Social protection and therapeutic-occupational experiences: life during the Covid-19 pandemic

Lívia Celegati Pan Marina Leandrini de Oliveira Marina Jorge da Silva Ana Paula Serrata Malfitano Roseli Esquerdo Lopes About the authors

Abstract

This text elaborates some reflections regarding the responses that have been undertaken by the sectors: health, social security and social assistance, which make up social security in Brazil. It assumes its centrality, to face the pandemic caused by SARS-CoV-2. Considering this context and assuming a professional action for social participation with autonomy, we share experiences in Social Occupational Therapy with young people who live in urban peripheries, certainly poor for the market/consumption, but rich in life, in the Covid-19 pandemic. The aim was to produce care that is consistent with social protection and is directed, in defense of the non-negotiable value of each life and of its pulse, towards the promotion of an emancipatory circulation, an issue that existed prior to the pandemic, albeit now aggravated, and always present among this group of young people.

Keywords
Pandemic; Social protection; Social vulnerability; Care; Occupational therapy


Pandemic Covid-19: ways of being ill, ways of living

The pandemic caused by SARS-CoV-2 has pointed out structural inequalities in our society and brought to the fore the centrality of the State in implementing social protection policies that ensure life, the importance of professionals for its effectiveness, and their understanding and support by civil society. This paper intends to weave some reflections in this direction and report part of our experience in the production of care in Social Occupational Therapy.

The way the virus spread around the world and arrived in Brazil, at the end of February 2020, implied a notion of a “rich people’s disease”(f(f)Expression used by one of the participants in our interventions.), in the sense that people who had access to circulation in foreign countries would be the ones exposed to contamination. With the increase in contagion, as it happened in other countries, the idea of a certain “democracy of the virus” was introduced, suggesting that we were all equally exposed to it and to getting sick. However, what we saw during the months of the pandemic’s evolution was also the social mark of Covid-19, with infection and death rates much more linked to the lower classes.

The precautions of social distancing and what has become popular as “stay at home”, the main recommendation of the health authorities to contain the transmission of the virus, have exposed the social inequality in Brazil. This has become evident in the abyss between those who depend on work and those who are bound by employment ties11 Castel R. As metamorfoses da questão social: uma crônica do salário. 10a ed. Petrópolis: Vozes; 2012. that ensure protection measures, whether with adaptations for remote work and work from home, or with respect to health guidelines, such as the mandatory use of masks and non-crowding, and those who are in a situation of social vulnerability11 Castel R. As metamorfoses da questão social: uma crônica do salário. 10a ed. Petrópolis: Vozes; 2012. and with little choice when faced with the concrete needs of maintaining life.

According to data gathered by the Solidarity Research Network22 Arantes JT. Estudo avalia a vulnerabilidade de trabalhadores na crise causada pela pandemia de Covid-19. São Paulo: Agência FAPESP; 2020., in April 2020, 83.5% of the workers were in a situation of vulnerability, with 36.6% of them linked to informal jobs and 45.9% who, although they had formal jobs, were linked to sectors affected by the economic crisis that, present earlier, has taken on proportions as alarming as the SARS-CoV-2 contagion.

This state of affairs, coupled with inequalities in territory, access to information, and resources for hygiene care and disease prevention, led to a distribution of Covid-19 throughout the country that distinctly marks population groups33 Santos JAF. Covid-19, causas fundamentais, classe social e território. Trab Educ Saude. 2020; 18(3):1-7. Doi: https://doi.org/10.1590/1981-7746-sol00280.
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, affecting the poorer strata more intensely.

The ramifications of this landscape, in a context that opposes economy and social security, exacerbating the contradictions between the demands of financial capital, of a production parameterized by consumption, and the social demands44 Rodrigues W. Estilos de vida, transição societal e reurbanização In: Rodrigues W, organizador. Cidade em transição: nobilitação urbana, estilos de vida e reurbanização em Lisboa. Lisboa: Celta Editora; 2010. p. 243-76., have intensified the experiences of violence along with the possibilities of contamination and death55 Sposati A. Covid-19 revela a desigualdade de condição da vida dos brasileiros. Rev NAU Soc. 2020; 11(20):101-3.,66 Sposati A. SUAS e proteção social na pandemia covid-19. São Carlos: Pedro & João Editores; 2020., deepening a pre-existing state of being socially unprotected(g(g)According to Sposati6, “experiencing social lack of protection is an expression of the social issue that materializes inequalities in the terms of living and living conditions of humans” (p. 10).). Given the extreme gravity of the situation, the sectors encompassed by social security in Brazil (health, welfare, and social assistance) need to be strengthened and in the front line of the required confrontations, ensuring and mediating the survival and dignity of the population’s living conditions.

Specification of some responses of social protection systems to the demands of the pandemic

To approach social security, we resume the history of the organization of rights to aid for vulnerable people and groups in Brazil, with characteristics largely marked by colonization, slavery, by private religious initiatives and interests, and authoritarian and/or populist governments77 Carvalho JM. Cidadania no Brasil: o longo caminho. 17a ed. Rio de Janeiro: Civilização Brasileira; 2013., and now added to the rise of neoliberal capitalism88 Yazbeck MC. Estado, políticas sociais e implementação do SUAS. In: Brasil, Ministério do Desenvolvimento Social e Combate à Fome, Instituto de Estudos Especiais, Pontifícia Universidade Católica de São Paulo. Capacita SUAS: configurando os eixos de mudança. Brasília: Ministério do Desenvolvimento Social; 2008.. In this journey, the 1988 Constitution stood out as a milestone for social protection in the country, establishing a social security system defined as “an integrated set of actions of the initiative of the Public Powers and of society, aimed at ensuring the rights to health, welfare and social assistance”99 Constituição (1988). Constituição da República Federativa do Brasil. Brasília, DF: Senado Federal; 1988..

At the present moment, in face of the growing number of sick people, deaths, and different kinds of precariousness as a result of the pandemic, the guarantee of the “social minimums” foreseen by the social security system, agreed upon in 1988, is urgent. Nevertheless, Sposati55 Sposati A. Covid-19 revela a desigualdade de condição da vida dos brasileiros. Rev NAU Soc. 2020; 11(20):101-3. warns that social protection policies are not a priority for governments that, on the basis of a neoliberal agenda, have organized their actions by emphasizing market transactions, making the State subservient to the economy.

Tavares, Silveira and Paes-Sousa1010 Tavares AB, Silveira F, Paes-Sousa R. Proteção social e Covid-19: a resposta do Brasil e das maiores economias da América Latina. Rev NAU Soc. 2020; 11(20):111-29., in an analysis of the Brazilian governmental responses to the pandemic, contrasting them with information from five other Latin American countries (Argentina, Chile, Colombia, Mexico, and Peru), point out that although Brazil quickly declared a state of emergency in relation to the pandemic, it took a long time to forward measures related to social protection:

Factors such as response time, sufficiency, coherence, and coordination are essential in social protection policies. Even if at an adequate level, measures adopted too late may have limited effectiveness. In turn, the lack of coordination of public agents and coherence in their orientation undermine any undertaken effort1010 Tavares AB, Silveira F, Paes-Sousa R. Proteção social e Covid-19: a resposta do Brasil e das maiores economias da América Latina. Rev NAU Soc. 2020; 11(20):111-29.. (p. 124)

Fifteen months have passed since the Ministry of Health declared a Public Health Emergency of National Importance due to the Covid-191111 Brasil. Ministério da Saúde. Portaria nº 188, de 3 de Fevereiro de 2020. Declara Emergência em Saúde Pública de Importância Nacional (ESPIN) em decorrência da Infecção Humana pelo novo coronavírus (COVID-19). Diário Oficial da União. 3 Fev 2020., In late May 2021, Brazil trespassed the mark of 450,000 deaths, making it the second country in the world with the highest number of deaths from the disease(h(h)COVID – 19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) – 05/25/2021. Available at: https://www.arcgis.com/apps/opsdashboard/index.html ). In this period, initiatives and mobilizations by workers of the services that make up the social assistance network of the social security systems have sought to respond to the complex dimensions of the demands that the pandemic scenario presents.

As a part of the social security, the Brazilian National Health System (SUS) had its importance recognized by its technical background used in the efforts to minimize the dissemination and increase the chances of recovery from the disease. SUS has undertaken, through health professionals, intensive follow-ups with the sick and attitudinal recommendations for the population. In the political conjuncture of the pandemic times, the SUS was already in a process of disinvestment and precariousness, markedly materialized by Constitutional Amendment 95, of 2016, and weakening of the conditions of supply of its services, when it found itself beset by the demands of the pandemic.

Among the measures indicated in Law 13,979 of 2020, to face the “public health emergency”, are social isolation and quarantine1212 Brasil. Presidência da República. Lei nº 13.979, de 6 de Fevereiro de 2020. Dispõe sobre as medidas para enfrentamento da emergência de saúde pública de importância internacional decorrente do coronavírus responsável pelo surto de 2020. Diário Oficial da União. 6 Fev 2020.. Although there was no consensus, representatives of the sector vehemently oriented those who could keep themselves in social isolation to do so, in order to avoid contagion, mass illness, and the resulting collapse in health care, particularly with regard to the capacity of care and beds in tertiary health care. These among other orientations were immersed in tensions and technical and political disagreements about their implementation and the need to keep the economy going, in a clear dispute for “economy over disease prevention measures”1010 Tavares AB, Silveira F, Paes-Sousa R. Proteção social e Covid-19: a resposta do Brasil e das maiores economias da América Latina. Rev NAU Soc. 2020; 11(20):111-29. (p.113), configuring a policy of death.

It is worth noting, as already pointed out in different debate spaces that the health recommendations were, and are, scarcely accessible to the population as a whole, particularly to people living in urban agglomerations66 Sposati A. SUAS e proteção social na pandemia covid-19. São Carlos: Pedro & João Editores; 2020.. Thus, the situations of vulnerability were immediately exposed in the pandemic by the impossibility of adopting, in an equitable way, the measures of self-preservation.

From slums to villages, the marks of inequality increase the challenge to prevent and control Covid-19 and require intersectoral strategies adapted to different contexts. The use of alcohol gel and masks, hand hygiene, and even the recommendation not to leave the house are measures that are out of reach for Brazilian realities, or the absence of basic rights, such as health, employment, and housing1313 Rocha RL. Ficar em que casa? [Internet]. Rio de Janeiro: RADIS; 2020 [citado 10 Set 2020]. Disponível em: https://radis.ensp.fiocruz.br/index.php/home/opiniao/editorial/ficar-em-que-casa
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. (p.10)

The poor, those who live in slums, the homeless, those in the prison system, traditional indigenous people, are all examples of groups that have come up against the limits of health recommendations due to their social and structural conditions and ways of life.

The extension of the crisis situation obviously encompasses demands and challenges prior to the pandemic that are not centralized in the health systems and affect societies in multiple and diffuse ways, calling with other urgencies, the aid of social protection systems as a whole.

One of the almost contiguous consequences of the pandemic in Brazil is the worsening of poverty and inequality, as “more people become unemployed and informal workers have their activities restricted1010 Tavares AB, Silveira F, Paes-Sousa R. Proteção social e Covid-19: a resposta do Brasil e das maiores economias da América Latina. Rev NAU Soc. 2020; 11(20):111-29. (p.112), and record reductions in the number of employed people1414 Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional por Amostra de Domicílios Contínua - PNAD Contínua 2020 [Internet]. Rio de Janeiro: IBGE; 2020 [citado 10 Set 2020]. Disponível em: https://agenciadenoticias.ibge.gov.br/media/com_mediaibge/arquivos/96d5c64ae19eba339d0698f945c1519d.pdf
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have been achieved. Unemployment was compounded by precarious working conditions during the pandemic, as Yazbeck, Raichelis, and Sant’Ana outline1515 Yazbeck MC, Raichelis R, Sant’ana R. Questão social, trabalho e crise em tempos de pandemia. Serv Soc Soc. 2020; (138):207-13.:

The centrality of financial capital and its dominance over productive capital brings serious consequences to the “class that lives from work” [...], with the maintenance of high unemployment rates, job insecurity and instability, growth of informal and precarious work, wage reductions, precarious labor relations, including outsourcing and fixed-term contracts, harassment, suffering and illness, among other aspects1515 Yazbeck MC, Raichelis R, Sant’ana R. Questão social, trabalho e crise em tempos de pandemia. Serv Soc Soc. 2020; (138):207-13.. (p. 208)

Filho and Fernandez1616 Pamplona Filho R, Fernandes L. Panorama das alterações trabalhistas durante a pandemia da Covid-19. Rev Direito UNIFACS [Internet]. 2020 [citado 12 Set 2020]:1-12. Disponível em: https://revistas.unifacs.br/index.php/redu/article/view/6821
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highlight legislative changes in this period, such as the Provisional Measure 927/20201717 Brasil. Presidência da República. Medida Provisória nº 927, de 22 de Março de 2020. Dispõe sobre as medidas trabalhistas para enfrentamento do estado de calamidade pública. Diário Oficial da União. 22 Mar 2020. and the law 14.020/20201818 Brasil. Presidência da República. Lei nº 14.020, de 6 Julho de 2020. Institui o Programa Emergencial de Manutenção do Emprego e da Renda. Diário Oficial da União. 6 Jul 2020. which, respectively, provided for changes established “unilaterally by the employer”1616 Pamplona Filho R, Fernandes L. Panorama das alterações trabalhistas durante a pandemia da Covid-19. Rev Direito UNIFACS [Internet]. 2020 [citado 12 Set 2020]:1-12. Disponível em: https://revistas.unifacs.br/index.php/redu/article/view/6821
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(p. 12), as telework, anticipation of vacations and holidays, granting of collective vacation, besides “a peculiar configuration of the working hours’ bank (a reserve for flexibility)”1616 Pamplona Filho R, Fernandes L. Panorama das alterações trabalhistas durante a pandemia da Covid-19. Rev Direito UNIFACS [Internet]. 2020 [citado 12 Set 2020]:1-12. Disponível em: https://revistas.unifacs.br/index.php/redu/article/view/6821
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(p. 12), with the addition of the authorization for proportional reduction of working hours and wages and suspension of the contract. The increased emphasis on offering sustainability and security to the employer reiterates the painful consequences for the worker1515 Yazbeck MC, Raichelis R, Sant’ana R. Questão social, trabalho e crise em tempos de pandemia. Serv Soc Soc. 2020; (138):207-13..

Regarding more specifically the sphere of Social Security responses to the pandemic, Nahas and Martinez1919 Nahas TC, Martinez L. Considerações sobre as medidas adotadas pelo Brasil para solucionar os impactos da pandemia do Covid-19 sobre os contratos de trabalho e no campo da Seguridade Social e da de prevenção de riscos laborais. Comunidade para la Investigacíon y el Estudio Laboral y Ocupacional [Internet]. 2020 [citado 13 Set 2020]. Disponível em: http://www.cielolaboral.com/consideracoes-sobre-as-medidas-adotadas-pelo-brasil-para-solucionar-os-impactos-da-pandemia-do-covid-19-sobre-os-contratos-de-trabalho-e-no-campo-da-seguridade-social-e-da-de-prevencao-de-riscos-labor/
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described that the Ministry of Economy, supported by Ordinance 373 of March 2020, made it possible, through the National Institute of Social Security - INSS, to interrupt the blocking, cancellation and suspension of benefits, such as Bolsa Família (conditional cash transfer) and Benefício de Prestação Continuada (old age and disability benefits), for up to 120 days. This was an important strategy for the beneficiary families in the first months of the pandemic, in face of the reduction of work and income. The suspension of blockades to programs that have interfaces with social assistance would also enable the services to organize task forces for the development of other social assistance actions related to Covid-19, but this is not what happened.

The Unified Social Assistance System (SUAS) has been identified as a very relevant structure for facing current challenges. It is a capillary network of units, services and programs with a socio-territorial perspective, social assistance protection and surveillance systems, multiprofessional teams specialized in basic and special social protection, with the possibility of managing regular and occasional benefits, among others. Its scope of intervention encompasses a multiplicity of social situations. Following Sposati66 Sposati A. SUAS e proteção social na pandemia covid-19. São Carlos: Pedro & João Editores; 2020., the different expressions of social lack of protection in the country constitute “the field in which SUAS workers operate” (p. 13).

The Decree 10.282(i(i)Regulating Federal Law Nº13.979), which defined essential public services and activities in the context of a pandemic, mentions social assistance and care for the vulnerable population2020 Brasil. Presidência da República. Decreto nº 10.282, de 20 Março de 2020. Regulamenta a Lei nº 13.979, para definir os serviços públicos e as atividades essenciais. Diário Oficial da União. 20 Mar 2020.. Despite affirming social assistance as a network of services, essential in their nature, the decree and its developments have proven to be scarcely (or not at all) precise in terms of effective directions in the understanding of what is incumbent upon the SUAS2121 Gouveia FO, Santos TAL. Pandemia e proteção social. In: Sposati A, organizador. SUAS e proteção social na pandemia covid-19. São Carlos: Pedro & João Editores; 2020. p. 34-47.. There are a number of misunderstandings (or not) about the place/role of social assistance in confronting Covid-19. Pursuant to Agenor2222 Agenor T. Tendências normativas da SNAS/MC para o SUAS na pandemia da Covid-19. In: Sposati A, organizador. SUAS e proteção social na pandemia covid-19. São Carlos: Pedro & João Editores; 2020. p. 70-82., the National Secretary of Social Assistance and SUAS were not inserted in the publications of the Ministry of Health and the Presidency of the Republic related to the pandemic, and:

The absence of a norm ended up having dual repercussions among SUAS operators and even led to the closure, in some municipalities, of CRAS and CREAS, which is now being reviewed. Some collective actors in society have played a leading role in these guidelines, as is the case of the National Front for the Defense of the SUAS, [...], among other local and regional SUAS forums2222 Agenor T. Tendências normativas da SNAS/MC para o SUAS na pandemia da Covid-19. In: Sposati A, organizador. SUAS e proteção social na pandemia covid-19. São Carlos: Pedro & João Editores; 2020. p. 70-82.. (p. 72)

This author refers to a “narrowing of the scope of SUAS, reducing its horizons and possibilities”2222 Agenor T. Tendências normativas da SNAS/MC para o SUAS na pandemia da Covid-19. In: Sposati A, organizador. SUAS e proteção social na pandemia covid-19. São Carlos: Pedro & João Editores; 2020. p. 70-82. (p. 82). It can be ascertained, for example, that the granting of emergency aid(j(j)Law 13.982 of April 2, 2020 expresses in its article 2: to grant emergency aid in the amount of R$600.00 per month to workers over 18 years old, with informal employment, monthly per capita family income below ½ minimum wage, and other requirements established by law.), one of the answers attributed to the federal government to get around a social collapse (as a result of the organization of social movements to reach the value of R$600.00, the imposed reality and, in fact, despite the federal executive), was operationalized without articulation with this system that aggregates, with greater appropriation, the demands around the social vulnerabilities of the Brazilian population.

The establishment of this benefit via bank branches ran into limits in its operationalization that generated barriers to access, disregarding the capillary network of SUAS, that is closer to the realities of specific population groups, implying a failure to guarantee the offer in cases known to be necessary2323 Sposati A, Costa R, Gouveia F. Provocações introdutórias: uma família sob pandemia. In: Sposati A, organizador. SUAS e proteção social na pandemia covid-19. São Carlos: Pedro & João Editores; 2020. p. 28-33..

Reiterating this perspective, the report from the Federal Audit Court, in monitoring the implementation of the emergency aid recommended, “that it should be used the Unified Social Assistance System (SUAS) network more effectively in the process of registering emergency aid to reach workers with socioeconomic barriers. Reaffirming, that it “should have a greater role in overcoming this difficulty in covering this most vulnerable population group”2424 Brasil. Tribunal de Contas da União. Acórdão nº 1420, de 3 de Junho de 2020. Processo 016.827/2020-1. Brasília, DF: Tribunal de Contas da União; 2020. (p. 37).

The standpoints that disregard the system, councils and forums of social assistance seem to be close to the voluntarism tendencies that lurk in the sector through incentives to individual actions, welfare assistance and disorganized support, almost always influenced by private interests of various kinds(k(k)As an example, we can cite the embezzlement of R$7,500,000.00, destined for the purchase of CoVid-19 rapid tests, for the Homeland-Volunteer program, led by the current first lady Michelle Bolsonaro, in benefit of evangelical missionary institutions, without any articulations with SUAS25.). Admittedly, the tensions around SUAS propositions, such as social assistance as a citizen’s right, a duty of the State, to be performed by public services, do not start in the pandemic, but the critical moment seems to unveil strategies of invisibility and disqualification of one of the important pillars of social security.

With the advent of vaccines, when the contagion curve is reversed and the decreasing of the number of cases and illnesses, the health sector will gradually be relieved and the demands on social assistance will be maintained and/or tend to increase. Although this does not bring direct implications to the initiatives to strengthen this sector, it is essential to point out that the recognition of its robustness and the attribution of responsibilities would not be enough, without first instrumentalizing the workers, units, services, and programs that make up the social assistance network.

Given this framework, tracing future settings is somewhat risky, given the dystopian nature of the pandemic and the political, economic, and social directions of this Brazil under the government that is now in place. In any case, the direction that societies in this second decade of the 21st century have taken under the aegis of performance-driven individualism in compressed times and under neoliberal capitalism2626 Giddens A. Modernidade e identidade. São Paulo: Zahar; 2002., allows us to foresee the deepening of its contradictions, the social inequalities that result from them, and the struggles for access to the public funds of a State that is weakened to effectively respond to the needs of the majority in its diversity. Hence:

Increasing the degrees of freedom of choice and decision-making capacity, and broadening the range of possibilities for choice, is therefore a crucial source of empowerment and individual freedom that embodies the realization of the civilizational project of modernity. This is the great political and civilizational challenge of our times44 Rodrigues W. Estilos de vida, transição societal e reurbanização In: Rodrigues W, organizador. Cidade em transição: nobilitação urbana, estilos de vida e reurbanização em Lisboa. Lisboa: Celta Editora; 2010. p. 243-76.. (p. 271)

With this context reading and taking the assumption of a professional action for social participation with autonomy, we share experiences in social occupational therapy with young people from popular groups, from the urban periphery and, certainly, poor for the market/consumption, but rich of life, in the Covid-19 pandemic.

Experimentation, virtuality and presence: ways of living and doing

Malfitano, Cruz and Lopes2727 Malfitano APS, Cruz DMC, Lopes RE. Terapia ocupacional em tempos de pandemia: seguridade social e garantias de um cotidiano possível para todos. Cad Bras Ter Ocup. 2020; 28(2):401-4. Doi: https://doi.org/10.4322/2526-8910.ctoED22802.
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pointed out the effort of the professional categories regarding the positioning on “their roles in dealing with Covid-19, reaffirming and even repositioning the potency of their contributions before the complexity of the demands posed by the moment we live in” (p. 401), dealing specifically with occupational therapy and the area’s manifestations about the subjects’ daily lives and lifestyles in the pandemic. They highlight the relevance of thinking in terms of social security, something uncommon in the area, “addressing social situations that involve the important differences and inequalities that most people, groups and communities with whom we work experience, especially in Brazil”. (p. 401). They state that “the work in occupational therapy, in the daily lives of the subjects, is only realized in the struggle for the possible life for all, in all the powers and differences that give them meaning and reduce inequalities” (p. 403).

In this direction, questioning ourselves about the possibilities of contribution from our place as a university and in the field, from the METUIA/UFSCar(l(l)The Metuia Project, created in 1998 and currently under the name Metuia Network - Social Occupational Therapy, congregating centers in seven universities in the country and occupational therapists with different institutional affiliations, propose the development of projects in teaching, research and university extension in Social Occupational Therapy and in its interconnection with different sectors, aimed at people and population groups in processes of disruption of social support networks28. At UFSCar, since 2004, the main focus has been on youth.), we have sought to build technical, ethical, and solidary actions, based on the notion of social protection and non-negotiable defense of life.

On the one hand, understanding the urgency of the moment and the worsening of the life situation of many people, articulated with what was being pointed out as a demand in the communities through which we pass in urban peripheries, we defend the engagement in the production of solidarity “right now”, carrying out and supporting campaigns to collect basic-needs grocery packages, in partnership with individuals and groups from the communities, with public and private organs of the city. As previously mentioned, the worsening living conditions of a large part of the Brazilian population, as a result of the economic crisis and aggravated by the Covid-19 pandemic, associated with the precarious public investment in social security policies, especially at this time, brings back the debate on the importance of civil society organization, despite the State’s omission2929 Centro Brasileiro de Análise de Planejamento. Redes de proteção social no contexto da pandemia do coronavírus [Internet]. 2020 [citado 29 Maio 2020]. Disponível em: https://www.youtube.com/watch?v=ckX6-Q51ciY
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.

Regardless of the fact that donation campaigns raise the debate around the assistentialism that has historically marked social assistance in Brazil and hindered its recognition as a right that makes up social protection, and it is of utmost importance that this criticism be made, as the moment calls for the construction of solidarity networks to guarantee the most basic thing that each and every person should be able to access. We affirm, therefore, an action in line with the principles of social security.

In parallel, and following Farias and Leite Jr (2021)3030 Farias MN, Leite Júnior J. Vulnerabilidade social e Covid-19: considerações a partir da terapia ocupacional social. Cad Bras Ter Ocup. 2021; 29:e2099. Doi: https://doi.org/10.1590/2526-8910.ctoEN2099.
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on the possibilities of Social Occupational Therapy contributing to face the consequences of the pandemic, the effort turned to the continuity of the work that, since 2004, we have developed with young people from urban popular groups in different social equipments3131 Lopes RE, Malfitano APS. Ação social e intersetorialidade: relato de uma experiência na interface entre saúde, educação e cultura. Interface (Botucatu). 2006; 10(20):505-15. Doi: https://doi.org/10.1590/S1414-32832006000200016.
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32 Lopes RE, Borba PLO, Cappelaro M. Acompanhamento individual e articulação de recursos em terapia ocupacional social: compartilhando uma experiência. Mundo Saude. 2011; 35(2):233-8.
-3333 Lopes RE, Malfitano APS, Silva CR, Borba PLO. Recursos e tecnologias em terapia ocupacional social: ações com jovens pobres na cidade. Cad Ter Ocup UFSCar. 2014; 22(3):591-602. Doi: https://doi.org/10.4322/cto.2014.081.
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with the challenge of using digital communication technologies following health guidelines of social distancing, and proposing interventions remotely.

With the onset of the pandemic and the suspension of face-to-face university activities, we seek to continue producing care3434 Tronto J. Assistência democrática e democracias assistenciais. Soc Estado. 2007; 22(2):285-308., through a WhatsApp® group that had been created in 2019 by one of the young people participating in our interventions, as a collective communication channel between us.

Through the social technologies developed by social occupational therapy, we have started, as early as March 2020, to adapt these intervention methodologies, developed for face-to-face proposals, for their use through communication applications. Especially the social technologies named Activities Workshops, Dynamics and Projects and the Singular and Territorial Accompaniment3232 Lopes RE, Borba PLO, Cappelaro M. Acompanhamento individual e articulação de recursos em terapia ocupacional social: compartilhando uma experiência. Mundo Saude. 2011; 35(2):233-8. have been the basis for thinking about our actions.

We initiated these activities with moments of conversation about the pandemic, approaching the Covid-19 and the idea of it being a “rich man’s disease”, the importance of complying with the measures to prevent the transmission of the virus, where the contagion and, until then, the disease itself were not perceived, but also of the difficulties and the impossibility of most of them following the orientation to stay at home, both due to work needs and housing conditions, family relationships and even the desire to “move around”.

Aware that the situation would extend further than initially projected, we also proposed moments named Virtual Workshops. Remote meetings were held twice a week, with fixed days and times and an average duration of two hours, at night, for the convenience of the young people. The days and times of the workshops were defined through a poll in the WhatsApp® group. We understand that this strategy, in addition to fostering a dialogic and participatory process, favored the participation of a greater number of young people, since it did not conflict with their daily activities, which, in general, were maintained.

Nevertheless, there was a difficulty in accessing some of these young people, who participated in the face-to-face meetings, because they did not have access to adequate equipment for connection (computers, tablets, and cell phones) and/or had little or no access to the internet. Not infrequently, young people had many restrictions on their internet packages, which, besides limiting the number of participants, also limited the participation of those who were present, restricting the possibility of video calls and/or changing the dynamics of conversations and other activities (online games, for example), as the precariousness of the connection sometimes implied an increase in response time. So, with failed attempts to make collective video calls, we were creating and adjusting proposals for the WhatsApp® group space itself.

The Virtual Workshops proved to be favorable to the experimentation of a space for exchanges and sociability, given the possibility of free conversations, dynamics, and directed debates, whose weekly planning selected current themes of social relevance and transversal to the meetings. We carry out playful activities, such as a number of games and interactive play through voice and text messages; audiovisual creation, with photos/images and music; a virtual talent show, and dialogues about specific themes - family and children, study and the lack of it, with the sharing of experiences and feelings.

The activities were part of the more general goal of providing care to young people during the pandemic period, but it is important to say that our actions were directed according to the content brought by them. In this regard, we identified favorable moments for offering leisure, strictly; for listening; for problematizing some issues, when we gained more evidence for bringing information and elements for their reflection and critical analysis; for mediating dialogues among them, based on their experiences, among several other designs that were being built.

From this collective space and understanding its limits, such as, for example, the difficulties in following up on all the messages, to encompass many people in a dialogue, the different possibilities of interpreting what is written, and the lack of physical and visual contact, we have also developed Singular and Territorial Follow-ups. Stemming from the collective spaces provided by the now virtual “Workshops of METUIA”, and aimed at subjects and/or groups in situations in which their demands require a more singular attention in the search for and joint construction of possibilities and paths in the life that they live3131 Lopes RE, Malfitano APS. Ação social e intersetorialidade: relato de uma experiência na interface entre saúde, educação e cultura. Interface (Botucatu). 2006; 10(20):505-15. Doi: https://doi.org/10.1590/S1414-32832006000200016.
https://doi.org/10.1590/S1414-3283200600...
,3232 Lopes RE, Borba PLO, Cappelaro M. Acompanhamento individual e articulação de recursos em terapia ocupacional social: compartilhando uma experiência. Mundo Saude. 2011; 35(2):233-8., The accompaniment has been offered as a more individualized support space to the young people in the group; even though being together is placed in the virtual space, it has allowed the strengthening of bonds, support for the demands presented, and creative experimentation.

In the workshops and follow-ups, we could count on undergraduate extension students who, involved with the project, contacted the young people individually and weekly to offer specific listening and support in their daily lives, despite and with the pandemic.

There were many processes searching for adaptation to offer attention and care in a context that had not been imagined until now, with positive developments in professional education, through the training of students who followed and also participated in this process.

As a consequence of the exchanges in some of these individual accompaniments, the idea of a space for sharing content to be produced together emerged. The result was the creation of a blog and the use of social networks, especially Facebook®, as a tool for dissemination and visibility of the posts and interaction among participants.

This has been a way to articulate the individual and collective dimensions of the action, since such content is produced singularly, in the relationship between one or one young person with someone from the team, but, at the same time, it is shared with the entire collective and used as triggers for debates during the Virtual Workshops. We would like to mention a call for photos created by one of the young people, called “Pandemic Times: the world from our windows”:

Figure 1
Photo by Caio that promoted the call for photos “Pandemic Times: the world from our windows”, for the Virtual Workshops.
Figure 2
METUIA/UFSCar Workshop.

Hence, we invited the other young people to share with us their photos of nature and from the windows of their homes, implying dialogues and reflections about the impacts of the pandemic on the circulation through spaces, the longing felt for places and people.

Given all the contradictions related to social media, we have started from its insertion in the daily life and lifestyles of young people3535 Barreiro RG. Entre redes: juventudes, ambientes virtuais e vidas entretidas [tese]. São Carlos (SP): Universidade Federal de São Carlos; 2019. and evaluated its potential at this time, as a resource for remote practices and access to this audience. Although in a restricted way, we observed that this has been a possibility of maintaining and strengthening the relationships built among the participants themselves and between them and the team, towards the constitution of social support networks to face situations of social vulnerability11 Castel R. As metamorfoses da questão social: uma crônica do salário. 10a ed. Petrópolis: Vozes; 2012., as well as promoting care and fostering forms of social participation.

The workshops maintained the premise of action in Social Occupational Therapy, putting on the agenda the possibility of creating not only spaces for interaction, but also for learning about collective life and democratic experiences of participation, discussing the role of young people and their co-responsibility in virtual meetings, in their community and territory, stimulating and supporting strategies for the equation of mishaps faced in everyday life, including the lack of compliance with health rules during the pandemic period.

Living the pandemic: everyday dimensions

The multiple ways of living/surviving the pandemic are intensely crossed by economic, political, cultural and social structures. The social protection systems are far from reaching an equitable reach and even from effectively accessing a large part of the Brazilian population.

From different perspectives, oppression and domination are fundamental themes for those who turn their attention to social struggles3636 Fraser N. Scales of justice: reimagining political space in a globalizing world. New York: Columbia University Press; 2009.,3737 Young IM. Justice and the politics of difference. Princeton: Princeton University; 2011., nevertheless, analyzing the pandemic and the quarantine from the perspectives of people who live its different expressions, Santos3838 Santos BS. A cruel pedagogia do vírus. Coimbra: Edições Almedina; 2020. questions:

How may they maintain interpersonal distance in the cramped living spaces where deprivation is almost impossible? Can they wash their hands frequently when the little water available has to be saved for drinking and cooking? Doesn’t the confinement in such cramped quarters have other health risks as dramatic or more dramatic than those caused by the virus? Many of these neighborhoods are now heavily policed and sometimes besieged by military forces under the pretext of fighting crime. Is this not, after all, the toughest quarantine for these populations? Won’t the young people from the slums of Rio de Janeiro, who have always been prevented by the police from going to Copacabana beach on Sundays so as not to disturb the tourists, feel that they were already living in quarantine? What is the difference between the new quarantine and the original one, which was always their way of life?3838 Santos BS. A cruel pedagogia do vírus. Coimbra: Edições Almedina; 2020. (p. 18)

The author’s provocation brings into play the issue of the poor and peripheral population’s access to public spaces, questioning the pandemic’s impacts on a daily life already marked by “quarantines”.

The experiments reported here are ongoing and in constant quest for improvement, guided by our reflections on social protection and our professional responsibility. Even if with a scope more related to the microsocial scope, and besides contributing to the confrontation of basic survival needs, they may guide a re-signification of daily life restricted in its emancipatory circulation. These restrictions, now aggravated by the pandemic, were and remain an issue in the lives of young people in Brazil and around the world. In a context of trivialization of death, it is all about the defense and action for the non-negotiable value of each life and its pulsing.

  • (f)
    Expression used by one of the participants in our interventions.
  • (g)
    According to Sposati66 Sposati A. SUAS e proteção social na pandemia covid-19. São Carlos: Pedro & João Editores; 2020., “experiencing social lack of protection is an expression of the social issue that materializes inequalities in the terms of living and living conditions of humans” (p. 10).
  • (h)
    COVID – 19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) – 05/25/2021. Available at: https://www.arcgis.com/apps/opsdashboard/index.html
  • (i)
    Regulating Federal Law Nº13.979
  • (j)
    Law 13.982 of April 2, 2020 expresses in its article 2: to grant emergency aid in the amount of R$600.00 per month to workers over 18 years old, with informal employment, monthly per capita family income below ½ minimum wage, and other requirements established by law.
  • (k)
    As an example, we can cite the embezzlement of R$7,500,000.00, destined for the purchase of CoVid-19 rapid tests, for the Homeland-Volunteer program, led by the current first lady Michelle Bolsonaro, in benefit of evangelical missionary institutions, without any articulations with SUAS2525 Rezende C. Governo Bolsonaro repassou a programa de Michelle R$ 7,5 milhões doados para testes de Covid. Folha de São Paulo [Internet]. 30 Set 2020 [citado 2 Mar 2021]; Poder. Disponível em: https://www1.folha.uol.com.br/poder/2020/09/governo-bolsonaro-repassou-a-programa-de-michelle-r-75-milhoes-doados-para-testes-de-covid.shtml?utm_source=whatsapp&utm_medium=social&utm_campaign=compwa
    https://www1.folha.uol.com.br/poder/2020...
    .
  • (l)
    The Metuia Project, created in 1998 and currently under the name Metuia Network - Social Occupational Therapy, congregating centers in seven universities in the country and occupational therapists with different institutional affiliations, propose the development of projects in teaching, research and university extension in Social Occupational Therapy and in its interconnection with different sectors, aimed at people and population groups in processes of disruption of social support networks2828 Lopes RE, Malfitano APS. Traçados teórico-práticos e cenários contemporâneos: a experiência do METUIA/UFSCar em terapia ocupacional social. In: Lopes RE, Malfitano APS, organizadores. Terapia ocupacional social: desenhos teóricos e contornos práticos. São Carlos: EdUFSCar; 2016. p. 297-305.. At UFSCar, since 2004, the main focus has been on youth.

Acknowledgments

We would like to thank the students from the Occupational Therapy course at UFSCar who made up the extension team, namely: Milena Rodrigues, Fernanda Desuó, Bruna Gonçalves and Thayla Passoni.

We also thank all the young people who participated and participate with us in our interventions, and especially Caio, author of the photo published here.

  • Pan LC, Oliveira ML, Silva MJ, Malfitano APS, Lopes RE. Social protection and therapeutic-occupational experiences: life during the Covid-19 pandemic. Interface (Botucatu). 2021; 25 (Supl. 1): e200753 https://doi.org/10.1590/interface.200753
  • Funding

    Office of the Dean of Outreach, Federal University of São Carlos.

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Publication Dates

  • Publication in this collection
    16 Aug 2021
  • Date of issue
    2021

History

  • Received
    29 Oct 2020
  • Accepted
    21 May 2021
UNESP Botucatu - SP - Brazil
E-mail: intface@fmb.unesp.br