a shift from the artistic to the political function of artwork, Walter Benjamin (1979) suggested that captioning would become the most important part of photography, the foundation of meaning.24 For some time after our first visit to Vita, I thought that these photos were enough, that they did the work of bringing this reality out of concealment and into the public eye. The photos stayed with me and fueled a desire to return to Vita—not to find a caption but to try to further engage some of the abandoned, to listen to and record what they thought of their plight, who they once had been. By hearing them and tracing their trajectories, I hoped to prevent them from remaining merely depictions of powerlessness and to address the routine domestic and public interactions that foreclosed the possibilities of their lives. Ethnography helps to disentangle these knots of complexity, bringing into view the concrete conditions and spaces through which human existences become intractable realities. And yet, as I began to know these people better, I was challenged to think of life in Vita also in terms of anticipation and possibility.
Before we went back to Vita in December 2001 to conclude the photographic work, I briefed Torben on what my research had found in Vita and beyond. Learning about Catarina’s life history and having clues to the lives of some of the other abandoned affected his approach to the photography. In his earlier pictures of life in Vita, he mostly photographed fragments of people’s bodies, conveying their death-in-life and overall detachment from a larger social body. This time, with some of their fragmented histories in mind, Torben pictured the abandoned at a certain distance, I would say. Enclosure, adjacency to others, and introspection are shown. Older than their bodies tell and yet with time left, the people of Vita appear more familiar to us than before, left with their own intimacy and a way to fold into themselves and reflect.
Infirmary, Vita 2001
Pedro, Vita 1995
Brazil
Consider the old man whose eyes were cast downward, his hands shaking, his body skeletal. Family members had left him at Vita’s gate. I asked him his name even though the volunteers told me that he did not know it. He muttered, “Pedro,” and smiled. He also knew where he had once lived: “Charqueadas.” He then grabbed his throat. “Grrrahaaa . . . hhhrhrraaahhgrrrrss . . . ahhrgaaahgrqqaa . . .” I could not understand. It was not the absence of words but the speaking of nonwords.
Oscar and other volunteers told me that Pedro probably had throat cancer, although they did not know for sure. When they brought him to a nearby hospital, the doctors would not see him—a document was missing—and told him to return in three months. The clinic will not refuse to see him, but it will put him in line, make him return to schedule appointments, and when the doctors finally have time for Pedro, it will probably be too late. Then the clinic can claim, as it does with too many others, that nothing can be done.
The residents of Vita are not simply isolated individuals who, on their own, lost the symbolic supports for their existence. Rather, the abandonados are the carriers and witnesses of the ways in which the social destinies of the poorest and the sickest are ordered. The experience of individuals who live in such a dead space/language is traversed by the country’s structural readjustment, unemployment, malfunctioning public health system, and infamously unequal distribution of wealth.25
Historically, Brazil’s welfare system has been structured so that state intervention varies according to the segment of the population claiming social protection. “Citizenship” has been deemed universal for the minority who are rich, regulated according to market forces for the working class and the middle class, and denied to the multitudes who are poor and marginalized. According to Sônia Fleury, the “noncitizens” might be entitled to some minimum form of social assistance and charity in exchange for their votes—this is their “inverted citizenship” (quoted in Escorel 1993:35). Those occupying the upper strata of society not only live longer; their right to do so is ensured through bureaucratic and market mechanisms.
As I talked to city administrators, public health officers, and human rights activists, I was able to identify some of the institutional networks through which Vita emerged and was integrated into local forms of governance as well as some of the everyday practices that help to constitute the residents’ nonexistence. With the adoption of Brazil’s democratic constitution in 1988, health care had become a public right. “Health is a right of every individual and a duty of the state, guaranteed by social and economic policies that seek to reduce the risk of disease and other injuries, and by universal and equal access to services designed to promote, protect, and recover health,” stated the new Brazilian constitution (Constitution of the Federative Republic of Brazil 1988). The principles of universality, equity, and integrality within health services (Fleury 1997) were supposed to guide the new Brazilian health care system (Sistema ⁄nico de Saúde, or SUS). In practice, however, efforts to implement these principles collided with historically entrenched forms of medical authoritarianism (Scheper-Hughes 1992) and the realities of fiscal austerity, decentralization, and community- and family-centered approaches to primary care, amid the rapid encroachment of private health care plans. In 1989, for example, the federal government spent eighty-three dollars per person on health care, but in 1993 this amount plunged to only thirty-seven dollars (Jornal NH 1994b).
Many of the country’s discourses and practices of citizenship in the 1990s were related to guaranteeing the universal right to health care as the economy and the state underwent a major restructuring.26 The activism of mental health workers was exemplary (Tenorio 2002). They actively engaged in making laws that shaped the progressive closure of psychiatric institutions and their replacement by local networks of community- and family-based psychosocial care (Amarante 1996; Goldberg 1994; Moraes 2000).27 This deinstitutionalization of the mentally ill was pioneered in the state of Rio Grande do Sul (Porto Alegre is its capital), where it was well under way by the early 1990s. In reality, however, the demands and strategies of the mental health movement became entangled in and even facilitated local government’s neoliberalizing moves in public health: the mad were literally expelled from overcrowded and inefficient institutions, and little new funding was allocated for the alternative services that had been proposed.
On the one hand, this local psychiatric reform confirmed the role of the Workers’ Party as a representative of a novel politics of social inclusion—PT, the Partido dos Trabalhadores, was already in power in the capital. It also occasioned a few exemplary services that treated “citizens burdened by mental suffering” and realized, if all too partially, a socialized form of self-governance. On the other hand, it shifted the burden of care from state institutions to the family and communities, which failed to live up to their idealized representations in the reform movement’s discourse. People had to learn new techniques to qualify for services and to live with what were, by and large, the limitations of new ideologies and institutions. Increasing numbers of mentally ill people began to live in the streets, along with the other leftovers of the country’s unequal and exclusionary social project. Many ended up in places like Vita.
Everyday life in the 1980s and 1990s in that region was marked by high rates of migration and unemployment, the rise of a drug economy in the poorest outlying areas, and generalized violence (see Ferreira and Barros 1999). As police forces increasingly engaged in erasing signs of misery, begging, and informal economies from the city, pastoral and philanthropic institutions took up the role of caregiver, albeit selectively. Simultaneously, families frequently responded to the growing burdens posed by new responsibilities for care and narrowing employment options by redefining their functional scope and value systems. As a corollary to all these institutional, economic, and familial processes, unemployed health professionals began opening their own care centers (modeled after Vita) for patients who had welfare benefits or some remaining assets. Around 1976, some twenty-five “geriatric houses” operated in
