Health in the time of war and peace, in hybrid format

Luis David Castiel About the author

As of this writing, Ukraine has been invaded by the Russian Army, which apparently has debatable control of the situation and may ultimately prevail. There are numerous explanations for the origin of this war, attempting to explain the reasons and possible geopolitical and humanitarian effects of the first armed conflict on European soil since the end of World War II in 1945.

The idea here is not to analyze the pertinence of such explanations. Rather, we focus on the fact that the war in Ukraine is occurring in a planetary context that was already highly complex, with the coronavirus pandemic and all its health/epidemiological, economic, political, and social repercussions. The speed and magnitude of this process has drastically altered how we live, work, study, socialize, and do business, while aggravating the precarious conditions already affecting underprivileged social groups. Broadly speaking, the pandemic has disrupted our ways of life as we knew them.

The world is also witnessing various degrees of planetary climate and atmospheric instabilities. Brazil is specifically suffering the deadly consequences of the synergy between these elements and the endless string of misdeeds by the Jair Bolsonaro government, further exacerbating the steady deterioration of the country’s economic and social situation.

Metaphorically, one can compare this precarious state of things (since the beginning of Brazil’s current ill-fated government administration) to the harmful effects of a “war”. The implicit aim is to create a form of politicization that undermines various technical sectors in health, culture, education, science, academia, agriculture, and public policy spheres in general in the country.

Brazil’s health field has suffered serious harms not only to public services in the Brazilian Unified National Health System (SUS), but also in the specific handling of the pandemic. This has happened in a context of significantly expanding impoverishment of population contingents already living in precarious conditions from the actions and inactions since the Michel Temer government, beginning in 2016.

The world is undeniably experiencing a context of severe uncertainty, especially due to the unavoidable management of COVID-19 risks. This configuration, under these circumstances, would be capable of consummating a perfect crime (“genocide”?), especially in certain socioeconomic formations with necropolitics impacting subaltern social groups and classes.

Based on the way the war in Ukraine plays out, some are forecasting economic damage to Brazil, a country that displays weaknesses in its economy at a time of high inflation and two-digit interest rates. Diniz 11. Diniz M. Como a guerra entre Rússia e Ucrânia impacta a economia brasileira. InfoMoney 2022; 24 fev. https://www.infomoney.com.br/mercados/guerra-russia-ucrania-impactos-economia-brasileira/.
https://www.infomoney.com.br/mercados/gu...
points out that fuels are the heaviest components in Brazil’s Broad Consumer Price Index (IPCA), and oil will tend to experience price hikes as the armed conflict continues. In other words, the war in Ukraine will further limit the possibilities for Brazil to reverse its monetary squeeze.

As one of the largest oil producers in the world, Russia has the capacity to produce more than 10 million barrels a day, compared to Brazil’s three million. That is, a reduction or interruption in this commodity’s supply could likely reduce the global Gross Domestic Product (GDP) in 2022.

The war in Ukraine may also bring inflationary pressure from the dollar. The US currency had been traded previously at the lowest level in seven months, with foreign investors’ appetite for Brazilian assets attracting billions in foreign exchange to the country’s stock exchanges. However, with the current risk aversion, demand for the dollar tends to increase, with investors purchasing dollars to acquire safer assets elsewhere.

The turbulence caused by a war in Eastern Europe may also lead to inflation in food products. Ukraine and Russia account for nearly a third of global wheat exports (28%) and nearly a fifth of corn exports (18%). Russia is also a powerful supplier of agricultural inputs and is among the largest global exporters of nitrogenous fertilizers such as ammonia and urea. Any wartime situation is expected to lead to a major price increase in these products.

Hybrid war also needs to be addressed. According to Belli 22. Belli L. Rússia também ataca Ucrânia pela internet. Entenda a ciberguerra. Folha de S.Paulo 2022; 25 fev. https://www1.folha.uol.com.br/mercado/2022/02/russia-tambem-ataca-ucrania-pela-internet-entenda-a-ciberguerra.shtml.
https://www1.folha.uol.com.br/mercado/20...
, there are armed conflicts with heavy weapons and explosives aimed at occupying territories, and simultaneously cyberattacks using various digital devices, tools, and weapons.

For example, Russia has employed an array of digital resources to destroy Ukraine’s infrastructure, or even to seize its infrastructure to turn it into supplementary weaponry. Thus, various Ukrainian government websites have been shut down by measures that make them inaccessible through denial-of-service attacks.

This had already happened in previous years with government websites and State-owned banks, suspending online public services and banking services in Ukraine. For example, the cyberattack called NotPetya shut down a large part of the country, including economic sectors, and even controlled the radioactivity monitoring systems in the Chernobyl nuclear plant.

It is thus obvious that not only the IT infrastructure is affected, since any interconnected systems and devices become vulnerable to the relentless invasion of software (i.e., malwares) used to damage computers, cellphones, and even entire networks, capable of producing failures and allowing interference in banking systems, power stations, telecommunications networks, and water reservoirs.

Such attacks can obviously produce psychological harms, as persons lose the possibility to communicate with their families and to receive relevant information on events. In recent years, Russia has also developed both offensive and defensive cybernetic capacities.

Meanwhile, the cyberwar has been exacerbated by the daily presence of the dark web and its illicit activities, where anonymity, encryption, and privacy are easily hacked while controversies, bizarre events, atrocities, and criminal acts occur. There is also a secret network in the dark web where it is possible to access any site, which is prohibited and impossible to achieve through conventional navigators. The dark web is used for criminal activities such as illegal trade, drug trafficking, hiring professional assassins, organization of terrorist groups, illegal purchases of weapons and ammunition, human and organ trafficking, and child pornography, among other crimes 33. Quora. What is the deep/dark web and how do you access it? https://www.quora.com/What-is-the-deep-dark-web-and-how-do-you-access-it (acessado em 16/Mar/2021).
https://www.quora.com/What-is-the-deep-d...
.

This is the expanded form, through social networks, of the phenomenon of far-right fanatical activism. Perverse forms of authoritarian government can be highly dangerous because they foster the psychological conditions for “total loyalty” in their followers’ paranoid traits, the kind of loyalty from fanatical supporters when individuals are fully convinced that only positions marked by denialism towards fascistic violence provides a paradoxical sense of place in the world. The absurd can become “true” when social media algorithms are programmed to supply users with an adulterated content capable of attracting them more frequently to the platform and holding them longer.

The algorithms forged by the engineers of chaos 44. Da Empoli G. Engenheiros do caos. Belo Horizonte: Editora Vestígio; 2019. force their followers to follow the message, no matter what position, no matter how reasonable or absurd, how realistic or imaginary, as long it intercepts their aspirations and especially fuels their fears. The game now consists of adding people that will converge in favor of extremist political positions and above all generate fanatical support for the largest number of groups to gain the majority. Such algorithms undermine traditional ideological differences and reduce the fabric of political conflict to a discourse of “elites” versus “persons”.

Contrary to any judgment of misinformative content as purportedly “foolish”, such content tends to follow a highly consistent logic, whereby false ideologues elaborate pseudo-truths that extend far beyond a simple digital act capable of generating rumors and falsehoods. In fact, such logic is a central element in an intentional fragmentation of social cohesion.

The current confusion is structured along two rational lines: (1) anger stemming from real social and economic precariousness as the effect of the predatory modus operandi of the neoliberal capitalist logic and its cynical claims and (2) robust communication devices, originally designed for commercial purposes, but adapted to manipulate crucial emotions and feelings such that misinformation is disseminated widely to serve the interests of authoritarian and backward governments and keep them in power.

The engineers of chaos and the leaders of far-left movements aimed to channel social anger for political purposes through these “pseudo-information” devices”. Strides with the internet, together with the expansion of social medias, changed the paths and means for policymaking and interaction in sociocultural terms. Representative democracies are being controlled, as occurred in the United States, Italy, Hungary, Turkey, United Kingdom (Brexit), and Brazil. The apparent errors in the current misinformation epidemic reveal a highly consistent logic. As mentioned, false ideologues create false truths that extend far beyond a simple digital act capable of generating rumors and falsehoods.

At any rate, the war in Ukraine has occupied our daily routines in synergy with the algorithmic normativity to which we are already subject. An analysis of this question requires refining some terms, especially “normativity”. We inevitably turn to Canguilhem 55. Canguilhem G. O normal e o patológico. Rio de Janeiro: Editora Forense Universitária; 2011., for whom the norm is nothing more than the effect that lends a certain value to something, whether an object, event, or action, as a function of its links to some implicit or explicit purpose.

In this sense, the norm is a value judgment’s position that manifests the “insufficiency” of a present in relation to a certain requisite. However, a certain normativity is now needed that exercises a more effective denial of the denialism that brings suffering from the perverse actions of misinformation. There is a new and terrifying fact for health resulting from the climate of war and its local and distant predatory actions.

To normalize is to evaluate. In times of serious health instabilities and the addition of a war with the potential for expansion of global economic effects, many norms that we adopted in social life that could provide values to protect safety and health are intensely undermined. In a sense, such rules refer to imperatives of what “should be done this way” because it is the best possible approach under the circumstances.

In the current Brazilian context (Russian invasion of Ukraine, COVID-19, Bolsonaro), the crucial problem may be defined by the fact that the norms that used to prevail are no longer valid. In many senses, Brazilians are living in a terrifying state of normative exception, the outcome of which is still unpredictable. This has profound adverse effects, both subjectively and objectively.

To elucidate, we can draw on ideas from Georges Canguilhem 55. Canguilhem G. O normal e o patológico. Rio de Janeiro: Editora Forense Universitária; 2011., who postulates that normativity is the instrument by which living beings (humans or animals) are individualized. A living being is thus no longer conceived as mechanism, but as power. “Normative attitude” pertains to life, to provide norms that assess the facts, to resolve obstacles and problems that would prevent the continuity of one´s condition as a living being.

It is important not to underestimate the problem of the current algorithmic tyranny. Human systems are governed globally by communication technologies that destabilize the classical forms of the world’s representation. The algorithms sequester language through a sort of authoritarianism exercised by those who capture the data, namely the oligopolies of large technology corporations (Big Tech).

This is an essential question for collective health. Regardless of the current war, it is necessary to confront the multiple expressions of the neoliberal form of government. This forces us to think critically not only on its effects on public policies, the State’s role, and social rights, but on social relations in terms of health, normality, disease, and healthcare itself.

Therefore, it is not unreasonable that various aspects of daily life in Brazil under the Bolsonaro government exacerbate the precarious conditions of many population contingents, with clearly severe effects, including in health terms. In addition, although Brazil is not engaged in an explicitly wartime context, as in the conflict between Russia and Ukraine, there is strong stimulus for access to weapons and clear threats of a coup d’état depending on the outcome of the country’s elections in October 2022. The situation is further complexified by cybercrimes in various formats. Such issues certainly raise challenges for the Collective Health field in Brazil, even if we are at peace. Peace?

Acknowledgments

Thanks to researcher Marilia Sá Carvalho.

References

Publication Dates

  • Publication in this collection
    08 Apr 2022
  • Date of issue
    2022

History

  • Received
    04 Mar 2022
  • Accepted
    04 Mar 2022
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Rio de Janeiro - RJ - Brazil
E-mail: cadernos@ensp.fiocruz.br