WHO CARES? REBUILDING CARE IN A POST-PANDEMIC WORLD
Lead Research Organisation:
UNIVERSITY COLLEGE LONDON
Department Name: Institute for Risk and Disaster Reductio
Abstract
The pandemic has highlighted the centrality of care as a necessary service performed by care workers that affects everyone. Our proposal will analyze how this focus on care has affected the practices of both care providers and care recipients, and how it has influenced social policies. Broadening our focus through international comparisons reveals how the Covid experience provides lessons in the medium and long-term.
Comparisons will proceed along four main axes, comprising different dimensions and approaches, reflecting the interdisciplinary team profile:
(i) The impact of the pandemic on needs and modalities of care provision: surveying alternative methodologies to harmonize data in a transnational perspective.
(ii) Labor conditions and rights in a post pandemic world: transnational analysis of/with paid care workers.
(iii) Care as a strategic dimension and pillar for public policies on social infrastructure rebuilding: comparing national and urban experiments.
(iv) Caring strategies when the state fails: qualitative analysis of care provision on vulnerable communities.
Defining axes is a way to intersect and integrate the research agendas from the different national teams, taking advantage of their competences to achieve an organized cross- fertilization of ideas and methods. Our selection of countries and teams will achieve two main goals. First, Brazil, Colombia, Canada, France, UK and the US provide enough variation in societal characteristics crucial to understanding the different configurations of care across national governance, welfare regime, health-care system institutionalization and jurisdiction over health policy, care employment, working conditions of care workers, level of labor market informality, home health-care policies, and Covid-19 pandemic policies. Second, the principal researchers of each national team have national and comparative care expertise and previous experience in collaborative research. The project leverages the local relevance of the foci from different axes as a strength of the research design. While each country team takes responsibility for an in-depth analysis of one main axis, our cross-cutting research strategy uncovers the mechanisms that reveals significant differences in the observed situations
Comparisons will proceed along four main axes, comprising different dimensions and approaches, reflecting the interdisciplinary team profile:
(i) The impact of the pandemic on needs and modalities of care provision: surveying alternative methodologies to harmonize data in a transnational perspective.
(ii) Labor conditions and rights in a post pandemic world: transnational analysis of/with paid care workers.
(iii) Care as a strategic dimension and pillar for public policies on social infrastructure rebuilding: comparing national and urban experiments.
(iv) Caring strategies when the state fails: qualitative analysis of care provision on vulnerable communities.
Defining axes is a way to intersect and integrate the research agendas from the different national teams, taking advantage of their competences to achieve an organized cross- fertilization of ideas and methods. Our selection of countries and teams will achieve two main goals. First, Brazil, Colombia, Canada, France, UK and the US provide enough variation in societal characteristics crucial to understanding the different configurations of care across national governance, welfare regime, health-care system institutionalization and jurisdiction over health policy, care employment, working conditions of care workers, level of labor market informality, home health-care policies, and Covid-19 pandemic policies. Second, the principal researchers of each national team have national and comparative care expertise and previous experience in collaborative research. The project leverages the local relevance of the foci from different axes as a strength of the research design. While each country team takes responsibility for an in-depth analysis of one main axis, our cross-cutting research strategy uncovers the mechanisms that reveals significant differences in the observed situations
Publications
ACCIARI L
(2024)
Essential yet excluded: COVID-19 and the decent work deficit among domestic workers in Brazil
in International Labour Review
Acciari L
(2023)
Caring is resisting: Lessons from domestic workers' mobilizations during COVID-19 in Latin America
in Gender, Work & Organization
ACCIARI L
(2024)
Essentiel mais exclu: le COVID-19 et le déficit de travail décent parmi les travailleurs domestiques au Brésil
in Revue internationale du Travail
Acciari, L (LA)
(2024)
Trabalho Doméstico
in Mulheres na Filosofia
Acciari, Louisa (LA)
(2024)
Não haverá igualdade salarial sem igualdade para as trabalhadoras domésticas
in Revista Ciências do Trabalho
Boufkhed S
(2022)
Building a better understanding of labour exploitation's impact on migrant health: An operational framework.
in PloS one
Boufkhed S
(2024)
'They treat us like machines': migrant workers' conceptual framework of labour exploitation for health research and policy.
in BMJ global health
Silverman J
(2022)
Domestic Worker Organizing in Neo-Authoritarian Brazil
in New Labor Forum
| Description | Findings from 21 focus groups conducted with 179 low-paid care and domestic workers in Brazil, Colombia, France, UK and the USA: 1/ Social and legal protection Overall participants felt that with the pandemic their workload had increased but not their salaries, and that this situation remained the same until now. Most domestic workers in Brazil and Colombia found it harder to get a job post-pandemic. In all the countries, many participants commented on their difficulties due to the cost of living crisis. Key barriers to accessing rights included: type of contract, level of informal job (Brazil and Colombia), and immigration status (USA and UK). In Brazil and Colombia, we also observed a polarisation between the domestic workers who lost their jobs and perceived unemployment as being the biggest problem, and those who remained employed and found instead that the main issue has been increased exploitation at work. 2/Health and safety at work Participants working in institutions appeared as being more protected than those working inside other peoples' homes. In general, they did receive training to do their tasks, and -when available- personal protective equipment (PPE) were compulsory in most institutions during Covid-19. The focus-group in France was a noticeable exception as care workers reported having been forbidden to use face masks during the first month of the pandemic to avoid scaring out patients. In contrast, most domestic workers did not receive training or PPE, and there were no clear rules or sanitary guidelines for work inside private homes. Instead, they had to juggle between different individuals' own ad-hoc rules that differed between homes. In France and the UK, institution-based care workers also complained about managerial techniques and excessive surveillance, and felt that their lives was less considered than those of their patients or bosses. 3/ Finance and migration In all countries, almost all participants shared issues related to their salary or payment, even though they were not international migrants. Many reported unlawful wage deductions, pay retention during the lockdown, constant task slippages and additional unpaid work, or the necessity to contract debt to survive. Immigration status was a key factor determining workers' access to rights and social protection. In the USA and UK, which have a 'hostile environment' for immigrants, restrictions on immigration rights created barriers for workers to defend themselves against employers' abuses or access the health systems. This was particularly true for the USA where several workers had an irregular status and for domestic workers in the UK whose visas are precarious and limited in time. Several participants reported for instance having refrained from going to the hospital or not having access to the health system at all. 4/ Shelter and security Elements of coercion and mistreatment were overwhelmingly present across the 5 countries, regardless of workers' status or work setting. Participants shared countless stories of being insulted, physically and sexually assaulted by employers and/or patients, and those with direct caring tasks expressed having felt forced to keep working despite the risks during the COVID-19 period because they were emotionally attached to their patients. Some domestic workers in Brazil, Colombia and the UK were forced to spend the lockdown at their employers' and prevented from going back to their own homes. 5/ Dehumanisation It shows more specifically workers' expectations about what their work should be and how they feel treated, beyond legal aspects. The international literature shows quite well the gender, race and colonial relations that shape domestic work, and the historical devaluation of reproductive labour (Blofied, 2009; Cox, 2006; Ehrenreich & Hochschild, 2003). In all our focus groups, participants saw their job as being extremely important, as many were frontline workers during the pandemic, and they perceive their work as sustaining society's care needs. However, they contrasted this with the lack of respect and dignity from employers, and many felt betrayed by their -often long-term- employers. There was a generalised perception that employers, and society more broadly, don't care about care workers. In all groups, participants shared stories of humiliation, such as insults about their physical appearance in Brazil and Colombia, or being subject to different treatment and rules than the patient or family during COVID-19 as if workers were the only carrier of the virus. 6/ Perceived health Finally, we asked workers about how they perceived their (physical and mental) health in general and during the pandemic. Mental health was very present in every focus groups, and most participants would refer explicitly to issues such as depression, anxiety, panic, fear and feeling of isolation. Many felt torn between the fear of getting sick or even dying, and the obligation to keep working to support their families and take care of other people. For those working in institutions, death was omnipresent, and they lost an unusually high number of patients. Physical health was also a concern for many, and very similar occupational health issues were observed across the groups, such as back pain, joints and muscular pain, and skin burnt from chemical products in the case of domestic workers. Several workers shared about new allergies that happened to them since the COVID-19 pandemic. |
| Exploitation Route | Using these findings, we designed a transnational survey that is currently being conducted in the 5 countries. Results will be available by June 2025. Thanks to the additional funding from UCL, we will also produce videos and policy briefs that will be ready by May 2025. |
| Sectors | Communities and Social Services/Policy Healthcare Government Democracy and Justice |
| URL | https://cuidado.cebrap.org.br/wp-content/uploads/2024/09/Copy-of-TAP-4-page-ver-4-1-1.pdf |
| Description | Care workers from Brazil and Colombia have made videos and given us their suggestions to write policy briefs for their governments. The material will be ready by May 2025. In the UK; we have supported the Voices of Domestic Workers to send written evidence to a call from the UK government on labour enforcement, and one from the UN on the situation of migrant domestic workers. Those reports cite our findings. |
| First Year Of Impact | 2024 |
| Sector | Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice |
| Impact Types | Societal Economic Policy & public services |
| Description | Capacity building for domestic workers in Brazil |
| Geographic Reach | National |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | 150 domestic workers trained to become leaders of their unions |
| Description | 'Doing' mixed-methods research collaboratively in multidisciplinary teams: a pilot study |
| Amount | £1,500 (GBP) |
| Organisation | University of Manchester |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 01/2023 |
| End | 07/2023 |
| Description | Empowering women care workers in Brazil and Colombia |
| Amount | £65,000 (GBP) |
| Funding ID | 189382 |
| Organisation | University College London |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 11/2024 |
| End | 03/2025 |
| Description | Citizen Domestic Work |
| Organisation | Federal University of Santa Catarina |
| Country | Brazil |
| Sector | Academic/University |
| PI Contribution | Invited by the University as a visiting fellow, to be the coordinator of a national training programme for domestic workers |
| Collaborator Contribution | Secured funds from the Ministry of Women, coordination of the training programme |
| Impact | Sociology and History Training of 150 domestic workers to become leaders of their movement |
| Start Year | 2024 |
| Description | Consortium project 'Who Cares' |
| Organisation | Universidade de São Paulo |
| Country | Brazil |
| Sector | Academic/University |
| PI Contribution | After receiving confirmation of the ESRC funding, the consortium for 'Who cares?' was formally established, with our partners from Brazil, Colombia, Canada, France and the US. The global PI for the whole consortium is based at the University of São Paulo. The UK team is responsible for work package 2: translational survey on care workers rights and labour conditions during the pandemic. To date, we have coordinated the ethics applications in the 6 countries and are about to start fieldwork. |
| Collaborator Contribution | The global PI for the whole consortium is based at the University of São Paulo, they coordinate our meetings, website, and workflow. They also coordinate a large Brazilian team currently doing fieldwork with care workers in Brazil. |
| Impact | - Ethics approval obtained from partners and at UCL - organisation of our first international conference in Paris to take place in May 2023 |
| Start Year | 2022 |
| Description | Sub-award project Who cares |
| Organisation | University of Manchester |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | Collaboration agreement made between UCL and Manchester to secure the time of the Co-I for the UK team, Dr Sabah Boufkhed. |
| Collaborator Contribution | - Coordination of the quantitative study of work package 2, - obtained small grant for a methodology workshop in Colombia to be held in April 2023. |
| Impact | - starting the fieldwork for work package 2, - small grant from Manchester to run a methods workshop in Colombia in April 2023. |
| Start Year | 2022 |
| Description | Feedback sessions with research participants |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Study participants or study members |
| Results and Impact | Feedback session with research participants in Brazil to present preliminary results and validate quantitative questionnaire |
| Year(s) Of Engagement Activity | 2024 |
| Description | Keynote speech |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | • Keynote speaker, "Care work as resistance in times of crisis", International Conference on Labour and Social History, Linz, September 2022 • Speaker at the panel "Who cares? Care work and the pandemic", Latin American Association for the Study of Work (ALAST), July 2022, (online) |
| Year(s) Of Engagement Activity | 2022 |
| Description | Launch of Advisory Board |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | Launch of our Advisory Board to gather experts in the field of care and domestic work. Expected to meet 3 times a year. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Public events |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Postgraduate students |
| Results and Impact | 2 public events held at UCL to disseminate results and give voice to workers engaged in our research |
| Year(s) Of Engagement Activity | 2023,2024 |
| URL | https://www.ucl.ac.uk/risk-disaster-reduction/events/2023/dec/whats-behind-modern-slavery-uk |
| Description | Training for domestic workers in UK, Brazil, Colombia |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Study participants or study members |
| Results and Impact | Training workshops for domestic workers on participated in our research in the UK, Brazil and Colombia on labour rights, ILO conventions, health and safety and leadership skills. |
| Year(s) Of Engagement Activity | 2023 |