Argentina en tiempos del Coronavirus

por Martín Caruso Bloeck

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El presidente Alberto Fernández se reunió, el 28 de enero, en Casa Rosada con el titular de la cartera sanitaria nacional, Ginés González García, quien le expuso un informe de situación acerca de la información epidemiológica existente a nivel mundial sobre el Coronavirus. (Foto de casarosada.gob.ar.)

Ya hace un mes que Alberto Fernández, Presidente de la República Argentina, anunciaba la entrada en vigor del llamado “aislamiento y distanciamiento social obligatorio”, el 20 de marzo. La medida implicó un cambio radical en la respuesta a la amenaza del Covid-19 cuando se lo compara a las insólitas declaraciones del Ministro de Salud, quien indicaba que “el coronavirus no funciona en el verano [argentino]” y que el país tenía otras prioridades.

A mi parecer, cabe caracterizar las medidas tomadas por el Gobierno desde entonces como terminantes. Las medidas de confinamiento en Argentina se destacan por su vigor: nada de traslados innecesarios, un paseo recreativo, ni siquiera ir al supermercado en pareja. A pesar de la falta de previsión y cierta inoperancia que suelen caracterizar a la dirigencia argentina, evidenciadas aún más por el coronavirus, me parecen dignos de destacar el liderazgo y la firmeza presidencial para tomar medidas frente a la situación.

La bala de plata, rehén de su propio éxito

Las medidas parecen estar dando resultados esperanzadores, aunque preliminares. La propagación de la enfermedad es lenta, el sistema sanitario no ha colapsado, y la proporción de tests positivos sobre realizados es relativamente baja. Es que en Argentina se ha venido probando de todo con tal de ayudar a mitigar la crisis. Aislar a comunidades enteras, tomar temperaturas, pruebas de olfato, tapabocas: lo que sea. Sin embargo, el ingenioso uso de estas herramientas low-tech (de baja tecnología) pone en evidencia fisuras que son transversales a muchos aspectos de la sociedad argentina. La cuarentena y todas estas medidas complementarias son lo único que hay para hacer frente al coronavirus, y por más ingeniosos que seamos los argentinos, la falta de recursos y previsión nos obligan a adoptar medidas con significativos daños colaterales.

Un conductor de autobús argentino usa una máscara para protegerse contra el coronavirus, marzo de 2020. (Foto de TitiNicola).

Un conductor de autobús argentino usa una máscara para protegerse contra el coronavirus, marzo de 2020. (Foto de TitiNicola).

Es así que nuestra bala de plata, el confinamiento, es rehén de su propio éxito. La ralentización del virus posterga el pico de contagios, lo cual obliga a una cuarentena más prolongada. Mientras que otros países han usado el tiempo ganado para implementar medidas menos perniciosas, cualquier intento por flexibilizar el confinamiento tiene complicaciones. Desde un aspecto operativo, está la consistente lentitud con la cual el país ha estado testeando a potenciales enfermos, lo cual pone en duda la capacidad de una rápida detección y respuesta ante un nuevo brote. Por otro, y esto es más bien una apreciación personal, está la manera en que puede ser interpretado cual intento de flexibilización. No por nada los argentinos tenemos un dicho que advierte sobre darle la mano a alguien y que éste nos agarre hasta el codo.

El menor de los males

Mientras más se extiende la cuarentena, más visibles se hacen sus perjuicios. La informalidad y las deficiencias crónicas en el mercado de trabajo dificultan la protección de los más vulnerables. El derrumbe en la actividad ha puesto en jaque a muchísimas pequeñas y medianas empresas (pymes) que arrastran una recesión de por lo menos dos años. El Gobierno ha hecho lo que ha podido para paliar los efectos de la crisis, otorgando ingresos de emergencia a los beneficiarios de programas sociales y créditos subsidiados a las pymes para que puedan pagar los sueldos de marzo. Y los de abril, Dios dirá. Para hacer las cosas peor, el país se encamina a su segundo año con inflación cercana al 50% y con poca perspectiva de que eventuales aumentos salariales lleguen a compensar más que una fracción de eso.

Es así que en todos los aspectos la capacidad de respuesta se termina chocando con la realidad que es la falta de recursos. Si el distanciamiento social hace estragos en las economías más pujantes del mundo, el problema es aún más grave en una economía como la Argentina que básicamente no ha crecido en diez años.

Captura de pantalla de un mapa constantemente actualizado de casos de coronavirus en Argentina desde La Nación. (Haga clic aquí para ver el mapa en vivo).

Captura de pantalla de un mapa, constantemente actualizado, sobre los casos de coronavirus en Argentina. Fuente: La Nación. (Haga clic aquí para ver el mapa en vivo).

Lo paradójico es que aún si Argentina fuera inmune al coronavirus, el efecto que éste tiene sobre los demás países sería por sí sólo un golpe durísimo a la economía argentina. Históricamente, Argentina ha sido especialmente vulnerable a los vaivenes de los mercados internacionales, y esta ocasión no es ninguna excepción. Para el colmo, el país se encuentra encarando una renegociación de deuda soberana con destino incierto en medio del riesgo de colapso en los mercados internacionales.

Probablemente sorprenda a muy pocos al recalcar lo nutrida que es la historia argentina en crisis económicas, tanto por su frecuencia como por su profundidad. Desde pequeños, nuestros padres nos cuentan las historias de las hiperinflaciones, crisis bancarias y fiscales. Y es así que intento disimular lo que puede terminar en una crisis de proporciones bíblicas cuando mi mamá me cuenta con angustia cuán complicado se pone el día a día. “No es nada por lo cual no hayamos pasado antes” le digo.

Mientras tanto, me pregunto si algún día estaré del otro lado del teléfono, si esta crisis será la que finalmente ponga al país en un sendero de progreso o si será otro tren que dejaremos pasar. Reflexiones de un día de sol californiano.

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Martín Caruso Bloeck se encuentra actualmente cursando un Ph.D. en el Departamento de Economía de UC Berkeley. Antes de venir a Berkeley, Martín estudió en la Universidad Nacional de La Plata en Argentina y trabajó como consultor externo para el Banco Interamericano de Desarrollo. Sus intereses de investigación se encuentran en los campos de la macroeconomía y las finanzas internacionales.

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Understanding Amazonian biodiversity patterns through an economically important palm Oenocarpus bataua

By Giovanna Figueroa

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Measuring an ungurahui leaf as part of the research. This one measured 8.81m long.
(Photo courtesy of Giovanna Figueroa.)

Notes from the Field: Student Research in Latin America
CLAS awards financial support to graduate students to travel to Latin America for pre-dissertation research. The following is a reflection on one student’s summer fieldwork experience. (For more information, please see CLAS Summer Field Research Grants.)

The Amazon basin is known to be the world’s most biodiverse region, harboring a variety of flora and fauna. Recent fires in the Brazilian Amazon have brought a lot of attention to the ways in which forest resources are managed and the rapid loss of tropical habitats due to deforestation. While it is true that we must act quickly to protect this ecosystem, the notion of a “pristine” forest that is often presented in popular news can be misleading. In actuality, humans have been managing the forest and domesticating plants for at least 10,000 years. (1) The main difference between then and now is the ways in which humans are using the forest.

Through the generous support of the Center of Latin America Studies at UC Berkeley, I was able to spend three months in the Peruvian Amazon studying an economically important palm tree, Oenocarpus bataua, locally known as ungurahui. This tree provides both humans and animals with a nutritious fruit, rich in protein and oil year-round. Additionally, its trunk and leaves are used for construction and crafts. The ecology of this plant is interesting, as it is the 7th most abundant tree species in the Amazon basin, found in Venezuela, French Guiana, Brazil, Colombia, Peru, and Ecuador. It is part of a subset of 227 species of trees which are considered hyperdominant, because they are much more abundant than the rest of the estimated 16,000 tree species in the region, and together make up more than half of the individual trees found in the Amazon. (2) Put another way, 1.41% of the estimated 16,000 tree species are very common, and the other 98.6% of tree species are rare. Being hyperdominant and economically useful isn’t unique to ungurahui. Studies have found that plants which are used by humans tend to be hyperdominant, and archeological sites have a higher proportion of hyperdominant tree species than surrounding forests. (3)

At the crown of an ungurahui. (Photo courtesy of Giovanna Figueroa.)

At the crown of an ungurahui.
(Photo courtesy of Giovanna Figueroa.)

This begs the question, are these plants abundant as a result of human management or have humans simply learned to use the resources which are most readily available to them? Perhaps this pattern could be due to some combination of human management and the overall ecology and survival strategy of these plants. These are the questions that initially brought me to Peru to study ungurahui. There has been a notable increase in demand and consumption of Amazonian products around the world (think açai), from which ungurahui is not exempt. Its pulp is used to make ice cream and oil for hair and cosmetic products in areas outside of the its natural range. In order to keep up with the demand, some people have turned to cutting down trees to harvest the fruit instead of traditional climbing methods. What are the possible implications of recent changes in human management of this hyperdominant species?

In order to begin answering these questions, I started working with a local pulp processing organization – Recursos Amazonicos Frutales (RAF SAC), based in Iquitos. They have designed specialized palm climbing gear, called a maquisapa, which makes harvesting fruits both safer and easier. RAF SAC personnel go around to communities where ungurahui is found and provide training workshops on how to use the maquisapa. They then work with these communities to purchase sustainably harvested fruits from them, which are processed, frozen, and sold around Iquitos.

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A different view of the 8.81m leaf shown earlier.
(Photo courtesy of Giovanna Figueroa.)

I targeted communities where RAF SAC works, which are found along different watersheds, to collect O. bataua fruits, leaves, and soil samples. I also recorded census data to understand how ungurahui varies in different locations and habitat types. My research began in San Juan de Raya (Raya), a community of about twenty houses found on the bank of the Río Pintuyacu. I teamed up with a resident of Raya who helped me find a population of Oenocarpus bataua about 30 minutes upstream. We used the maquisapa to climb the trees and a special pole saw to collect fruit samples and leaf tissues, which will be used for genetic analysis and to make herbarium specimens. After talking to a few locals from Raya, I learned how local changes in the weather affect the time for fruit to mature — more rain speeds up the ripening process. I was taught how to prepare chapo, a traditional beverage, which is made by macerating the pulp in a small volume of water and drunk with sugar and dried manioc. The chapo was shared with the community, but I kept the seeds for subsequent analysis and experiments after the collection trips.

Making chapo de ungurahui by macerating fruits in water (left), and picking out seeds from macerated pulp mixture to use for germination experiments (right). (Photos courtesy of Giovanna Figueroa.)

Making chapo de ungurahui by macerating fruits in water (left), and picking out seeds from macerated pulp mixture to use for germination experiments (right).
(Photos courtesy of Giovanna Figueroa.)

After a few days back in Iquitos, where we sterilized and froze the collected fruits, our team arrived in Nueva York, a larger community found on the Río Tigre. We had heard that the fruits from this site were different in texture and produced more oil than fruits from other regions. Locals confirmed this, but we were not able to find any trees bearing mature fruits to see for ourselves. We learned that felling trees is more common than climbing there, which we were able to confirm during our search for fruiting trees. The only trees which had any signs of recently producing fruits had been cut down.

A recently felled O. bataua tree in Nueva York. (Photo courtesy of Giovanna Figueroa.)

A recently felled O. bataua tree in Nueva York.
(Photo courtesy of Giovanna Figueroa.)

Our last two trips along the Ríos Blanco and Ucayali were completed in October 2019. We were able to census and collect from three ungurahui populations, and found two other Oenocarpus species, O. balickii and O. mapora, that were also sampled. Using all the seeds from the collecting trips, I set up a manipulative experiment aiming to understand how density, distance, and different origin sites affect seed germination and survival. These will be monitored while I am offsite by local collaborators.

I will be collaborating with researchers from the Institute of Research and Development in Montpellier, France and the Instituto de Investigación de la Amazonía Peruana in Iquitos to perform nutritional content studies on the fruits that we collected. We will also be extracting and sequencing DNA from leaf samples in order to get a better understanding of the ways that humans and the environment influence one another. I will be returning to Iquitos in a few months to continue collecting and monitoring the progress of my experiment.

REFERENCES
1. Clement, C., De Cristo-Araújo, M., Coppens D’Eeckenbrugge, G., Alves Pereira, A. & Picanço-Rodrigues, D. Origin and Domestication of Native Amazonian Crops. Diversity 2, 72–106 (2010).
2. ter Steege, H. et al. Hyperdominance in the Amazonian Tree Flora. Science 342, 1243092–1243092 (2013).
3. Levis, C. et al. Persistent effects of pre-Columbian plant domestication on Amazonian forest composition. Science 355, 925–931 (2017).

Giovanna Figueroa.Giovanna Figueroa is a Ph.D. candidate in the Department of Integrative Biology at UC Berkeley. She specializes in tropical plant ecology, specifically understanding drivers of plant abundance and diversity patterns in Amazonia. She has worked in the Peruvian Amazon since 2018 and will continue to expand her work there and in other Amazonian regions for her dissertation.

Giovanna is a recipient of the 2019 CLAS Summer Field Research Grant.

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Investigating the link between Drinking Water Quality and Chronic Kidney Disease in Jalisco, Mexico

By Kaitlyn Jackson

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Kaitlyn at the biology laboratory of the Instituto Tecnológico y de Estudios Superiores de Occidente (ITESO), analyzing water sample results for total coliform bacteria and E. coli. Yellow bottles indicate positive for total coliforms. (Photo courtesy of Kaitlyn Jackson.)

Notes from the Field: Student Research in Latin America
CLAS awards financial support to graduate students to travel to Latin America for pre-dissertation research. The following is a reflection on one student’s summer fieldwork experience. (For more information, please see CLAS Summer Field Research Grants.)

Mexico is currently facing a public health crisis in chronic diseases. The Institute for Health Metrics and Evaluation (IHME) most recent data for Mexico (2017) shows that chronic kidney disease (CKD) is the second largest factor in Disability Adjusted Life Years (DALYs), a metric that combines deaths and disability. This trend has held constant since 2007. In 2016, non-communicable diseases (NCDs) were responsible for 80% of the countrywide deaths in Mexico, with diabetes and heart disease accounting for 40% of all NCD-related deaths. Chronic Kidney Disease in Mexico causes 25% of deaths related to diabetes and 28% related to heart disease. Hospital admissions for patients under the age of 25 suffering from CKD have skyrocketed, tripling in some areas of Mexico in the last five years.

Concurrently, over-exploitation of Lake Chapala, Mexico’s largest freshwater reservoir, has resulted in a serious water crisis. The state and federal water authorities continue to utilize this precious resource for drinking water, agriculture, and industry, and continue to develop infrastructure in response to increasing urban and agricultural demands. Lake Chapala provides sixty percent of the drinking water to Guadalajara, a city with a population of over four million. Not only have population growth and agricultural demands depleted Lake Chapala’s water levels, which in turn lowers water quality, but also the Santiago River, which is fed by Lake Chapala, contains an estimated 1,090 toxic pollutants. Inhabitants of rural communities such as Mezcala, San Pedro Itzicán, and the small city of Chapala are suffering from epidemic rates of CKD, especially in young adults and adolescent populations. This is highly unusual, as CKD typically affects older adults or those with diabetes.

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Children playing in Chapala, Jalisco, Mexico. (Photo courtesy of Kaitlyn Jackson.)

Chronic diseases place a burden on both individuals and healthcare systems, and hinder economic growth, highlighting our purpose in investigating all risk factors of CKD, including drinking water quality, access, and consumption behavior. Under the guidance of Professor Charlotte Smith, we set out to unravel the mystery behind this drastic rise in CKD within the rural and primarily indigenous communities Mezcala and San Pedro Itzicán, as well as in Chapala, one of the more prominent cities within the region of the Chapala Lake basin.  

Beginning in January 2019, our research team formed a collaborative partnership with the Instituto Tecnológico y de Estudios Superiores de Occidente (ITESO) to develop a mixed-methods study to collect preliminary data in Mezcala, San Pedro Itzicán, and Chapala, under the framework of the 6th Sustainable Development Goal — access to safe water as a human right. Over the last five years, ITESO has built extensive and trusted relationships in the three communities mentioned above. A strong alliance was built combining ITESO’s expertise in hydrology and engineering and UC Berkeley’s in drinking water exposures and public health.

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The town of San Pedro Itzican from above on the shores of Lake Chapala. (Photo courtesy of Kaitlyn Jackson.) 

Between May and August 2019, we conducted 99 household surveys, 12 key informant interviews, and 6 focus groups regarding perceptions of drinking water, health behaviors, exposure to environmental and occupational contaminants, and relevant disease history. Through 15 key informant interviews with religions leaders, local non-profits, municipal government employees, indigenous leaders, and distinguished academics with knowledge and experience working in the Jalisco region of Mexico, we gained insight and built the trust which allowed us to return each and every week.

Because chronic disease exposures are more complex than acute diseases like diarrhea, and often involve multiple exposures as well as genetic predispositions, we conducted a project to both amplify the local voices who had previously been silenced and ignored, and additionally share collected information to give these vulnerable populations the tools to call for action. Organizing focus groups with volunteer brigade members, youth leadership organizations, fisherman unions, families suffering the severity of a CKD diagnosis, and the board members of an indigenous community group allowed for us to have extended conversations with diverse groups of people, to hear first-hand of their lived experiences. Elderly participants gazed into the distance with a forlorn look in their eyes, describing a time when, as children, they swam, drank, bathed, and played in Lake Chapala. When we gazed out into the vast hazy green lake, our research team listened as these same participants described with disgust the decline of the lake’s health over the last 20 years. No one dares to take a swim these days.

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The community church located in the town square of Mezcala, located on the banks of Lake Chapala. (Photo courtesy of Kaitlyn Jackson.)

Simultaneously, our team collected data on drinking water quality, food consumption, and occupational and lifestyle behaviors. We tested water quality in participating households, measuring levels of arsenic, copper, nitrate, nitrite, total chlorine, free chlorine, and the presence or absence of total coliforms and E. coli. Primary drinking water sources included purchased 20-liter garrafones from local manufacturers, tap water, and rooftop water tanks. Water quality testing for environmental and microbial contaminants allowed for comparisons between water quality perceptions and reality. After analysis, members of our research team will return to Mezcala, Chapala, and San Pedro Itzicán to deliver individual participant results, as well as workshops to discuss and interpret the importance and meaning of each and every result.

It was tragic to meet mothers, brothers, sisters, and daughters, all of whom either had or knew someone dying of kidney failure. Seeing this first-hand has motivated our research team to continue forward with our project in a way that directly benefits the involved communities. Following the lead of our collaborators at ITESO, we have agreed to assist in the production and content of a documentary to spread awareness throughout Jalisco and Mexico about this public health crisis. We have begun to analyze our dataset using geospatial statistical methods. Preliminary results suggest that inhabitants of the Lake Chapala basin face significant structural barriers in accessing safe drinking water. We hope that our results from this study will support calls for action by local communities during this water crisis. The knowledge gaps surrounding the true CKD burden, in tandem with a growing local water crisis and decreasing water quality, highlights the need for increased attention to Lake Chapala and the need for access to clean drinking water. The hope is that by synthesizing public health research with community participation, we can provide these vulnerable populations with the strength and confidence to seguir adelante.

KaitlynJackson-250pKaitlyn Jackson will be graduating with her MPH from the UC Berkeley School of Public Health Global Health & Environment program this May. A backpacking fanatic from the Pacific Northwest, Kaitlyn’s passion for Spanish was born while spending two weeks living in a coffee farming community in the Dominican Republic when she was 15 years old. This passion led her all the way to Santiago, Chile, where she spent three years working for two social impact organizations. Kaitlyn’s dedication for global public health stems from her desire to focus on enhancing the lives of the most vulnerable and underserved through public health solutions grounded in data driven evidence. In her free time, you can find Kaitlyn experimenting in the kitchen with spices from across the globe or walking her black lab, Layla. Kaitlyn is a recipient of the 2019 CLAS Summer Field Research Grant. 

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A photo of a household water sample directly taken from the tap. Yellow indicates coliform bacterial contamination. Two live mosquito larvae were also detected. (Photo courtesy of Kaitlyn Jackson.)
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Drinking water well pump in San Pedro Itzican. This pump pulls water from a thermal underground water source. The pipes of this well are therefore scalding hot to the touch, due to the high natural water temperature. A pigpen is located next to the well.  (Photo courtesy of Kaitlyn Jackson.)

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The author conducting a focus group with fisherman and fishing families in the town of Mezcala. (Photo courtesy of Kaitlyn Jackson.)

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Why Bolsonaro backtracked on firing Mandetta

By Carolina Botelho

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Brazil’s president, Jair Bolsonaro (with mask off), at a press conference on Covid-19 with his health minister (third from left), Luiz Henrique Mandetta, March 22, 2020. (Photo by Isac Nóbrega / PR.)

The president’s backtracking was only possible because a considerable part of the Brazilian elite felt threatened.

Read this article in Portuguese

(Please note: After this article was written, President Jair Bolsonaro of Brazil fired his health minister, Luiz Henrique Mandetta, on April 16, 2020.)

April 6th was a particularly tense day for Brazil. Not for the normal reasons to which we have already become accustomed, such as the President of the Republic, his children, and his supporters. No, this day went beyond that. The threat to dismiss the only minister who seems to value the idea of the republic, as is expected from a public servant, had already been announced. Bolsonaro was going to fire Luiz Henrique Mandetta, the Minister of Health. Mandetta is the only person on Bolsonaro’s team who has shown concern and acted to save lives in this horrible epidemic that has generated alarm in almost all of the world, or at least the “civilized” world. By the end of the day, the president had backtracked, or rather, others had pushed a reversal of Bolsonaro’s decision. Who were they?

This is an important question at the moment. Who made Bolsonaro backtrack on his decision? Normally in a democracy, it would be expected that political and social institutions would recommend the necessary caution to the president in the face of the threat of Covid-19. It would also be expected that he would accept these recommendations. In the case of Brazil, institutions have fulfilled their roles, but Bolsonaro has disregarded all of them, dismissing scientific debates and expert knowledge. The results of this equation are simple: our democracy loses on a daily basis. However, April 6th seemed different. Many analysts argue that it was the generals who surround Bolsonaro and contain his “excesses” who demanded that the president backtrack. While I agree with this theory, it is not the complete answer. So, I rephrase the question as, “Who were the generals listening to before they made Bolsonaro backtrack?”

THE ELITES ARE CAPABLE OF EXERCISING TRUE VETO POWER IN SUPPORT OF A COUNTRY’S ECONOMIC AND POLITICAL DEVELOPMENT

I want to emphasize a common theme in social science literature (the field most despised and denigrated by Bolsonaro): elite theory. I studied a little of this theory as an undergraduate, and then used it in my master’s thesis almost two decades ago. In 2019, when organizing an undergraduate course, I judged the theory to be important enough to include in the bibliography, and I do not regret it.

Jair Bolsonaro com o presidente dos EUA, Donald Trump, na Flórida, em 7 de março de 2020. Um membro da equipe de Bolsonaro testou positivo para o coronavírus alguns dias depois. (Foto de Alan Santos / PR.)

Jair Bolsonaro with U.S. President Donald Trump in Florida on March 7, 2020. A member of Bolsonaro’s team tested positive for the coronavirus a few days later. (Photo by Alan Santos / PR.)

Recently, a Datafolha poll showed that 51% of people interviewed said that Bolsonaro is more harmful than helpful in the fight against the coronavirus, and 39% of interviewees disapproved of the President in general. This would be easy enough to accept. However, this data also highlights more interesting results: Bolsonaro is poorly rated by women (43% disapproval), people with higher education (50%), and the rich (those with wages equal to or greater than 10 times the minimum wage, 46%).

The president will say that he does not trust polls, but elite theory explains why Datafolha is correct, and why part of Brazilian society has backed away from its support of Bolsonaro.

With the caveat that social isolation has altered the methodology of the most recent polls, disapproval of the President among the richest Brazilians has grown from 28% in December to 46% in April. The importance of this group is not trivial. Bottomore, an elite theorist, has shown that elites can exercise a true veto power in support of a country’s economic and political development. As observed by Elisa Reis, even the possibility of gradual change depends considerably on the acquiescence of the elites. According to Reis, “the importance of the elites lies in the direction and control they can exercise over the complex and difficult transition of one form of organization to another.”

Abram de Swaan’s work addresses the emergence of national social welfare policies in Europe. To de Swaan, the elites’ perception of social problems has a fundamental importance. Along with Reis, de Swaan argues that, in the case of Europe, the elites saw advantages in the collectivization of solutions to social problems, and public power became the natural agent in the provision of “citizenship goods” like health, education, and social security. For de Swaan, the elites are, as a general rule, self-serving, and they act to avoid “negative external effects” such as epidemics, pollution, crimes, rebellions, and migrations.

Ruas vazias em São Paulo, 5 de abril de 2020. (Foto de Elize Massard da Fonseca.)

Empty streets in São Paulo, April 5, 2020. (Photo by Elize Massard da Fonseca.)

In my master’s thesis, my main hypothesis suggested that among the Brazilian elites, there are few similarities with the European ones analyzed by de Swaan. I argued that there is no awareness of interdependence of social classes, which would enable mobilization to solve problems in Brazil in a cooperative way, facilitating the creation of social policies that favor the poor. However, at that point we had not felt the weight of an epidemic, or rather, of a pandemic such as we are experiencing today.

Brazilian society is facing many risks if the government does not take urgent responses. I say the entire society because the negative effects will be shared by all. It is certain some will be affected more than others, but all will lose. Losses will start with the spread of a lethal and up until now little-known virus, which entered the country via the travel of elites. Losses will continue with the lack of hospital beds, a worsening economic crisis, the threat of social upheaval, and looting by groups that are desperate for assistance. Everyone will be affected.

The decision to backtrack on the firing of Mandetta was only possible because a considerable portion of the elite were feeling threatened, as reflected in the polls. While this does not guarantee that the Minister of Health will remain in office, it does add support to some of his policies that will help control the epidemic. It remains to be seen what these elites think about the importance of democracy.

This article was originally published on Nexo on April 7, 2020, and was translated by CLAS staff.

Carolina Botelho.Carolina Botelho is a researcher at Pontifícia Universidade Católica do Rio de Janeiro, and a professor and postdoctoral fellow at Escola Nacional de Ciências Estatísticas / Instituto Brasileiro de Geografía e Estatística. She holds a doctorate in political science from the Instituto de Estudos Sociais e Políticos da Universidade do Estado do Rio de Janeiro, and a master’s degree in sociology and anthropology from the Universidade Federal do Rio de Janeiro. She is an Affiliated Scholar of the Center for Latin American Studies at UC Berkeley.

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The Treatment and Control of Chronic Disease in Chile

By Claire Boone

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Very excited to be at the Ministry of Health in Santiago, Chile. (Photo courtesy of Claire Boone.)

Notes from the Field: Student Research in Latin America
CLAS awards financial support to graduate students to travel to Latin America for pre-dissertation research. The following is a reflection on one student’s summer fieldwork experience. (For more information, please see CLAS Summer Field Research Grants.)

Chronic diseases such as hypertension and type 2 diabetes are increasingly affecting Latin America: currently about half of the years of life lost in the region are attributable to chronic disease. (1) In Chile about a third of the adult population has hypertension, double the prevalence in the United States. (2) While Chile has recently been categorized as a high-income country by the World Bank, income inequality is extremely high, and the difference in quality of life between the richest and poorest wealth quintiles is stark. Unsurprisingly, the poorest sector of the population also bears a disproportionately large disease burden, particularly of chronic diseases.

Risk factors for chronic diseases are often more prevalent in low-income populations, and Chile is no exception. Common risk factors include being overweight or obese, a diet low in fruits and vegetables and high in sugars, and a sedentary lifestyle. In 2015, Chile set the then-record for the highest consumption of soda calories per capita, surpassing the United States.

So, how can a country halt or even reverse the trend of increasing chronic disease?

There are two main policy areas to focus on: prevention and treatment. Prevention – or preventing those who aren’t sick from becoming sick – has been the focus of a major policy movement in Chile, something the New York Times recently called “the world’s most ambitious attempt to remake a country’s food culture.” (3)

The movement includes several high-profile policies: a sugar tax introduced in 2014, which at 18% is one of the highest in the world. A ban on marketing of unhealthy foods to children, which includes the removal of all mascots from cereal boxes, cookies, and candy. And the Food Labeling Act, which adds stop sign-shaped labels to all foods high in sugars, salt, fat, or calories.

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The Primary Care Division (División de Atención Primaria, DIVAP) at the Chilean Ministry of Health in Santiago was where I called home this summer. My coworkers supplied me with a desk, great internet, and excellent lunch company. (Photo courtesy of Claire Boone.)

Evaluations of these policies are currently ongoing and it is likely too early to say whether they have successfully prevented any chronic disease. They do seem to be changing behavior, which is a crucial first step: a recent evaluation found the promising evidence that the food labelling policy was associated with a 18-25% reduction in sugar-sweetened drink consumption.

In the meantime, Chile is also working to better control disease among patients already diagnosed.

Health care in Chile is two-tired, with three quarters of the population using the large government-provided system, FONASA, and the rest paying for private insurance. In the public sector, the Ministry of Health established the Programa de Salud Cardiovascular (Program for Cardiovascular Health) over 15 years ago. This program includes free primary care as well as free medications for patients diagnosed with hypertension, type 2 diabetes, and/or dyslipidemia.

An interesting component of the cardiovascular program, and the focus of my research, is the appointment reminder system. Patients attending primary care facilities who are enrolled in the cardiovascular program receive an SMS reminder 24-48 hours before their scheduled appointment. If they do not have a cell phone, an automated call is made to their landline. Importantly, the patient has the option to respond either confirming or cancelling the appointment. If it is cancelled, the slot is automatically assigned to another patient.

In a public health care system health care provider working hours and wait times for appointments are major ongoing concerns. This appointment rescheduling program has the capacity to function both as a timely reminder to patients with chronic disease and as a way to improve efficiency within the system. Since patients are able to cancel on short notice the facility might be able to see more patients overall, as fewer slots will be wasted on no-shows.

Last summer, our team worked to evaluate the impact of the SMS appointment reminder program on the number of appointments made at each facility. Since the program was implemented in different facilities at different times, we were able to evaluate the program’s impact on two groups: chronic patients who receive the SMS reminders, and non-chronic patients who do not receive the reminders but who attend clinics where the SMS program was implemented.

Mornings were improved after the discovery of a cheap fruit vendor near to the metro! (Photo courtesy of Claire Boone.)

A typical work day at DIVAP included meetings, brainstorming with ministry of health workers, and lots and lots of wrestling with very large datasets. Mornings were improved after the discovery of a cheap fruit vendor near to the metro! (Photo courtesy of Claire Boone.)

Interestingly, we found that the SMS reminders did not change the number of appointments chronic disease patients attended, on average. While at the time we didn’t have the data to test this, it seemed that some chronic patients were cancelling on short notice. This allowed for more appointment slots to open up for non-chronic patients: we found that non-chronic patients who attend clinics with the SMS program attended more appointments.

This study left us with more questions than we started with, and so I returned to Santiago, Chile in summer 2019 to continue the work, this time more closely with the Ministry of Health.  I was based on the Primary Care Division of Chile’s Ministry of Health in Santiago (MINSAL DIVAP). During the month I spent there, I worked with local researchers to access and clean the four large datasets we will use in this new impact evaluation: electronic health records from primary care appointments, medication prescription and withdrawal data, emergency room records, and data on SMS reminders sent and received.

These data are huge in scale – they represent about 60% of all patients in Chile with a chronic disease. Now we will be able to measure not only the impact on appointment attendance, but also the impact of the program on health and health behaviors, such as prescription refills.

The evaluation team — myself, DIVAP, and collaborators at the public policy school at La Pontificia Universidad Católica de Chile — worked to create an evaluation plan and formalize study outcome definitions. Using very large datasets has its challenges, but working with the ministry’s IT team, we managed to transfer all the data we need to complete this evaluation in a couple of months.  The analysis is well underway, and the results of this study will be used to directly inform decisions at Chile’s Ministry of Health.

REFERENCES

  1. Anauati MV, Galiani S, Weinschelbaum F. The rise of noncommunicable diseases in Latin America and the Caribbean: challenges for public health policies. Lat Am Econ Rev. 2015 Dec 1;24(1):11.
  2. Fasce E, Campos I, Ibáñez P, Flores M, Zárate H, Román O, et al. Trends in prevalence, awareness, treatment and control of hypertension in urban communities in Chile: J Hypertens. 2007 Sep;25(9):1807–11.
  3. Caballero, Victor Ruiz, “In Sweeping War on Obesity, Chile Slays Tony the Tiger.” The New York Times, February 7, 2018.
    https://www.nytimes.com/2018/02/07/health/obesity-chile-sugar-regulations.html

Claire Boone.

Claire Boone is a Ph.D. student in Health Policy/Health Economics at UC Berkeley. She holds an MPH in epidemiology/biostatistics. She specializes in the evaluation of health policies and programs, and is particularly interested in the prevention and management of chronic diseases. She has been working with researchers and policy makers in Chile for three years, and plans to continue this work for her dissertation.

Claire is a recipient of the 2019 CLAS Summer Field Research Grant. 

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Por que Bolsonaro recuou e não demitiu Mandetta

Por Carolina Botelho

20/03/2020 Coletiva de Imprensa do Presidente da República, Jai
Presidente Bolsonaro e seu ministro da Saúde (à sua direita). (Foto de Isac Nóbrega/PR.)

A marcha à ré do presidente só foi possível porque uma parte considerável da elite brasileira se sentiu ameaçada

A última segunda-feira (6) foi um dia especialmente tenso para o país. Não pelos motivos ordinários que já estamos nos acostumando a naturalizar em relação ao presidente da República, seus filhos e seus apoiadores. Não, esse dia foi um pouco além. A ameaça real de demissão do único ministro que parece valorizar a ideia de república como se espera de um gestor público tornou-se quase palpável e já havia sido anunciada. Bolsonaro iria mandar embora o seu ministro da Saúde, o único do time que tem se preocupado e agido para poupar vidas num período horrível da história das epidemias com o qual o mundo “quase” todo, ou pelo menos, o mundo “civilizado”, tem se preocupado. O presidente ao final do dia voltou atrás, ou melhor dizendo, voltaram atrás na decisão de Bolsonaro. Quem foi?

Essa é uma importante interrogação neste momento. Quem fez Bolsonaro voltar atrás? Em uma democracia na qual os eventos ocorrem de maneira tranquila, seria esperado que as instituições políticas e sociais recomendassem ao presidente a prudência necessária diante da ameaça da covid-19, e ele aceitaria. No caso brasileiro, as instituições têm cumprido seu papel, mas Bolsonaro despreza todas elas, desqualifica o debate científico e deslegitima os especialistas. O resultado dessa equação é simples, nossa democracia perde diariamente, mas ontem pareceu diferente. Uma grande parcela dos analistas afirma que foram os generais que hoje circulam em torno de Bolsonaro para conter seus “excessos” que exigiram a marcha à ré do presidente. E eu concordo, só que essa não é toda a resposta. Dito isso, reformulo mais uma vez a frase: a quem os generais ouviram para depois fazerem Bolsonaro recuar?

AS ELITES SÃO CAPAZES DE EXERCER UM VERDADEIRO PODER DE VETO AOS RUMOS DO DESENVOLVIMENTO ECONÔMICO E POLÍTICO DE UM PAÍS

Tenho insistido em um tema muito frequente nos estudos das ciências sociais, aquela ciência mais desprezada e desqualificada por Bolsonaro (por quê?): a teoria das elites. Estudei um pouco sobre ela na graduação e também utilizei a teoria na minha dissertação de mestrado há quase duas décadas. Em 2019, ao oferecer um curso para a graduação, julguei o assunto importante para incluir na bibliografia e não me arrependo.

Jair Bolsonaro com o presidente dos EUA, Donald Trump, na Flórida, em 7 de março de 2020. Um membro da equipe de Bolsonaro testou positivo para o coronavírus alguns dias depois. (Foto de Alan Santos / PR.)
Jair Bolsonaro com o presidente dos EUA, Donald Trump, março de 2020. Um membro da equipe de Bolsonaro testou positivo para o coronavírus alguns dias depois. (Foto de Alan Santos / PR.)

Recentemente, o Datafolha mostrou que 51% das pessoas entrevistadas disseram que Bolsonaro mais atrapalha do que ajuda no combate ao coronavírus e 39% reprovam o presidente de modo geral. Seria algo simples de aceitar, mas esse dado traz um resultado mais interessante. Bolsonaro é mais mal avaliado por mulheres (43% de reprovação), pessoas com curso superior (50%) e mais ricos (acima de 10 salários mínimos mensais, 46%).

O presidente dirá que não confia em pesquisa, mas a teoria das elites explica por que o Datafolha está correto e parte dos brasileiros desembarcou da sandice do projeto Bolsonaro.

Embora a metodologia tenha sido alterada nas últimas pesquisas devido ao isolamento social, entre os mais ricos, a reprovação ao presidente subiu de 28% em dezembro para 46% em abril. A importância desse grupo nas sociedades não é trivial. Bottomore, um teórico das elites, já mostrou que elas são capazes de exercer um verdadeiro poder de veto aos rumos do desenvolvimento econômico e político de um país. Como observou Elisa Reis, até as possibilidades de uma mudança gradativa no Brasil dependem consideravelmente da aquiescência das elites. Segundo ela, “a importância das elites está na direção e no controle que elas podem exercer sobre a complexa e difícil transição de uma forma de organização social para outra”.

Abram De Swaan tratou da emergência de políticas nacionais de bem-estar social na Europa. Para ele, a percepção das elites sobre os problemas sociais possui um significado fundamental. No caso da Europa, e como bem lembrou também Elisa Reis, De Swaan mostra que as elites viram vantagens na coletivização de soluções a problemas sociais e que o poder público tornou-se o agente natural na provisão de “bens de cidadania” como educação, saúde e previdência. Para De Swaan, a elite é, em regra, interesseira e age com o objetivo de evitar os “negative external effects” que ele exemplifica com epidemias, poluição, crimes, rebeliões e migrações.

Ruas vazias em São Paulo, 5 de abril de 2020. (Foto de Elize Massard da Fonseca.)
Ruas vazias em São Paulo, 5 de abril de 2020. (Foto de Elize Massard da Fonseca.)

No meu estudo realizado no mestrado, a minha hipótese principal sugeria que não há, entre as elites brasileiras, semelhanças com as analisadas por De Swaan, ou seja, não existe entre elas uma consciência sobre a interdependência das classes sociais, o que viabilizaria uma mobilização para a solução dos problemas no Brasil, de forma cooperativa, para facilitar a criação de políticas sociais que favorecessem os pobres. Entretanto, até aquele momento, ainda não tínhamos sentido o peso de uma epidemia, ou melhor, de uma pandemia como o que estamos experimentando hoje em nossas vidas.

Concretamente falando, a sociedade corre muitos riscos, caso o governo não tome medidas urgentes. Digo toda a sociedade porque os efeitos negativos serão partilhados por todos. Está certo que recairá mais para alguns grupos do que para outros, mas todos vão perder. A começar pela contaminação por um vírus até então pouco conhecido e letal, que entrou no país via elite, mas também pela falta de leitos, a crise econômica que se agravará, a ameaça de convulsão social e de saques pelos grupos que estão desassistidos. Todos vão ser afetados.

A marcha à ré de Bolsonaro só foi possível porque uma parte considerável do grupo da elite captado pelas pesquisas se sentiu ameaçada. O que por sua vez, não garante longa permanência ao seu ministro da Saúde, mas dá fôlego a algumas políticas de controle da epidemia. Resta saber o que esse grupo pensa sobre a importância da democracia.

Publicado originalmente no Nexo, 7 de abril de 2020

Carolina Botelho.

Carolina Botelho é pesquisadora da PUC-Rio (Pontifícia Universidade Católica do Rio de Janeiro), professora e pós-doutoranda do Ence/IBGE (Escola Nacional de Ciências Estatísticas do Instituto Brasileiro de Geografia e Estatística). É doutora em ciência política pelo Iesp/Uerj (Instituto de Estudos Sociais e Políticos da Universidade Estadual do Rio de Janeiro), mestre em sociologia e antropologia pela UFRJ (Universidade Federal do Rio de Janeiro) e Visiting Scholar do CLAS/UC Berkeley (Estados Unidos).

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Covid-19 in Brazil: Lessons from a period of crisis

By Elize Massard da Fonseca

Empty streets in São Paulo, Brazil. (Photo by Elize Massard da Fonseca.)

Empty streets in São Paulo, Brazil. (Photo by Elize Massard da Fonseca.)

The new coronavirus is one of the most severe global health crises in history. 15 years ago, member countries committed themselves to the World Health Organization (WHO)’s International Health Regulation, which provides harmonized measures for global public health emergencies (World Health Organization 2005). As the Covid-19 emergency began, however, governments adopted starkly different approaches to fighting the epidemic. Despite established international norms and evidence-based guidelines based on previous influenza outbreaks, many government leaders, including President Jair Bolsonaro of Brazil, continue to sow doubt about the significance of the disease.

As Berkeley scholars have demonstrated, times of crisis create uncertainty but also shed light on political entrepreneurs. These crises are tough periods, but also carry the potential for change and policy innovation (Collier and Collier 1991, Pierson 2004). Therefore, there are several lessons we can draw from the Covid-19 outbreak.

A sign in a Brazilian pharmacy: We don't have masks. (Photo by Elize Massard da Fonseca.)

A sign in a Brazilian pharmacy: “We don’t have masks.” (Photo by Elize Massard da Fonseca.)

1) International guidelines for responding to global health emergencies will fail if they ignore politics. Crises are messy. They involve the cooperation of various interests, and coordination among political opponents is tough. In Brazil, a major obstacle to successfully countering the coronavirus epidemic is the dispute between the president and other government figures, including his health minister and state governors. This problem is not exclusive to Brazil — collaboration problems have appeared in many countries. Covid-19 emerged alongside a rise in nationalist politics and conservatism, which has influenced the direction and timing of the public response. Of course, such unexpected behavior would have been difficult to predict; however, the disarray makes clear that the WHO must be far more prepared to take on coordinating roles.

2) Evidence-based policies are crucial but they do not automatically translate into public policy; this is particularly true in watershed moments when many policy options are available. No matter how much pressure President Bolsonaro faces, be it from the Minister of Health, the public health community (which, in Brazil, is a powerful advocacy group), or the scientific community, it all falls on deaf ears. It is beyond the scope of this short blog post to analyze such political behavior but, echoing the call of Buse, Dickinson, and Sidibé (2008), it is clear that political scientists must have a role in the development of evidence-based policies. History tells us that the stubbornness of the South African President in denying the HIV/AIDS epidemic cost that country many lives. This is not very different from what is happening in Brazil and many other countries, unfortunately.

Henrique Mandetta, the Brazilian Minister of Health, in one of the ministry's trademark vests. (Photo by Isac Nóbrega/PR.)

Henrique Mandetta, the Brazilian Minister of Health, in one of the ministry’s trademark vests. (Photo by Isac Nóbrega/PR.)

3) We should be careful who we credit for taking effective action in response to public health crises. The Brazilian Minister of Health, Henrique Mandetta, has been in the limelight in the fight against the coronavirus. His popularity is now 21% higher than that of the president; he has been praised for making important technical decisions and being a strong voice for evidence-based policies. Mandetta is a physician by training, but also a savvy politician. Political entrepreneurship develops by circumstance, but also requires the construction of a social coalition and innovative framing (Pierson 2004); Mandetta has it all. He recently formed an alliance with governors in the opposition parties and gained the sympathy of the public health community. He is constantly wearing the national health system vest, and recently stated that “doctors do not abandon their patients.” In Mexico, Undersecretary of Health Hugo López-Gatell has also taken on a leadership role in the fight against the epidemic, while President Andrés Manuel López Obrador has adopted a discourse similar to that of Bolsonaro. The health officials are a product of the unique circumstances, and have shown themselves to be quite skilled at building coalitions.

It is difficult to know for certain whether this crisis will lead to a change in the direction of social protection and health policies in Brazil and around the world. It is certainly likely, however, that the world will come out of this crisis changed. From the structure of the economy to public health coverage to personal hygiene, coronavirus will have left a mark.

Government agents supervise sales of sanitizer, masks, and other medical supplies to prevent price gouging and hoarding, March 2020. (Photo by Paulo H. Carvalho / Agência Brasília.)

Government agents supervise sales of sanitizer, masks, and other medical supplies to prevent price gouging and hoarding, March 2020. (Photo by Paulo H. Carvalho / Agência Brasília.)

Finally, allow me to offer some insight for anyone worried or curious about what it is like to live with social distancing measures in Brazil. The uncertainty surrounding the epidemic is stressful in and of itself, but coupled with conflicting messages from the government and the apocalyptic sight of field hospitals being set up in soccer stadiums, I get the sense that the worst is yet to come. Please, stay at home and follow the guidelines from health authorities. Do what you can to ensure the safety of your community.

References

Buse, K, C Dickinson, and M Sidibé. 2008. “HIV: know your epidemic, act on its politics.” J  R Soc Med 101:572–573.
Collier, RB, and D Collier. 1991. Shaping the Political Arena: Critical Junctures, the Labor Movement, and Regime Dynamics in Latin America. Princeton: Princeton University Press.
Pierson, P. 2004. Politics in Time: History, Institutions and Social Analysis. Princeton/Oxford: Princeton University Press.
World Health Organization. 2005. International Health Regulations. Geneva: World Health Organization.

Elize Massard da Fonseca.

 

Elize Massard da Fonseca is Assistant Professor of Public Administration at the São Paulo School of Business Administration, Getulio Vargas Foundation (EAESP/FGV). She was a visiting scholar at CLAS in 2019, and can be reached at elize.fonseca@fgv.br.

 

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Boric: angustia y esperanza en Chile

Por Sofía Barahona y Felipe Vial

Chilean deputy Gabriel Boric speaks for CLAS at UC Berkeley, February 2020. (Photo by Nicolás Novoa-Marchant/www.sdpaudiovisual.com.)

El diputado chileno Gabriel Boric habla con la comunidad de CLAS en UC Berkeley, febrero de 2020. (Foto de Nicolás Novoa-Marchant / www.sdpaudiovisual.com).

Article in English

El pasado 10 de febrero, el diputado chileno de Convergencia Social, Gabriel Boric, estuvo en Berkeley invitado por el Centro de estudios Latinoamericanos (CLAS, por sus siglas en inglés). Se juntó a conversar con miembros de la comunidad de UC Berkeley sobre el estallido social en Chile y describió las principales agendas de reforma que se están discutiendo en su país: la agenda social, que busca dar respuesta a las problemáticas más urgentes de los chilenos; la de derechos humanos, cuyo fin es tanto garantizar el reconocimiento, sanción y reparación de los numerosos casos de vulneración de los derechos humanos de manifestantes, como también reformar las FF.AA y Carabineros; y la agenda constitucional que se manifestará, entre otras cosas, en el plebiscito que se realizará el 26 de abril para saber si se aprueba o no la redacción de una nueva constitución. (1)

Con respecto al proceso constitucional, Boric nos dejó varias reflexiones. Los niveles de violencia y manifestaciones que estamos viviendo como país son una respuesta a la violencia institucional que generó durante décadas la marginalización de un significativo porcentaje de la población. Los avances que nos posicionaban como uno de los países más desarrollados de Latinoamérica no reflejaban las realidades diarias que vivían miles de chilenos. Una de estas era un alto endeudamiento estudiantil ligado a títulos de instituciones que no cumplieron las expectativas. Las demandas de las movilizaciones reflejan también descontento con bajos salarios, pensiones, y un sistema educacional y de salud altamente segregado.

Es este clima político y social el que nos mantiene, como planteó el diputado, en una constante tensión entre la angustia y la esperanza. Angustia por las necesidades urgentes que aún no tienen solución, por la violencia, la represión, y la falta de soluciones concretas en el corto plazo a las necesidades más urgentes de los chilenos. Esto es utilizado como argumento por los sectores más conservadores para no avanzar en el proceso constitucional, declarando que no existen las condiciones mínimas que garanticen un proceso democrático. Además, plantean que un cambio constitucional tomaría mucho tiempo y que para solucionar los problemas más urgentes se pueden hacer reformas. Es irónico que aquellos son los mismos que se opusieron a un proceso constitucional durante el segundo gobierno de Michelle Bachelet – en condiciones mucho más “estables” que las de ahora – y son los mismos que han acusado de inconstitucionales muchas de las reformas propuestas en los últimos años.

A huge protest march in the Plaza Baquedano in Santiago, October 2019. (Photo by Hugo Morales.)

Marcha de protesta en la Plaza Baquedano en Santiago, Chile. Octubre de 2019.
(Foto de Hugo Morales.)

La segunda parte de esta tensión constante es la esperanza. El levantamiento social se sublevó contra la violencia institucional y dio paso a una gran oportunidad de cambio. Fueron los mismos ciudadanos que se autoproclamaron “despiertos” y sin intenciones de volver a dormir. El Congreso comenzó a legislar como nunca, los políticos lograron ponerse de acuerdo, la gente tomó las calles, volvió a conversar con el otro y a participar. La única certeza que tenemos es que, aunque los próximos años serán difíciles para todos, existe la inédita posibilidad de construir un nuevo pacto social impuesto por la razón y por la democracia, no la fuerza. Un acuerdo transversal para que, en nuestra carta fundamental, el marco social en el que nos desenvolvemos, quepamos todos.

1. La fecha del plebiscito constitucional fue cambiada al 25 de octubre de 2020 debido a la pandemia del coronavirus.
https://www.cnnchile.com/pais/plebiscito-nueva-fecha-25-octubre_20200319/

Sofia Barahona.

 

Sofía Barahona es la Coordinadora de Desarrollo de LYRIC, una ONG con sede en San Francisco que trabaja con jóvenes LGBTQ. También ha trabajado en East Bay Sanctuary Covenant y OLAS-LGBTQ Sanctuary Project, dos ONGs que trabajan con migrantes latinoamericanos en el Área de la Bahía. En 2017, antes de mudarse a los EE.UU., fue presidenta del sindicato de estudiantes de PUC Chile (FEUC) y portavoz del Movimiento de Estudiantes de Chile.

Felipe Vial.

 

Felipe Vial es un estudiante de doctorado de tercer año en el Departamento de Economía de UC Berkeley. Recibió tanto su B.A. y M.A en Economía en PUC Chile. Sus intereses de investigación giran en torno a la economía laboral y la economía política, particularmente centrados en los sindicatos y la acción colectiva

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Boric: Anguish and Hope in Chile

By Sofía Barahona and Felipe Vial

Chilean deputy Gabriel Boric speaks for CLAS at UC Berkeley, February 2020. (Photo by Nicolás Novoa-Marchant/www.sdpaudiovisual.com.)

Chilean Deputy Gabriel Boric speaks for CLAS at UC Berkeley, February 2020.
(Photo by Nicolás Novoa-Marchant/www.sdpaudiovisual.com.)

Artículo en español

On February 10, Chilean Deputy Gabriel Boric, of the Social Convergence party, spoke at Berkeley for CLAS. He discussed the social unrest in Chile and described the main agendas of reform that are being discussed in the country. There is a social agenda to find an answer to the most urgent problems of Chileans. There is also a human rights agenda, to guarantee the recognition, sanction, and reparation of numerous cases in which the rights of protesters have been violated, as well as the need to reform the armed forces and the police. Finally, there is the constitutional agenda that will be pushed forward by, among other things, the April 26 plebiscite to decide whether or not to begin the process of drafting a new constitution. (1)

On the constitutional agenda, Boric left us with several thoughts. The levels of violence and protests that Chile is experiencing as a country are a response to the institutional violence that generated decades of marginalization for a significant percentage of the population. The economic advances that positioned us as one of the most developed countries in Latin America are not reflected in the daily realities for Chileans. One reality is high student indebtedness linked to institutions that do not meet their promises of better jobs on graduation. Protesters’ demands also reflect widespread discontent with low wages, pensions, and a highly segregated education and health system.

It is this political and social climate that keeps Chile, as Boric stated, in a constant tension between anguish and hope. Its anguish is due to the urgent needs of the country that still have no solution, as well as ongoing violence, repression, and a lack of concrete programs to meet Chileans’ most urgent needs in the near future. The social upheaval these conditions have sparked is used by the most conservative politicians and their backers to oppose the constitutional agenda, arguing that the minimum conditions to guarantee a democratic process do not exist today. Those conservatives also argue that a constitutional change would take a long time, and that short-term reforms can solve the most urgent problems. It is ironic that those actors are the same people who opposed a constitutional reform process during Michelle Bachelet’s second government — in conditions that were much more stable than now — and have also labeled many of the recently proposed reforms as unconstitutional.

A huge protest march in the Plaza Baquedano in Santiago, October 2019. (Photo by Hugo Morales.)

A protest march in the Plaza Baquedano in Santiago, Chile, October 2019.
(Photo by Hugo Morales.)

The second part of this constant tension is hope. The social upheaval in Chile grew in the face of institutional violence and has created a great opportunity for change. It is citizens who have declared themselves “awake” and with no intention of going back to sleep. The Congress began to legislate as never before, politicians managed to reach agreements, the people took to the streets, dialogues ensued, and people continued to participate. The only certainty we have is that, although the next few years will be difficult for everyone, there is the unprecedented possibility of building a new social pact created through reason and democracy, not imposed by force. An intersectional agreement such as our fundamental document, the social framework in which Chileans operate, has space for everyone.

1. Please note, since this blog was written, the plebiscite has been postponed until October 25, 2020, in response to the Covid-19 pandemic.
https://www.cnnchile.com/pais/plebiscito-nueva-fecha-25-octubre_20200319/

Sofia Barahona.

 

Sofia Barahona is the Development Coordinator at Lavender Youth Recreation and Information Center, an San Francisco-based NGO working with LGBTQ youth. She has also worked in the East Bay Sanctuary Covenant and OLAS-LGBTQ Sanctuary Project, two NGOs that work with Latin American migrants in the Bay Area. In 2017, before moving to the U.S., she was President of PUC Chile’s student union (FEUC) and a spokesperson for the Chilean Student Movement.

Felipe Vial.

 

Felipe Vial is a 3rd year Ph.D. student in the Department of Economics at UC Berkeley. He received both his B.A. and M.A in Economics from PUC Chile. His research interests revolve around labor economics and political economy, particularly focused on unions and collective action.

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When “staying home” might not be an option for everyone: Reflections on the effects of Covid-19 in Brazil

By Laura Belik

The São Remo favela in São Paulo, Brazil. (Photo by Ben Tavener.)

The São Remo favela in São Paulo, Brazil. (Photo by Ben Tavener.)

In Brazil, according to the 2010 Census, 11,425,644 people (6% of the population) live in what is classified as Aglomerados Subnormais (Subnormal clusters), including favelas, comunidades, squatted land, invaded land, and the like. In a country where 81% of the people reside in urban areas, informal settlements are often overcrowded areas with low-income populations where access to basic infrastructure is not a given. Most of these people also make up a large part of the 41% of the population in the informal labor market, with jobs that are not regulated or protected by the state. While these unstable conditions already represent a struggle in their lives, a crisis such as Covid-19 make some of these issues ever more evident.

Common scenarios like families of nine or more sharing a one-room shack exemplify why social-distancing might simply not be an option. Intermittent access to water and open-air sewage systems right beside one’s home make it difficult to meet the World Health Organization’s sanitation regulations. On top of that, hand sanitizer has become an unaffordable item, or more commonly simply out of stock. When thinking about the effects of a fast-spreading virus in cities like São Paulo and Rio de Janeiro, wealth disparity and its consequences on the urban setting, how the urban form echoes social and economic inequality, become even more recognizable. No one can escape the effects of the coronavirus, but prevention methods to “flatten the curve” are a luxury that only the privileged can enjoy.

In Rio de Janeiro parties and the baile funk have been called off, and there is a curfew established by gangs and militias for people to return to their homes. At 8 pm, sirens normally used to announce risky situations such as storms and landslides are now an official Covid-19 curfew warning. Public health measures, as well as everyday practices, are once again determined and held informally by the ones that truly dominate these spaces. Neighborhood associations in peripheral areas have also been actively responding to the crisis in whatever ways they can, and collectively demanding official guidelines and support from the state.

Cleaning of public spaces in Brasilia, March 30, 2020. (Photo by Lúcio Bernardo Jr / Agência Brasília.)

Cleaning public spaces in Brasilia, March 30, 2020.
(Photo by Lúcio Bernardo Jr / Agência Brasília.)

Federal, state and local governments have been brainstorming specific measures to relieve at-risk populations during the spread of the epidemic. The use of hotels and even naval ships to house and isolate the elderly and other high-risk populations from informal settlements has been considered as an option.

“Stay at home” becomes a loaded term with multiple layers when cities heavily rely on informal relations. Many people cannot afford not to work, and will not be able to get help from the government precisely because of their lack of documentation. “If I don’t die of the virus, I will die of hunger,” says José Maria, 65, a street vendor who sells ice cream and is concerned with his income over the next few months. Home might also be an unstable place that has never symbolized safety in any sphere, not just considerations of health. In times of seclusion, Covid-19 makes clear how urban spaces in Brazil are disparate and unequal, and reemphasizing that thinking about our cities is a complex and interdisciplinary issue with no single solution at hand.

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Laura Belik is a Ph.D. Candidate in Architecture – History, Theory and Society at UC Berkeley. She holds an M.A. in Design Studies from Parsons – The New School (New York) and a B.Arch. in Architecture and Urban Planning from Escola da Cidade (São Paulo- Brazil). Her main research interests are urbanism, history of architecture, politics of space, design theory, and curatorial studies.  Her dissertation research focuses on the histories and dimensions of socio-spatial inequalities in the Brazilian Northeast region, and how to interpret the multiple memories related to the built environment.

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