Public policies in open scenes of crack use: The hotels in the De Braços Abertos programme as an experience of a consensual and participatory environment

Políticas públicas em cenas abertas de uso de crack: Os hotéis do programa De Braços Abertos como experiência de ambiente consensual e participativo

Abstract

The Programa ‘De Braços Abertos’ (PBA) [Open Arms Programme] was planned and implemented by authorities of the city of São Paulo, between 2014 and 2016, and provided for the accommodation of its beneficiaries in hotels. We perceived a lack of specific research on the ways this programme was operated. Through an ethnography and the construction of close relationships with the teams of professionals working in these hotels, we were able to verify: (1) the constant attempts by the programme’s agents to develop bonds with the beneficiaries, (2) the skilful, attentive listening to the demands and daily stories lived by the beneficiaries, and (3) the problem-solving efforts in a consensual and participatory environment. In contrast to life on the streets, along with the professional intervention, the new context provided by PBA hotels has, in many cases, paved the way for changes in the drug users’ relationship with crack consumption to a more controlled pattern.

Key words: Crack cocaine; Open Arms Programme; ethnography; hotels

Resumo

O Programa “De Braços Abertos” (PBA) foi planejado e implementado pelas autoridades do município de São Paulo, entre 2014 e 2016, e previa a hospedagem de seus beneficiários em hotéis. Percebemos a falta de pesquisas específicas sobre as formas de funcionamento desse programa. Por meio de uma etnografia e da construção de relações próximas com as equipes de profissionais que atuam nesses hotéis, pudemos constatar: (1) a constante tentativa dos agentes do programa em desenvolver vínculos com os beneficiários, (2) a escuta qualificada e aguçada das demandas e histórias cotidianas vividas pelos beneficiários e (3) os esforços de resolução de problemas em um ambiente consensual e participativo. Em contraste com a vida nas ruas, acompanhado da intervenção profissional, o novo contexto proporcionado pelos hotéis PBA abriu caminho para a mudança na relação dos usuários de drogas com o consumo de crack para um padrão mais controlado.

Palavras-chave: Crack; Programa Braços Abertos; etnografia; hotéis

Introduction

The III Levantamento Nacional sobre o uso de drogas pela população Brasileira [III National Survey on Drug Use by the Brazilian Population] (Bastos et al., 2017) revealed that approximately 1.4 million people between 12 and 65 years of age reported having used crack and similar drugs at least once in their lifetime, corresponding to 0.9% of the survey population, with pronounced differences between men (1.4%) and women (0.4%). In the 12 months prior to the survey, use of this drug was reported by 0.3% of the population. A paper by Alves and Pereira (2019) showed that the first reports of crack use in the city of São Paulo date back to the late 1980s, and that the appearance of Cracolândia, a large area characterised by the presence of thousands of drug users and other visitors every day, located in the central region of the city, took place in the mid-1990s. At the time, the Programa ‘De Braços Abertos’ (PBA) [Open Arms Programme] - the 2014 public policy addressed in this article -, crack consumption in Cracolândia had spread over a dozen blocks and reached 3000 users.

The use of crack did not begin in Brazil, but in the US in the mid-1980s. This drug was a market innovation, creating jobs for unemployed youth, with better pay and working conditions than they could achieve through formal jobs. Crack changed the mode of consumption of cocaine to smoking, which intensified and shortened its effect (Reinarman and Levine, 1997). Despite the aggravation of the effects promoted by crack in relation to snorted cocaine, the majority of those who experiment with the drug do not become regular users, nor do they evolve towards heavy or self-destructive consumption (Reinarman, Waldorf and Murphy, 1997). Brazilian data do not support the idea of an inevitable escalation in crack use among people who experiment with the drug (Nappo, Sanchez and Ribeiro, 2012). In this impoverished region of downtown São Paulo, where Cracolândia is located, heavy use of addictive substances seems to be more closely linked to what Bourgois (2006) observed concerning crack use in certain North American inner cities. Drug addiction, together with criminality and violence, is related to a life full of stress owing to the impossibility of earning an income that guarantees a minimum of dignity, such as a lack of housing for the individual and their family.

Before we explore the subject of this article, a brief explanation of the context in which our topic develops is in order. Cracolândia is an open scene of crack consumption, which has persisted in the central region of São Paulo for almost three decades (Alves and Pereira, 2023), creating its own territoriality as a dangerous, degraded place that people should avoid. Despite this, the use of crack in these circumstances can provide a community-type life, with fraternal relationships between the dispossessed (Alves, 2014), materialised in constant and multiple exchanges (Adorno et al., 2013). The people who frequent or live there end up becoming the object of attempts of state control, which combines repression and surveillance with assistance and care (Rui, 2012). The institutional scenario that seeks to extinguish Cracolândia ends up encouraging the movement of individuals through the different programmes implemented in the region, while at the same time helping them to remain on the streets (Fromm, 2017). Cracolândia is constituted as an itinerant territoriality amid other territorialities that dispute the region, mainly through large urban interventions (Frúgoli Jr and Cavalcanti, 2013).

This article addresses the topic of the hotels included in the PBA, intended to house people who used to use crack in the central region of the city of São Paulo. These hotels are facilities that sometimes form part of the drug use scene and that have become socially relevant as lodging for this public, as explained below. However, for a proper understanding of the innovative character of these hotels, it is important to contextualise the reality in the area known as Cracolândia, or Craco as it is known by many of its regulars, both the crack users and professionals assisting them. Even though not all the people using crack at Cracolândia sleep there, a few hundred drug users lived in shacks near the ‘fluxo’ [flow], the name given to the densest concentration of users, and these people, around 300 individuals, were the first beneficiaries of the PBA. Following their acceptance to join the programme, they were allocated to hotel rooms in Cracolândia, receiving three meals a day, and were also able to participate in the Programa Operação Trabalho (POT) [Operation Work Programme] which required cleaning squares and sidewalks in the morning and receiving 15 reais (roughly U$ 5 at the time) per day of work. In the afternoon many attended professional training courses.

The new mayor, right-wing politician João Doria Jr., who replaced Fernando Haddad of the Partido dos Trabalhadores [Workers Party], governed the city from 2016 to 2018, abolished the PBA in 2017, and was then elected governor of the state of São Paulo. At that time, it had 500 beneficiaries and there were plans by Haddad to extend the programme to 1000 people. The biggest issue highlighted by Doria as a reason to extinguish the PBA was the intense drug trade that had formed in the ‘flow’, with dozens of kilos of crack being traded simultaneously.

The PBA seems to have had a positive impact in reducing drug use among the people who participated in it. In a survey of 80 participants, over 65% beneficiaries ‘claimed to have reduced crack use after joining the PBA’ (Rui, Fiore & Toffoli, 2016: 26). In the same study, many of them reported that they had unsuccessfully tried to reduce their drug use through hospitalisation in therapeutic communities. Despite this, in 2017, after a large police operation that removed drug users from the Cracolândia region, the new mayor of the city of São Paulo announced the end of the PBA by initiating a new programme called Redenção [Redemption]. The programme installed adapted containers for people to stay in overnight, eat meals, and use the bathroom. One of the focuses of the programme was to convince crack users to voluntarily admit themselves to therapeutic communities for treatment. After this announcement, some hotels, which housed the programme’s beneficiaries, received termination notices regarding their city government contracts. At the time of writing this article, more than three years after the PBA was closed down, among the seven hotels that existed at the end of the programme, only three remain active, and are now linked to the Redemption programme. Two of them were transformed into the Serviço Integrado de Acolhida Terapêutica (SIAT) [Integrated Service for Therapeutic Housing]. This shift also implied the dismissal of most of the technical staff that worked in the hotels.

It is not the aim of this paper to present a more detailed comparison between the PBA and SIAT services; however, to give the reader an idea of the evolution of services available for the population that lives on the streets and uses crack in downtown São Paulo, it is worth noting that this service is now provided in three types of facilities, called SIAT I, II and III. SIAT I is suitable for the reception of people who are in situations of greater vulnerability, usually those who have been living on the streets. When these people begin to show what the professional jargon commonly denominates ‘better organisation’, they are referred to SIAT II.

In these centres, together with the hotel staff, they begin to elaborate their treatment plan to enable them to move onto the following stage, SIAT III, a service focused on the search for work and the possible disengagement of these residents from the Redemption programme. Two hotels of the former PBA, located in neighbourhoods further from Cracolândia, were transformed into SIAT III.

In all the SIATs, people can live in the facility; however, there are some distinctions with the old PBA hotels, related initially to drug consumption. In the hotels, as in the SIATs, people were not allowed to use illicit drugs inside the room, however, if someone was seen using, the technical staff’s attitude was to talk and understand the reason for the consumption in the hotel, while in the SIATs, if this occurs, the person is expelled from the programme.

The PBA was a programme implemented in the city of São Paulo designed to meet the demands raised during 2013 among homeless people who used crack in Cracolândia, located at the downtown neighbourhood of Luz. With an inter-departmental character, it primarily involved the municipal departments of Health, Social Work, Labour, Human Rights, and Urban Safety. It was designed to provide shelter, health care, food, occupational activity, professional training, and financial assistance to beneficiaries who worked in cleaning and janitorial positions, and it started on January 14, 2014. Three hundred people enlisted in the programme and they were hired by the POT of the Secretaria Municipal de Desenvolvimento, Trabalho e Empreendedorismo (SMDTE) [Municipal Secretariat of Development, Labour and Entrepreneurship] to work in cleaning activities in the region.

After waking up and leaving the hotel, their routine involved going to the Bom Prato restaurant (a restaurant subsidised by the government) for breakfast, where they were supervised by an agent from the SMDTE, in charge of a group of up to 20 beneficiaries. The team was hardly ever complete, and the absentees were actively searched for in the programme hotels by the 44 social educators of the Secretaria Municipal de Assistência e Desenvolvimento Social (SMADS) [Municipal Secretariat of Assistance and Social Development] and health agents of the Secretaria Municipal de Saúde (SMS) [Municipal Health Secretariat]. As the basis for active searches, information on the beneficiaries absent from work was obtained by these professionals after breakfast, at the place where the team started their shift. Next, SMADS social workers and community health workers, who were also responsible for groups of 20 beneficiaries each, went to these hotels to meet the beneficiaries who were absent and verify the reasons for their absence. Between 1 and 2pm, a group composed of SMADS, SMDTE and SMS professionals would meet to discuss the various demands of that day. Community health workers were the only professionals not available at the rate of one per group of 20 beneficiaries, since only one of them was stationed in each of the hotels in the programme.

Former residents of Cracolândia shacks and ‘malocas’ (improvised huts), in turn, tried to adapt their hotel rooms to the typical life they previously led on the streets, while at the same time changing the regular occupation style of the hotels to better adjust it to their transitional way of life. For example, they occupied corridors and stairways to have conversations and engage in leisure activities and roamed around rooms and buildings and sub-located their rooms to third parties on weekends when the SMADS social workers were usually off. They were present on workdays at the entrance hall and tried to establish some control over the occupancy of the rooms. Occupation was not freely decided, it was defined through requests posed to the professional teams and in particular to a specific social worker with extensive experience in the region. At the beginning of the PBA, this social worker knew most of the beneficiaries who were former residents or habitués of Cracolândia by first name or surname.

It is important to emphasise that the places where crack is used, including Cracolândia, are perceived as spaces that are linked exclusively to the use of this specific drug, and the drug is represented by stigmatising images associated with physical dependence (Romanini & Roso, 2012). This does not seem to occur by chance, given that the area provides a great opportunity for large enterprises in the future, which can only be achieved through the eviction of the current residents, the drug users.

When they want to revitalise, they call an area Cracolândia. This is a way of getting their hands on it, getting the support of the ruling class: this is Cracolândia. Thus, those who are there are expelled, [and] the area depreciates [...].’ (Wisnik and Corullon, 2006)

Particular cases can reveal how gentrification processes in certain neighbourhoods can clash with the presence of open scenes of drug use, similar to Cracolândia. Collins (2019) shows how in the case of the Pelourinho region in the Brazilian city of Salvador, gentrification was more than a market-driven exclusionary relationship, it was ultimately to promote often highly unequal property relations to influence how humans perceive the world and themselves. Another case, outside Brazil, in which real estate interests clashed with assistance to drug users, was that of a small needle exchange programme in Asheville, North Carolina, that operated three hours a week at the back of a bookstore. It was forced to close for operating an illegal homeless shelter. Castillo (2019) realised that the city’s concern was how the programme attracted the ‘wrong kind’ of people to a rapidly gentrifying part of the city; the monstrosity of people who may look homeless gathered on a street that is struggling to look modern.

Drug users are not the only concern that may arouse revulsion in certain areas of cities, they still have to deal with the possibility that harm reduction initiatives themselves will abandon their real interests. Smith (2016), for example, argues that the colonisation of harm reduction by people he terms ‘harm reduction hipsters’ has entailed the spatial displacement of users through processes of gentrification and social exclusion. The recent prestige of harm reduction among hipsters and the corresponding increase in their involvement in institutionalised public health indirectly works to displace drug users as the central driver of the development of harm reduction policies, service delivery, research and evaluation programmes, relegating people who use drugs to passive research subjects and other stigmatising and symbolic positions.

Cases in which people who use drugs (PWUD) do not have their rights respected and are exposed to police repression can have a deleterious impact on their health. Research conducted with municipal police officers who participated in the crackdown on open drug trafficking in Tijuana revealed that these officers perceived that the intent of the operation was to displace and detain homeless PWUD, not to help or rehabilitate them (Morales et. al., 2020).

The nearly two-decade-long struggle for the rights of drug users in Vancouver’s Downtown Eastside led to a favourable municipal response, with the establishment of Insite, North America’s first legal supervised injection programme. By 1993, the Portland Hotel Society (PHS), a Canadian non-profit society focused on providing advocacy, housing, services and opportunities for drug users, had been founded. The PHS was instrumental in getting city hall to recognise the humanity of deeply marginalised addicts and demanded respect for them as problematic citizens (Lupick, 2018).

With the ongoing opioid crisis in Canada, supervised consumption sites (SCSs), where people can use drugs in a safe environment and access health services, are becoming permanent facilities in many cities. This causes many community members to oppose the placement of SCSs in their neighbourhoods, since they link them to increased social disorder, leading to more crime (Wallace, Chamberlain and Fahmy, 2019; Sampson and Raudenbush, 2004). However, when exploring the relationships between SCSs and their surrounding communities, it has been shown that they do not directly contribute to social disorder, since this usually predates the implementation of SCSs.

A cross-sectional study of people who inject drugs (PWID) in 19 major US cities found that PWID living in neighbourhoods with higher levels of gentrification were more likely to be homeless in the previous year (Linton et al., 2017). Stigmatising, depreciating and expelling are all processes linked to gentrification phenomena (Bidou-Zachariasen, 2003). However, this does not fit entirely within this model (Frugoli Jr and Sklai, 2009), because a clear banning procedure for people residing in their real estate is not implemented in such spaces. Eviction practices will not always be adopted. Over time, some municipal authorities will oppose it, while others will not. The article shows how the PBA hotels became a possibility to remain living in that part of the city centre, for the people who smoked crack on those streets, but in qualitatively different conditions.

Among the options aimed at the so-called homeless population - understood as a ‘heterogeneous population group, composed of people with different realities, who have in common living conditions of absolute poverty and a lack of belonging to formal society’ (Motta, 2005: 3) - is the ‘social hotel’, provided for ‘independent and socially active users through a contract with hotels’ (Prefeitura de São Paulo, 2009: 116). In addition to these facilities, there are the ‘living centres’, ‘reception centres’, and ‘dormitories’.

Following Pichon-Rivière’s (1998) ‘theory of the link’, we analyse the type of coexistence provided by the hotel environment, among the PBA beneficiaries and professional staff, which seems to be related to the construction of relationships of certain types of trust and bond.

We were unable to find bibliography on how the hotels were operated, their impact on former PBA beneficiaries and on the people who work there. The documentary that carries the name of one of the hotels in the PBA programme, Hotel Laide, directed by Debora Diniz, shows how care lies at the centre of these hotels’ priorities, rather than abstention from crack. It is no wonder that three years after the PBA was closed, some of the hotels remain busy and working. This fact raises some questions, the first of which is to determine the factors leading to the resilience of this new type of practice. Another is that even though the PBA is not a programme aimed at abstaining from crack use, the persistence of the beneficiaries in the hotels requires answers regarding the main consequences that the new environment brought about in the pattern of drug consumption. To answer such questions some objectives were set for this article. First, since there is no available bibliography, we describe some aspects of the functioning of the hotels that we consider important in understanding the resilience of these facilities. Second, we seek to characterise the type of relationship that is established between the professional staff and PBA beneficiaries. Finally, we verify how the change of environment and daily routine impacts the person’s relationship with crack consumption, in comparison with life on the streets. Because they recovered part of what the city had already learned from the social hotels, a lot has been added as a facility aimed to serve the homeless population who smoke crack. To understand this context, it is important to understand a little about how the programme works.

Materials and methods

This article originated from research undertaken in the São Paulo region known as Cracolândia. We conducted an ethnographic study, seeking to understand the existing public policies related to crack consumption, that was developed, from February 2016 to July 2018, through participant observation, interviews and monitoring of the daily life of health professionals and care providers, and of people who use crack. This scenario has offered us, as authors, the opportunity of discussing ideas for nearly four years and enabled us to participate in the writing, conception and final revision of the article - as use of ‘we’ throughout the text indicates.

In this article, we decided to present an overview with regard to the operation of the PBA hotels, together with the work developed by the professionals who worked in them, from their point of view. We believe that the experience of the workers hired at the end of the programme described through their own narratives and our field reports are sufficiently relevant to justify our analysis.

This ethnographic study consisted of a field study, conducted by the use of two or more data collection techniques, in our case, interviews and field notebook writing. It might be a helpful way to address a detailed, descriptive accumulation of behaviours, attitudes and feelings that produce the fullest possible picture of the lived environment of the PBA hotels. During the study, we were able to get close to the subjects of this research, which led us to the experiences lived by contemporary authors researching drug use, such as Bourgois (2006) with crack sellers, and Bourgois and Schonberg’s (2009) work conducted among heroin users, which were conducted within the best tradition of anthropological practice that proposes the creation of a narrative concerning the other and starts from the relationships built in the field.

The active search was carried out in the hotels in trios formed by the type of professionals described above, who would go door to door in search of the missing beneficiaries. At the beginning of the PBA, the members of these technical teams worked exclusively in the same hotel. However, due to the life changes that affected some of the beneficiaries, there was a considerably high turnover rate among apartments and even among hotels. This happened for different reasons, such as couples breaking up, the desire for better accommodation, or the curiosity of getting to know and stay in different rooms or hotels. Thus, the trios had to account for 20 beneficiaries distributed in different hotels. This marked one of the strong points of the programme: integrated, individualised and comprehensive care provided through the work of professionals from the fields of social work, health and labour, constantly in touch with the beneficiaries.

All the PWUD consented, by signing an authorisation form for the use of their image and to have their photos taken. Our recruitment was by convenience sampling, using the classification of Mainardes (2009), where information collection is performed according to the disposition that the interlocutors have in relation to the researcher. The interlocutors were included according to the criterion of homogeneity (Turato, 2003), the sample was closed and limited to workers in the hotels. The recruitment strategy of asking workers in the hotels for referrals to other colleagues proved to be successful in terms of achieving the required sample, as well as enriching the quality of the research. The research sites were accessed after contact and a brief conversation via mobile phone with a hotel employee. A meeting was scheduled and it was left to our interlocutors to invite other people to the conversations. In order to gain people’s trust, we used to bring with us a copy of our book Jamais fomos zumbis: contexto social e craqueiros na cidade de São Paulo [We were never zombies: social context and crackheads in the city of São Paulo], which was usually known to our interlocutors because they had read or heard about it. Once contact had been initiated, it was common for the people with whom we talked to show interest in the progress of our work and to provide ask suggestions and ask questions. The research was approved by the Research Ethics Committee of the Federal University of São Paulo and all interlocutors signed a term of free and informed consent. The data obtained were organised by cross-referencing two criteria: the units of analysis (episode and interaction), and the importance of the interlocutor for the research. The findings were returned to the community through two meetings with the interlocutors, at different times and on different days, in order to facilitate access to the largest number of interested parties.

Results

In this section, we present the results obtained by examining the following themes: 1) the main difficulties imposed on the PBA by the end of Mayor Haddad’s administration; 2) the importance of the formation of bonds between members of the professional team and the beneficiaries; and 3) the creation of collective, political, and contractual subjects in the hotels.

At the onset of the PBA, the hotels had to work according to the ‘flow’, as the crack scene is called. For the second round of contracts, the beneficiaries were provided better quality and slightly more distant hotels. Foreseeing the possibility of expanding the programme and searching for better quality service, in 2016, the last year of the programme, teams were hired to improve their management. The contracts were then governed by the SMS instead of the SMDTE.

The change in the management of the hotels and the arrival of new professionals, like Rodriguinho, a social worker assigned to one of the hotels in the programme, who was hired by the Instituto de Atenção Básica e Avançada à Saúde (IABAS) [Institute of Primary and Advanced Health Care], was not all that distant from the expected setbacks imposed by such an unfortunate moment: the end of 2016, the conclusion of Haddad’s term as mayor of São Paulo. In early 2017, the PBA began to be discontinued in the hotels which led to the reassignment of members of the Guarda Civil metropolitana (MCG) [Metropolitan Police Force], which was under the command of city hall, who had been trained in conflict mediation and became part of the hotel management teams. At the time, Rodriguinho explained the initial idea behind the work of the MCG within the programme.

They worked in a civil manner, checking the residents in and out and performing one or two interventions. And it was actually really cool over time, right? We exchanged ideas and they lost that brainwashing that militarism does to people’s heads and understood that the hotels residents are people like us, right? Only with other issues. And now, with the dismantling of the PBA, the Department of Public Safety left the programme and took away the management of the hotels precisely to put an end to the programme.

The MCG officers were trained in conflict mediation and harm reduction to work in these hotels. There had been continuous attempts to articulate the Department of Health with the MCG’s Programa de Proteção a Pessoas em Situação de Risco [Programme for the Protection of People at Risk]. Therefore, the work performed by the MCG caused such a profound change that it was able to reverse the most entrenched expectations and resistance among professionals in the programme. It is frequently the case that these professionals are also activists who mobilise in favour of the rights of Cracolândia’s regulars. During our ethnography, we witnessed how the services rendered in the entrance halls of the hotels were a constant challenge for the PBA, who tried to prevent people outside the programme from endangering the welfare of beneficiaries within the hotels. From 2017 onwards, when the new mayor began his term, which led to the end of the PBA, the meetings to supervise the teams ceased to be organised. The most different everyday occurrences in this public service, characterised by transient accommodation, ceased to be supported by city hall. Indeed, there was an obvious boycott against the beneficiaries of the programme, while the professionals who previously provided them with all kinds of assistance had to start organising autonomously. Below we show a painting made on the wall of one of the hotels studied. The image depicts the hotel’s façade collapsing when hit by a steel ball with the inscription ‘Cidade Linda’ [Beautiful City], Mayor Doria’s motto for the city government. (Figure 1)

Figure 1
Elisângela Silva (2011), Do “De Braços Abertos” ao “Redenção”: um caminho percorrido e uma história a contar, p. 62

We talked to some of these new professionals. We also spoke to the people who had worked in the hotels before the organisation of specific teams. They acknowledged the difficulties of the newly hired IABAS team. Mariana, 35, a social worker in a hotel located some distance from Cracolândia reported even more severe problems.

It’s like this: it went wrong because these guys aren’t (...) they’re crack users, you can’t talk to them anyway you feel like, you have to know how to talk to this population. Otherwise, they turn against you!

They assaulted the team. The team stays inside the hotels. There were a lot of aggressions. You know? The users didn’t accept the teams. The staff at the hotels, right? And it was turbulent at first, but now it seems to be going well.

In a short time, there was an improvement in the relations between the social workers, the Department of Health and POT, who were responsible for following up the events and dealing with all kinds of demands presented by the beneficiaries, as well as the people residing in different housing services. However, the lack of supervision and support could lead to situations in which a social worker might withdraw from their daily responsibilities, a behaviour consistent with the new administration, from the many complaints we heard in this regard. Jonas, 38, who also worked in one of the hotels and was hired in 2016 by the IABAS, told us about the opportunities made possible by the presence of a professional team at the beneficiaries’ place of residence.

We’re able to get much closer [to the beneficiaries], right? We can strengthen the bonds, the trust much more, anyway, and I think this kind of work is much closer to the beneficiaries, to their lives, understanding them as whole human beings, you know, their peculiarities. Thus, you can better understand the reasons why they’re there.

In his theory of the link, Pichon-Rivière (1998) considers it to be the dynamic structure established in the subject-object relationship. Coherence and bonds in a group rest on the game between assuming and adjudicating several roles. Thus, communication is established in the bond from the moment both subjects take on the respective role assigned by the other. Compared to Jonas’s previous activity as a POT janitorial team supervisor, working at the hotel enables greater trust and bonding with the beneficiaries. We can also understand him better by recognising in Jonas, and in many other professionals and agents, a deeply empathic, motivated social worker who is in constant relationship with the beneficiaries. Work is better, and seemingly more rewarding and motivating, to the extent that more opportunities are offered for the professional to reach the people who originate the subjects of their own daily tasks.

Listening has a very therapeutic role, right? And this listening transforms into a reflection, not just one (…) but a twofold reflection for the beneficiary, right? There’s a much more effective exchange, there’s a much deeper exchange, right? You’re talking to him today, tomorrow he’s sorry, then we talk about the same issue, and we continue the previous line of thought, right? I think there’s a more powerful reflection, in this case. At least from the beneficiary’s point of view and from the professional’s point of view, anyway.

Getting rid of the residents and their problems does not relieve Jonas. As he confided, if there is something he does not appreciate, it seems to be linked more to the lack of time to reap ‘life’s questions’. To this end, and in contrast to the case of telephone operators, a closer approach is needed, since life seems to be told in whispers, murmured, blown through lips that respond and seek the most critical possibility opened up by ‘trust’: the bond. This is a ubiquitous term in the discourse of professionals working at Cracolândia, which seems to result from the strength of an exchange established through quality, interested, competent listening, that is, the type of listening that is able to respond to the always urgent demands of those who live on the edge, because impatience also has its reasons.

The approach in which understanding through listening, within the set of particularities that can only be revealed over time, conditions our grasp of the individual: the completeness of the human being. Only in this way can beneficiaries be transmuted into a ‘case’, becoming the object of teamwork, dialogue, debate, the search for alternative solutions to the most diverse ‘issues’, as Jonas came to describe. These cases were formulated after approaching, listening to, and bonding with the subjects, and only after that can they have some resonance within the group of professionals who will review and reflect on them. It is a reflection that begins with and lingers through daily empathic contact. We do not trust just anyone to talk about our family and love dramas, or, at least, not everyone has such resourcefulness. Thus, listening is an exchange, a daily reflexive act regarding attitudes taken within and outside the hotel, which enable us to grasp and formulate a certain point of view. Jonas briefly describes the reflective process mediated by practice.

(…) you can share this reflection with them, right? You can do [that], for example, when it comes to health issues.

The guy has tuberculosis, or he’s HIV positive, anyway, he’s here with a lot of problems, right? And we address them, and together we reflect on the guy’s quality of life.

This goes on twenty-four hours a day here, there’s a doctor, there are health issues.

So, these reflections (…) they are constant reflections, from which we can provide practical guidelines.

Getting a new ID document is the first step towards a kind of reintegration into legality, going to the doctor, and starting treatment are actions preceded by processes with ups and downs, regrets and falls. The next shift, the new technical team, is informed of these facts, 24 hours a day, 7 days a week, in the rhythm dictated by the ‘flow’, always there, available, prolonging the hours, days and nights. Think and smoke, smoke and think.(Figure 2)

I feel this is how it is when you’re up like twenty-four hours straight, right? You change shift, you change professionals, but the care continues because the team converses a lot. We have a logbook, right? (…) we talk for at least half an hour about everything.

Figure 2
Elisângela Silva (2011), “De Braços Abertos” ao “Redenção”: um caminho percorrido e uma história a contar, p.52

Health care and social services professionals go to the hotels in response to demands made by the teams, and at other times they may go to the ‘flow’ or work on the streets performing the same care and assistance, such that the service covers the hotel, the streets, and the drug use scenario.

Yes! This is how it is: These people who live in the hotels and work in the streets roam around a lot, right? There, in the ‘flow’, and in this territory in general. These people also have a connection, right?

These are the words of Lumena Almeida Castro Furtado who worked as the PBA coordinator in the final phase of the programme when the new hotel teams were hired. You assist those with whom you form bonds, and you form bonds with those who you assist. Every day, there is a search for comprehensive assistance in the formulation of an ‘individual treatment plan’ by the Department of Health and an ‘individual care plan’ by the Department of Social Services, which could form the ingredients of what Lumena Almeida Castro Furtado, among others, calls a ‘life project’ (Anthropology of Drugs, 2017).

Next, we consider how political, collective, and contractual subjects are created in the hotels. When Garcia, Tykanori, and Maximiniano (2014: 154), analysed the PBA, they emphasised its potential to create political, collective, and contractual subjects. Freed from what we call the dictatorship of the ‘corre’ [alert!] (Alves 2017), PBA beneficiaries now live in another ‘daily temporality’ and enjoy a new perspective. The contracts established on how routine takes place in these rooms and in other hotel facilities demonstrate the importance of these PBA characteristics very keenly perceived by Ivana, 26, a trained psychologist, who works in one of the programme hotels. She explains why sending people from hotels to the assistance homes (SIATs) is not productive.

I don’t believe that people will go there! I think people would rather be on the streets; you know? Many of them have already been to shelters, to ‘assistance homes’, right? Not many, almost all of them, right? I don’t know, but maybe ninety per cent or more. (…) but they adapted to the hotel; it’s a different thing, right? There’s greater freedom, you feel more at home, more comfortable, their possessions are there, they have their bed, and they arrange it how they want to. But, for example, there are visiting hours, room cleaning, you know? Which we have already agreed upon, and then we agree things with them during our meetings (…).

In the assistance homes in São Paulo, democratic management should be the rule, but it is not. Meetings, when they take place, have limited deliberative power and rules can thus be imposed from top to bottom by the management team. The room for negotiation is usually small, and the hours are strict. In the hotels, the technical staff is usually open to dialogue and they also present a different way to accommodate people in rooms. Having a room of your own, as occurs in the hotels, differs significantly from having a bed to sleep on, the situation experienced in the assistance homes. Space and permission to keep their pets also matter a lot. The image below shows Dedé, a pet belonging to a couple of residents, just outside the steps of the hotel entrance. (Figure 3)

Figure 3
Elisângela Silva (2011), “De Braços Abertos” ao “Redenção”: um caminho percorrido e uma história a contar, p. 45

Rodolfo, a social worker hired by the Department of Health to work at some PBA hotels, explains the new situation that was created by the programme.

This is also a success in the De Braços Abertos programme, where doors are open, and people can come and go as they please, it is like they are in their home, they have no curfew. This seems very important to me.

Having a roof over your head is not the same thing as having the same roof, in the same room and with the same ‘buddies’. There is greater freedom and, at the same time, greater stability, a benefit in terms of what J.P. Grund (1993) calls the structure of life: a larger number of affective bonds, commitments, obligations, and responsibilities. Grund considers these aspects to be key for improved relations with drug use and influences the pattern of crack and alcohol use that can change from constant use, say 15 rocks a day, to occasional use. The continuation of our conversation with social worker Rodolfo exposes the way the structure of life operates.

In the hotel I’m at now, for example, I see this a lot, even though there are people who arrive at four in the morning, which is the case of Miguel, aka Zebrinha. He turned sixty last week and he doesn’t miss a single day at work.

He sleeps during the day, but not so much. When it’s about six o’clock he goes to Bom Prato to eat, which is where we offer food for them to eat (…). He comes back, takes a shower, and goes to the ‘flow’.

He returns every day, without question, between half-past three and four in the morning. He arrives, takes a shower, we talk a little, he goes to sleep, and he wakes up at seven for work. Everyday. He was able to get into a routine, which is something a user normally can’t do, right?

Zebrinha’s case clearly shows how commitments and a place to sleep can have a major impact on a person’s life structure, composed of an important set of variables that guided Grund’s study and which refer to regular patterns of work, recreation and activity that shape and constrain the daily lives of drug users. It also emphasises the importance of a routine (both conventional and drug-related) that structures daily patterns as keys to a life structure. It seems logical to Grund to include personal relationships, commitments, goals, obligations, responsibilities and expectations that are demanding and simultaneously have social (affective) or economic (salary) value as equally important determinants. Regular contact with users whose addiction is under control and with non-users, such as the professionals who work in the hotels, is also very important. For Grund, it is also essential to take part in structures and activities that are not primarily motivated by drug-related incentives.

The proper political and contractual achievement that Garcia, Tykanori, and Maximiniano (2014: 154) discuss comes from the organisation of genuinely deliberative meetings, in which the team does not relinquish its share of responsibility, as per Ivana, a social worker allocated in a hotel some distance from the downtown scene.

We leave some of our stuff here, but it is not a total mess, you know?

Music. We allowed music, the use of radio and such.

Well, on weekends we can have loud music until a little later, until midnight, right? During the week we can have it on until ten.

When they arrive at the hotel, and it is like ten, eleven o clock, people are already sleeping, so the volume needs to be lower, something that can only be heard inside their rooms, right?

PBA beneficiaries living in hotels, even after the official end of the programme, could not be burdened with bureaucratic obligations in the name of democracy, with responsibilities and decisions that could displease one another. Therefore, the programme’s team of professionals must take decisions on some issues, otherwise the residents could be at risk. In the example raised by Ivana, it is clear that intimate visits could disturb occupants of the same room. Any misinterpreted act, something that might be seen as disrespect, for example, had the potential to cause hostility. In an interview given at his office, Benedito Mariano, the Secretary of Public Safety, compared the ‘flow’ to a ‘jail yard’, where the rules of an organised crime group called the Primeiro Comando da Capital [First Capital Command] resembled those described by Biondi (2018).

Therefore, returning to the considerations made by Ivana, the social worker, the sexual habits and modes of the penitentiary system are not necessarily adaptable to life in a hotel. This does not mean, in any way, that they wanted to prevent the formation of lasting bonds between couples. In this situation, however, other rules like the right to have their own place to sleep, came into play. In Ivana’s words:

So, let’s put it like this, it’s the team that makes decisions, right? There will be no conjugal visits, for example, right? Because, firstly, the rooms are shared, right? So, you can’t turn the hotel into this prison logic (…) It’s like this: if the person has a partner, there are double rooms, right?

Ivana explains that the beneficiaries of the programme live in shared rooms and couples are guaranteed their own room. At the beginning of the PBA, deliberation on changing room occupation was the responsibility of a specific social worker with a few years of experience in Cracolândia issues due to the work she developed at the Serviço de Atenção Especializada Campos Eliseos [Campos Eliseos Specialised Care Service]. Something previously analysed by Alves (2017), which is also present to some extent in Garcia, Tykanori, and Maximiniano (2014), is the importance not only of horizontal care with each other, but also of the various sanctions employed to constrain crack use.

Discussion

The hotel enables different possibilities of a daily routine lived under the imperatives of the drugs. An everyday life marked by wandering around and by a fatigued, hungry, thirsty body corresponds to a mind conducive to daydreaming and waking up, and then dreaming again until finally shutting down on the sidewalk. Therefore, their state is comparable to that of a zombie, a pejorative term used by the media (Farina Zanotto and Büchele Assis, 2017: 777) to refer to people who use drugs in Cracolândia, that is, a state in which an individual daydreams. It does not refer to the totality of what we called, on another occasion (Alves, 2017), the crack user’s sleep/alert cycle, but only one part of it. It refers more specifically to the part corresponding to the state of movement of the body during rest caused by days and days of drug use without sleeping. To assign the crack user the nickname ‘zombie’ is to take a particular state of their daily existence and consider it as something that happens all day long, every day. This state is followed by proper sleeping, when the body rests, and then waking up with a ‘clear mind’, that is, ready for a more pleasant ‘drag’. In this sense, bodies and minds are seen as one.

The alert mind corresponds to a body in motion, and the fatigued body corresponds to a mind that daydreams. This mind can sometimes be more awake or more involved in dreaming. The shuffled perception experiences the dream in reality, and reality in the dream. It can wake up and dream again and again, and the body will keep moving, following the crack users on their ‘walk’. When finally falling into a deep sleep, objectively lying on a sidewalk or poorly accommodated in a shack, the user will be in position to rest a little deeper, but in order to do so, they have first paid the price of gradually fainting, in a long process of fighting to remain a little more semi-awake at the expense of crack rocks. Thus, what is commonly referred to as a binge, drug use until complete exhaustion, can be better conceptualised by taking into account the user, her/his mind/body in an environment that provides crack rocks. These rocks are obtained through the action of searching for funds and are collected during the ‘corre’, which is necessary to maintain their bodies and minds alert until their dreams merge with reality. If drug use generally enables a new perception of reality, crack use blends it with our dreams in an environment where everything seems to conspire to make it rest a challenge. (Figure 4)

Figure 4

Having a place to sleep is critical in order to cause a break in the crack user’s alert/sleep cycle. Their rhythm begins to be governed by the three daily meals, the working hours of their morning cleaning job, and by nocturnal sleep provided by the accommodation of beneficiaries in hotels in the area. For some, this daily load of activities was increased by participating in vocational training courses, such as gardening, computer skills, hairdressing and others. This corresponds to a range of obligations that structure the lives of crack users and provide them with a daily routine. Several responsibilities were established concerning time, appearance, dress, hygiene, and the maintenance and handling of their learning and work materials. The change in the activities that structure everyday life and the environment in which they live corresponds to a change in that person’s relationship with the drug.

Considering that there is no available bibliography on this unprecedented experience regarding the PBA hotels, we set ourselves the challenge to describe them and determine the reasons for their resilience. This article has sought to bridge this gap through the analysis of ethnographic reports, and interviews with healthcare professionals, and social services staff within the hotels. The type and depth of information that emerged depended much on the quality of the relationships established with our interlocutors. It was a movement that emerged from the relationship with them, in order to know more about the relationship between them.

The PBA was a programme run by the city of São Paulo designed to meet the demands raised during 2013 among people who lived in the streets and used crack in the São Paulo region known as Cracolândia, located in the downtown neighbourhood of Luz. It had an inter-departmental character involving the municipal departments of Health, Social Services, Labour, Human Rights and Public Safety. Implemented in hotels, initially close to the ‘flow’, over time they improved in quality and were transferred slightly further away. The teams of professionals, hired in the final year of the PBA, could be characterised by their constant search for greater trust, empathy, and the formation of bonds with the beneficiaries.

Lastly, without disregarding the importance of decriminalisation, safe consumption sites, safe supply, and based on that presented in this article, we suggest that: the zombie-like state, unfairly attributed to crack users, can be overcome by creating an environment with responsibilities regarding time, appearance, clothing, hygiene, and the maintenance and handling of learning and work materials, where a person can sleep instead of being forced to stay on the streets. By changing their environment and their daily routines, their relationship with the drug shifts to a more favourable one.

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Notes

• 1
  The names of all the interlocutors involved in the research have been changed to protect the identity and privacy of those concerned.
• 2
  As the former drug user Antonio told us, the wake-up drag, that is, the one taken while their mind was still clear, was the most pleasant one compared with the drags meant to keep them awake.

Edited by

• Editors
  Andrea de Souza Lobo (https://orcid.org/0000-0001-7525-1953)
  Antonio Carlos de Souza Lima (https://orcid.org/0000-0001-5260-236X)

Publication Dates

• Publication in this collection
  21 Oct 2024
• Date of issue
  2024

History

• Received
  09 Feb 2023
• Accepted
  18 June 2024