Care, Knowledge, and Crisis: Institutional Memory and Situated Technologies in a Public Hospital in the Global South

How public health institutions in the Global South mobilize institutional memory, everyday practices, and situated technologies to manage extreme uncertainty during health crises? Based on long-term qualitative research conducted at a Brazilian public infectious disease hospital between 1980 and 2022, the study examines organizational responses to successive epidemics, including HIV/AIDS, H1N1, yellow fever, COVID-19, and a suspected Ebola case. Rather than focusing solely on formal governance structures or biomedical protocols, the analysis foregrounds how care is practically enacted through historically accumulated knowledge, improvisation, and ethical decision-making in everyday institutional life.
Methodologically, the research draws on oral history interviews with health professionals, analysis of institutional documents, and narrative reconstruction of crisis situations. These materials reveal persistent tensions between standardized, technology-driven models of clinical management and context-sensitive forms of care shaped by local constraints, professional experience, and social inequalities. Special attention is given to the role of technological infrastructures, such as clinical protocols, surveillance systems, and decision-support tools, and to how they are interpreted, adapted, and sometimes contested by frontline workers.
Rather than treating technology or artificial intelligence as neutral or universally progressive forces, the paper argues that technological tools acquire meaning only through situated use within specific institutional, historical, and political contexts. Building on critical perspectives in social sciences and science and technology studies, the paper proposes the concept of a biopolitics of care to capture how care practices operate simultaneously as organizational strategies, ethical commitments, and political responses to crisis.
By centering empirical evidence from a public hospital in Brazil, the study contributes to debates on society and technology, health governance, and Global South knowledge production. It challenges dominant narratives that frame technological innovation as detached from history and power relations, suggesting instead that institutional resilience depends on the interplay between technology, memory, and socially embedded practices of care.