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Paper short abstract

Based on ethnography in a primary healthcare facility, this presentation examines how care and violence intertwine in the treatment of a chronic condition such as hypertension. It shows how moral judgments, racialization processes, and routine delays turn care itself into a form of violence.

Paper long abstract

This presentation examines the intimate entanglement of care and violence through the ethnographic case of Geny, a non-white woman living with hypertension and severe circulatory complications in the outskirts of São Paulo, Brazil. Drawing on ethnographic fieldwork conducted between 2023 and 2024 in a public primary healthcare service, it explores how violence emerges not only through the absence of care, but also through care practices themselves, particularly in the management of chronic illness. Geny’s condition, ischemia progressing toward cyanosis and requiring urgent surgical intervention, was repeatedly acknowledged as severe, yet systematically treated as something that could wait. Despite formal referrals and clinical recognition of urgency, hospitals refused to admit her, sending her back home to “await” specialized care. This repeated deferral shows how chronicity can operate as a temporal form of violence, in which deterioration unfolds through delays framed as routine care management. Engaging María Puig de la Bellacasa’s question “how to care?”, the presentation interrogates not how to provide more care, but how care is enacted, withheld, or transformed into harm within unequal healthcare systems. Violence here is neither exceptional nor external to care, but it materializes through everyday clinical routines, moral judgments, and classificatory practices that racialize patients and legitimize inaction. By foregrounding ethnography, this presentation contributes to anthropological debates on care and violence, showing how their entanglement reshapes experiences of chronicity and raises ethical and methodological challenges for studying care in contexts where harm is produced through its very practices.