this door-to-door work, by no means unintentional, is precisely the kind of public debate and democratizing grass-roots mobilization Martins calls for (Gonçalves and Maciel, 2020). Detailed on-the-ground practices taking place in the favelas recall what Paulo Freire, renown Brazilian educator and philosopher, termed critical consciousness (Freire, 2005 [1970]). Freire was an ardent critic of how education had been used by state authorities during Brazil’s 20 year-long dictatorship to socialize students, young and old, to acquiesce to authority. For Freire, critical pedagogy and emancipatory learning required not just the possibility of critique, but also dialogic praxis, or practice-based learning fostered through multidirectional forms of communication that challenge “expert” versus “lay-person” hierarchies (Silva et al., 2020, Béhague, 2020). In the context of grass-roots mobilization, Freire’s work typically conjures a view of disenfranchised people as the prime targets of awareness campaigns. But critical consciousness is taking shape in the favelas in ways that unsettle core assumptions about power and paternalism in humanitarian aid, global health,and development (Huesca, 2008). 

Thainã Medeiros, a reporter with the media group Papo Reto, and resident of the favela Complexo do Alemao, told us that the multiple social and political crises created by the pandemic generate opportunities for people to be forced out of their own social and political bubbles. “We think everyone thinks like us, but this is not at all true,” he told us, “And during these crises we manage to connect with people outside our bubble. You bring volunteers together, people who are not necessarily political, people who normally would not talk to one another, and they start to come out of their bubbles. Some people are critical of the food distribution work we do. They say it’s paternalistic. But you ask people outside the favela to recognize that people are hungry. This is a communications job.” 

For Medeiros, wealthy donors, representatives of the church, and other elite they work with, are much the subjects of consciousness raising as favela residents. “It’s particularly tricky because these people are being asked to donate time too, not just goods or funds. This becomes an opportunity for their own education. Because sometimes they arrive here with a very conservative discourse. We have to education them. ‘No, you can’t just donate anything, rotten food or ripped clothing; or no, you cannot get a photo of you donating in the favela.’ But then, by the night, they are hugging the crack addict and questioning their own values. This is very potent.” Scholars have noted that solidarity groups risk reproducing pre-existing societal divisions by becoming mere proxies for pre-existing political or civil society organizations. This may be more the case in the current rise of solidarity networks among the middle class. For the activists and journalists we interviewed, working across economic, racial, gendered, and political divides sat at the center of their practices.

What sustains favela journalists, volunteers, and managers is not merely resilience, altruism, or survival needs. Of course, they show remarkable grit and compassion. But what is noteworthy here is the creation of a highly responsive and pliable network, data system, and intricate systems of redistribution, coupled with meaningful relations built over time, as well as a healthy dose of informed critique about the political and economic structures that cause harm. The relationships and infrastructures being mobilized to respond to the pandemic have been long in the making, both during previous crisis moments, such as in the aftermath of major floods, during peaks of police brutality, or with the organizational work sex workers mobilized during the HIV/AIDS epidemic. Between each crisis one finds the steady building of systems needed to counter what the reporting organization RioOnWatch has called, “necropolitics,” drawing from Cameroonian philosopher Achille Mbembe’s work which underscores the State’s power to selectively remove the right to life. Despite high levels of precarity, the commitment to local expertise and redistribution means that surplus is shared. In Rocinha,for example, local activitists and journalists recently helped doctors at the local clinic demand and create a system to ensure that COVID-19 deaths be accurately registered. When doctors in the Maréran out of masks, they received donations from favela organizers. 

To state that favela residents are creating infrastructures rather than systems, institutions, or networks is to draw explicitly from social scientists’ recent interest in studying new forms of politics that arise when people do more than struggle to secure rights from the state (Larkin, 2013). Building and maintaining infrastructures take expertise, time, labor, civic-minded relating, imagination, and flexibility. This is distinct from the hyper-professionalization that typifies the way governments, and many NGOs and global health institutions, develop evidence-based policies. The very practice of creating, refining, analyzing, and rebuilding infrastructures — what feminist scholar of disability and design Aimi Hamraie refers to as “the people’s infrastructure” — nurtures key capacities that governmental and scientific communities, and institutional bureaucracies, often do not. Practicing infrastructure-building is a form of critical pedagogy, for it reveals the fault-lines in governance structures while also providing methods of self-determination for experimenting with a different way of organizing and living life. 

We have witnessed similar successful examples of complex grassroot infrastructure-building in Hong Kong, Cape Town (Van Ryneveld et al., 2020), and India, to name a few. Accounts such as these should in no way be used to relieve governments, institutions, and individuals in positions of authority of their civic responsibilities — to the structural, moral and political changes that are needed and importantly, to learning from grass-roots practice. To be sure, the risk that solidarity language and associated successes will be used to justify the very government policies that lines the pockets of big business is very real. This is by no means new. Community based initiatives have a long and vexed history in public and global health. As research on the primary health care movement of the 1970s shows (Cueto, 2004), public health outreach with “community” leaders has tended towards instrumentalism, feeding what Vincent Navarro describes as process of “policy without politics” (Navarro, 2003).Perhaps the starkness of the multiple intertwined crises of the pandemic will (finally) help reframe community actors not as “complements” to public health institutions, or as implementors of policy but as core producers of knowledge and civic-minded action (Doherty et al., 2020). Perhaps learning about solidarity in this way might be read as an invitation, so well-articulated by Lauren Berlant, to shift from a politics of critique and denouncement to one saturated with the “the ethical pressure to figure out repair in the face of intensifying world disrepair” (Berlant, 2019: 4).

---

‎Dominique P. Béhague is a social anthropologist, Associate Professor in the Department of Medicine, Health and Society at Vanderbilt University, and Reader in the Department of Global Health and Social Medicine at King’s College London. Her research in southern Brazil explores the intersection of psychiatric reform, social movements, and the emergence of “adolescence” as an object of psycho-developmental expertise. She has also researched the politics of evidence-based efficacy models in global health decision-making.

Trey Minter is a 3rd year student in Medicine, Health and Society, Public Policy and Education at Vanderbilt University. His specific interests include the intersection of health and education policy in the United States and alternative medical practices, specifically Latin American Social Medicine, in the context of decolonization.‎

Francisco Ortega is ICREA (Catalan Institution for Research and Advanced Studies) Research Professor at the Medical Anthropology Research Center of the Universitat Rovira i Virgili, Tarragona, Spain. He is also Visiting Professor at the Department of Global Health and Social Medicine of King’s College, London. His books include Corporeality, Medical Technologies and Contemporary Culture (Routledge, 2014), and with Fernando Vidal, Being Brains: Making the Cerebral Subject (Fordham University Press, 2017) and Neurocultures: Glimpses Into an Expanding Universe (Peter Lang, 2011).

---

This is a translation of a contribution to a series on global health featured by El Laboratorio Filosofico sobre la Pandemia y el Antropoceno (The Philosophy Lab on the Pandemic and the Anthropocene).

Acknowledgments

We want to thank the journalists and activists who share their time and insights with us, in particular:

Thainã de Medeiros, Journalist and museologist, co-founder of the Coletivo Papo reto, Alemão Complex, Rio de Janeiro. thainasfdemedeiros@gmail.com

Gizele Martins, Master’s in Education, Culture and Communication, Journalist and activist, Maré Favela, Rio de Janeiro.  amareense@gmail.com

Ethics statement

Ethics approval was granted by Vanderbilt University’s Institutional Review Board (IRB #201663). Interviewees consented to be interviewed and named in this publication. They have read the publication and confirmed that the direct quotes and summaries of their views are correct.  

References

Béhague, D. P., Et Al. 2020. Dialogic Praxis—A 16-Year-Old Boy With Anxiety In Southern Brazil. New England Journal Of Medicine 382,201-204.

Berlant, L. 2019. Reading Sedgwick, Then And Now. Reading Sedgwick, Duke University Press, 1-5.

Cueto, M. 2004. The Orgins Of Primary Health Care And Selective Primary Health Care. Am J Public Health,94.

De Oliveira Andrade, R. 2020. The Brazilian Slums Hiring Their Own Doctors To Fight Covid-19. Bmj,369.

Doherty, T., Kroon, M., Reynolds, L., Fawcus, S., Lake, L. & Solanki, G. 2020. Building Back From The Ground Up: The Vital Role Of Communities. Bmj Global Health,5,E003928.

Fernandes, L. D. M. M., Pacheco, R. A. & Fernandez, M. 2020. How A Primary Health Care Clinic In Brazil Faces Coronavirus Treatment Within A Vulnerable Community: The Experience Of The Morro Da Conceição Area In Recife. Nejm Catalyst Innovations In Care Delivery,1.

Fleury, S. & Menezes, P. 2020. Pandemia Nas Favelas: Entre Carências E Potências.

Freire, P. 2005 [1970]. Pedagogy Of The Oppressed, New York, The Continuum Publishing Company.

Gonçalves, R. S. & Maciel, G. G. Covid-19 E As Formas De Resistência So-Cial Nas Favelas Cariocas. Cidades: Dilemas, Desafios E Perspectivas,155.

Huesca, R. 2008. Tracing The History Of Participatory Communication Approaches To Development: A Critical Appraisal. Communication For Development And Social Change,180.

Larkin, B. 2013. The Politics And Poetics Of Infrastructure. Annual Review Of Anthropology,42,327-343.

Leal, L. P. & De França Filho, G. C. 2020. Solidariedade Democrática Em Movimento: Respostas À Grande Crise Da Pandemia De Covid-19. Nau Social,11,281-291.

Navarro, V. 2003. Policy Without Politics: The Limits Of Social Engineering. Am J Public Health,93,64-7.

Ortega, F. & Orsini, M. 2020. Governing Covid-19 Without Government In Brazil: Ignorance, Neoliberal Authoritarianism, And The Collapse Of Public Health Leadership. Global Public Health,15,1257-1277.

Silva, F., Martins, P. & Carrieri, A. 2020. For The Decolonization Of The Researcher’s Self: An Encounter With Brazilian Quilombola Women And Reflections About The Coloniality Of Rurality. Hypatia,35,490-508.

Tufekci, Z. 2017.Twitter And Tear Gas: The Power And Fragility Of Networked Protest, Yale University Press.

Van Ryneveld, M., Whyle, E. & Brady, L. 2020. What Is Covid-19 Teaching Us About Community Health Systems? A Reflection From A Rapid Community-Led Mutual Aid Response In Cape Town, South Africa. International Journal Of Health Policy And Management.