Socioeconomic Challenges That Impact Public Health In Brazil

Socioeconomic Challenges That Impact Public Health In Brazil 

James A. Dadzie 

Environmental Science in Public Health 

Environmental injustice is concerned with inequalities that exist within the physical environment as a direct result of the effects of wider socioeconomic and sociopolitical systemic forces (Pellow 2002.) Waste disposal in Brazil shares some similarities with the history presented by Pellow. For Brazil in general, the situation is slightly different. The situation is different in the sense that historically, discrimination whether - perceived or real - has never been based on race but more on the order of class and socioeconomic status. Chicago as a part of American society, has experienced its own share of institutionalized racism; in comparison to Brazil in recent times however, scholars have expressed markedly divergent opinions about race relations in Brazil (Baiocchi & Corrado 2010.) The complexity of race relations in recent times and the consequent social stratification based on socioeconomic status has led to some of the most devastating public health issues the nation has ever faced (Leite et al., 2014; Race relations in Brazil 2014; Guimarães et al., 2011.) Major health issues faced by some of the most impoverished communities are dengue fever, malaria and until recently zika virus. Inadequate efforts put into urban planning, illegal economic activities leading to deforestation have all contributed to the creation of inadequate housing conditions (Ahonen 2016) in the state of Pernambuco for instance. 

To understand the cause of constant flooding which destroys property and lives alike - pollution and the breeding of mosquitoes to mention but a few - it is imperative to first give a fair idea of what the geography of the perennially affected areas are like. According to research, approximately half of the population of Brazil have places of domicile which can be found at most one hundred and twenty-five (125) miles of the sea (Christian & Costa, 2007.) There are many rivers that empty into the sea with this level of closeness and the main occupational activity is fishing along the rivers especially in a state like Pernambuco (Christian & Costa, 2007.) Years of excessive fishing as well as extraction of natural resources have contributed to the reduction in size of coral reefs (Brazil has lost 80 pct of coral reefs in 50 years, study says 2012.) The types of materials used for fishing activities play a major role in the gradually diminishing quantity and quality of marine life (Leite et al., 2014.) There are over four thousand beaches which gives one a fair idea of the potential for pollution (Christian & Costa, 2007.) 

Most of the solid waste and sewage found on the beaches are from landfills further inland. It is estimated that of the fifty-six thousand (56000) tonnes of solid waste generated per day by inhabitants who dwell close to various forms of natural water bodies such as lagoons, rivers and close to the beaches, forty-two thousand (42000) tonnes finds its way to landfills and that, unfortunately, is generally accepted as the norm (Christian & Costa, 2007.) There seems to be a trend at least in northeastern regions of Brazil, specifically around communities near the beaches and other water bodies. The population found close to the water bodies seem to be the ones bearing the burden of other communities further inland. Christian & Costa (2007) mention how it has become the norm but there seems to be very little to no action on the part of the inhabitants in some communities to voice their concern. Especially in parts of a city such as Recife, some community dwellers seem to have lost hope possibly due to politicians not following through on their promises. 

In the year 1980, engineers came up with condominial sewers to help control the amount of sewage that found its way into rivers and lagoons (Nance & Ortolano, 2007.) Nance & Ortolano (2007) provide a brief history of the sewage system in two places within the northeastern territories of Brazil where waste in the form of sewage is a huge problem and solid waste contributes to flooding in the event of very heavy rainfall. The cities of Recife and Natal were considered. Seven total projects to install condominial sewers were assessed by Norton & Ortolano (2007.) Three and four separate projects in Recife and Natal respectively were considered. The participants who were essentially the relevant stakeholders consisted of engineers, community leaders and citizens (Nance & Ortolano, 2007.) The participants totaled two hundred and ninety-seven (297) who were involved in one way or another with the project to install condominial sewers. Problems arose that could have easily been avoided if the government and the relevant stakeholders had done their parts. After much complaint by inhabitants in places like Natal, the condominial sewers were developed.  

Conventional sewers were a lot more expensive to construct and maintain whereas the condominial sewers were much more cost effective. Considering the socioeconomic status of the population as well, the condominial sewers were more affordable. The added advantage of the new condominial sewers was the ease of manageability and the material of which it is made is comparatively less expensive than the conventional sewers which made them more cost effective. Research shows that communities found along the coastal areas and stretching a few hundred miles inland tend to be among some of the most impoverished (Guimarães et al., 2007; Nance & Ortolano 2007.) The political landscape is such that policies outlined by elected officials are not followed through in the event of a change in local government. In a city like Recife for instance, the construction of condominial sewers faced several setbacks and in some cases construction was only halfway completed (Nance & Ortolano 2007) and yet the inhabitants, after many years of complaints made to the relevant officials, seemed to have been neglected by the very officials entrusted with the general development of the people - environment and health inclusive. 

There are several reasons that explain Recife’s mediocre performance when one considers the construction of condominial sewers. Among them, according to Nance & Ortolano (2007) is the seeming lack of political involvement of the residents. In other words, the social capital of the community was not used, thereby allowing an opportunity with great potential of success to go to waste. Involvement with elected officials in the form of constant communication was absent. The channels of communication necessary for mobilizing community efforts for the betterment of the people would have been relevant in eliminating the problem of sewage disposal. Considering the situation in Natal, strong organization among the affected residents and the determination to alter the status quo resulted in consistently better Sewer Performance Index (SPI) scores. The SPI scores consisted of twenty-seven (27) measures of performance including the actual effectiveness of the new systems as well as effects realized as a direct result of the new installations. The score ranged from zero (0) to one hundred (100) where a score of 0 indicated low performance and 100 represented high performance. Broken down further, a score within a range between 0 and 33 was considered low, 34 to 67 are considered mid-range and finally 68 to 100 indicated high performance. Taking a close look at the low SPI scores of Recife in comparison to the better performance of Natal, one gets the impression that the issue is not so much about social stratification as much as it is the willingness for elected officials and residents to engage each other effectively for desired development (Nance & Ortolano 2007.) For Recife alone, SPI scores varied widely indicating that there were segments of the population which went beyond the bare minimum level of participation to ensure the new condominial sewers were installed to fully realize the potential of the new technology. It is highly likely that for the segments of the population which did not experience as much success as Natal, there has been a buildup of frustration with elected officials due to many years of feeling neglected and marginalized. Considering the evidence put forth by researchers then, the problems associated with sewage disposal in Recife can be termed environmental injustice. Inaction on the part of elected officials and residents alike, disagreements among technical experts such as engineers about the right way forward, all seemed to have all played a role in the problem under consideration. According to Nance & Ortolano (2007) Some engineers disagreed about the best way forward regarding the implementation of the new projects in Recife. Politicians who were supposed to follow through on the needs of the people seemed to be more concerned about their own agenda; therefore, as the more vulnerable population experiencing the negative impacts of pollution, it only makes sense to get actively involved in social issues and make their voices heard. 

Considering solid waste, the coastal areas of Brazil are among some of the most impoverished and this reflects in the built environment found in the affected areas. Due to the increased population of dwellings close to the coast, (Leite et al., 2014; Guimarães et al., 2011), there is an enormous amount of pressure placed on the environment (Leite et al., 2014.) The strain on the environment often results in waste, especially in the form of plastics and rubber to name but a few which tend to choke (Guimarães et al., 2011) waterways. It is important to note that the level of damage done by improper waste disposal is exacerbated by the non-biodegradable nature of a good chunk of waste often found in the hydrographic regions of Brazil (Santos et al., 2009.) Over the past few years, there has been an influx of migrant workers to the regions northeast of Brazil mostly because of job availability (Guimarães et al., 2011); the increase in population as well as the fish processing industry located in the region has placed undue strain on water resources (Ahonen 2016.) Very little is being done by way of ensuring the safety of residents from the disposal of toxic and non-biodegradable materials (Guimarães et al., 2011; Nance & Ortolano 2007.) 

In view of the empirical evidence discussed, one can say that both environmental racism and injustice both play a role in the current state of public health in Brazil. Inaction on the part of government as well as the apathy displayed by industries towards the safety of the environment constitute environmental racism. In Recife and Natal for instance, it took many years of government petitioning for efforts to be in making environmentally friendly sewers available. Although the original intention was noble, the inhabitants of Recife were sidelined in the completion of projects (Nance & Ortolano 2007.)  

The strategic location of industries along the coast which attracts poor working class individuals tends to be an issue as noted by (Guimarães et al., 2011.) The problem with the fishing industry for instance is not the provision of employment, but rather the wanton disregard business executives and government officials have for the environmental safety displayed through the lack of efforts to make a positive investment in the quality of lives of the people constitutes environmental injustice. 

The lives of the vulnerable population under consideration is in perpetual jeopardy in view of the evidence presented. For the status quo to change for the better, it behooves the government to effectively play its role by carrying out its duties to the people. The existence of mining and fishing industries seem to have no standards set by the government. The negligence of proper laws to protect the vulnerable population under consideration (Pellow 2002) is a contributory factor to the evident environmental inequality.