Agente comunitário de saúde: a construção de um poder capturado

A política de Atenção Básica à Saúde no Brasil, revitalizada pelo Ministério da Saúde, tem a saúde da família como estratégia prioritária para a sua organização. Ancorada no trabalho em equipe multidisciplinar, na vinculação de compromissos e na corresponsabilidade da atenção às famílias, esta estratégia pretende reformular o modelo de atenção à saúde. Isto significa ultrapassar a tradicional assistência institucionalizada que prioriza a tutela para ir na direção da atenção à saúde, o cuidado sendo capaz de gerar a autonomia dos indivíduos. O Agente Comunitário de Saúde, integrante da equipe, é o sujeito do povo facilitador da interlocução entre o saber científico e o saber popular. Depositário de poder transformador, ele tem nas suas funções de educação e promoção de saúde o instrumento para a disseminação de conhecimento emancipatório, promotor de autonomia , com vigilância em saúde, operar o cuidado como essência humana. Entretanto, esse novo resultado dos normas e das regras instituídas na organização dos serviços de saúde, o que se soma às relações que se estabelecem entre os trabalhadores da saúde e os mais distintos grupos sociais. Esta dissertação consiste em um estudo de caso que encontra razão da forma com que os ACSs das Equipes de Saúde da Família de Manguinhos (Rio de Janeiro), contribuem para a atenção à saúde; nela, o cuidado emancipador promove a desconstrução de desigualdades. Esta é uma pesquisa de origem qualitativa que obteve, através da técnica de grupo focal, seu material de análise de conteúdo. Utilizando a categoria analítica o agente cuidador, identificamos as seguintes categorias empíricas: o agente tem que ser paciente, o agente sentindo-se excluído, o agente é dono da chave da porta. Diante do material analisado, pudemos observar que os agentes de Manguinhos adotam a paciência de saber escutar como ferramenta tecnológica, além da paciência perseverante, utilizada diante das muitas dificuldades reveladas por eles. Ainda na dinâmica relacional, observamos que os ACSs alternam sentimentos de exclusão e inclusão diante de determinados grupos sociais. Entretanto, o sentimento de exclusão é potencializado, a nosso ver, pela estigmatização social sofrida por serem moradores de comunidades submetidas a todo tipo de violência. Enquanto, facilitadores da entrada dos usuários no sistema de saúde, observamos um monopólio da assistência à saúde que não ocorre para transformações da produção do cuidado em saúde, e que são verificadas nas tensões características de ações na forma de ajuda-poder, revelando um dos mecanismos utilizados pelos ACSs no seu reconhecimentos sócio-ocupacional. Acreditamos que, embora esta dissertação seja um estudo de caso, é possível estabelecer analogias com as ESFs de metrópoles brasileiras. Neste sentido, somente a formação técnica do ACS baseada na problematização dos temas levantados poderá superar ações mantenedoras de assimetrias de poder. Devem ser ultrapassadas metodologias que reforcem o lugar social do ACS no último nível da hierarquia da divisão do trabalho em saúde. Apenas desta forma será possível impedir a captura dos ACSs por poderes hegemonicamente institucionalizados. Então, e só então, será possível veicular um saber emancipador, construtor de autonomia, mitigador de desigualdades, no qual a utopia tornar-se-á realidade.

Backtracks: a devised performance

Backtracks aimed to investigate critical relationships between audio-visual technologies and live performance, emphasising technologies producing sound, contrasted with non-amplified bodily sound. Drawing on methodologies for studying avant garde theatre, live performance and the performing body, it was informed by work in critical and cultural theory by, for example, Steven Connor and Jonathan Rée, on the body's experience and interpretation of sound. The performance explored how shifting national boundaries, mobile workforces, complex family relationships, cultural pluralities and possibilities for bodily transformation have compelled a re-evaluation of what it means to feel 'at home' in modernity. Using montages of live and mediated images, disrupted narratives and sound, it evoked destablised identities which characterise contemporary lived experience, and enacted the displacement of certainties provided by family and nation, community and locality, body and selfhood. Homer's Odyssey framed the performance: elements could be traced in the mise-en-scène; in the physical presence of Athene, the narrator and Penelope weaving mementoes from the past into her loom; and in voice-overs from Homer's work. The performance drew on personal experiences and improvisations, structured around notions of journey. It presented incomplete narratives, memories, repressed anxieties and dreams through different combinations of sounds, music, mediated images, movement, voice and bodily sound. The theme of travel was intensified by performers carrying suitcases and umbrellas, by soundtracks incorporating travel effects, and by the distorted video images of forms of transport playing across 'screens' which proliferated across the space (sails, umbrellas, the loom, actors' bodies). The performance experimented with giving sound and silence performative dimensions, including presenting sound in visual and imagistic ways, for example by using signs from deaf sign language. Through-composed soundtracks of live and recorded song, music, voice-over, and noise exploited the viscerality of sound and disrupted cognitive interpretation by phenomenological, somatic experience, thereby displacing the impulse for closure/destination/home.

Women's conference in Mexico City (NGO)

General note: Title and date provided by Bettye Lane.

Family going on vacation.

Inscription: Verso: Arrington Family, Bronx, New York.

Przestrzenne formy upamiętniania Zagłady

This book is a synthesizing reflection on the Holocaust commemoration, in which space becomes a starting point for discussion. The author understands space primarily as an amalgam of physical and social components, where various commemorative processes may occur. The first part of the book draws attention to the material aspect of space, which determines its character and function. Material culture has been a long ignored and depreciated dimension of human culture in the humanities and social sciences, because it was perceived as passive and fully controlled by human will, and therefore insignificant in the course of social and historical processes. An example of the Nazi system perfectly illustrates how important were the restrictions and prohibitions on the usage of mundane objects, and in general, the whole material culture in relation to macro and micro space management — the state, cities, neighborhoods and houses, but also parks and swimming pools, factories and offices or shops and theaters. The importance of things and space was also clearly visible in exploitative policies present in overcrowded ghettos and concentration and death camps. For this very reason, when we study spatial forms of Holocaust commemoration, it should be acknowledged that the first traces, proofs and mementoes of the murdered were their things. The first "monuments" showing the enormity of the destruction are thus primarily gigantic piles of objects — shoes, glasses, toys, clothes, suitcases, toothbrushes, etc., which together with the extensive camps’ space try to recall the scale of a crime impossible to understand or imagine. The first chapter shows the importance of introducing the material dimension in thinking about space and commemoration, and it ends with a question about one of the key concepts for the book, a monument, which can be understood as both object (singular or plural) and architecture (sculptures, buildings, highways). However, the term monument tends to be used rather in a later and traditional sense, as an architectural, figurative form commemorating the heroic deeds, carved in stone or cast in bronze. Therefore, the next chapter reconstructs this narrower line of thinking, together with a discussion about what form a monument commemorating a subject as delicate and sensitive as the Holocaust should take on. This leads to an idea of the counter-monument, the concept which was supposed to be the answer to the mentioned representational dilemma on the one hand, and which would disassociate it from the Nazi’s traditional monuments on the other hand. This chapter clarifies the counter-monument definition and explains the misunderstandings and confusions generated on the basis of this concept by following the dynamics of the new commemorative form and by investigating monuments from the ‘80s and ‘90s erected in Germany. In the next chapter, I examine various forms of the Holocaust commemoration in Berlin, a city famous for its bold, monumental, and even controversial projects. We find among them the entire spectrum of memorials – big, monumental, and abstract forms, like Peter Eisenman’s Memorial to the Murdered Jews of Europe or Daniel Liebeskind’s Jewish Museum Berlin; flat, invisible, and employing the idea of emptiness, like Christian Boltanski’s Missing House or Micha Ullman’s Book Burning Memorial; the dispersed and decentralized, like Renata Stih and Frieder Schnock’s Memory Places or Gunter Demnig’s Stumbling Blocks. I enrich descriptions of the monuments by signaling at this point their second, extended life, which manifests itself in the alternative modes of (mis)use, consisting of various social activities or artistic performances. The formal wealth of the outlined projects creates a wide panorama of possible solutions to the Holocaust commemoration problems. However, the discussions accompanying the building of monuments and their "future life" after realization emphasize the importance of the social component that permeates the biography of the monument, and therefore significantly influences its foreseen design. The book also addresses the relationship of space, place and memory in a specific situation, when commemoration is performed secretly or remains as unrealized potential. Although place is the most common space associated with memory, today the nature of this relationship changes, and is what indicates popularity and employment of such terms as Marc Augé’s non-places or Pierre Nora’s site of memory. I include and develop these concepts about space and memory in my reflections to describe qualitatively different phenomena occurring in Central and Eastern European countries. These are unsettling places in rural areas like glades or parking lots, markets and playgrounds in urban settings. I link them to the post-war time and modernization processes and call them sites of non-memory and non-sites of memory. Another part of the book deals with a completely different form of commemoration called Mystery of memory. Grodzka Gate - NN Theatre in Lublin initiated it in 2000 and as a form it situates itself closer to the art of theater than architecture. Real spaces and places of everyday interactions become a stage for these performances, such as the “Jewish town” in Lublin or the Majdanek concentration camp. The minimalist scenography modifies space and reveals its previously unseen dimensions, while the actors — residents and people especially related to places like survivors and Righteous Among the Nations — are involved in the course of the show thanks to various rituals and symbolic gestures. The performance should be distinguished from social actions, because it incorporates tools known from religious rituals and art, which together saturate the mystery of memory with an aura of uniqueness. The last discussed commemoration mode takes the form of exposition space. I examine an exhibition concerning the fate of the incarcerated children presented in one of the barracks of the Majdanek State Museum in Lublin. The Primer – Children in Majdanek Camp is unique for several reasons. First, because even though it is exhibited in the camp barrack, it uses a completely different filter to tell the story of the camp in comparison to the exhibitions in the rest of the barracks. For this reason, one experiences immersing oneself in all subsequent levels of space and narrative accompanying them – at first, in a general narrative about the camp, and later in a specifically arranged space marked by children’s experiences, their language and thinking, and hence formed in a way more accessible for younger visitors. Second, the exhibition resigns from didacticism and distancing descriptions, and takes an advantage of eyewitnesses and survivors’ testimonies instead. Third, the exhibition space evokes an aura of strangeness similar to a fairy tale or a dream. It is accomplished thanks to the arrangement of various, usually highly symbolic material objects, and by favoring the fragrance and phonic sensations, movement, while belittling visual stimulations. The exhibition creates an impression of a place open to thinking and experiencing, and functions as an asylum, a radically different form to its camp surrounding characterized by a more overwhelming and austere space.