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Citizenship

I returned to Vita in March 1997, two years after my first visit with Gerson Winkler, the human rights activist, and Torben Eskerod, the photographer. This time, I could see an incipient citizenship being generated along with social death. Some of Vita’s residents were now being effectively rehabilitated and given the possibility of a future. In the recovery area, men were developing discipline, becoming drug-free, and being retrained as potential workers; a few of them even had access to state-funded AIDS disability pensions, specialized medical care, and free antiretroviral therapies. People in the infirmary, however, continued to live in utter abandonment, Catarina now among them—waiting with death.

The previous November, Zé das Drogas had been evicted from the establishment by a philanthropic coalition called Amigos do Vita (Friends of Vita), headed by Representative Luchesi. Captain Osvaldo, a police officer working for the state of Rio Grande do Sul, began to administer Vita. The volunteers working there were more reserved now and generally refused to talk about what had led to the coup. Over time, I learned that Zé had become consumed by his cocaine addiction and that he and his immediate associates had used Vita as their source of income. “The more rundown the place, the more donations they got,” an insider told me, reluctantly. A local human rights coordinator alluded to the political interests of Luchesi and his associates: Vita would now be their base for denouncing the ruling government and advertising their own paternalistic politics.

In addition to his responsibilities for Vita and the police department, Captain Osvaldo attended to Representative Luchesi’s personal security and took night courses in law. He proudly considered himself the mayor of Vita. “Here, we work with finances, health, the provision of food, building maintenance. . . . It is a city of sorts.” This population, the captain noted, “does not pay taxes, so how to sustain this work?” He explained that Vita had taken advantage of new state legislation encouraging civic responsibility for welfare functions and had officially become what is called an “entity of public utility.” Given this new status, the institution could now receive state funds to build its infrastructure as well as accepting tax-exempted industry donations.

Vita was indeed undergoing impressive structural changes—“an environmental transformation,” as the captain described it. Much construction was going on in the recovery area (though not in the infirmary): houses and shacks for lodging were replacing the tents, new administrative offices had been built, and space had been allocated for a pharmacy, a medical and dental clinic, and a large building for state-funded job training. Monthly contributions from Friends of Vita and various industries provided for daily living. Vita was also raising money through its bakery, producing some fifteen hundred small loaves of bread for its inhabitants’ daily consumption as well as four hundred sweet breads sold in nearby neighborhoods. Individual donations were still pouring in, mainly from Luchesi’s radio listeners.

“Privileged society does not contribute. Their only contribution is to call the radio and say, ‘There is a homeless person in front of my building, making the sidewalk dirty.’ I say, bring the person here, and he says, ‘No, he will fill the car with smells and dirt.’ Can you imagine if we were to bring in all the cases that are called in?” The captain stressed that “we are now overpopulated.” Before the change in administration, some ten to fifteen people showed up every week needing some form of help. Now, however, a triage system was in place to keep Vita’s population “stable,” in the words of the institution’s secretary.

Such triage was the job of Dalva, a social worker and the captain’s wife. Previously, she had worked at the Santa Rita Hospital, but after changes in the universal health care system, she was sent to the emergency service. “My role was to decide who would receive treatment and who wouldn’t. Terrible, right, to decide who will go on and who will not?” She had been volunteering for more than a year at Vita, “but Zé das Drogas always created barriers to my work. He seemed to be afraid of what I could do.” She suggested that there had indeed been an intricate plot to change the course of the institution. “Vita was not rehabilitating. But now it has changed. In order to do good work, we must diagnose and know our clientele. This is a very diversified population. We must have a group and an individual approach, work on all questions, and try to bring the family into the rehabilitation process.”

Both the captain and his wife were excited about building a model program of human regeneration. As the captain put it: “I don’t believe that people recover in hospitals with more medication. Throwing the person in here and filling him with religious doctrine doesn’t solve the problem, either. The most important things are food, work, and housing. If these three things coexist, then there is a ‘why’ for the person to live. We will rescue their citizenship.” The city of Vita was now a rescue operation. I kept wondering what the immediate economic and political gain of such planned change would be and how this work would affect the lives of its residents in the long term.

Several inhabitants of the recovery area referred to what was going on as “modernizing.” Luis asserted: “We eat as human beings. Before, we had big bowls and ate with our hands. Now we have trays.” A former drug addict, Luis had first come to Vita in 1987, when he was just eighteen. “See these scars? I injected wherever I could find a vein,” he acknowledged, pointing to his arms, legs, and forehead. “Even in my head. See, my throat, I pierced it. I was so mad.” Luis ran away from Vita several times but always returned. His family in the nearby city of Canoas wanted nothing to do with him. “I began when I was twelve years old. I did not respect my mother anymore. I robbed the family, I lost my character, I became garbage. Then they brought me here.”

Luis said that under Zé’s administration there was “too much liberty,” no control at all: “We were allowed to come back even if we were drunk or high. Now it is much more rigorous. This is very good for those of us who are addicted and sick.” In former times, the residents “never saw the donations. The tents were rotten, filled with roaches and rats. Now we see the building going on.”

Outside Vita, Luis was a petty thief. In 1990, he was caught shoplifting and sentenced to two years in the Porto Alegre Central Prison. “I saw the worst. But I was cool and endured it. Once, they stuck a broom in a guy’s ass, up to the mouth. I was quiet and survived.” In 1992, Luis decided to take the HIV test. Three of his friends from the drug circle had already died of AIDS. He was found to be seropositive and was “hit hard by the news.” But he decided to face it. “If I was man enough to do it to myself, I had to be man enough to face it.” In 1993, at Luchesi’s radio station, Luis met his wife, Nair, then fifteen but already the mother of a little girl. Zé das Drogas allowed them to live together in a tent in Vita. Soon they had two more kids, both HIV-positive: “It was natural, and welcome.” Luis observes that many people in the recovery area are HIV-positive, “but they don’t want to admit it.”

Because of his good behavior, Luis has been guaranteed Vita’s support in his efforts to ensure access to medical and welfare aid for himself and his family. Vita, he says, “is my family now.” As I heard from several residents, the para-state institution now providing for them had replaced the biological family and had become a temporary place of work. “I am weak. I like being dependent here. My thinking is always in here. Here, I feel safe. I work, I am learning to make chairs. The social worker will register me to get an AIDS pension. I hope I can stay here the rest of my life.”

During Zé das Drogas’s administration, daily life in the recovery area had been structured around worship and Bible studies. Now the emphasis was on personal hygiene, civic values, eating well, total abstinence from smoking and drinking, work therapy, and group self-reflection. After dinner, a general meeting was held, and a log of daily events was read. According to the captain, “This is the time of justice. To call someone by his name rescues personhood, makes that person feel important, part of something. We mention the working shifts for the next days as well as internal promotions. When there are faults and wrongdoings, we report them and punish them harshly. Three strikes mean that you’re out for good—no return. That’s the platform of our work: they are useful, they are important. They must rescue themselves.” Now there was a deadline: “We expect them to recover in six to eight months. We will help them find a place in the market—it is there that they belong. Then, afterward, it is their life.”

Part of this new regimen involved constantly checking Vita’s residents for drugs and sexual behavior (even though the captain insisted that “alcohol has annulled their sexuality”). The daily logs of the first month under the new administration (mid-February to mid-March 1997) were filled with references to catching people smoking, using cocaine and alcohol. Illicit sexual activities were euphemistically referred to by describing people caught in an “inappropriate position and place.” Social regeneration also meant being part of the broader legal system. Several notes reported that residents had been summoned by the police to address warrants. Other notes were from the newly constituted “Tutelage Councils” (Conselhos Tutelares). These councils were citizens’ associations whose task it was to advocate for human rights within families and communities and to monitor state and medical institutions. They worked in conjunction with the Public Ministry—the citizenry’s legal forum for challenging the state. The logs also reported that three deaths had been registered in the infirmary in twenty-four days.

I asked the captain about his vision for the infirmary and its residents. “It is very difficult,” he replied. “It represents the putrefaction of the street. They don’t exist as a juridical fact. They have AIDS, tuberculosis, all these things that don’t exist in statistics.” He told me that there were some fifteen cases of AIDS in the infirmary alone, nearly 10 percent of that population, and that treatment was available to these patients only on an emergency basis.

“There, you also have the mentally ill, the elderly, the abandoned. They don’t have anything to give anymore. What does one expect from them? Nothing. Simply put, they will be that which they are now. It is a depository of human beings. We cannot bring them back to society. As horrible as it is, here one sees a truth.”

As the captain denounced the intractability of the abandoned, his words subtly suggested that the abandonados themselves were unable to anticipate anything but death and had no purpose but to die: “In their thinking, they have more in terms of dying than living. What does a normal person want? To move up in life, to reach another plateau. . . . What can they expect for themselves? Nothing.” As the captain critiqued the condition of Vita as “a thermometer of the political unimportance of human life” to the outside world, he participated in the process of letting die inside Vita with his “realistic” conception of the abandoned: “Their future is dead; they will stay behind.”

The social worker had a more optimistic take on the situation, though I wondered whether and how her view would be put into practice. “An old man was fasting for three days, protesting his abandonment by the family,” she sighed. “There are days when I leave this place crazy.” Horror stories abounded, like that of Vó Brenda, a seventy-five-year-old wheelchair-bound “grandma.” Rats had eaten her toes. “Our shack was too old,” she told me, after Dalva introduced us. “The rats came under the blankets and gnawed my feet.” She insisted that her alcoholic husband was a good man. “We spent fifty years happily together.” But he never took her to the hospital. “He had to work, he had no time,” the woman sadly explained. When the husband died, Vó Brenda’s son, unable or unwilling to care for her, left her at Vita.

“They all have a history, a name,” Dalva said. She was beginning to catalog all the cases, trying to identify the nameless people in local registries and hospitals and, whenever possible, attempting to contact their families. Many times, she explained, “families use hospitalization in Porto Alegre as an opportunity to abandon.” Dalva was referring to about forty mentally ill patients in the infirmary who were not receiving psychiatric care. “They shouldn’t be here.” The majority of infirmary cases involved people who “once had a dignified life.”

They all have “the same pattern,” she argued, and, as the captain did, she emphasized the active involvement of these individuals in the process of their own abandonment. “They are the ones who were always drunk or took drugs, couldn’t work anymore, and then came the time when the family didn’t give them another chance and closed the doors. . . . They moved from one place and job to the next, began to age, to sleep in the streets. All because at some point they decided to abandon the family. And, all alone, they needed the favor of a stranger or the police to get to a hospital or to be dropped here.”

What sustains them?

“Some have the expectation that a family member will come and take them out of here. They make the family into their ideal, which in fact it never was.” I was told that families showed up only when they needed the abandoned person’s signature to settle inheritance issues or to keep his or her welfare benefits flowing into the household. Vó Brenda’s son visits her to guarantee that he will receive her shack when she dies, Dalva reported. Working amid a “lack of legal documentation and lack of memory,” the social worker was mapping the population and trying to build partnerships with psychiatric and general hospitals as well as to mediate welfare claims. The immediate goal, however, was to get beds for those in the infirmary and to keep the place sanitized.

Oscar was now the infirmary’s coordinator. He was a rare person, I thought, because he was always there, and he cared. Other volunteers appeared only irregularly, and, as I learned, there was much abuse of the abandoned. Oscar had come to Vita in the early 1990s from the state of Santa Catarina, leaving behind his wife and two teenage daughters. He had recovered from his intravenous drug addiction, converted to Pentecostalism, and found a new wife in the village surrounding Vita. He adopted his wife’s two sons, and they had a daughter of their own. They made Vita their home.

Although Oscar was not paid to coordinate the infirmary’s work, he was happy to have shelter, free food, and access to a car—“I even have a cell phone.” He was also euphoric about the changes under way. “The new coordinators have many projects. They have very good ideas and are trying to solve things in the quickest way. But it takes time. Things are developing.” This altruistic and hard-working man was always there to welcome me in the following years as I charted Vita’s development and, particularly, Catarina’s history. Over time, I became very fond of him. “We are friends,” we both said.

Vó Brenda, Vita 2001

Oscar had taken his father, sick with advanced cirrhosis, to a special room in Vita. “I am feeding him. He is not here because of family abandonment, but because I can take better care of him. My siblings are helping out with the food.” Oscar was the institution. He had a vision of care that he had no power to implement, although he spoke of it openly: “People need better and more varied kinds of food, also some kind of therapy, like you offer when you listen to them. . . . If families came at least once a month and left some special food, I would prepare it for the grandpas and grandmas with much joy.”

But instead, he continued, “they just stay here, and when something bad happens to them, we take them to the hospital, and they are immediately sent back. We do the back-and-forth, and in one of these back-and-forths, they will die.” Oscar was specifically thinking of the AIDS cases. “I don’t think they have much time.” The captain’s rationality and the social worker’s commitment both collapsed in the face of the truth that, as Oscar saw it, “there is no return.”

As I learned at the city’s epidemiological surveillance service, there was no means of tracking deaths in places like Vita, although the deaths of Vita’s residents were now at least registered at local hospitals. In the end, the deaths of these individuals could not be traced back to their abandonment. And the clinic and the state were symbolically acknowledged as having cared.

The dilemmas voiced by the captain—particularly his emphasis on Vita the place, rather than the people—were revealing for what they suggested about the complex politics of death at work here: “We ask ourselves, if we know the problem, why don’t we solve it? This is a paternalistic view of things. Even if the institutions that are supposed to do the work of caring don’t do it, we still cannot let these creatures rot in the streets. . . . So, should we be paternalistic or let these creatures die?”

That said, the captain became pragmatic in pondering the future of Vita. “We shall not turn this place into a hospital. At most, the infirmary can be a place where people who leave the hospital and have nowhere to go can recuperate for a while.” In this view, people in the infirmary would eventually die out, except for those few whose families might rescue them after being pressured by the social worker.

I began to realize the strategic value of not framing Vita as a health-enhancing site. By officially registering Vita as an “entity of public utility” at a time when the Workers’ Party administration in Porto Alegre was redefining the system of public health inspection, the coordinators were preventing the city administration from interfering in their management of the institution. Defining Vita as a clinic or hospital might have invited city interference in the form of enforcing sanitary regulations or conducting legally required visits by city health professionals. In other words, the coordinators were keeping Vita to themselves. Here, we understand the function of conceiving the destiny of the abandoned as self-generated, irreversible death. The few who recover set the limits of who is considered worthy of having a biological existence—and this measure informs the public health institutions and pastoral extensions of a local triage state (Biehl 1999b; 2004).

After many visits, I also saw that the abandonados—with their daily rations of bread and bean soup and hot water—were not being kept alive in vain. While dying in Vita, they still had a final social function. Under the new regime, everyone admitted for rehabilitation had to spend a few days in the infirmary as part of their initiation into Vita. Additionally, throughout their stay, men in rehabilitation had to come up to the infirmary and take care of some of the abandoned, dispose of their wastes, and move their bodies back and forth. As one of Vita’s new coordinators explained, the infirmary served as “a platform of information for the ones down here. It is useful for getting the addicts to fall back into reality, for if they don’t change, that’s their end.” The captain was more straightforward. He described the abandoned as “cobaias [experimental guinea pigs]. Their life is over. They show the young ones what will happen to them.”

Oscar and Luciano had once told me that medical and familial circumstances had made the abandonados in the infirmary inappropriate for living. It was now evident that the negotiation over the human/animal boundary that had produced them had become a subjective technique. Lauro had been in Vita for three weeks when I met him. The thirty-year-old man sat next to Lucas, formerly known as Vaquinha (Little Cow), about whom nothing was known. Lauro said that he had adopted and baptized “the poor thing” as Lucas. “Now he has a name. He talks little. He is mentally retarded. I am responsible for him. He is like my child now—we play.” Lucas looked the same age as his new caretaker, and there was a warmth to their relationship.

Lauro said that he had been a factory worker, but he had been fired. “I became dependent on alcohol and drugs and descended to hell. I was even sleeping in the streets.” He lost contact with his wife and daughter. “I finally realized that either I stopped or I would end up dying. . . . So I asked God to give me the chance to change my life, and He partly fulfilled this. The first step has been taken, which is to be here . . . to be far away from drugs and alcohol.” As part of his initial rehabilitation therapy, he has to take care of Lucas, bathe him, change his clothes, watch him as he crawls around, sit silently next to him. This human relation has filled a void in him. “I help him, so automatically he helps me too.”

How so?

“By helping him, I am helping myself.” Lauro then spoke of Lucas and himself in the plural, as belonging to two distinct collectives: “They give force to us. Only to look at them already helps us to walk forward, to not stay in the same condition they are in.” He voiced an impersonal feeling: “One develops a tenderness toward him. He is a well-behaved guy, right?”

Lauro claimed that as he followed these people’s deterioration and inescapable destiny, he developed a new appreciation for health and a resolve to retain it. “Yes . . . seeing this situation is one more force keeping me from plunging deeper into a well, till there is no return. Thank God, I found this place. I feel good just being able to help, to still have the health. When I look around, I see people who don’t have this health, disabled—this helps me a lot.” He then asked Lucas to speak: “Show him that you can talk.” In that most disturbing encounter, the man became a spectacle, not meant to be heard or addressed. His worth as a human socially and medically devalued, Vaquinha/Lucas remained the animal form through which the salvageable human constituted himself.³²

The new pedagogical role of these abandoned men and women stems precisely from their alleged inability to produce anything more than bodily infections, parasites, and silent suffering. Their social death is the negative image of the future. In the end, the negative ones are object lessons for potential citizens—or, better, they provide a ground for the appearance of a distinct concept of citizenship. I say “concept of citizenship” because local governments do not provide the means needed for this regenerated citizenship to become a structural possibility. Philanthropic sites like Vita make the personal regeneration of a marginal individual possible and livable either for a limited period or in the form of fiction. This concept of citizenship enlivens the image of the state as universal and life-enhancing. Yet, empirically, citizenship remains a matter of triage and, of course, money. As some are being healed in that simultaneously “militarized” and philanthropic setting, they wake up next to those who are socially dead, blind, without name, without origin, without ties. Like Cida, the nameless young woman with AIDS who, according to volunteers, “now and then asks us to tie her to her bed. She does that when she feels like killing herself. . . . Then, a few hours later, she mumbles to be untied. How do you understand such a person?”

In Vita one sees how life is achieved through death—the ambiguity and violence involved in this process. The negotiation over the human and nonhuman forms part of a complex set of relations through which individuals are linked to each other and to the political body. The Other’s dying makes it possible for one to belong to a family-like institution, to a new population and subjective economy. The ethnographic challenge is to find these empirical relations and linkages—technical, political, conceptual, affective—and to bring them out of thoughtlessness. The random encounter with Catarina and the events it precipitated made it possible to retrieve a world deemed to be lost.

Catarina, Vita 2001