Thiago Nascimento did not expect help from the Government when the coronavirus arrived in his neighborhood. He was concerned that, as in other favelas—informal shantytowns throughout the city—people were vulnerable due to a lack of income, safe housing, and clean running water. A study later showed that people in favelas were twice as likely to die if they had covid-19 than those in higher-income areas of the city.
Nascimento’s faith in government assistance went from bad to worse as the pandemic progressed. Amid a surge of cases in May 2021, police carried out a drug raid in his favela, Jacarezinho, killing 28, injuring innocents and terrifying residents. When community members built a monument to honor the dead, the police demolished it. “This broke any trust“, told me.
Experts often cite mistrust in government as a key reason certain communities have suffered disproportionately during deadly outbreaks, including Ebola and Covid-19. Mistrust is a serious problem in a pandemic if it prevents people from obeying health recommendationsseek medical attention and accept vaccinations.
In marginalized communities, mistrust is often rooted in a history of discrimination, neglect or abuse by authorities. So the onus for mending those relationships should fall to governments that have proven unreliable, and that requires political change. But the next pandemic—or other disaster—may happen sooner. In the meantime, health officials and researchers would do well to learn how to help the communities that need it most.
The lessons are found in Brazil’s favelas because, in the face of decades of government neglect, many have created internal systems to support each other. When covid-19 began to spread, community leaders like Nascimento raised money to provide food and masks to those in need. In Jacarezinho, Nascimento co-founded a collective called LabJaca to report covid-19 figures because he and others suspected official counts had underestimated the number of cases. Soon, LabJaca was one of several groups entering data into a dashboard that tracked the disease in 450 Rio de Janeiro favelas.
In the Morro dos Prazeres favela, Janice Delfim, a community leader, was printing out lessons for children when schools closed because their families did not have computers at home. And when the children complained of hunger, she turned to non-governmental organizations for donations of food, masks and hygiene products. In other favelas, community leaders installed faucets so people without running water could wash their hands.
Jair Bolsonaro, the then President of Brazil, denied the seriousness of covid-19 while hospitals were overflowing. But even as health authorities issued recommendations for people to wash their hands and stay home, Delfim said his words rang hollow to those living without running water or the ability to work from home. “our reality is different“, told me.
Fernando Bozza, a doctor at Fiocruz, a research institute in Rio de Janeiro, realized the need to work at the community level as covid-19 began to spread in the favelas. He and other Fiocruz scientists partnered with the non-governmental organization Redes da Maré, which had long served Rio’s huge Maré favela and community residents.
Through this coalition, scientists provided free covid-19 tests. When someone tested positive, a member of the group would offer to deliver food, cleaning supplies, and masks to the person’s home, as well as conduct health checks over the phone. Coalition residents also passed on circulating rumors for scientists to correct. “It was a continuous listening process with people from the community leadingBozza said.
Coalitions like this have sprung up around the world. Community-led initiatives must be evaluated with the same rigor as any intervention. In an unpublished report, Bozza’s team found that weekly deaths from Covid-19 dropped 60 percent in Maré after eight months of working with the coalition, versus a 28 percent drop over the same period between a similar number of people living in similar favelas in Rio.
It is more difficult to study the impact of community-led efforts on longer-term problems such as diabetes and poverty. These issues make people vulnerable to pandemics, so it is important to address them. Jason Corburn, a public health researcher at the University of California at Berkeley, cautioned that this work takes time. “Some of these problems are 20 or 80 years old, so we need to track them over time, incrementally.“, said.
Despite a recent push for more community-led efforts in public health, alliances built during the pandemic are dissolving as projects close with covid cases declining. Those quick exits generate mistrust.
The communal spirit survives with or without external support. Today, Nascimento is connected with community leaders in many favelas and they continue to coordinate efforts. Lately, they have addressed police violence and helped residents who have been left homeless or hungry due to flooding. The Delfim residents’ association has grown because more people want to help. There is no shortage of work to be done, and it carries mental health benefits that emerged during the pandemic and continue. “Got together“, said. “It was like group therapy”.
INTELLIGENCE/AMY MAXMEN
THE NEW YORK TIMES
BBC-NEWS-SRC: http://www.nytsyn.com/subscribed/stories/6661098, IMPORTING DATE: 2023-04-14 16:40:08
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