NASHVILLE, TN — According to a study co-led by Dominique Béhague of Vanderbilt University, Brazilian citizens lacking traditional public health expertise have stepped up and collaborated in impoverished neighborhoods known as favelas to make significant strides in their community's response to the COVID-19 pandemic.
Béhague, Associate Professor of Medicine, Health and Society, and Francisco Ortega, Research Professor at the Catalan Research and Advanced Studies Institute in Barcelona, Spain, co-authored a recent article on their findings in The Lancet.
They contend that collective social medicine—built on mutual aid and solidarity practices among neighborhood groups and local journalists—challenges conventional assumptions about the effectiveness of hierarchical leadership models, disease-specific programs and other common public health practices.
“Government and institutional investment in public health is vital, but we have also seen a growing number of distinct initiatives and funding streams, which can lead to duplication of efforts, lack of coordination and unnecessary hyperspecialization,” said Béhague, who is also affiliated with King's College, London.
“Favela community organizers are showing us that effective public health action can take shape at a local level in a synergistic and multi-pronged way. This begs the question of why the public health community has not been more effective at the national and global levels with all the resources they bring to bear,” he added.
Researchers noted that the activities of community activists in favelas tackle COVID-specific concerns while addressing overarching social determinants like unemployment, mental health and food security. Their labor is decentralized and shared cooperatively among local groups and individuals, including journalists who help with food delivery while reporting and countering disinformation about COVID-19.
Favela activists have established their own data collecting systems to acquire an accurate image of the state of local COVID-19 and respond quickly, from monitoring and distributing money to managing volunteers and combating disinformation.
“The community activists’ alliances, which reject traditional hierarchies and commit to working through political differences, are fighting COVID-19 in a much more equitable manner,” Behague stated. “These unorthodox approaches demonstrate that social medicine is a model for reimagining public health—not just in the favelas of Brazil but also around the world.”
The paper is part of a "Revitalizing Global Social Medicine" series edited by Michelle Pentecost, Vincanne Adams, Rama Baru, Carlo Caduff, Jeremy A Greene, Helena Hansen, David S Jones, Junko Kitanaka and Francisco Ortega.
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