István van Deursen Varga

Health for black and women populations as public policies and intellectual fields: supporting arguments for a case study on systemic institutional racism

Woman, black, and peasant: these characteristics imply the mutually potentialized and overdetermination of the three biggest social and programmatic vulnerability conditions that affect Brazilian population segments which are already very poor. The state of Maranhão, Brazil, is estimated to have 6,714,314 inhabitants (data from 2012), among whom 25.19% are extremely poor; it has one of the largest concentrations of black people (around 74% of the population), the highest rural population concentration (61.90% of households), and the biggest number of quilombola communities in the country – currently, a total of 467 Palmares Foundationcertified communities, which are spread through 69 municipalities (Comunidades Quilombolas, 2016), some of which have the worst Human Development Index in the state and in the country; it also has a large number of babaçu coconut female breakers, a number that might reach 200,000 women. The introduction, in Maranhão, especially in the 1980s, of several organized social movements focused on women (for instance, peasants, female coconut breakers, and traditional midwives), as well as on black population and quilombola communities, motivated very dynamic political and social activism, and knowledge production and socialization in the state scenario. In the case of peasants, quilombolas, and female coconut breakers, the activism was initially mobilized around the land ownership issue and the protection of their territory and their material conditions of survival and work. The recent consolidation of those movements allowed for the inclusion of new mobilization agenda and claiming to government powers, among which the access to health care policies and services and good quality education services which meet their needs and specificities. The proposal from the Technical Women’s Health Care Area (ASTM) of the Ministry of Health (MS) regarding the funding for a Black Women’s Health Care Technical Specialization Course (CESMN) in the Health Care and Environment Graduate Program in the Federal University of Maranhão (PPGSA/UFMA), in 2009, intended on training and qualifying health care professionals in different fields to provide proper care to the black population, and more specifically to black women, in SUS (Brazilian Unified Health System) service network. CESMN’s political project was conceived by Maria de Fátima Oliveira Ferreira (from the National Health Care, Sexual Rights, Reproductive Rights Feminist Network), and the political-pedagogical project was built and supervised by her and by István van Deursen Varga, Rosana Batista Monteiro, Antônio Henrique França Costa, and Luís Eduardo Batista. It was not, therefore, about establishing a new academic specialty in the health care field, but about offering emergency responses (once the course was only expected to be given to two groups) to one of the largest and most serious social public health

Systemic hypertension control in black population in Maranhão, Brazil: problems and challenges

We present and discuss the circumstances of the construction and a part of the impact among professionals and managers of health services and social movements, in Maranhao, Brazil, of a text drawn up by members of the Nucleo de Extensao e Pesquisa com Populacoes e Comunidades Rurais, Negras Quilombolas e Indigenas [Research and Extension Center of Rural, Black Quilombolas, and Indigenous Populations and Communities] (NuRuNI), of the Programa de Pos-Graducao em Saude e Ambiente [Graduate Program in Health and Environment] of the Federal University of Maranhao (UFMA), on problems identified in the control of hypertension among blacks, and the challenges for the effective implementation and operationalization of the National Policy of Integral Health of the Black Population in the state. The need for our mobilization for the elaboration of this text (which objective was to alert the authorities and operators of the Brazilian Unified Health System, as well as activists from social movements, on the importance and the seriousness of these problems, because it is the nosology of higher prevalence in the state and in the country, and that entail greater number of sequels and secondary serious nosologies) and for our intervention in the context of health policies in the state has been highlighted as a result of classes on the subject, during the Graduate Specialization in Black Womens Health, promoted by NuRuNi, with the support of the Coordenacao-Geral de Saude das Mulheres [General Coordination of Womens Health] of the Ministry of Health, with funding from the Fundo Nacional de Saude [National Health Fund].We present and discuss the circumstances of the construction and a part of the impact among professionals and managers of health services and social movements, in Maranhao, Brazil, of a text drawn up by members of the Nucleo de Extensao e Pesquisa com Populacoes e Comunidades Rurais, Negras Quilombolas e Indigenas [Research and Extension Center of Rural, Black Quilombolas, and Indigenous Populations and Communities] (NuRuNI), of the Programa de Pos-Graducao em Saude e Ambiente [Graduate Program in Health and Environment] of the Federal University of Maranhao (UFMA), on problems identified in the control of hypertension among blacks, and the challenges for the effective implementation and operationalization of the National Policy of Integral Health of the Black Population in the state. The need for our mobilization for the elaboration of this text (which objective was to alert the authorities and operators of the Brazilian Unified Health System, as well as activists from social movements, on the importance and the seriousness of these problems, because it is the nosology of higher prevalence in the state and in the country, and that entail greater number of sequels and secondary serious nosologies) and for our intervention in the context of health policies in the state has been highlighted as a result of classes on the subject, during the Graduate Specialization in Black Womens Health, promoted by NuRuNi, with the support of the Coordenacao-Geral de Saude das Mulheres [General Coordination of Womens Health] of the Ministry of Health, with funding from the Fundo Nacional de Saude [National Health Fund].

Promotion of black women's health in Castelo village, municipality of Alcântara, Maranhão, Brazil

A Politica Nacional de Saude para a Mulher Negra dispoe de um aparato legal que da suporte a sua implementacao, conquistado pelo movimento negro. Tendo como parâmetro as legislacoes referentes a saude da populacao negra e a saude da mulher, alem dos documentos disponibilizados pela Secretaria Municipal de Saude de Alcântara, este trabalho teve como objetivo geral analisar os servicos basicos de saude prestados as mulheres negras do povoado Castelo e como objetivos especificos realizar levantamento empirico dos programas e projetos voltados para mulheres negras oferecidos pelo municipio de Alcântara; verificar se no povoado Castelo ha algum atendimento especifico para mulheres negras; identificar as principais demandas das mulheres da comunidade ao servico de saude local; averiguar como o quesito cor esta sendo empregado pela equipe da Estrategia Saude da Familia que atende a comunidade. A metodologia consistiu em identificar, atraves de documentos disponibilizados pela Secretaria Municipal de Saude (SEMUS), as acoes e servicos voltados para as mulheres na comunidade, e por meio de questionario aplicado aos profissionais, seus conhecimentos sobre a Politica Nacional de Saude Integral da Populacao Negra. Concluimos que, apesar do aparato legal, reconhecido e citado pela SEMUS em seu Plano de Saude atual, as legislacoes nao tem sido suficientes para que esse segmento social tenha suas peculiaridades reconhecidas. Informacoes basicas para planejamento de acoes especificas, como a coleta do quesito cor, por exemplo, nao sao realizadas pela SEMUS. Nao identificamos nenhuma acao planejada que considere as caracteristicas raciais e etnicas das mulheres da comunidade.