Popular Education and Health in educational processes: challenges and perspectives** This present article results from a critical and reflective essay. There was no data collection, nor were human subjects approached, which is why such research was not assessed by Research Ethics Committee.

Pedro José Santos Carneiro Cruz Maria Rocineide Ferreira da Silva Vanderleia Laodete Pulga About the authors

Abstract

Amidst the growth of a conservative neoliberal model in the current Brazilian public agenda, Popular Education and Health (EPS) presents itself as a possibility for the production of experiences directed to the constitution of health as a right; moreover, it is also committed to the development of people's role in the search for good living and for the critical confrontation with social determinations of health. The present article addresses EPS in formative processes, their challenges and perspectives. Centrally, it problematizes aspects such as: criticality in the movements and practices of EPS; the critical and mobilizing processes of protagonism; network action and the articulation of the struggle of movements and EPS practices. It is expected that these reflections will contribute to the debate on EPS and its role as a theoretical and methodological referential for training in the health area.

Popular education and health; Health training; Social movements; Popular participation


From the people, we seek strength

“It is not enough for our cause

to be pure and just

It is necessary that purity and justness

exist within us.

We are on the same boat.

All of us agree – we must fight.

Fight for what?

To release old hatred?

or to attain freedom

and to possess what we have created?

(Agostinho Neto)

Introduction

The current Brazilian context has been characterized by the upscaling in human exploitation, predominantly through the gradual establishment of an ultraliberal agenda in the economic and social field. A series of realignments in the political approach of state action has been put into practice in the national life, especially after 2016. This has incurred the dismantling of public social policies by removing from the State the responsibility for promoting essential human and social rights.

In 2020, the arise of the COVID-19 pandemic reveals a health crisis of remarkable proportions. Such pandemic (and its outcomes in the territories) highlights, in a substantial and growing way, the persistent onslaught of social exclusion processes in the lives of the majority of the Brazilian population. It occurs mostly by intensifying the effect of social, economic, political and cultural determinants on the health field11. Rocha C. “Imposto é roubo!” A formação de um contrapúblico ultraliberal e os protestos pró- impeachment de Dilma Rousseff. Dados. 2019; 62(3):e20190076.,22. Miranda L, Carvalho AI, Brito C, Mendonça MHM, Vasconcellos MTL, Lima SML. Crise e saúde: implicações para a política, a gestão e o cuidado em saúde. Cienc Saude Colet. 2019; 24(12):4372..

This ultraliberal (or totalitarian neoliberal) trend has been signaling, in different parts of the world, that the solutions to the recent capitalist crises would be the conservative restoration and the affirmation of the market fundamentalism, by which everything is commodified. All forms of life and relationships become merely objects of purchase and sale.

This scenario also highlights processes such as: insistent attritions on democracy, its institutions and relations; the reinforcement of the logic of domination, exploitation and alienation in the social, economic, cultural, labor and power spheres; the increase in polarization with the use of force and multiple ways of violence; the control on the production of subjectivities and intersubjectivities; the attempt to impose hegemonial beliefs and rituals with a conservative, racist, misogynistic and prejudiced basis; and attempts to suppress and/or destroy fundamental aspects of ethnic and cultural identities and diversities, which are so strong in Brazilian society11. Rocha C. “Imposto é roubo!” A formação de um contrapúblico ultraliberal e os protestos pró- impeachment de Dilma Rousseff. Dados. 2019; 62(3):e20190076.,33. Rech MJ. Crise e golpe. Rev Direito Praxis. 2019; 10(4):3116-25.,44. Mascaro AL. Crise e golpe. São Paulo: Boitempo; 2018.. These processes are not only carried out by the governmental action occupying the elective public spaces, but it also has the support of part of the population organized in neo-fascist and conservative groups and movements.

Thus, it is precisely at this moment that is urgent the need for movements, practices and experiences that both denounce these dehumanizing contexts and announce other pedagogical, cultural, political and social paths. Paths that enable the permanent construction of another model of society, necessarily in conjunction with the immediate formation of other relationships and sociability, especially those guided by social justice and a perspective of human emancipation44. Mascaro AL. Crise e golpe. São Paulo: Boitempo; 2018..

In the context of Collective Health, the Popular Education and Health (EPS) presents itself as a fruitful field of possibilities for the unveiling of a social, scientific and professional action in health. The EPS is committed to the collective production of practices, experiences and movements which, through the dialogical sharing of knowledge, contribute to social transformation and the emancipation of people. In particular, for collaborating in a joint effort to promote life and struggle for the realization of human dignity, reflected in teaching and learning processes which are deeply connected to the confrontation with social exclusion of the popular classes and their protagonists55. Cruz PJSC, organizador. Educação popular em saúde: desafios atuais. São Paulo: Hucitec; 2018..

In the multifaceted scenario of Brazilian health, the concept of Popular Education has been highlighted as a methodological, political and epistemological approach guiding the action of workers, protagonists of social movements and popular practices, as well as actors from the university scene. EPS works to promote social experiences and teaching and learning processes aimed at establishing health as a right, and also the development of people’s protagonism in the search for good living and for the critical confrontation with the social determinations of health and living. The methodology is its founding component, as it is based on participatory and dialogical action. It intermediates the formation of subjects for the construction of life with quality and dignity by having them participating in social works in different territories, contexts and situations66. Botelho BO, Vasconcelos EM, Carneiro DGB, Prado EV, Cruz PJSC, organizadores. Educação popular no sistema único de saúde. São Paulo: Hucitec; 2018..

This present work constitutes a critical and reflective essay produced from the interpretation of its authors about the challenges of EPS and its formative processes in the current Brazilian context. Therefore, its writing is based upon the reflections by the authors in their experiences in the coordination of the Management Group of the Thematic Group of EPS at the the Brazilian Association of Public Health (Abrasco), in the period between October 2016 and February 2020. The following aspects are centrally problematized: the criticality in the movements and practices of EPS; the critical and mobilizing processes of protagonism; network action and the articulation of the struggle of movements and EPS practices.

As Mello77. Mello M. Educação crítica e educação popular: um diálogo (norte-sul) entre comadres. Pedagogica. 2013; 1(30):68-104. asserts, the tensions underway need answers that are not simplistic, nor dualistic. Above all, it is prudent and urgent to exercise the critical, self-critical and reflective dimension for those who are the protagonists of EPS experiences.

Complexity and refinement in thinking and acting are required for unveiling a rigorous, precise and assertive understanding of the current social reality in Brazil, which has been changing rapidly. If it is true that EPS has theoretical and methodological subsidies to support this process, the ability to study, analyze, and problematize is essential to be built with, in and from experiences, in order to produce a critical theory and practice, capable of offering elements of analysis and overcoming the current social77. Mello M. Educação crítica e educação popular: um diálogo (norte-sul) entre comadres. Pedagogica. 2013; 1(30):68-104..

In our opinion, the reflective effort shared in this article proves to be important as a self-critical exercise. It also nurtures the problematization of EPS practices and movements across the country. If on the one hand the perspectives outlined here are certainly not the only possible ways of looking at EPS and its challenges, on the other hand, they can be ideas for provoking the thoughts, and they can also mobilize the systematization of its practices and outcomes, resulting in the emergence of other perspectives and ideas.

The challenge of promoting criticality in EPS movements and practices

The question that sustains this challenge is to understand to what extent the movements and practices of EPS, in their different spaces, have effectively applied criticality in an emancipating ethical-political perspective. Being evidenced not just in the speech of the protagonists of EPS, but having it as a concern so daily and systematic that it is reflected in the way it conducts, evaluates and unveils the actions and reflections.

The transforming action in people’s daily practices and social processes – in the perspective of building a society free from all forms of oppression, domination, exploitation, discrimination and violence – is an ethical-political and pedagogical challenge present in EPS actions. In this regard, it is necessary to develop critical capacity, understood as a way of analyzing reality, considering it through a dialectical prism. In other words, taking it in its contradictory essence and in permanent transformation88. Melo Neto JF. Heráclito: um diálogo com o movimento. João Pessoa: UFPB; 1996..

By confronting the contexts of political oppression, dehumanization and social exclusion, it is urgent to use theories that can comprehend and explain the dominant reality in our society, which is ethically unjust and contradictory. By assuming the analysis of these contradictions, the dialectic in Karl Marx qualifies as one of the most important theoretical foundations for the conduct of these works.

Therefore, the criticality must be configured in a careful study and must focus on reality and on its determinations, by taking as its starting point the inherent complexity and its various facets, contradictions, appearances and illusions. Thus, an important understanding of criticality consists precisely in that which points to the unveiling of the ability to see reality and its determinations in its contradictions, its diverse and (often) contrasting facets, in the philosophical line founded by Karl Marx.

Nowadays, it is essential that the protagonists of the EPS movements and practices contemplate the dimension of criticality in their thoughts and actions. For that, first of all, we need to conceive the action in EPS not only in its practical dimension, but also in its reflective facet, producer of new knowledge about the world, about EPS itself, about each one of its experiences and about ourselves.

Criticality is, therefore, potentially present in the making of each EPS practice. However, its protagonists must be willing to broaden the view on this doing in order to unveil it. Understanding, thus, that the systematic undertaking of a critical analysis that fosters learning and reveals the limits of each action is part of “doing EPS”.

Therefore, qualifying the knowledge of reality, the protagonists’ self-knowledge, and the improvement of actions in the search for human emancipation, as hits, mistakes, potentialities, and limit situations are highlighted. Consequently, elucidating socially, culturally, economically and politically the paths taken by EPS, so as to verify to what extent its initiatives are promoting changing processes in situations and in relations that promote exclusion.

It is important to have clear the awareness of the unfinished nature of each of the subjects involved in the EPS, and also the compression of the changing reality, or simply that transformation is possible: The transformation of us and of the world. In the dialectic perspective, this thought comes from Heraclitus, who said that our reality is permeated by different tensions at all times, resulting from different human interests. This permanent, tense struggle is the engine of changes, because sometimes an attitude/will/way of acting prevails, sometimes it will be another, and so on. Therefore, “a essência, o elemento primordial, é o vir-a-ser. Tudo está em perpétuo movimento. A realidade está sujeita a um vir-a-ser contínuo88. Melo Neto JF. Heráclito: um diálogo com o movimento. João Pessoa: UFPB; 1996. (p. 21).

In this sense, another fundamental dimension for the criticality of the EPS protagonists is the constant provocation to be exquisite transformation thinkers, in addition to being excellent transformation activists. In other words, to conceive that protagonism is not only done in action, but in thought. The exercise of critical, revolutionary, non-conformist thinking is one of the fundamental marks for EPS, especially today. It is clear, then, the need to train thinkers through EPS, and not just social activists. That is to say: it is necessary to train social activists who, conceiving their inconclusion and the limits of their work and ideas, seek in critical reflection the basis and essence of their social action; a dialectical reflection that happens individually, but also collectively, favoring different perceptions from different perspectives and points of view. That is to say, various dimensions.

The criticality encourages the practice of dialogue as an essential condition in the agreement, planning and implementation of actions. Dialogue is an emulsifying element of human and subjective interactions. It becomes a fundamental condition for conducting work in a participatory, supportive and awareness-raising manner. As Zea-Bustamante states99. Zea-Bustamante LE. La educación para la salud y la educación popular, una relación posible y necesaria. Rev Fac Nac Salud Publica. 2019; 37(2):61-6., it is nothing but an intentional and never neutral encounter.

Hablar del diálogo como epicentro de las acciones de la educación popular implica entender la educación como un acto de amor, como un encuentro intencionado y nunca neutral, donde, a través de la palabra, se logra que quienes participan en el acto educativo − estudiantes, docentes y comunidade − signifiquen su mundo, reconozcan los aspectos que lo constituyen y puedan así establecer procesos de empoderamiento para transformar sus realidades99. Zea-Bustamante LE. La educación para la salud y la educación popular, una relación posible y necesaria. Rev Fac Nac Salud Publica. 2019; 37(2):61-6.. (p. 63)

With regard to criticality, it is also worth noting that it recommends EPS actors to consider the historicity of facts, realities and subjects. In this perspective, the historical look emerges as a basic condition to be considered in the development of work in EPS. One cannot consider a phenomenon without historicizing it, because the criticality movement conceives that things have different determinations in its constitution. People, things, realities are, at a given moment, syntheses of many different determinations.

Therefore, without considering its historicity, one cannot think of an action for criticality, consistent with the surrounding reality and its determinations, aiming at its transformation. EPS must then be conceived and practiced as a dialectical process, as Melo Neto1010. Melo Neto JF. Extensão popular. 2a ed. João Pessoa: UFPB; 2014. and Santos1111. Santos BS. Para uma pedagogia do conflito. In: Silva LH, Azevedo JC, organizadores. Novos mapas culturais, novas perspectivas educacionais. Porto Alegre: Sulina; 1996. p. 15-33. claim. As Mello77. Mello M. Educação crítica e educação popular: um diálogo (norte-sul) entre comadres. Pedagogica. 2013; 1(30):68-104. explains, based on the dialogue between the ideas of Michael Apple and Paulo Freire, the Popular Education prioritizes criticality when it proposes to reveal the formation of subjectivities committed to the search for relationships and experiences that make it possible to break with any illusions and conformist subjectivities. Such committed subjectivities are based on the belief that the ways in which our societies and their educational apparatus are currently organized can lead to social justice. To this end, Mello77. Mello M. Educação crítica e educação popular: um diálogo (norte-sul) entre comadres. Pedagogica. 2013; 1(30):68-104. positions as central content for the critical educational process: the policy of redistribution (processes and economic dynamics of exploitation) and the policy of recognition (cultural struggles against domination and struggles for identity).

We believe that such elements are essential to think about EPS with criticality, understood as a theoretical and epistemological dimension of the practice and production of health thinking. In this sense, when studying a reality through a critical eye, a greater methodological demand is necessary, as Melo Neto1212. Melo Neto JF. Extensão universitária: bases ontológicas. In: Melo Neto JF, organizador. Extensão universitária: diálogos populares. João Pessoa: UFPB; 2002. p. 7-22. advises.

According to this author77. Mello M. Educação crítica e educação popular: um diálogo (norte-sul) entre comadres. Pedagogica. 2013; 1(30):68-104., the Popular Education has, in its theoretical construction, dimensions of critical education that substantiate its deepening in the direction of criticality. Such understanding is, in his words, more robust and involves placing on the agenda radical changes of the underlying epistemological and ideological assumptions in educational processes. This also implies a pedagogical practice eminently based on radical changes in each person’s commitments to the social. Based on Apple’s idea, Mello77. Mello M. Educação crítica e educação popular: um diálogo (norte-sul) entre comadres. Pedagogica. 2013; 1(30):68-104. states that education needs to cultivate attitudes consistent with social transformation in order to be effectively critical.

The challenge of unveiling educational processes in EPS that are critical and mobilize protagonism

It is necessary to consider, in the scope of the movements and practices of EPS, to what extent and in what ways these initiatives have reflected in the concrete alterativeness. In other words, which paths the protagonists of these experiences have taken so that they can concretely promote viable-unknowns, reflected by new social, cultural and political possibilities for life in society. These questions are the ones that will mobilize the reflections made in this topic.

EPS is not restricted to pedagogical action, nor to social activism. Its theoretical-methodological framework clearly points and proposes new perspectives for doing and thinking about health, in the search for new sociability and for social horizons, different from those currently hegemonic. It is expected, therefore, that the development of its practices and movements will lead to the formation of protagonists and the formation of relationships characterized by the intransigent defense and the permanent promotion of principles such as justice, solidarity, equality and freedom, enabling life with joy and dignity for all people. Thus, gving them the chance to seek “to be more”, as Paulo Freire would claim1313. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 25a ed. São Paulo: Paz e Terra; 1996..

Seen in this these terms, doing EPS means building new possibilities of being and acting in the world. There is no need to wait for the world to change in order to establish new social relationships and new ways of participating, intervening and building. Through EPS, it is possible to promote experiences that manage to collectively and procedurally outline new social horizons and new political hegemonies in the spaces created by EPS.

We agree, therefore, with Paro et al.1414. Paro CA, Ventura M, Silva NEK. Paulo Freire e o inédito viável: esperança, utopia e transformação na saúde. Trab Educ Saude. 2020; 18(1):e0022757., who highlight the praxiological character as a presupposition of any pedagogical process that intends to mobilize the construction of change, or in Freirian terms, of the viable-unkown1313. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 25a ed. São Paulo: Paz e Terra; 1996.. To this end, the authors emphasize that a

[...] consubstancialidade entre as dimensões ontológica e política [...]. Colocando em evidência as relações excludentes e de injustiça, a leitura da realidade pode suscitar uma miríade de sentimentos envolvendo espanto, rebeldia, inconformismo, raiva, mas também coragem, ousadia e esperança. Nesse momento, faz-se presente o imbricamento entre as dimensões ontológica e política da pedagogia freireana, na medida em que a indignação e a esperança só se justificam quando são mobilizadoras de mudanças1414. Paro CA, Ventura M, Silva NEK. Paulo Freire e o inédito viável: esperança, utopia e transformação na saúde. Trab Educ Saude. 2020; 18(1):e0022757.. (p. 9)

A new act in health has already been woven from several EPS initiatives, where other principles and different methodologies are unveiled, and a theory of knowledge is elaborated. An act in which health services are spaces capable of qualifying people’s search for “being more”, of respectful and democratic relationships, in addition to providing concrete subsidies to improve life in society, being guided by the principles of solidarity, justice, freedom and equality.

But how can this action be promoted and cultivated? In our view, a relevant path consists of the pedagogical characteristic of EPS regarding the permanent institution of people’s protagonism in all stages of the educational process. Such protagonism is not given to people, but is promoted and mobilized by encouraging the construction of critical analyzes carried out by these actors and by establishing their own spaces so that they can reflect on the social processes they experience.

The protagonism will be woven and improved from the moment each actor exercises a critical reflection capable of pointing out not only inconsistencies and gaps in the other, but in themselves, showing their likeliness to make mistakes and the conception that their knowledge is not the only one. Thus, always learning to act together with those involved in learning relationships and mutual transformations, overcoming the authoritarian and vertical logics in the daily action.

Em continuidade ao legado freiriano, comprometido com a emancipação humana e a transformação social, nós nos colocamos diante da necessidade de lutar e construir um mundo com justiça social para todos e todas. Nesse sentido, o reconhecimento da diversidade está atrelado à luta pelo direito à diferença como ponto de partida, vislumbrando a igualdade material como ponto de chegada. Assim se traduz a urgência em lutarmos pela equidade, entendida como direito à igualdade de oportunidades, considerando as diferenças1515. Pini FR. Educação popular em direitos humanos no processo de alfabetização de jovens, adultos e idosos: uma experiência do projeto Mova-Brasil. Educ Rev. 2019; 35:e214479.. (p. 18)

The stimulus to protagonism cannot, however, consist only of a stage, a device or a specific dynamic of the formative process. According to EPS, protagonism must be considered as an essential pedagogical principle that must be woven and exercised in the transversality of its activities. With this, we point to the relevance of considering how much this aspect cannot be reduced to the utilitarian pedagogical view, but it needs to constitute an ethical precept that impacts the entire organization and orientation of the practices and movements of EPS.

Thus, by this understanding, such protagonism will only be generated when sharing, in the educational space in question, the exercise of trust in people’s attitudes, mirrored in the valorization of their knowledge and in the belief that their boldness and courage will enable the construction of actions, promising interventions and initiatives. Promoting protagonism in EPS will necessarily result in a moving process, that is, a walk. For this reason, it is also necessary to be patient with the gaps and limits of each protagonist, their movements and their practices; it is also necessary to face obstacles as points of critical analysis and substrates for new directions for the actions undertaken.

In this context, another dimension revealed by this debate will be in the essential search for an effectively horizontal relationship between teacher and student, without authoritarianism, guided by dialogue and a loving bond. Zea-Bustamante99. Zea-Bustamante LE. La educación para la salud y la educación popular, una relación posible y necesaria. Rev Fac Nac Salud Publica. 2019; 37(2):61-6. points out elements that he considers to be central to educational processes with such characteristics:

El reconocimiento del otro como agente válido, histórico y con saberes; Replantear los espacios de poder en el acto educativo, la educación como escenario de negociación cultural, donde se pongan en juego los saberes, las experiencias y las prácticas comunitarias, donde la historia y los conocimientos de las personas sean el punto de partida para la concreción del acto educativo; Establecer un acto de amor, es decir, el diálogo como encuentro y reconocimiento de la alteridad, reconocimiento del otro con quien se puede transformar el mundo99. Zea-Bustamante LE. La educación para la salud y la educación popular, una relación posible y necesaria. Rev Fac Nac Salud Publica. 2019; 37(2):61-6.. (p. 64)

To what extent are we managing to promote this type of relationship in the EPS formative processes of movements and practices? In many of the progressive proposals for health education, while dynamics and initiatives are much discussed to encourage student protagonism and criticality, the absolute power of the educator in educational spaces is little affected. As Rios and Caputo1616. Rios DRS, Caputo MC. Para além da formação tradicional em saúde: experiência de EPS na formação médica. Rev Bras Educ Med. 2019; 43(3):184-95. argue, despite the evolutionary process of health education in Brazilian experiences, both in its curricular and methodological aspects, there are still important gaps to be overcome in the perspective of a humanistic and integral formation. In this sense, the idea that

[...] não basta apenas transformar as metodologias e a grade curricular; é fundamental inserir os estudantes em espaços de prática e reflexão, onde eles possam ter contato com atividades que extrapolem a formação puramente técnica e dialoguem com a realidade. [...] o sujeito reflete não apenas sobre a sua atuação como futuro profissional, mas também acerca do seu papel de cidadão1616. Rios DRS, Caputo MC. Para além da formação tradicional em saúde: experiência de EPS na formação médica. Rev Bras Educ Med. 2019; 43(3):184-95.. (p. 185)

Our view, in the face of these challenges, is in the sense that it is necessary to encourage in EPS a relationship of companionship and fraternity between educators and students, in which the task of learning is a shared journey between human beings with the same characteristic of being contradictory, of having their tastes and cultivate their dreams.

The educator, in any formative process through EPS, needs to exercise his humanity, with all the inconclusion immersed in it. It is undoubtedly an act of courage, because it implies opening up, exposing oneself, but it does not mean withdrawing its role of pedagogical guidance, support, encouragement and incentive. It implies creating spaces for participatory management of the educational space and educational actions. In this perspective, there is a concrete involvement of the educator with the development of the student and his search to “be more”. There is a companionship on the path of this long and hard journey called formation.

In our understanding, this applies to the educational process not only at the academy, but far beyond it, involving health services, contexts of public policy promotion, basic, elementary and secondary education schools, popular social movements, popular groups and community practices.

Still within the scope of the challenge discussed in this item, it is necessary to consider promoting other relationships and new sociability. That is, the EPS formative processes need to emphasize not only the approach of a series of contents, but also the production of new ways of being in the world and with others. Thus, the formative methodologies in EPS cannot be separated from the ethics and aesthetics of the new world to be built.

Therefore, from the point of view of EPS, there is no point in talking about active methodologies within health education without prioritizing an active presence in health services, in the spaces of social movements and practices, and in other social contexts. This is strengthened in Freire1313. Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. 25a ed. São Paulo: Paz e Terra; 1996., when he draws attention, in his work Pedagogia da Autonomia, that teaching requires embodiment by example. The immersion into social work inserted in the concrete world and in its determinations allows the desiring production and constitutes the fundamental basis for any proposal of health education whose interest is in the critical, citizen and emancipatory development.

In that way, we point out that it is not possible to develop formative processes in EPS without a firm, organic and deep articulation of the contents, the teaching and learning experiences with the dynamics of social reality, with the pulsating life in the territories and with the concrete challenges and throbbing questions present in each reality. This can only be understood when felt by the consistent and systematic presence in social works in the context of EPS practices and movements, which includes contributing to the construction of the autonomy of the people who work and intervene in this living territory.

In EPS, learning necessarily involves learning to mobilize the people involved in the processes of doing health, so to effectively create, develop and improve a critical and reflective action on the concrete problems of their respective contexts.

The challenge of fostering network action and articulating the struggle of the movements and EPS practices

In our view, graduating in EPS should be built in a manner linked to the concrete exercise of participation in popular social movements and other forms of social and political organization. As Dantas et al.1717. Dantas ACMTV, Martelli PJL, Albuquerque PC, Sá RMPF. Relatos e reflexões sobre a Atenção Primária à Saúde em assentamentos da Reforma Agrária. Physis. 2019; 29(2):e290211. states, EPS “visa ao resgate da organicidade interna, orientada à prática e vinculada a uma análise mais ampla da questão de saúde por meio do incentivo e da construção da autonomia transformada em luta1717. Dantas ACMTV, Martelli PJL, Albuquerque PC, Sá RMPF. Relatos e reflexões sobre a Atenção Primária à Saúde em assentamentos da Reforma Agrária. Physis. 2019; 29(2):e290211. (p. 7).

Therefore, the present topic is woven from the consideration of the extent to which the formative processes promoted by the EPS movements and the practices are unfolding into individual protagonism. Not only this, but also in the mobilization of people’s participation in these same spaces and in broader contexts, in the perspective of their critical insertion and political performance in the face of social reality and its determinations.

Actively participating in the construction of popular social movements allows people in training to develop, for example, protagonism, as we claimed earlier in this text. Experiencing spaces of articulation and political and social organization, especially by popular social movements, allows, on the one hand, that people get involved in the production of new sociability. These, in turn, are mirrored in other ways of living together, in new perspectives of social relationship, in the valorization of mystique and solidarity, as well as in the development of an organization of life based on the struggles for change of what oppresses and bothers. The insertion in spaces of broader political participation also allows people to extrapolate the dimension of participation-observation, towards a concrete participation-action, through the experimentation of their contributions in various social struggles. That is, overflow the critical and creative action, of individual nature, for a protagonism collectively made; social work committed to a collective desire and necessarily mediated by dialogical communication.

It is in the concrete making of the struggles in popular social movements that the protagonists of the EPS will be able to broaden their views beyond local practices and to perceive the potential of collective construction and organized social action among people with different knowledge, including varied techniques and professions. One learns, for example, interprofessionality and transdisciplinarity through practice and live work in action.

Specifically in the field of EPS, the insertion in the space of national EPS collectives has a rich pedagogical potential for the participating people, expanding their critical capacity and their strategic vision by learning to deal with macro-political situations and the challenge of fighting for EPS as a principle ethics of social, human, cultural and educational relations at the university. In addition, participation in the construction of these collectives gives rise to the experience of the EPS protagonists in the struggle for recognition of this in the Brazilian National Health System (SUS), in the active insertion of their practices and their movements together with health services and policies, especially for the promotion and defense of the National Policy for Popular Education in Health in SUS (PNEPS-SUS).

The trajectory of EPS collectives in the construction, implementation and defense of PNEPS-SUS demonstrates that it is essential to activate, in a permanent and capillarized way, the communication networks between EPS social actors and their struggles. Thus, the learning of EPS protagonists movements and practices may also occur by understanding the senses, meanings and paths of different experiences in different contexts and scenarios. Valuing the participation of people in networks and in articulations of movements and practices implies mobilizing each person to learn from the other, with the initiatives of other regions of the country, and with ventures quite different from their own.

The possibility of dialogue in networks of EPS experiences can be unveiled, for example, both by presenting the process of each person’s EPS construction works, their movements and their practices, as well as listening to the presentations of companions in the field. This way, one learns about methodologies and theoretical perspectives, and the view to the same problems that generated such actions is broadened. It is noticed that the community demands are not assigned to that community where the experience was developed, nor are the problems in focus limited to that city, but they occur in other regions with similar and different forms of struggle and confrontation. Sharing experiences enables the EPS protagonists in the formative processes, to exercise a conjunctural look on social issues, which is done in a procedural way and according to their own time.

Thus, the relevance of encouraging participation in EPS groups in regional and national meetings is perceived, which expands the dimension of sharing experiences. Especially for those actors in the midst of a process of local protagonism, the coexistence with other actors at the regional and national level will allow them to see that social struggles and EPS constitute initiatives in different corners within the country and outside of it.

With this verification, they will be able to give more importance and value to the work locally developed in their communities and at their university. They will realize that EPS is not a distant dream of a few “crazy” people in the context where they study. They discover that there are many other dreams and an immense diversity of other “crazy people” dedicated to making those dreams possible in many other places.

As if that were not enough, in these meetings, the people involved also discover the significant importance of their work for generating innovations and knowledge in health, from the moment they see the dynamism with which people from other regions not only admire their work, but also learn from them and incorporate many of the elements in the construction of their local actions. They then perceive the dimension of knowledge that their experiences carry and the relevance of that knowledge being continuously systematized and disseminated.

Final considerations

Based on the objectives proposed for the reflections in this essay, we can conclude that, when we speak of EPS, we are talking about a practical body that illustrates an ethics of living. However, achieving the harmony between what is done in practice and what is believed to be ideal poses a constant challenge for those who are involved in the EPS experiences.

The constitution of a health action that is affirmed in Popular Education must take place in a dialectical relationship between the practical and the ethical. Insofar as, at a certain point, ideals/ideologies/utopias constitute an ethics that leads certain subjects to undertake actions that seek to achieve a new way of living in society (ethics leading to the constitution of another practice). At the same time, those actions constitute new forms of relationship and sociability1818. Batista MSX. Movimentos sociais e educação: construindo novas sociabilidades e cidadania [Internet]. In: Anais do 8o Congresso Luso-Afro-Brasileiro de Ciências Sociais; 2004; Coimbra, Portugal. Coimbra: Centro de Estudos Sociais da Universidade de Coimbra; 2004 [citado 10 Abr 2020]. Disponível em: https://www.ces.uc.pt/lab2004/pdfs/MAriadoSocorroXavierBatista.pdf
https://www.ces.uc.pt/lab2004/pdfs/MAria...
,1919. Calado AJF. Novos e velhos movimentos sociais populares: quais saberes necessários à construção de uma sociabilidade alternativa? In: Scocuglia AC, Jezine E, organizadores. Educação popular e movimentos sociais. João Pessoa: UFPB; 2006. p. 59-76., reverberating in a new ethics (practice leading to the constitution of another ethics, now universal).

In view of all this, we conclude that, when talking about EPS, we refer to the challenge of bringing another theoretical and epistemological perspective to act in health. A perspective that is able to point out possible paths for other achievements firmly guided in the search for a solidary, humane and environmentally loving rationality.

With EPS, we can also rehearse strong responses against the hegemonic movement of signification of men and women as market values, in which the main concern is their stability, movement and balance of companies. Context in which unparalleled efforts are made to recover from financial crises, while the crisis of human material existence remains in vogue, whether expressed by hunger, economic poverty and misery, or reflected in the daily violence with which the world lives, and mirrored in discrimination and competitiveness; in the construction of an ethically averse idea that inequalities are natural and individual responsibilities.

As a favorable place for critical reflection and production of emancipatory knowledge and technologies, health services could, through EPS, direct their actions and reflections to overcome this situation. This can be attained by rehearsing songs and generating popular movements that respond to the demands of the majority of the world population. Also by recommending, through its actions and interactions, a firm decision that we need to move towards another direction. After all the reflections made throughout these pages, we firmly believe that EPS gives methodological body and ethical/philosophical guidelines for the constitution of other health education, as it sets a path towards the realization of utopias dreamed and shared collectively.

In this sense, we emphasize that EPS is, at the same time, the application of science in an edifying and emancipatory way along with the popular classes, and a path of struggles in motion for the transformation of the Society in which it is inserted. The implementation of educational actions guided by defined ethical principles, with reinforcement to the collective and with concerns aimed at social majorities, will be conducted in order to ensure that alternatives are possible, inhibiting production models that only maintain or strengthen the mechanisms of exclusion. EPS in formative processes necessarily committed to the need to resist and re-exist, in the daily construction of hope and good living, in the weaving of viable-unknown experiences with a new society and a new humanity.

Acknowledgments

To all the people who make up the Thematic Group on Popular Education and Health of the Brazilian Association of Collective Health (Abrasco), for their generosity in the solidary and collaborative formulation of reflections on the field of Popular Education and Health, their paths, challenges and perspectives. We also express our gratitude to the Executive Secretariat and the Abrasco Board for their systematic support for the activities of this Thematic Group over the years.

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  • *
    This present article results from a critical and reflective essay. There was no data collection, nor were human subjects approached, which is why such research was not assessed by Research Ethics Committee.
  • Translator: Thiago Fernandes Dantas

Publication Dates

  • Publication in this collection
    30 Nov 2020
  • Date of issue
    2020

History

  • Received
    12 May 2020
  • Accepted
    23 June 2020
UNESP Botucatu - SP - Brazil
E-mail: intface@fmb.unesp.br