Examining care injustices

This week in North Philly Notes, Akemi Nishida, author of Just Care, writes about care as an analytical framework to understand the contemporary United States

During the COVID-19 pandemic, we were forced to recognize what was at the stake in the political debates on public healthcare programs such as Medicaid, the overstretched nature of the care labor force, and our own vulnerabilities. We also witnessed continuous fights for social justice including Black Lives Matter and Asian Americans against hate crimes, as well as the development of mutual aid networks to survive together.

Just Care suggests care as a lens to understand these phenomena—and incorporates care as not only an object of study but also an analytical framework. The book examines care injustices where people—whether they are situated as care workers, care receivers, or both—deteriorate under the name of care, when care is used as a mechanism to enhance the political economy and neglect the well-being of those situated as care workers and care receivers. It also addresses care justice, or just care, which occurs when people feel cared for affirmatively and when care is used as a foundation for more-just world building.

Just Care is based on research conducted at the request of disability communities to reveal how the public care services they receive are increasingly becoming money-centered, while they demand these services to be human-centered. Also, as a disabled person, my own experiences of receiving and providing care informed my work.

Just Care considers the experiences of care workers and care receivers under the Medicaid long-term care programs, queer disabled people who participate in community-based care collectives to interdependently support each other, and disabled and sick people of color who engage in bed activism to fight for social change from their bedspaces. By being in conversation with and witnessing care routines, the multiplicity of care became particularly noticeable—it is turned into a mechanism of social oppression and control while simultaneously being a tool with which marginalized communities activate, engage in, and sustain social justice fights.

Here are some key points from the book:

• When scholars and activists work to dismantle injustices surrounding care activities, they often approach them by looking into solely the labor exploitation care workers experience or the lack of adequate care recipients endure. Instead, Just Care engages in relational analysis to think through how these circumstances are intertwined and mutually witnessed and experienced, as care workers and receivers spend the majority of their daily lives side by side.
• An example of relational analysis is my tracing of the parallels between the histories of welfare programs for single mothers and families in need, (neo)colonialism and labor migration, and public healthcare programs like Medicaid, from the perspectives of critical race, transnational feminist, and disability studies.
• This analysis shows that in addition to differences in degrees and kinds of care people individually need, intersecting oppressions including racism, neocolonialism, patriarchy, and ableism shape who is currently pressured to take up caring responsibilities and how their own care needs or disabling conditions are quickly neglected. Such oppressions also make us think of disabled people exclusively as recipients of care and rarely acknowledge their caring contributions to society, let alone how the public healthcare services they receive are rarely adequate and can function to surveil them.
• Care services for disabled people are primarily planned by centering financial benefits for the care industrial complex and budget suppressions for governments and are not based on disabled people’s needs and preferences.
• This focus on financial benefits means that well-being of care workers and care recipients become secondary concerns. This leads them to experience mutual debilitation, rather than the presumed idea that one group thrives on the back of the other.
• Some care workers and care recipients under such debilitating public healthcare services develop interdependent relationships to help one another, in the middle of care-based oppression they experience, by transgressing the strict roles given to them.
• Disabled people have started care collectives to practice interdependence and based on their insistence that everyone needs care and can provide care. Engaging in interdependence in the middle of a society that values individualist independence is destined to be full of challenges. One challenge they faced is material (to physically meet all the care needs emerging within the group), and another is affective (to make sure conflicts within the group will not affect quality of care).
• Disabled and sick people engage in social change from their bedspaces, or “bed activism.” Bed activism entails critiquing of intersecting oppressions that manifest in bedspaces and offering visions for a more just world by centering the wisdom of sick and disabled people that emerges from their bedspaces.
• Bed activism can happen actively, for example, when bed dwellers engage in social change by writing a blog post. It also happens in inactive moments, for example, when they rest in their beds while going through depression, pain, or fatigue. Even those moments inform bed activists about their relationships with their bodies and minds or the social conditions that restrict them to their beds.

We all need care and are capable of caring for others in various ways. When we start from this foundational understanding, how can we each engage in just care or more-just world making through care? Just Care points the way to answering this question.

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