I have been working in the healthcare and social sector for almost nine years. I joined Street Nurses more than six years ago—first as a field nurse, then as co-coordinator of the Housing First team (housing). My work has taken place on the street, in people’s homes, and in precarious living situations—where “classic” care pathways no longer reach people, or do not reach them sufficiently.
Providing care at the margins of the system
In these spaces, violence is rarely spectacular. More often, it is diffuse, chronic, and normalised. It shows up through poverty, drifting from place to place, exclusion from fundamental rights, and discontinuous support. It is also embedded in institutional and political frameworks that make people more vulnerable instead of protecting them. This structural violence damages bodies and lives, leaving lasting traces in the way people can relate to the world.
Primary care as work of connection
It is in this context that primary care takes on its full meaning. It is not limited to technical acts or managing emergencies. Above all, it is rooted in the relationship: recognising the humanity of people made invisible, rebuilding connection where it has been broken—sometimes for a very long time. This requires a stance of presence, consistency, and acceptance of uncertainty.
Taking time, accepting the slowness of processes, returning after a refusal, supporting people without making help conditional on immediate agreement: these essential principles increasingly collide with work organisations that leave little room for the time needed to build trust and for the complexity of situations we support.
When the meaning of the work is put to the test
In recent years, these tensions have profoundly shaken the meaning I attach to my work. The accumulation of situations of extreme precarity, the repetition of violence that could be avoided, and the slowness of structural responses eventually wear you down. They lead to a sense of powerlessness that is not the result of individual disengagement, but of a broader context.
Unpacking the myth of “calling”
It is precisely here that the discourse about “calling” often reappears. My career choice has frequently been framed as a calling or as self-sacrifice. I have always found that deeply troubling. While it can sound flattering, it depoliticises the challenges of care and social work on the one hand, and on the other hand helps legitimise low wages and deteriorating working conditions. It turns a collective responsibility into a personal disposition—as if access to dignified living conditions and fundamental rights depended on individual goodwill rather than on political choices that are made and owned.
The loss of meaning experienced by many healthcare and social workers belongs to this context. It is the product of political decisions that contribute to the production and maintenance of structural violence. Choices made in housing, health, social security, or migration have very concrete effects on the life paths of the people we support—and on the very possibility of guaranteeing dignified living conditions.
Providing care as a political act
Not naming this responsibility means individualising what stems from collective decisions and placing the moral burden on individuals within a system that, structurally, produces exclusion.
Continuing to provide care and support in these conditions is anything but obvious. It is neither a calling nor an individual sacrifice. It is a choice of radical commitment, grounded in a political understanding of care, practised day after day as resistance to structural violence.
For some, January is a time for good resolutions. It could also be the moment when political leaders finally make their own—and fully assume their responsibility to guarantee dignified living conditions.
In the meantime, mine remains unchanged: to keep working with the consequences of their choices.
Manon, nurse and co-coordinator of the Housing First team