HealthCareStruggles/content/doc/stillnotrobots.md

+++
title="Still, we are not robots"
has_items=["cervelloelettronico.md", "piupostomacchine.md", "maggioranzadev.md", "counterproductive.md"]
+++


This final section collects documents, fragments and insights that connect the past stories gathered in these pages with the present time. The last two decades have been marked by a new cycle of automation and other technological changes in the ways people work, heal, live and protest. Without pretense of being exaustive, we gathered materials that resonate with the four red threads introduced in the previous sections: techniques of exploitation; health and environmental conditions; gendered discrimination; and forms of resistance. 

![](static/images/no_robot.png)


# The story from which we start: Still, we are not robots 

*The Work Environment* first produced at FIAT and *Against Noxiousness* of Porto Marghera agreed in identifying one mid-term tendency crucially relevant in our present times: mental noxiousness. 

In the language of *The Work Environment*, this was the idea that while the first 3 factors of noxiousness were going to be mitigated by tendencies within capitalism itself, the 4th factor pertaining to mental wellbeing was going to get worse:

![](static/images/mentale_ieri.png)
*the work environment yesterday*
![](static/images/mentale_oggi.png)
*the work environment today*


While in *Against Noxiousness* we can read:

>In the new factory, coupled with a modest reduction in toxicities and thus in occupational diseases traditionally understood, there will be a strong increase in mental health disorders

“Against Noxiousness” (Comitato Politico, 28 February 1971).

We know today that, far from diminishing or disappearing, the first three factors of hazards have been delocalized in regions of the word where laws around health, workers' safety and environmental pollution are lax, non-existent or avoidable through corruption. However, the emphasis on the mental factors impacting our lives at work intercepted precisely what the workers of Lebole experienced with the introduction of MTM methods, the process of "modernization" of the assembly line and management  - soon renamed the "scientific organization of exploitation" - with the current working conditions under the algorithmic management regime.

As one textile worker interviewed by Luigi Firrao put it, 

> Today a girl enters the factory at the age of 14-15. The working conditions she finds are the first and the only ones she knows: she accepts them as normal. She doesn't think it can be any different. She asks the trade unionists to get her more 

money, she may go so far as to ask to work less quickly, but not a change in the way of working.

from a letter of Adele L., fashion industry worker from Como

![](bib:e610c577-e6a6-4a11-9e45-dbec435f011b)


![](static/images/how_it_was.png)

As the grandaughters of that 15 year old girl, we do not know different working conditions than those we inherited as normal. Do we even know how to ask the questions that would be needed to fight off contemporary forms of technical violence, alghorhythmic expolitation and demand a change not in terms of conditions of employment, but of our way of (re)producing life? 

# From maddening rhythms to creepy algorithms


![](static/images/piu_macchina.png)

> One of Amazon’s many revenue streams is a virtual labor marketplace called MTurk. It’s a platform for businesses to hire inexpensive, on-demand labor for simple ‘microtasks’ that resist automation for one reason or another. If a company needs data double-checked, images labeled, or surveys filled out, they can use the marketplace to offer per-task work to anyone willing to accept it. MTurk is short for Mechanical Turk, a reference to a famous hoax: an automaton which played chess but concealed a human making the moves.

>The name is thus tongue-in-cheek, and in a telling way; MTurk is a much-celebrated innovation that relies on human work taking place out of sight and out of mind. Businesses taking advantage of its extremely low costs are perhaps encouraged to forget or ignore the fact that humans are doing these rote tasks, often for pennies.

>Jeff Bezos has described the microtasks of MTurk workers as “artificial artificial intelligence;” the norm being imitated is therefore that of machinery: efficient, cheap, standing in reserve, silent and obedient. MTurk calls its job offerings “Human Intelligence Tasks” as additional indication that simple, repetitive tasks requiring human intelligence are unusual in today’s workflows. 

- from: Daniel Affsprung, [The Past and Future of “Artificial Artificial Intelligence“, Cyborgology](https://thesocietypages.org/cyborgology/2021/04/19/the-past-and-future-of-artificial-artificial-intelligence/ ), *The Society Pages*, April 19, 2021. 

**Caging workers for their own good**

> A cage for workers on wheels. It sounds like the stuff of science fiction. It’s not. In 2016, Amazon filed a patent for a device described as a “system and method for transporting personnel within an active workplace”. It is actually a cage large enough to fit a worker. It’s mounted on top of an automated trolley device. A robotic arm faces outwards.

>The worker cage was designed by Amazon’s robotic engineers. It was intended to protect workers in Amazon’s warehouses when they needed to venture into spaces where robot stock-pickers whizz around. Amazon’s worker cage was quietly patented and only came to global attention thanks to the diligent digging of two academics. When the workers’ cage started to appear in newspaper headlines, Amazon executives declared it a “bad idea”.

>Amazon may have dropped the plans, but that should not come as a surprise. The company doesn’t need a robotic cage for workers – it already has one of the most all-pervasive control systems in history. In its huge warehouses, workers carry hand-held computers that control their movements. A wristband patented by the company (but which is not yet in use) can direct the movement of workers’ hands using “haptic feedback”. Stock pickers in Amazon warehouses are watched by cameras, and workers have reportedly been reduced to urinating in bottles in order to hit their targets, and they are constantly reminded of their productivity rates. Investigations by journalists have also exposed a worryingly high level of ambulance call-outs to Amazon warehouses in the UK.

- from: Andrè Spicer, [Amazon’s ‘worker cage’ has been dropped, but its staff are not free](https://www.theguardian.com/commentisfree/2018/sep/14/amazon-worker-cage-staff), *The Guardian*, 14th September 2018.

![](static/images/amazon_cage.png)
*the Amazon cage drawing that accompanies the patent*

>Now a days, employee health and well-being is the most important consideration in the work place. Because it will affect the productivity of an individual employee and team contribution. Eventually, the automatic facial expression analysis using machine learning has become an interesting and active research area from past few decades.In this paper, Real time Employee Emotion Detection System (RtEED) has been proposed to automatically detect employee emotions in real time using machine learning. RtEED system helps the employer can check well-being of employees and identified emotion will be intimated to respective employee through messages. Thereby employees can make better decisions, they can improve their concentration level towards work and adopt to the healthier life style and much productive work styles. CMU Multi-PIE Face Data is used to train machine learning model. Each employee will be equipped with a webcam to capture facial expression of an employee in real time. The RtEED system designed to identify six emotions such as happiness, sadness, surprise, fear, disgust and anger through the captured image. Results demonstrate that expected objectives are achieved.

- from: K. S. Chandraprabha, A. N. Shwetha, M. Kavitha and R. Sumathi, [Real time-Employee Emotion Detection system (RtEED) using Machine Learning](https://ieeexplore.ieee.org/abstract/document/9388510), 2021 Third International Conference on Intelligent Communication Technologies and Virtual Mobile Networks (ICICV), 2021, pp. 759-763, doi: 10.1109/ICICV50876.2021.9388510.

# How are we? On the degradation of planetary health


>Diseases are one of the most faithful mirrors of the way man enters into a relationship with nature, of which he is a part, through work, technology and culture, i.e. through changing social relations and historically progressive scientific acquisitions.
  - Berlinguer, introduction to the conference "La medicina e la società contemporanea", Instituto Gramsci, 1967


The aftermath of WWII saw a number of struggles for health to become recognised as a common good. Many people fought for health practices to be supported via the public sector, and for care to be made available universally and for free at the point of use (that is, paid for through general taxation). Some of these struggles were more successful, other were less so, but whenever change came about it was not a top-down decision, but a result of complex mobilizations that often created transversal connections between those affected, organizers and professionals.

We focus on Italy not only because it is our context of origin, but also because during the decades 1960s and 1970s, it was an extremely lively political laboratory that became significant beyond its own context.

Italy in these decades was subjected to a fast industrialization that deeply altered the life and work patterns of many. Assembly line work, organised according to the principles of scientific management, was brutal, dangerous, poisonous and mentally alienating. It should come as no surprise therefore that the struggles for health were largely working class struggles, addressing simultaneously question related to conditions of labour at the workplace, environmental degradation, gender roles in the home and the desirability of technological innovation. 

In the aftermath of the decade-long neoliberal crisis of care and the more recent pandemic, many political imaginaries related to the protection of collective health rely on mutual aid and solidarity networks. Many of the initiatives that want care to be more accessible and inclusive are set up as self-organzised practices. Many activists and organizers are loudly critical of public healthcare provisions which are perceived as negligent and over-bureaucratic at best, incompetent and punitive at worst. 

Looking back at the Italian struggles for health of the 1960s and 1970s is a relevant tasks today as this history reminds us of a different possibility in orienting our political imaginaries. Rather than presenting autonomous and self-organzied practices as the opposite of languishing public infrastructures, they remind us that these very different alignment of forces is possible, as these  struggles led to the creation of a public health care system in 1978. 

The pressure for creating such public health care system was born from an unprecedented alliance between left political forces, advanced experiences renewing medical practice, radical health activism, struggles by trade unions, workers’ groups, student and feminist movements. The 1978 reform was a universal, public, free health service, offering a wide range of provision outside the market, largely modelled on the British NHS and reflecting the definition of health spelt out by the WHO in 1946.

Abandoning the tradition of a corporatist health system with its limited coverage of separate professional groups, Italy’s reform introduced a public and universal health service, financed through general taxation, freely available to all.

The link between the self-organized struggles and the new public system becomes apparent in the way it was designed in its original conception (albeit soon corrupted by a series of reactionary modification to the law).  In several areas – mental health, occupational health, women’s health, drug treatments - new knowledge on illness prevention, new practices of service delivery and innovative institutional arrangements emerged, with a strong emphasis on territorial services addressing together health and social needs. The movements' legacy was palpable in the integrated vision of health – physical and psychic, individual and collective, linked to the community and the territory – that emerged. The struggles were clear in their proposal: a new, less hierarchical type of doctor-patient relationship was needed; healthcare should be linked to territories and, as much as possible, conducted in participatory manner; preventive approaches, rather than curing, were central in this vision. This political strategy viewed health as combining a collective dimension and an individual condition; collective struggles were therefore needed to address the economic and social roots of disease and public health problems. This approach was paralleled by the feminist movement in addressing women’s health issues, including the important experiments in self-organized health clinics. As Giulio Maccacaro had argued in 1976, the strategy was a bottom-up “politicization of medicine”, challenging the way industrial capitalism was exploiting workers and undermining health and social conditions in the country.

**Politicizing Expertise, Over and Over Again**

The Covid-19 pandemic brought back at the centre of attention the relationship between medical-scientific knowledge and political strategies in the field of healthcare, the very same relationship that has been the core issue in the historical struggles around healthcare that we have been encountering in the archives centred on 1960s and 1970s' experiences in Italy.
During the pandemic, the dynamics of decision-making regarding the management of the health crisis were characterised by many difficulties that brought to the surface some key aspects of the relationship between the governed and the governors, the so called ‘experts’ and those who are not; in other words, the crucial and essential nodes of democratic order.
On this terrain, all the critical signs characterising the current processes of depoliticisation that the neoliberalist governance has generated during last decades have become apparent.

Let’s be clear: the contribution of experts is relevant in order to make decisions in the most informed way possible, all the more so in situations of health emergencies; however, the massive recourse to them runs the risk of taking the place of the responsibility of politics and institutions, the risk of presenting solutions as unquestionable, just because they are ‘technically’ founded, without a common discussion on what is needed and which are priorities.

During the pandemic, this exclusion defined at least two different models of care, of taking care of the emergency. On the one side, the care proposed by governments, that has been often rhetorical and sectorial. Let’s think for instance on all dispensable bodies who were put in charge of the growing necessities of care, without receiving back any increase in wage, or at least an increase of the safety conditions in which they worked. On the other side, we have the model of care promoted by solidarity and mutual aid collectives, neighbourhoods and groups, whose aim was to redistribute the resources needed to face the emergency as much as possible, while at the same time denouncing the extremely dire conditions in which public services versed, due to decades of strategic disinvestment.

# The machinic feminine, the machinic neutral 

**Terms of service**
 
The terms of service, and the term service itself, while perfectly acceptable and of current use today in job descriptions of all kinds, shares a long history with the power asymmetry and structural violence of ‘servitude’. The epochal passage from having household servants to hiring domestic helpers did not fully dissipate the contradictions at play in this kind of work. Servile and service work share at the core of their organizational praxis a logic of concealment of their actors and operations. They share techniques of hiding the unpleasantness of work (resentment, fatigue, boredom, humiliation, and so forth) under a thick layer of expected emotional and attentive labour. This creates an social environment which is conducive to unidirectional care relations, a problem that feminist scholars still see as unresolved. We need to consider such feminist critique of the continuities between servitude, service and patriarchal expectations of comfort and convenience. These cultural assumptions have been providing the basis for developing a plethora of new digital tools and platform-mediated services: it is at this juncture that the logic of invisibilization of labour proper of servitude becomes potentiated by technology’s tendency to recede away from consciousness.   

**Social Reproduction and Hyperemployment**

>The histories of machines, femininity, and waged labour have long been understood as deeply entangled and mutually constitutive. This merging of woman, machine, and work is taken in a new direction in the twenty-first century, with the advent of the “digital assistant”. These applications are knowledge navigators, available as part of various operating systems, which recognise natural speech, and use this ability to help answer user’s queries and to aid in organizational tasks, such as scheduling meetings or setting reminders. Perhaps the most famous of these is Apple’s Siri – now widely recognised as the voice of the iPhone – but there are several others, including GoogleNow and Microsoft’s Cortana, all of which perform similar functions with varying degrees of efficiency. The connections between these digital assistants and the conventions of low-status clerical work are obvious; Microsoft even went so far as to interview human PAs whilst developing Cortana, and a reviewer from Wired magazine declared that using Siri is: ‘kind of like having the unpaid intern of my dreams at my beck and call, organizing my life for me’ (Chen, 2011: n.p.). These apps represent, in many respects, the automation of what has been traditionally deemed to be women’s labour. [...] This brings us to the topic of ‘hyperemployment.’ What do we mean by this term? Hyperemployment is an idea, advanced by Ian Bogost, which links contemporary technological developments with a qualitative and quantitative change in personal workloads. His argument is that technology – far from acting in a labour-saving capacity – is in fact generative of ever more tasks and responsibilities. 

from: Helen Hester, [Technically Female: Women, Machines, and Hyperemployment](https://salvage.zone/technically-female-women-machines-and-hyperemployment/), Salvage magazine, 2016.

**Female-sounding at least**

>Once you start listening you can’t stop hearing it. The voice – female, or female-sounding at least, pre-recorded ‘real’ voices or mechanised tones, or, often, a weird cut-up mixture of both, dominates the sonic landscape. From the supermarket checkout machines with their chaste motherish inquiries (‘have you swiped your Nectar card?’) to repeated assertions regarding the modes of securitised paranoia (‘in these times of heightened security’), the female voice operates as a central asset in the continued securitisation and control of contemporary space, cutting across what little is left of the public realm and providing the appearance and the illusion of efficiency, calm and reassurance in commercial environments. 

- from: Nina Power, [Once You Start Listening You Can’t Stop Hearing It](https://ninapower.net/2017/12/07/once-you-start-listening-you-cant-stop-hearing-it/), *The Wire* n. 352, June 2013.

**Make-up for the voice**

>Accents are a constant hurdle for millions of call center workers, especially in countries like the Philippines and India, where an entire “accent neutralization” industry tries to train workers to sound more like the western customers they’re calling – often unsuccessfully. As reported in SFGate this week, Sanas hopes its technology can provide a shortcut. Using data about the sounds of different accents and how they correspond to each other, Sanas’s AI engine can transform a speaker’s accent into what passes for another one – and right now, the focus is on making non-Americans sound like white Americans. 
[...]
>Narayana said he had heard the criticism, but he argued that Sanas approaches the world as it is. “Yes, this is wrong, and we should not have existed at all. But a lot of things exist in the world – like why does makeup exist? Why can’t people accept the way they are? Is it wrong, the way the world is? Absolutely. But do we then let agents suffer? I built this technology for the agents, because I don’t want him or her to go through what I went through.” The comparison to makeup is unsettling. If society – or say, an employer – pressures certain people to wear makeup, is it a real choice? And though Sanas frames its technology as opt-in, it’s not hard to envision a future in which this kind of algorithmic “makeup” becomes more widely available – and even mandatory. 

- from: Wilfred Chan, [The AI startup erasing call center worker accents: is it fighting bias – or perpetuating it?](https://www.theguardian.com/technology/2022/aug/23/voice-accent-technology-call-center-white-american), *The Guardian*, 24th August 2022


# In way of conclusions

Through the pages and the documents gathered in Maddening Rhythms we have unpacking the story of Lebole workers to disentangle some of the aspects that characterised their conditions of life, work and struggles. Our time spent in the archive we traced some of the debates , key terms and inventive organizational techniques that characterised the decades 1960s and 1970s, which as we saw marked the epochal passage to a new level of technologization of work. Our meandering through the many newspaper clips and typed manuscripts was simultaneously a quest to find tools for reading the present. 

A present that we then begun to map through a number of in-depth, semi-structured interviews with fifteen workers employed in different occupational sectors, but who all share a significant relation with digital technologies as part of their job experience. We are extremely grateful to all of those who took the time to talk to us, sharing sometimes difficult stories about their work life and their relationships with co-workers, clients and (often alghoritmic) bosses. These conversations were points of entry in the simmering landscape  of platform work and gig economy. 

In Italy (INAP) there are over 570,000 platform workers, 1.3% of the national population. They are riders, delivery workers, AI trainers, data compilers, content creators, sex workers and many more. 
50.7% of them ended up in this kind of work because they have no other alternatives. For 48% of them, platform work is their main source of income.


What emerges from the juxtaposition between past and present stories describing the work environment and its impact on health? 

First of all, we found many, at times surprising, lines of continuity. Not only the obsessive rhythms of work, but also a weariness of the effects of technology on psychic and physical health; an ever increasingly "scripted" job description, where not only tasks, but behaviours and movements are meticulously monitored; the quest for ways to expand workers struggles beyond the places of work, to include demands around environmental care and reorganization of social reproduction; a call to politicize the role of experts, perceived as distant and unaware of the actual experiences of workers. But we also found some fissures, marking stark lines of discontinuity. For example, the separation between bodies at work, and its consequences that the contemporary spatial and temporal organization of labour is having on a ever-weaker social solidarity. Isolation and solitude increased a lot in contemproary accounts (as one of our interviees, Cadmioboro, put it: "we are all alone").

Like the Leboline, the workers we interviewed are situated in a very 'young' technological landscape.
For instance, Angelo Junior Avelli reminded us that the introduction of food delivery platforms in Italy dates back only to 2015, and one year later we already witness the first strike action in the sector by Foodora workers, followed in 2017 by many others mobilizations, including the one at Deliveroo, which leads to the passing of the law n. 128 in 2019, a law instituting some measures of protection for riders and other platofrom workers, including compulsory insurance coverage against accidents at work and occupational diseases and the introduction of a basic salary. This resonates with the stories that Luigi Firrao heard by the Lebole worker he interviewed in 1967 and 1969, who also needed a bit of time to organize their efforts to organize and formulate demands against the new organization of their work through the MTM method. 

However, a precise understanding (and, consequentially, a political awareness) of the mechanisms organizing digital work is very uneavenly spread among contemproary gig workers, who struggle to find common places (virtual or in real life) where to share their knowledges. It is not a coincidence that the most visible group, that of the rider, also shares a starker visibility in public spaces and opportunity for in-person meetings, compared to many other kinds of platform work.

Currently there are a number of fighting and resistance practices emerging within and beyond platforms, from strike actions to individual tricks adopted to slow down. Forms of self-management / ownership of the algorithm - as experimented with by the cooperative platforms movement - are also taking hold. There are those who, in continuity with the early days of industrial production, invoke forms of Luddite sabotage. Others identify in an universal unconditional basic income the only measure capable of restoring the power of the working class of rejecting working conditions that are dangerous and humiliating. Still others are engaged in new forms of unionization, such as recent attempts at Amazon, Apple and Deliveroo. Finally, there are those who see a need to deal with a more radical transformation of the digital infrastructure that regulates not only work, but ever more ubiquitously, most aspects of life. A need for a sustainable redesign of the tech sector, one that would include a consideration of its environmental impact as well as its psychological one. There all all kinds of experimentalisms agitating in the background of the platform sector, not simply reduceable to a clear antagonism, but embracing more oblique strategies of resistance and survival.
Rather than speculating on the future directions these and other protests will contribute to shape here, we wish to conclude this work in progress sharing our conviction, which grew during these months of research, around the paramount importance to conitue keeping track, in this political conjuncture, of the mutual implications and reconfigurations of welfare and technology.