Who cares? Self-organised health spaces and alliances of care in Palermo and Rome

Abstract

The contribution presents the preliminary findings of a militant research project on healthcare geographies. Grounded in the mutualistic and transfeminist politics of the social spaces we are part of (Ambulatorio Popolare Borgo Vecchio in Palermo and Nonna Roma in Rome), we conceive care as both individual and collective health, as well as a transformative practice of collaborative relationality. These spaces generate (counter)policies in economically and socially marginalized contexts. The gradual erosion of public welfare in Italy has led to a healthcare system that is increasingly underfunded, stratified, and often inaccessible. The Covid-19 pandemic further accelerated these ongoing trends, but it also sparked a need to rethink care and well-being, raising questions about who is included or excluded from health policies and how alternative social reproduction politics can be imagined in a world shaped by capitalism’s crises. In response, various political and social initiatives have emerged, creating popular clinics, self-managed healthcare spaces, and care centres in several Italian cities. These spaces produce collaborative knowledge, socialize practices, and reclaim reproductive services through alliances among marginalised subjectivities. While addressing local needs, they also advance political struggles for a functioning, accessible, and free healthcare system. Yet, these initiatives face significant challenges: the risk of state delegation to these spaces, and the tension between activist and beneficiary relationships, complicating the balance between addressing social needs and pursuing political ambitions. Our goal is to explore healthcare geographies in post-pandemic cities and the new marginalities that have emerged. What care policies are being produced in these spaces? How can popular clinics contribute to shaping alternative healthcare policies, in a world where healthcare increasingly appears as a privilege rather than a right? How can we build care spaces that both reclaim health services and enact radical societal transformations?