O TERRITÓRIO DA SAÚDE PÚBLICA: espaço, sujeitos e sentido em uma Unidade Básica de Saúde em Araguaína-TO

Abstract

This paper aims to analyze how public health problems are presented to the users and workers / employees of a Basic Health Unit (UBS) through a reading of the UBS space. We also sought to analyze how public health problems are presented in the narratives of users and workers / employees. To achieve these objectives, a field analysis was carried out for two weeks at UBS, for which we mobilized theories about the territorial system (RAFFESTIN, 2011, 1993) and topos (HAMMAD, 2016) to understand the function and interaction (LANDOWSKI, 2014) that was immanent in the UBS space sectors, and, in a second moment, interviews were made with users and employees / employees of UBS. In order to analyze such interviews, we used the generative path of meaning of greimasian semiotics, and more specifically, the narrative course (FIORIN, 2016; BARROS, 2005) with some elements of the socio-demiotic (LANDOWSKI, 2014). Thus, methodologically, we used the field studies (RAFFESTIN, 2011, 1993; SAQUET, 2010, 2011), of greimasian semiotics with (FIORIN 2016; BARROS 2005), the partneriosemiotic of Landowski (2014), and space semiotics (HAMMAD, 2016). The research showed that there is a spatial differentiation of the conflicts generated by the interaction between the users and the workers / employees, where the spaces occupied by subjects with more intellectual capital are spaces more distanced from the conflicts, and the spaces marked by more controversial interactions is what we designate prevention and reception system. With the analysis of the narratives, we conclude that access to the territory desired by the users is done in a diversified way, and that, in the case of the user that does not fit the SUS priority definitions, access is usually marked by an excess of narrative programs (where the subject must wait to receive modal objects or objects of desire from others), and sometimes being denied the conditions of subjects, leading them to passivity or conflict, thus denying the participation of subjects in the construction of the territory. Another problem built by the interviewees is the monopoly of the actancial position of the destination by the health professionals, monopolizing the access to specialized health services. The narratives of the workers / employees subjects were separated by their positions in the structure of the UBS, so, on one side are those who have the first contact with the users, among them one of the main elements reported is the precariousness of their jobs and the violence suffered in the direct relationship with users who, in turn, blame workers / employees for lack of access (evidencing the importance of social control); and, on the other hand, workers / employees who have later contact with the user, because they have less conflictive relationships in their work experience, have blamed higher instances of power for the difficulties such as lack of work material and management problems, both at the municipal level and at UBS itself.