Havia um consultório no meio do caminho: cartografia sobre cuidado em saúde na percepção de usuários de um Consultório na rua

Abstract

In recent decades, we have witnessed a structural change in health services in Brazil that alludes to the conquest and progressive implementation of a new paradigm in defense of humanization and comprehensive care. However, for specific populations, such as those living on the streets, the effectiveness of this right requires the perseverance of social movements, given the historical state omission, and the adequacy of the SUS to the particularities of this public. In this sense, the street clinic, despite its recent creation, represents one of the possible care strategies. This dissertation aimed to unveil the perception of users of the Street Clinic regarding the assistance provided by this service, mapping existential territories that permeate the relationship of users with healthcare and its consequences in the production of subjectivities. For this purpose, a cartographic research was carried out based on the researcher's circulation with the staff of the Street Clinic, from november de 2019 to december 2021, in the municipality of Montes Claros/MG and interviews with users of this service, who were referenced by the professionals of the Street Clinic. The interviews were recorded, transcribed and the data were subsequently validated internally by researchers from the Interdisciplinary Qualitative Studies and Research Laboratory in Health (LabQuali). Respondents could speak freely about their life story, health, territory and the place of women on the streets. This dissertation is one of the products of a project that seeks to investigate several work dimensions of the Street Clinic, which justifies the breadth of the proposed themes. Using the street notebook while circulating with the team, the affectations, sensations and movements were also registered, thus drawing existential networks and connections. One of the interviews was selected as “data production operator interview” because it covered in depth all the themes established as an interview script, its content names the thematic categories that were raised from the users' speeches and the researcher's experience in the territory. As a result, it was evidenced that the breaking of bonds and “being alone” promote ruptures that provoke displacements and new trajectories, considered to be a challenge for health policies, since care also involves embracing helplessness. Another aspect highlighted by the research concerns the invisibility of people living on the streets, which are also captured by segregating discourses, where power relations crystallize and territories are defined. Finally, the role of the Street Clinic is evident not only as an articulator, but above all as a reference service for the homeless population, highlighting the bond as a fundamental tool of care, as well as on-site assistance and the involvement of users in self-care.