The battle against hunger during the COVID-19 pandemic: mental health arrangements in a favela at São Paulo

Amanda Seraphico Carvalho Pereira da Silva Lumena Almeida Castro Furtado Valéria Monteiro Mendes Arthur Chioro About the authors

ABSTRACT

The return and worsening of hunger during the COVID-19 pandemic were important setbacks experienced by the Brazilian population in recent years, as a result of a necropolitics form of government, which refused to look at and offer public policies aimed at vulnerable populations. The act of eating, in itself, is a promoter of (physical and mental) health, which has been denied to a large part of the population during the pandemic. This research, based on cartography method, aimed to investigate arrangements of mental health produced in the communities, in Heliópolis, a favela in São Paulo. Among the main findings, we highlight arrangements to expand the food supply, rescue the political importance of individuals residing in the territory, marches denouncing the situation of hunger in the favelas, as well as affective sharing of stories mediated by the sharing of food. These actions show the importance of the act of eating as a promoter of (physical and mental) health and highlight the importance of the relationships produced and mediated by food. The fight for food and its sharing, in a scenario of political dismantling and return of hunger in the country, presented itself as a form of resistance and collective confrontation to necropolitics.

KEYWORDS
Hunger; COVID-19; Mental health

Introduction

The return of Brazil to the hunger map was a phenomenon that occurred in the midst of the COVID-19 pandemic, resulting from a genocidal government with guidance and actions based on necropolitics11 Mbembe A. Necropolítica. 3. ed. São Paulo: N-1 edições; 2018. 80 p.. A politics that kills and lets die, whose core is the unequal distribution of the opportunity to live within the framework of the capitalist system. This logic has as a consequence the fact that some lives are understood as of greater value, while the rest can be discarded.

The phenomenon of hunger, in terms of debate in the health area, has undergone extensive restructuring: it has ceased to be merely calculated as calorie intake by individuals to be addressed in its psychological and social aspects and crossed by inequalities22 Schall B, Gonçalves FR, Valente PA, et al. Gênero e insegurança alimentar na pandemia de covid-19 no brasil: a fome na voz das mulheres. Ciênc. saúde coletiva. 2022 [acesso em 2023 nov 4]; 27(11):4145-54. Disponível em: https://doi.org/10.1590/1413-812320222711.07502022.
https://doi.org/10.1590/1413-81232022271...
.

Hunger is understood as a social and multifactorial phenomenon. As such, it must be fought by public policies that are directly related to the structural inequalities of the Brazilian reality33 Salles-Costa R. Desafios políticos da retomada da fome e da insegurança alimentar no Brasil. In: Campello T, Bortoletto AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 123-34.. The profile of hunger in Brazil is of families in situation of vulnerability, black and brown, and, in general, headed by women33 Salles-Costa R. Desafios políticos da retomada da fome e da insegurança alimentar no Brasil. In: Campello T, Bortoletto AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 123-34..

Belchior and Moreira44 Belchior D, Moreira A. “O maior espetáculo do pobre da atualidade é comer”. In: Campello T, Bortoletto, AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 147-154 reaffirm the production of death and hunger of black and indigenous populations by the Brazilian state since before the pandemic and its aggravation during this period. The political regime of liberal democracy restructured inequalities and continues to produce, daily, the dehumanization of this portion of society44 Belchior D, Moreira A. “O maior espetáculo do pobre da atualidade é comer”. In: Campello T, Bortoletto, AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 147-154.

Discussing hunger in our country involves ethical issues that demand an absence of neutrality regarding this phenomenon55 Dowbor L. “Fome, uma decisão política e corporativa”. In: Campello T, Bortoletto AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 181-93.. When food production is in surplus and yet the people go hungry, the inequality of income concentration and the absence of government actions that redistribute food are political choices that liberal democracy has allowed in Brazil55 Dowbor L. “Fome, uma decisão política e corporativa”. In: Campello T, Bortoletto AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 181-93..

In addition to this, the widespread legalization of pesticides and the consumption of industrialized foods are practices promoted by the country, both negatively affecting the health (physical and mental) of the population66 Torre E, Amarante P. Saúde mental, direitos humanos e justiça ambiental: a ‘quimicalização da vida’ como uma questão de violação de direitos humanos decorrente da intoxicação institucionalizada. Saúde debate. 2022; 46(esp2):327-44..

In the context of a black territory affected by the pandemic, this study entered the periphery of São Paulo, in the neighborhood of Heliópolis, the largest favela in territorial extension of the capital São Paulo77 União de Núcleos, Associações dos Moradores de Heliópolis e Região. Heliópolis - Maior favela de São Paulo. [acesso em 2022 jul 15]. Disponível em: https://www.unas.org.br/heliopolis.
https://www.unas.org.br/heliopolis...
.

The data verified at the national level, of increased hunger and food insecurity in the pandemic, were also intensely observed in this community. According to a survey conducted by Observatório De Olho na Quebrada88 União de Núcleos, Associações dos Moradores de Heliópolis e Região. Heliópolis contra coronavírus: saúde alimentar na pandemia. 2020. [acesso em 2022 jul 15]. Disponível em: https://drive.google.com/file/d/1qEIuFiVnbXxLm6toe9pLl9bNhXxGgV53/view.
https://drive.google.com/file/d/1qEIuFiV...
, only 58% of households had three meals a day in the period of the first wave of COVID-19 (mid-April 2020).

Considering that hunger is not only a macro phenomenon and that it directly affects the bodies-subjectivities of those who suffer from it, this research aimed to analyze the production of mental health care arrangements in the territories and communities affected by the return and worsening of hunger.

Methodology

This is a qualitative study, based on cartography99 Rolnik S. Cartografia Sentimental: Transformações Contemporâneas do Desejo. São Paulo: Editora Estação Liberdade; 1989. method, held in the territory of Heliópolis, periphery of São Paulo (SP). The insertion in this place took place by the contacts of the Public Health Laboratory (Lascol) of the Federal University of São Paulo (UNIFESP) with the Union of Nuclei, Associations of Residents of Heliópolis and Region (UNAS), that is, by one of the main social movements of the neighborhood.

Cartography is a drawing of the landscape that is made while it is transformed; it is able to give voice to feelings and desires present in different psychosocial landscapes; it is the way of recording that a vibrational body makes about what it perceives, feels, and experiences concerning these social landscapes99 Rolnik S. Cartografia Sentimental: Transformações Contemporâneas do Desejo. São Paulo: Editora Estação Liberdade; 1989.. With this perspective, the field of research was developed in the studied territory. In public health, the use of cartography has allowed the connection and invention of modes of care and production of life.

The act of cartographic research leads to movements through various ‘worlds’, or through the connections between them, or even to create worlds of health care at each moment in which a new field of research is produced, because this methodology does not collect data, but produces them in act10(2).

The instrument used was the Field Diary (FD), with notes on the affective displacements produced by the meetings, which occurred mostly in 2022. In the production of the cartography, moments, emotions, and sensations of all those involved with the research were shared.

This article, inserted in the scope of public health, uses key concepts that guided its construction, among which: the perspective of users, the production of encounters, and affective territories.

From Merhy1111 Merhy EE. O conhecer militante do sujeito implicado: o desafio de reconhecê-lo como saber válido. In: Franco TB, Peres MAA, Foschiera MMP. Acolher Chapecó: uma experiência de mudança com base no processo de trabalho. São Paulo: Hucitec, 2004. p. 21-45., the logics of biomedical knowledge were questioned and it was sought to build horizontal relationships with those who are assisted/cared for by health equipment. The displacement of this place of supposed scientific knowledge about the object being studied places centrality on the perceptions and perspectives of users of health systems.

This first key concept extrapolates the dimension of the professional/user relationship in health and was essential for constructing a research and researchers who were open and available to the unknown. Thus, from the cultivation of this movement to allow oneself to be affected, it was possible to produce encounters. With this key concept, we understand that encounters are events between bodies, that mobilize affections and that move those involved in this production1212 Gomes MPC, Merhy EE. Pesquisadores IN-MUNDO: um estudo da produção do acesso e barreira em saúde mental - Porto Alegre: Rede UNIDA; 2014. 176 p..

Faced with the curiosity that an encounter provides, this contact with others and with new and old affections, this cartography was constructed. It is in the perception of oneself, in the naming of affections and relationships, in the voices and languages that unfold from the encounters, that affective territories emerge99 Rolnik S. Cartografia Sentimental: Transformações Contemporâneas do Desejo. São Paulo: Editora Estação Liberdade; 1989..

This research also counted on spaces of exchange between the subjects who composed it, with the writing of FD at each trip to the physical territory of Heliópolis and at each new affective territorial unfolding produced by the research journey itself.

This study is part of a broader research, inserted in a Research Program for SUS (PPSUS), funded by the São Paulo Research Foundation (FAPESP), approved by the Research Ethics Committee of UNIFESP, under the opinion number 4,737,913.

Results and discussion

From the first contact with the territory of Heliópolis, the marks of hunger and the pandemic were strongly present, on the faces of the many residents who appeared at the door of UNAS requesting the inclusion of their names in the queue of basics food baskets. This phenomenon was recurrent because, in 2020, UNAS was able to collect and distribute more than 40,000 baskets, which also contained protection equipment against COVID-191313 União de Núcleos, Associações dos Moradores de Heliópolis e Região. Doações levam esperança as famílias de Heliópolis e região. 2020. [acesso em 2022 jul 15]. Disponível em: https://www.unas.org.br/single-post/doacoes-levam-esperanca-as-familias-de-heliopolis-regiao.
https://www.unas.org.br/single-post/doac...
.

Whether due to food itself, which sustains people’s physical and subjective bodies, or to the political action proposed by UNAS during distribution, this was the first mental health care arrangement found in the research. After all,

UNAS used the moment of distribution of basic food baskets to make light and relaxed discussions about public policies, the role of government, and the importance of votes in the dimensions of access to food, vaccination, care in a pandemic, among other topics that emerged. (Excerpt from the Field Diary, 02/08/2022).

These conversations rescued the role and political production of hunger, but they were also moments of collective processing about the reality with which the territory was faced. Being able to talk about what was being experienced, in the skin, in the empty belly, in the daily difficulties, promoted affective encounters and promoted mental health in that territory.

In the speech of the community leaders about this action, the character of resistance and subversion included in this gesture was evident. Donating food in a country suffering from hunger, is already, in itself, a resistance1414 Rodrigues D. Alimento: memória e ancestralidade. In: Campello T, Bortoletto AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 165-73.; convening individuals suffering from hunger and necropolitics11 Mbembe A. Necropolítica. 3. ed. São Paulo: N-1 edições; 2018. 80 p. to collectively share their pain is to subvert the place imposed by that same politics on those bodies.

The problematization and appropriation about the reality in which one lives and the production of a critical reflection1515 Freire P. Pedagogia da autonomia: saberes necessários para a prática educativa. São Paulo: Paz e Terra; 2021. transform an act that could only be assistentialist into political-assistance, socially engaged.

In the logic of occupation of public spaces, the 24th Walk for Peace, which takes place annually in the territory, has an important role to denounce the situations of violence experienced by the community. In 2022, not for nothing, one of the main agendas was hunger.

[Walk] marked by choruses led by the sound car, such as: ‘Rice is expensive, beans are expensive, get everyone together and send Bolsonaro away’ (O arroz tá caro, o feijão tá caro, junta todo mundo e manda embora o Bolsonaro). Various banners with the words ‘Whoever is hungry is in a hurry, hunger hurts’. Or, even, the shirts of the children, who carried an empty plate and data on hunger in Brazil and in the community of Heliópolis. (Excerpt from the Field Diary, 24/07/2022).

In addition to the complaints about hunger, children and adolescents carried posters with numerical data on the murders of this population in actions of the military police, reiterating that the color of the body targeted by hunger is the same as that hit by the bullet frequently: black44 Belchior D, Moreira A. “O maior espetáculo do pobre da atualidade é comer”. In: Campello T, Bortoletto, AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 147-154.

These experiences, which had voices by the posters, constitute and cross the production of subjectivity of these people who live there and who are not always considered by the mental health care services. Hunger is not a new phenomenon for black people, but its exacerbated update has a direct impact on the health conditions of this population44 Belchior D, Moreira A. “O maior espetáculo do pobre da atualidade é comer”. In: Campello T, Bortoletto, AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 147-154.

To discuss hunger during the pandemic in a markedly black territory, therefore, is to look at inequalities. It also serves to illustrate the collective confrontations and the powers of actions, institutional or not.

Another arrangement found was the provision of food by the Centers for Children and Adolescents (CCA) linked to the UNAS, which did not close during the pandemic. By providing food for the children and youth who attended, they could provide shelters and verify cases of violence. Thus, the service was able to offer care and assistance to families, expanding the territory’s network beyond health equipment.

The CCA gained centrality in the fight against hunger and in the promotion of culture during the pandemic; and, after the most critical phase of the disease transmission process, one of these facilities emerged as a great meeting point for the community. Having a reference space within the territory was also shown to be an important way to expand access to mental health care.

Conversations mediated by food, be they salty, sweet, or simple black coffee, are crossed by multiple senses. The affective and memory rescue dimension that food carries with it1414 Rodrigues D. Alimento: memória e ancestralidade. In: Campello T, Bortoletto AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 165-73., in a hungry country, became even greater during the pandemic. I said: today I left home without eating, I didn’t have time. But honestly, I just need a black coffee.

‘Let’s go to the CCA, there you’ll find it’. We found three more people willing to find me a coffee, but not the drink. At the end of this saga we were in six people, three chicken croquettes and two large cups of coffee, obtained in the community library. (Excerpt from the Field Diary, 04/05/2022).

Another arrangement that deserves to be highlighted is Observatório De Olho na Quebrada, which produced research on the hunger of the population of Heliópolis and disseminated it massively in the community itself. This Observatory is composed of young people, who meet daily to produce and rescue data about the neighborhood they live in, and these meetings are mediated by sharing food.

It was central, throughout this research, to closely monitor the work carried out by this group. It was also by the shared food in the space of the Observatory that it was possible to connect, know new worlds, and circulate affections. Between candies, coffees, and cookies, belonging to this collective was being constructed. Food, therefore, comes to strengthen the bonds already existing in this group.

Sharing the act of cooking and the division of food, throughout the pandemic, were therapeutic tools to deal with the unknown imposed by COVID-19.

She says that she began to cook more also out of habit, and to have an ‘occupation for her head, so as not to freak out’ [...] now being able to share the tasks of dishes with her mother and leftovers with another young woman from the Observatory. (Excerpt from the Field Diary, 03/29/2022).

Non-pharmacological interventions for the management of mental health care were essential to cope with the pandemic1616 Garcini LM, Rosenfeld J, Kneese G, et al. Dealing with distress from the COVID-19 pandemic: Mental health stressors and coping strategies in vulnerable latinx communities. Health Soc Care Community. 2022 [acesso em 2024 abr 11]; 30(1):284-94. Disponível em: https://doi.org/10.1111/hsc.13402.
https://doi.org/10.1111/hsc.13402...
. The establishment of routines, including culinary and physical education activities, appeared in several reports by the young people of the Observatory, especially the women of the group.

We are neighbors, but weren’t seeing each other. Until the day his mother went to work and he ran out of food, so I showed up there with rice and steak for us to eat. Since then, the isolation between us ended, we maintained it with other people, but among our families it no longer existed. (Excerpt from the Field Diary, 05/20/2022).

The production of individual and collective care based on food was something extremely pulsating in the territory of Heliópolis during the pandemic, and this is the most common form of collective confrontation.

This political act from the people for the people rescues a quilombola heritage in a black territory44 Belchior D, Moreira A. “O maior espetáculo do pobre da atualidade é comer”. In: Campello T, Bortoletto, AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 147-154. In addition to the technologies developed in the quilombos to expand and share food production, collective actions and activities are historical marks in the daily lives of these populations44 Belchior D, Moreira A. “O maior espetáculo do pobre da atualidade é comer”. In: Campello T, Bortoletto, AP. Da fome à fome: Diálogos com Josué de Castro. São Paulo: Editora Elefante; 2022. p. 147-154.

Conclusions

The perverse political project imposed on Brazil during the COVID-19 pandemic exacerbated social inequalities and produced the return of hunger as a social phenomenon. Food insecurity, added to the lack of food on the plates, has color, with black and brown populations being the most affected by them.

The absence of a decent and quality diet kills slowly, malnourishes and makes one sick, producing subjectivities impregnated by mental suffering. Fighting hunger is possible, and it is conditioned to the implementation of public policies connected with a country project that seeks to face and overcome the absurd inequalities that constitute the Brazilian reality.

In the midst of the pandemic, with the worsening of vulnerability situations, the rescue of quilombola and collective practices ensured the maintenance of health (physical, but also mental) of populations exposed to hunger. It produced life. Sharing food was a collective and community gesture, which created bonds, circulated affections of care and kindness, and built new possible realities.

This study reflects the reality of an urban portion of the population that suffered from the ills of hunger. In the field of health, the discussion on hunger must be done in a more critical and recurrent way, considering the social and unequal reality of Brazil. And, from this conception, assist in the construction of effective public health policies that reflect the reality of the population.

In a hungry country, eating and sharing food is not a mere assistentialist practice. Above all, it is a political and resistance act.

  • Financial support: non-existent

References

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    Mbembe A. Necropolítica. 3. ed. São Paulo: N-1 edições; 2018. 80 p.
  • 2
    Schall B, Gonçalves FR, Valente PA, et al. Gênero e insegurança alimentar na pandemia de covid-19 no brasil: a fome na voz das mulheres. Ciênc. saúde coletiva. 2022 [acesso em 2023 nov 4]; 27(11):4145-54. Disponível em: https://doi.org/10.1590/1413-812320222711.07502022
    » https://doi.org/10.1590/1413-812320222711.07502022
  • 3
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  • 6
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    Garcini LM, Rosenfeld J, Kneese G, et al. Dealing with distress from the COVID-19 pandemic: Mental health stressors and coping strategies in vulnerable latinx communities. Health Soc Care Community. 2022 [acesso em 2024 abr 11]; 30(1):284-94. Disponível em: https://doi.org/10.1111/hsc.13402
    » https://doi.org/10.1111/hsc.13402

Publication Dates

  • Publication in this collection
    17 June 2024
  • Date of issue
    Apr-Jun 2024

History

  • Received
    15 June 2023
  • Accepted
    14 Nov 2023
Centro Brasileiro de Estudos de Saúde RJ - Brazil
E-mail: revista@saudeemdebate.org.br