Rio de Janeiro, Brazil – On a Tuesday morning, just days before Brazilians head to the polls for nationwide municipal elections, Dr Gustavo Treistman weaves through stalls at a busy street market in Grajaú, a neighbourhood in Rio de Janeiro’s north zone.
The 33-year-old emergency room doctor navigates his way around tables piled high with vibrant fruits and vegetables, handing out pamphlets to nearly everyone he passes. Clad in a face mask bearing the words “Out with Bolsonaro”, he approaches vendors and shoppers with hesitation.
Some absentmindedly grab the pamphlets; others listen closely as he quietly explains his ideas. One vendor bumps fists with Treistman before he moves on to the next stall.
“My name is Gustavo, I’m running for city councillor – I’m a doctor,” the soft-spoken candidate says to another vendor. “I believe we need to strengthen the public health system.”
Treistman is one of the 19,400 health workers running in local elections set to take place across the country starting on November 15, according to data from Brazil’s Supreme Electoral Court. The candidate, who is campaigning with the United Socialist Workers’ Party, has promised to fight for more public funding for healthcare if he is elected.
For fruit vendor Andrea Ribeiro Lima, the rhetoric of health workers holds appeal. “It really resonates with the moment we’re living in,” said the voter, who lives in the city of Nova Iguaçu, on the northern fringes of Rio. “Here, all we want is health and security.”
The number of candidacies by doctors, nurses and other medical professionals – from all sides of Brazil’s political and ideological spectrum – has jumped 15 percent in 2020 compared with the last local election in 2016, according to the electoral court.
Many of these candidates are scrambling to win over Brazilians with campaigns centred on healthcare, as the country continues to wrestle with one of the world’s worst coronavirus outbreaks.
“They are trying to create this bond with the population,” said Eduardo Grin, a researcher at the think tank Fundação Getúlio Vargas. “They are trying to say, ‘look – I will take care of you.’”
As COVID-19 ravages Brazil, the timing for these political hopefuls may be just right. While corruption and security were front and centre in Brazil’s 2018 national elections – which helped far-right President Jair Bolsonaro rise to power – healthcare has now overshadowed these issues for many voters, observers say.
While doctors have played a consistent role in Brazilian politics over the years, the pandemic has created a unique opening for a fresh wave of candidacies by health workers, some of whom may have harboured political ambitions before the pandemic, Grin noted.
“The health crisis is the problem of the moment,” he told Al Jazeera over the phone from Sao Paulo. “In this sense, the pandemic has now provided a window of opportunity that candidates were looking for.”
Brazil has recorded more than 5.6 million cases of COVID-19 and 162,000 deaths, making the outbreak the world’s second deadliest, trailing behind the United States.
The pandemic has been marked by bitter clashes between Bolsonaro and local governments, as the president railed against lockdown measures, called the virus a “little flu” and urged Brazilians to go back to work. Yet the controversial leader’s messaging seemed to resonate with Brazilians, especially with the millions of frustrated informal workers for whom staying at home was financially devastating. At its peak in April, social isolation in Brazil reached just 59 percent and plunged as low as 46 percent soon after.
A few months ago, the poorly prepared public health system in cities across Brazil was collapsing under the weight of new cases, as hospitals ran out of critical care beds. Meanwhile, Brazilian authorities struggled to effectively lock down cities; as isolation measures deteriorated, COVID-19 cases surged. Poorer communities – including densely populated favelas – that are already underserved were particularly hard hit by the virus.
Now, health workers who battled on the front lines of the COVID-19 crisis are suddenly being viewed by many voters as credible and trustworthy, according to Dr Gerson Salvador, an infectious disease specialist at the University Hospital of Sao Paulo.
“People saw that they could count on health workers,” he said over the phone. “They saw that doctors and nurses sacrificed themselves to respond to the crisis, they were working on the front lines, despite the government’s erratic response.”
Health workers are also helping political parties appeal to disaffected Brazilian voters, many of whom have grown disillusioned with politics in recent years, following a far-reaching corruption scandal that broke in 2014, implicating nearly every main party and resulting in the removal of a left-wing government after 13 years in power.
In Rio, widespread corruption during the pandemic further hit voter confidence and marred the response to COVID-19, as funds meant for ventilators and field hospitals were allegedly skimmed off by top state officials and their allies, according to investigators. Police suspect some 700 million reais ($129m) – 41 percent of funds spent by the state during the pandemic – may have been diverted and Rio’s governor is facing impeachment proceedings related to alleged fraud in the health sector.
Adopting Bolsonaro’s rhetoric
“Patients are dying – they are dying because of a lack of attention,” Dr Angela Tenório says, speaking to the camera in a white doctor’s coat with a stethoscope slung around her neck.
The general practitioner, who is also seeking a seat on Rio’s city council, pleads for the support of her followers through social media. “I don’t promise, I do,” she continues in the video posted on Facebook in late October.
Among her proposals is a new hospital, exclusively for critical care patients, with the aim of easing the burden on emergency public clinics. She says it will be financed through fundraising at home and abroad.
“When families shout, ‘attend to my father, attend to my mother,’ they are not being heard,” she told Al Jazeera in an interview at the home of her publicist, taking off her mask and leaning back in a heavy armchair.
She wears a shirt printed with an image from a viral video that made her a household name in 2012, after she had an angry outburst during a shift at an overwhelmed public hospital in Rio’s Campo Grande neighbourhood. “I don’t have shame to ask on behalf of those who are fighting to survive. It’s a project that will save many lives.”
Tenório is a supporter of Bolsonaro and casts herself as an anti-corruption figure in the upcoming elections. Echoing the president, she blames cities and states for the mishandling of the pandemic.
“We had the goodwill of the president, wanting to help all the states,” she said. “Unfortunately, we once again ran up against a draining of public funding. We saw hospitals failing, shortages of ventilators, people were dying. All because of corruption.”
Although Bolsonaro’s handling of the health crisis spurred the departure of two health ministers who disagreed with his strategy and sparked outrage around the world, emergency welfare vouchers for the poor have helped boost his popularity.
As they campaign for support, some candidates, like Tenório, have gone a step further with their discourse, vying to align themselves with the president’s rhetoric, controversially promoting the use of unproven COVID-19 remedies, including the anti-parasite medication ivermectin and the malaria drug hydroxychloroquine.
Tenório claims to have cured countless COVID-19 patients with a concoction of drugs that have not been proven effective against the virus. In July, she was banned from Facebook for promoting the controversial remedy.
Misleading and untrue claims by candidates are proliferating during the elections – and they run the risk of misinforming and causing harm to voters, according to Salvador.
“There are doctors who are disseminating misinformation and fake news in this process – it’s unethical, it’s opportunistic, it’s anti-scientific,” he said. “Hopefully the voter is able to discern this.”
Brazil’s Supreme Electoral Court is also cracking down on misinformation: last month, it struck a deal with social media networks like WhatsApp, Facebook, Twitter and TikTok to combat the spread of fake news during the election, although it has focused on prevention rather than removal of users who blast out false information.
Against a backdrop of the coronavirus crisis and voter disillusionment, doctors and nurses may be particularly well-suited to win back hearts, minds and votes, said Salvador.
In Brazil, where politics is deeply fragmented with more than 40 political parties vying for the attention of voters, health workers are emerging as a powerful electoral tool. “It’s natural that the party leadership looks towards health workers as good candidates who can bolster support for parties,” he said.
Yet some critics say the wave of candidates from the healthcare field represents little more than political opportunism, as parties seize this opportunity to capture voters amid the pandemic.
“Without a doubt, COVID-19 became viewed as an opportunity, a path to being elected,” said Grin.
Dr Treistman, who works in a public hospital in Rio’s western fringe, says he believes that many of his rivals are adopting an agenda focused on healthcare with the sole purpose of getting elected.
“Some of us are running because we believe we can really affect change,” he said.
“Unfortunately there are others … using this agenda centred on justice, centred on healthcare – but they are only worried about gaining votes. When they get into office, they abandon their commitment.”
System in crisis
Brazil’s healthcare woes started long before the coronavirus hit in February. The Latin American country has one of the largest free universal healthcare systems in the world, which exists alongside private clinics accessible to Brazilians with insurance plans or cash.
In recent years, however, public healthcare services have been weakened by funding cuts, which in 2016 drew angry Brazilians to the streets in protest. Dwindling funding has left the system more vulnerable than ever to health shocks like COVID-19.
For Dr Treistman, the pandemic only made it clearer that healthcare must become a government priority. “There’s been a weakening in the public healthcare system over the years … We need to go back to strengthening it,” he said.
As part of his campaign, he is promising to fight for more funding of the public healthcare system, which is suffering from a shortage of more than 8,200 health workers but faced further cuts during the pandemic.
“I don’t have an illusion that this election will resolve the problems present in the healthcare system,” he said. “But I think it’s important for us to use the spaces available to gain visibility for our struggle.”
But even if more health workers are elected to political posts, the change that Brazilian voters crave may not come so easily. For one, Brazil’s public health system is financed and moulded on the federal level, leaving local authorities little room to expand funding.
Now, as COVID-19 batters Brazil’s economy and the emergency aid balloons public spending, the country will likely have even fewer resources to put towards healthcare going forward, Grin noted.
“Today, healthcare has voter appeal – but there won’t necessarily be all the resources that voters expect or imagine,” he said. “There is a really big chance that voters become frustrated by the incapacity of the newly elected officials to meet their demands.”
As the elections inch closer, voter Thiago Soares, a coconut vendor in Grajaú, remains a sceptic. While he believes in some of the proposals that these candidates are laying out, he is not holding out hope for a dramatic political shift.
“They only appear around here at this time, when it’s close to elections,” said Soares, a resident of Magé, a city on the northern periphery of Rio de Janeiro. “There are always a lot of promises made. And then nothing ever seems to change.”