Discrimination in health care workers in Brazil – an interview with Brunah Schall

For the past year, Yarrow has been participating in the Gender and COVID-19 working group which brings together practitioners and academics from all over the world to look at the gendered effects of the pandemic and the lockdown measures. 

One area the group has been particularly in focus is the way that race and gender intersect in the context of the pandemic. We know from studies of the pandemic that Women of color have been most impacted by the pandemic. Women, especially women of color in Brazil are already most impacted by unequal government policies and suffer higher rates of things like domestic abuse, which became worse during the pandemic. Black Brazilians have died at higher rates from COVID-19 and been more impacted financially.

We spoke to one researcher studying these intersections. Brunah Schall has a master’s and doctorate in sociology and is currently doing a postdoc researching gender and vector control in the context of the pandemic. She’s also a member of the Gender and COVID-19 working group and recently co-authored a study on the experience of frontline health workers during the pandemic in Brazil, and the anti-gender policies of the current government. 

This interview has been edited for length and clarity. 

Photo courtesy of Brunah Schall

Yarrow Global: You started off as a biologist but now you are a sociologist. What made you change fields?

Brunah Schall: My main field of research in sociology was studying evolutionary biology and the controversy around creationism and evolution here in Brazil. I moved from biology to sociology because I wanted to understand better the social relations surrounding this controversy. I was also very interested in scientific outreach and that put me in the direction of the humanities. So I’m new to gender studies, but I’m really enjoying it.

YG: You recently coauthored a study which examines gender and race in the experiences of frontline health workers in Brazil during the COVID 19 pandemic, called Gender and Race on the Frontline, a collaboration that came out of the gender and COVID 19 project in Brazil. What were the main findings of your study? 

BS: So that article was based on an online survey. For this article we analyzed, I think, the third round of this survey. Basically we analyzed how public health professionals in Brazil accessed training in PPE in the pandemic and institutional support for their mental health, for example the feelings they had: the fear of getting sick, if they felt prepared to face the pandemic, how many colleagues? had COVID, harassment. And later on we added questions about domestic work. Basically, what we are seeing is that Black women usually have less support, less access to PPE and worse mental health, as well as less institutional support. And this did not change throughout the pandemic. So basically, after almost two years of the pandemic they still have the same problems. For all of the categories the results were very, very bad. All the white men had bad results, but we saw that Black women suffer the most and in some cases, Black men had worse conditions than white women. For example, they reported feeling more tired. They reported receiving less social support. In some cases we saw that (discrimination) is more racialized than gender specific. Overall, Black women are most affected. 

YG: And did you also analyze the results according to a professional background? So for example if black nurses were more affected than white doctors? 

BS: Yes. Black women are predominant among nurses and community health workers. And we also see this difference. White men are predominantly physicians. And white nurses occupied more management roles than most nurses. So there is also this difference. 

YG: Why is an intersectional view important when looking at discrimination among health care providers? 

BS: Because they are tied together. Gender is a relational category and interacts with race. So if we only look to gender, we are missing an important part of the scenario. As I said, in some cases, race is even more predominantly causing these inequalities than gender. So it’s important to look at this both together in Brazil, and in most of our research we try to look at them both together. Because when you talk about white women, it’s a completely different context than Black women. White women have more access to education than Black women. And so on. This has its roots in the colonial history and in the structural racism that is everywhere here in Brazil, we can’t deny it. So it’s very important always to look at gender associated with race. 

YG: Do you have the impression that the intersection of race and gender make even more of a difference in Brazil? And if so, why? 

BS: Yeah, I think here in Brazil, especially because of our colonial past. It’s very important and we can’t deny it. But I think in other contexts as well, like the United States, for sure, it’s also very important. It’s very racialized. I would say it is important everywhere, but especially here because of our historical legacy of women and how the history of the nursing profession here in Brazil is very tied to Black women, also Black men. Also because slave work was very related to care work 

I should also talk about traditional knowledge, which in Brazil is also very important in the health field. We have a lot of knowledge which comes from indigenous people, quilombolas, which are traditional people who live in communities that are descendants of formerly enslaved people. And so quilombolas, Indigenous peoples, have a lot of non-occidental knowledge. Maybe not the kind of knowledge that you learn in college, but knowledge that is very important in the communities. Popular knowledge. And this is very mixed in here in our health care. 

YG: Was there anything that surprised you in your study findings? 

BS: We weren’t actually surprised to see that women are the most affected. Especially because women are the majority of the health workforce and because we know Black women make up the majority of professions that are more precarious. I was surprised to see some women respond to our open question about harassment with cases in which they had been harassed by other women, for example women harassing women based on maternity, based on motherhood. And that was surprising. We (started looking into the concept of the) sociological male. It was a new concept for all of us. Women who occupy roles that are usually occupied by men can reproduce men’s behavior. It might be tied to political views, you know, using words like “gender ideology”. But that was a little bit surprising. 

But gender is not about women and men. It’s about relations, and women in relation to other women can reproduce gender norms as much as men and gender prejudice. But nevertheless, it is disappointing to see something like this right now. 

YG: You mentioned the anti-gender stance of the current government, especially Jair Bolsonaro, and its effects on the pandemic response in Brazil. What does feminism have to do with health? 

BS: Everything. Yeah, health, it’s health and care and –  if women don’t have equal access to how decisions are made, to how things are organized (then we reproduce) gender inequalities. But the health system is supposed to be universal and to be for all. To have a feminist view of health, I think, is to aim for this idea of universal health. For respect for the differences, not only gender, race and class but also everything else that interacts with it. Bolsonaros’ policies are totally gender blind. They are reinforcing inequalities; they are not addressing them at all. And our research shows this very well.Basically feminism is aiming for this more equitable world with less inequality and less prejudice. Yeah. So I think it has everything to do with health. It’s one of the main things that should be universal. It’s a universal right, but in practice, it’s not for all. 

Citation: Wenham, C., Fernandez, M., Corrêa, M., Lotta, G., Schall, B., Rocha, M., & Pimenta, D. (2021). Gender and Race on the frontline: experiences of health workers in Brazil during the COVID-19 pandemic. Social Politics.

Cover photo courtesy of Fiocruz

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