Vita. João Biehl

persons anymore. . . . We want to reach a level of zero confinements in the infirmary. We are not a hospital. We are basically a rehabilitation service, so that people can return to society and work.”

      I asked Oscar to elaborate on the rationale for this shift in policy. Tired of having his pledge to improve the infirmary dismissed, he reluctantly spoke his mind: “Today, the people who administer the institution have their own private interests. This is a political game. They are not interested in the social good of the persons. They are more interested in the visibility the institution has to the outside world. Given all the donations, life in the infirmary should be much better than it is, in terms of food and treatment. I am tired of fighting. . . . They are concerned with the image of Vita outside, while the reality in here is completely different.”

      As for the future of the infirmary and its inhabitants, he said, “the vision of the administration that the captain passed on to me is that these people will be terminating themselves until we have zero of them. . . . Perhaps in a few years, none of these people you have been talking to will be left.” As if it had all been self-generated, I noted, and with no accountability for their suffering. Oscar made an affirmative gesture. “How else? This is the social reason: these people don’t produce, they don’t vote.”

      Oscar told me that I was standing in front of “a shattered man,” but that he “would move onward with life, with the help of our Lord.” He had recently found out that that he was HIV-positive. “AIDS was not the thing I feared most,” Oscar said. “I was scared to death that my wife and child would be infected as well. They didn’t do anything wrong, like I did, all those years of injecting drugs. But maybe I got infected here in the infirmary as I handled AIDS patients. I finally had the courage to tell my wife, and she was tested. Thank God, she and the child don’t have the virus. She told me that she would not leave me, that she would face it with me.”

      With the help of Vita’s social worker, Oscar was learning to navigate the local medical AIDS world. He was being seen by an infectious-disease specialist and had his CD4 levels checked regularly. “The doctor said that I am healthy, that I don’t need the cocktail yet, and I will do whatever I can to postpone using it. But thanks to the government, we now have hope.” Oscar was referring to the free distribution of antiretrovirals by the Brazilian government.

      For the abandoned, however, medical assistance remained minimal. A doctor-philanthropist was still visiting Vita once a week, basically spending one or two hours signing disability reports for the inmates of the recovery area. Depending on the availability of transportation and the good will of volunteers, some of the diseased in the infirmary found immediate treatment at a nearby public health post. Specialized treatment—for cancer or diabetes, for instance—“is a lottery,” explained Alencar, a volunteer who, along with hundreds of other people, stood in line from 5 P.M. to 8 A.M. at the university hospital every week, waiting for a ticket to schedule an appointment. “And it generally takes a few more months to see the doctor,” he added.