This article focuses on the development of the intervention built within the research of the People’s Health Movement ‘Civil Society Engagement for Health for All’, in a public school in Porto Alegre, southern Brazil. Through this experience, it was aimed at discussing the possibilities and difficulties of the insertion of a social movement in the school environment, together with other actors in the health field, to stimulate social participation. This is an intervention directed at the youth, in the school environment, uniting several segments: school, Family Health Unit, health council, social movement and universities. Referenced on the proposal of the systematization of experiences as a method, the experience is described through the sequence of activities performed, based on the conception Buen Vivir, which cultivates belonging and respect for nature. The revitalization of the school’s abandoned forest was the guiding axis of the set of actions. This experience has shown, on the one hand, the difficulty of stimulating social participation linked to social control and of practicing actions with strong connection between school and health service. On the other hand, it made it possible to attempt non-institutionalized forms of participation, based on the constant exercise of citizenship and solidarity actions.
Social participation; Health promotion; Environmental health; Family Health Strategy
The concept of social participation, forged during the political effervescence characteristic of the 1970s and 1990s in the Country, constitutes one of the structuring elements of the Unified Health System (SUS) and emerges in line with a set of devices that seek to enforce, in practice, the effective participation of society in public policies. In this sense, it refers to the right of citizenship and the exercise of democracy, which, in the words of Escorel and Moreira, consists of,
[...] the exercise of democracy in daily life, which requires permanent reflection on its rules, limits and possibilities. It is, therefore, a learning process that is exercised respecting differences and in the expansion of spaces for coexistence and public debate11 Escorel S, Moreira M. Participação Social. In: Giovanella L, Escorel S, Lobato LVC, et al., organizadoras. Políticas e Sistemas de Saúde no Brasil. Rio de Janeiro: Fiocruz; 2008. p. 979-1010.1007.
In this context, social participation is linked to the democratic perspective that, from the beginning, inspired the construction of Brazilian public health policy. Health and democracy are, therefore, dimensions intrinsic to SUS itself. This was even the theme of the 8th National Health Conference (CNS)22 Brasil. Ministério da Saúde. 8ª Conferência Nacional de Saúde. Relatório final [internet]. Brasília, DF: Ministério da Saúde; 1986. [acesso em 2019 jul 26]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/8_conferencia_nacional_saude_relatorio_final.pdf.
http://bvsms.saude.gov.br/bvs/publicacoe... , in 1986, considered a milestone in the history of the construction of health and SUS conferences.
The association between democracy and health has mobilized Brazilian society in defense of the expansion of the concept of health, elevating it to the condition of right and serving as a guiding idea for the construction of the bases of the social security chapter in the Citizen Constitution of 1988, giving legal materiality for ‘health as a right of all and duty of the State’. Thirty-three years later, in 2019, the 16th National Health Conference, which was called ‘8th + 8’, brought as its central theme ‘Democracy and Health: Health as a Right and Consolidation and Financing of the SUS’, seeking to rescue, update and reaffirm the propositions of the 8th CNS.
The more than three decades that separate the 8th from the 16th CNS point to the need to face old challenges that remain current: the effects of institutionalization, which end up restricting social participation in health to the spaces of councils and conferences, which are formally recognized as social control; little autonomy in relation to the executive power; the numerous issues related to the theme of representativeness, among others. Another challenge to be faced relates to the difficulty of renewing the participants in the instances of social control in health, since they are always the same ones who participate and, in the vast majority, they have been doing it for a long time. Since the 1990s, when conferences and councils gained their legal institutionality, society’s adherence has been made almost exclusively by the same subjects, historical heirs of a militancy that began even in the 1960s, with the basic social and ecclesial movements. The demotivation of young people to participate in these spaces and the lack of expressiveness of actions directed specifically to this population segment also contribute to this.
At the same time that the need for renewal of representations is so clear, questions are asked about the elements that have contributed to this scenario. The lack of ‘community spirit’, increasingly striking today, contributes to the weakening of social ties, as well as to the increase of violence and the consequent retraction in the occupation of public spaces, be they the street, the square, the school or the city in general, ending up making it impossible for the subjects to establish bonds with each other, to get together around a common cause or project. It is worth mentioning an excerpt from Eymard Vasconcelos: “The increase in the consumption of goods, the agitation and alienation, resulting from the system, disperses the wills, fragments the dreams and accommodates”33 Vasconcelos EM. A luta para preservar e construir uma sociedade que permita a todos a realização dos anseios fundamentais do coração. In: Wong Un JÁ, Mano MAM, Vasconcelos EM, et al., organizadores. Estórias da Rua que foi Balsa: Trilhas e intuições na Educação Popular em Saúde. Belo Horizonte: Guayabo Edições; 2016. p. 97-103.99, which summarizes well the context of the need for (re)creation and aggregation of wills, which is so well applied today.
According to Gohn:
Social movements are sources and agencies of knowledge production. The school context is an important space for participation in education. School participation generates political learning for participation in society in general44 Gohn MG. Movimentos sociais na contemporaneidade. Rev. bras. educ. 2011; 16(47):333-363.347.
The author emphasizes, furthermore, that the learning within a social movement is multiple, during and after a specific action, both for the group and for the individual subjects44 Gohn MG. Movimentos sociais na contemporaneidade. Rev. bras. educ. 2011; 16(47):333-363.. In this perspective, the idea arises of reconciling the autonomy and creativity of the social movement with the commitment and solidity of public policy, to work with the motivation of young people to exercise social participation in everyday life.
Thus, the objective of this article is to share the experiences of a research/extension project whose intention was to sensitize and involve youth in spaces for social participation in health and to stimulate the formation of new political subjects from the integration with the actions of the School Health Program (PSE). Starting from a broader question - ‘How can civil society engagement be more effective in achieving health for all?’ - the intention is, through the experience described, to discuss the possibilities and difficulties arising from the insertion of a social movement in the school space, together with other actors in the health field, in order to encourage social participation.
The intervention that will be presented in this article was conceived in the context of an action research of the People’s Health Movement (PHM), a network of organizations and people committed to the realization of the right to health in the world. Its foundation, in the year 2000, took place through the conjunction of popular movements from all over the world, concerned with the distancing of the goal ‘Health for All in the year 2000’, signed at the International Conference on Primary Health Care, in Alma-Ata, in 19785 . The PHM, among other actions, is committed to the production and dissemination of knowledge that contributes to an increasingly effective activism in the search for health for all. As part of this commitment, the research program ‘Civil Society Engagement for Health for All’ was developed.
This program, with the objective of understanding how civil society can be more effective in its work to achieve health for all, in terms of mechanisms, processes and practices, involved six countries on four continents: Brazil, Colombia, Italy, Democratic Republic of the Congo, South Africa and India. Each country, organized around its PHM circle, developed the research locally, according to the characteristics and needs of the context in which it operates. The research was carried out in two phases: the first, exploring and understanding the context of local activism (exploratory dimension); and the second, proposing actions to strengthen health activism (participatory dimension).
In Brazil, three PHM regional circles participated (Maranhão, Southeast and Porto Alegre), each putting the research into practice according to its reality. In Porto Alegre, capital of Rio Grande do Sul, the research aimed at social participation in health as an expression of activism. In the first phase, investigating the context of social control, prior exploration with key actors highlighted the need to raise awareness and involve the young population in spaces for social participation. Thus, the focus of the second phase was defined, which constituted the construction of an intervention in the school space, which will be presented in this article. The intervention place was chosen according to the availability and interest of the people who would be involved, taking into account the relationships built with the research participants in the first phase. The project was initially presented to the team at one of the Family Health Units (FHU), who had expressed a special interest in participating. In conjunction with the FHU team, with the PSE as a base action, a state school in the territory was chosen, based on the assessment that there was an affinity with the authors’ proposal to promote health and citizenship with collaborative activities and that would favor the active participation of the school community.
To develop the intervention, conceptual milestones were aligned with the ideals of the PHM as a whole, especially with the Latin American network of the Movement. The first one is Buen Vivir, or Sumak Kawsay66 Confluencia Nuevo B´aqtun. El Buen Vivir de los Pueblos de Guatemala [internet]. Cidade da Guatemala: Confluencia Nuevo B´aqtun; 2014. [acesso 2019 ago 1]. Disponível em: http://alainet.org/images/Buen%20Vivir%20Guatemala-pdf.pdf.
http://alainet.org/images/Buen%20Vivir%2... , an expression that comes from the ancestral peoples of Latin America, according to which ‘feeling good’ translates as a feeling of belonging and respect for nature, to Mother Earth, and to all life in an ecosystem where the human being is life within life. It is a citizen experience towards nature and, also, a civilizing project or a utopia in permanent recreation. In this conception, the relations between human beings and nature can be of respect and care, contradicting the hegemonic practice of today, marked by utilitarianism, competition and greed.
The concept of permaculture, one of the main axes of the actions developed, is aligned with that of Buen Vivir. Created by Australians Bill Mollison and David Holmgren, in the 1970s, it is a set of knowledge from traditional societies that brings innovative techniques, with the aim of creating a ‘permanent culture’, sustainable, based on cooperation between men and nature. One of the fundamental principles of permaculture is respect for the wisdom of nature, which guides the development of a proper and adequate system for each place77 Mollison B. Permaculture: A Designer's Manual. 2. ed. Tyalgum: Tagari Publications; 1988.,88 Claudio CJ. Conceitos de agroflorestal [internet]. Ipoema Instituto de Permacultura. 2016 dez 23. [acesso em 2019 jul 19]. Disponível em: https://ipoema.org.br/2016/12/23/conceitos-de-agrofloresta/.
https://ipoema.org.br/2016/12/23/conceit... . From the strategy of observing and copying nature, numerous techniques can emerge to plan the sustainability of green spaces, such as the small forest of the school where the work took place.
To subsidize the development of the construction and implementation of the intervention in the school, we chose the proposal for the systematization of experiences, elaborated by Jara99 Jara HO. A sistematização de experiências: prática e teoria para outros mundos possíveis. Brasília, DF: CONTAG; 2012., whose main characteristics are presented in chart 1. All these characteristics could be, in some way, experienced in different moments, considering the possibilities and difficulties imposed by the process, which is summarized in chart 1.
Characteristics of the systematization of experiences according to Jara (2013)
This work was developed with the intention of integrating the actions of the PSE, an intersectoral policy instituted in 2007 by the Ministries of Health and Education1010 Brasil. Decreto nº 6.286, de 05 de dezembro de 2007. Institui o Programa Saúde na Escola - PSE e dá outras providências. Diário Oficial da União. 6 Dez 2007.. The PSE aims at contributing to the comprehensive education of students through actions of promotion, prevention and health care, in order to face the vulnerabilities that compromise the full development of children and young people in the public school system1111 Brasil. Ministério da Saúde, Ministério da Educação. Caderno do gestor do PSE. Brasília, DF: MS; ME; 2015.. PSE actions in schools are carried out by family health teams in the corresponding territory. Thus, from the planning of the intervention, the interface with the Santo Alfredo FHU, located in the health district Partenon, was established. Next, university extension projects were created, involving professors and students from two public universities: State University of Rio Grande do Sul (Uergs) and Federal University of Rio Grande do Sul (UFRGS). Both projects were approved by their respective Extension Chambers (codes: 899, at Uergs; and 36283, at UFRGS).
Next, activities carried out in a process that took place over two and a half years, from September 2016 to December 2018 are presented.
An intervention at school with the school
The school at issue, located in a region of high social vulnerability, covers elementary education, from the first to the ninth year. It has been in operation since 1985, has 260 students and 24 employees. According to data from the 2017 Census, it has eight classrooms, an open sports court, a playground (out of order), bathrooms, kitchen, cafeteria, a room for teachers and management. Its facilities include a large external area, little explored, with a small forest, which the school community calls bush.
The work has been built to the extent that it was opportune to link knowledge and practices on citizenship, human rights, Buen Vivir, permaculture, healthy eating and the promotion of a culture of peace. From there, the connections established could generate reflection on other possible ways of living in the current society, which encourages consumerism and individualism1212 Giugliani C, Rocha CMF, Antunes D, et al. Ação Comunitária pela Saúde em Porto Alegre. Porto Alegre: Rede Unida; 2016..
Conversation rounds with the teachers and the school management began in March 2017. For three months, the possibilities for joint action were debated, considering the diversity of experiences that the presence of a social movement could add to the school space. The ‘Solidarity Day’, held at the school in May of that year, was the first meeting of the research/intervention group with the school community and the Local Health Council (CLS). Activities on that day included a task force for cleaning the yard and video recording of statements by parents, students, staff and teachers about their expectations and desires regarding greater collective participation in caring for the school. Based on that, the path for a first action was outlined: the revitalization of the school forest as a teaching/learning space.
The actions that made up the intervention focused on understanding that human health and the health of the planet are just one. In addition, we reinforced the interdisciplinary approach to knowledge, as well as awareness of the use of medicinal plants, permaculture and composting. Solidarity, cooperation in teamwork and valuing the consumption of healthy foods were elements present in all activities. Chart 2, in chronological order, shows the activities carried out, their objectives and the actors involved. In another publication, a more detailed description of each activity can be found1313 Giugliani C, Flores EMTL, Cesa KT. Saúde e cidadania na escola: experiências inovadoras que promovem o bem viver. Saberes Plurais. 2018; 2(3):33-54..
Activities developed at the school, detailing the period of performance, participants, objectives and actions
In order to implement the forest revitalization actions, a geographer and permaculture expert was added to the team, who brought with him ten years of experience in public schools in the city. The act of rescuing the abandoned green area and transforming the school’s forest into a classroom has provided, in practice, the cultivation and use of medicinal plants, as well as the collective use of a contemplative and interaction space. Thus, contact with the forest was expanded, through diverse experiences, such as workshops of introduction to permaculture and agroforestry, principles of sustainability, cultivation of Unconventional Food Plants (Pancs) and construction of compost heaps (figures 1 and 2). The theater workshops, based on the book ‘Don Quixote and the garbage-breathing Dragon’1414 Cesa KT. Dom lixote e o dragão que cospe lixo. Porto Alegre: Marca Visual; 2016., which addresses sustainability and respect for nature, reinforced the aspects worked in the forest.
Cultivation of spices, herbs and vegetables at school. On the right, one of the compost heaps built by the students and the permaculturist can be observed
Mascot of the project elected in the vote
Reflections and learnings
The experience of developing this intervention at school gave rise to many questions, especially: what calls people to be together today? What other ways of being together have we experienced? What are the threads that connect us to keep on living in community?
Given the above, it can be considered that the participatory process we intend to build has operated as a device for creating wishes and promoting health. The idea of creating wills mentioned here is related to the conditions that made it possible, from the effort of a group of institutions (school, social movement, universities and health services), to open spaces for new productions and learnings within a public school that, like the vast majority in Brazil, suffers the effects of the scrapping of its physical structure, the shortage and devaluation of teachers, and the depreciation in the qualification of the teaching staff.
In the wake of the dismantling of public policies, objectively and subjectively, students, parents, teachers, health workers and the school community as a whole are also affected. In the health-education interface, it is possible to notice that a large part of the demand for care that reaches the health service comes from school spaces. Issues such as violence, drug abuse, the childhood obesity epidemic, among others, point to the importance of joint action by health and education to face these problems. Aware of this dynamic, the intervention sought to boost processes of invention, creation and daring in the relationship with the common space of the school, triggering a participatory process of construction, information, learning and growth. From the experience involving health and education in the space of a public school, the shared belonging around a common was plotting other meanings for what was experienced together.
It was a great surprise to realize, on the first visit, that at the chosen school there was a green area with abundant and alive nature within its walls, but that, being abandoned, it caused contempt and even fear. It was dangerous, perhaps forbidden, to enter the forest. However, what was seen, in the course of the work, was a sanctuary with enormous potential to shelter, in all its diversity, many teachings, entertainment and recovery of ancestral culture. And then there was the possibility of an agroforestry, a green classroom, in short, a magical space for learning and experiences. From there, it was asked: could a cooperative work around nature be a learning device for social participation?
When reflecting on the guiding axis that would base the activities, it was concluded that the concept of Buen Vivir would allow exactly this: a new civilizing paradigm, where nature is not considered as something external or as a threat, but as part of the very dynamics of life and condition of future existence1515 Sbardelotto M. Sumak Kawsay: uma forma alternativa de resistência e mobilização. UHU-Unisinos. 2010; 10(340):5-9.. A counterpoint to the current model of development, where nothing - water, forests, food, life - escapes the circuits of capital.
The starting point was to awaken children’s sensitivity and interest in the nature that surrounds them. There was an investment in the experience of taking the whole school to visit one of the most traditional and recognized community gardens in Porto Alegre, rescuing the ancestral wisdom present in the concept of Buen Vivir. This activity enabled an interdisciplinary approach to knowledge, providing a different perspective on nature, living beings and health, and which, subsequently, allowed teachers to continue working in the classroom on the concepts brought by the experience, such as agroecology, healthy eating, medicinal herbs and other topics related to Buen Vivir.
The next step was to collectively plan the appropriation and belonging of the school community to the proposal that emerged. Thus, the activity of creating a name and a mascot for the project had 43 drawings registered and produced a creative and participatory dynamics, where all students at the school exercised their vote and were actively involved. The name chosen by the students for the project was ‘Our greener world’, and the mascot design was a little bucket with gardening tools (figure 2).
The contact with the forest was expanded through workshops to introduce permaculture and agroforestry, clay sculpturing (figure 3), cultivation of Pancs, composting and construction of compost heaps, Qigong, among others. The rediscovery of such a rich microenvironment in the school space brought enthusiasm to students, teachers and researchers. Many students, for the first time, were able to touch the land. The joy of cultivating, pruning and cleaning the area was demonstrated by the willingness to participate in activities developed within the forest. An invitation was enough for many volunteers to appear to collaborate in a given activity, among the many that were carried out.
Children working with clay and elements of nature
The workshops opened space for the exercise of participation and citizenship, which, in general, are still little experienced in the school environment. However, it is in this space, built together, that the young people’s sense of collective belonging could awaken, paving the way for joy, creativity and protagonism in social participation. Unprecedented experiences were given opportunity, awakening new senses in the subjects involved and nurturing the desire to be together.
The participation to which reference is made when analyzing this process goes far beyond simply being part of a collective activity. Young people, when experiencing a collaborative process, constantly participate in situations in which everyone is encouraged to suggest, give an opinion, contribute. By having an active part and freedom in the activities carried out at school, they realize that their participation is of fundamental importance, but no less important than the participation of the other. They learn that the greater the collective commitment, the better and more rewarding the process as a whole1616 Hansted TC. Teatro, educação e cidadania: estudo em uma escola do Ensino Básico [dissertação]. Campinas: Universidade Estadual de Campinas; 2013. 322 p.. The performance of the theater activity, for example, in addition to promoting cultural expansion and personal improvement, stimulated the exchange of experiences, the exercise of problem-solving, the celebration of diversity and the collaborative spirit among young people, fundamental in a healthy school community.
In a broader sense, the concept of youth can be understood as a unique moment of the life cycle, simultaneously with the specific social and cultural conditions in which the subject is inserted1717 Boghossian CO, Minayo MCS. Revisão Sistemática Sobre Juventude e Participação nos Últimos 10 anos. Saúde Soc. São Paulo. 2009; 18(3):411-423.. Much has been said about the weak engagement of young people in the social and political issues that affect them. Among the factors that may be contributing to this situation, we can consider the inadequacy of traditional practices and spaces and their inability to dialogue with the real needs of this specific group, what calls us to consider other and new forms of communication, organization and mobilization1212 Giugliani C, Rocha CMF, Antunes D, et al. Ação Comunitária pela Saúde em Porto Alegre. Porto Alegre: Rede Unida; 2016.. As holders of rights,
Adolescents and young people have the desire to be heard and the need to be recognized for their abilities. [...] they need to be seen in a concrete way as citizens, capable of positioning themselves at the different levels of daily life in which they are immersed. A large number of young people have an ideal of transforming society into something more human and fairer, but they have no idea how to make it happen, nor do they receive any incentive in this regard1818 Brasil. Ministério da Saúde. Secretaria de Atenção em Saúde. Diretrizes nacionais para a atenção integral à saúde de adolescentes e jovens na promoção, proteção e recuperação da saúde. Brasília, DF: MS; 201052.
In this sense, Boghossian and Minayo1717 Boghossian CO, Minayo MCS. Revisão Sistemática Sobre Juventude e Participação nos Últimos 10 anos. Saúde Soc. São Paulo. 2009; 18(3):411-423. return to the concept forged by the educator and activist in the area of childhood and adolescence, Antonio Carlos G. da Costa. The authors say:
In its conception, protagonism presupposes the creation of spaces and mechanisms for listening and participation of young people in real situations at school, in the community and in social life, with a view to both social transformation and their comprehensive education(17)416 .
The perspective of the protagonism or participation of young people, therefore, consists in promoting with them the development of autonomy, self-esteem, assertiveness and life projects. In addition, youth participation is a powerful strategy for promoting health and preventing violence, drug abuse and sexually transmitted infections/Aids.
Still, based on the characteristics of the systematization of experiences (chart 1)99 Jara HO. A sistematização de experiências: prática e teoria para outros mundos possíveis. Brasília, DF: CONTAG; 2012., it can be said that the work carried out provided an opportunity for a better understanding of the practice, thereby generating openness to new experiences. It also provided an historical reconstruction of all activities carried out, along with a constant reflective exercise on how the processes took place, existing reasons and meanings, consequences and causes, contradictions, coherences and inconsistencies, continuities and ruptures, bonds and absences. By ordering and recovering what happened in our particular experience, we are able to interpret and understand it in a historical and social context that embraces us, plunging into the current political situation which involves social participation. This situation is characterized as a threat to democracy and people’s participation in decision-making spheres. An example is the publication by the Federal Government, in April 2019, of Decree nº 9.759, which extinguishes and limits the performance of councils that provide for the participation of civil society1919 Brasil. Decreto nº 9.759, de 11 de abril de 2019. Extingue e estabelece diretrizes, regras e limitações para colegiados da administração pública federal. Diário Oficial da União. 11 Abr 2019..
The critical reflections provided throughout the process generated learning, from the identification of problems, questions, tensions and contradictions. The filming and records of conversations in the form of a diary, the workshops, the construction of a play performance, the elaboration (still unfinished) of a video, are rich materials that can be used in other experiences. In this sense, there is both the prospect of continuing to work in the same school, as well as developing a new proposal in another public school.
Participants, including students, teachers, school principal, PHM activists, FHU professionals, health counselors, university students and the community in general, they grew up and got stronger with the process, where each one’s contributions were articulated and added up to produce something relevant for all people. This characterizes collective and participatory action. As an example, the construction of compost heaps and the use of the little buckets involved, in addition to students, their families, school staff, among other people, generating knowledge and practice beyond what had been initially planned. We believe in examples like this, where community participation operates as an agent for transformation, where the search for a more supportive and cooperative way of life can trigger change. Seeking to mobilize youth protagonism in the construction and promotion of social participation in health, this intervention was built, inspiring the educational focus of social movements. In addition to being present in the proposed activities, the involvement of PHM activists brought enthusiasm to practice new forms of learning, constituting a multiplying pedagogical effect. In this sense, the experience of university extension comes to the fore, another potent element of this experience:
University extension is the freest space for the creation of new pedagogical practices against hegemonic ones. It is the place for the social movement within the university. The new is not generated only from the reflection of great scholars. On the contrary, it is mainly the result of social movements33 Vasconcelos EM. A luta para preservar e construir uma sociedade que permita a todos a realização dos anseios fundamentais do coração. In: Wong Un JÁ, Mano MAM, Vasconcelos EM, et al., organizadores. Estórias da Rua que foi Balsa: Trilhas e intuições na Educação Popular em Saúde. Belo Horizonte: Guayabo Edições; 2016. p. 97-103.102.
Thus, it is evident the richness of aggregating different ways of producing knowledge from the experiences of different subjects, who, in their diversity, converged on this project, in building knowledge within and for the collective. The school and its community, the university, the health unit, the health council, the social movement, all of these groups and spaces can benefit from what was produced by them. The richness of networking also makes it possible to resize local action in global thinking and articulation. This bridge between local and global finds, in partnership with social movements and universities, a huge power.
According to Gohn44 Gohn MG. Movimentos sociais na contemporaneidade. Rev. bras. educ. 2011; 16(47):333-363., learning from social movements can be of various orders: practical (how to organize, how to participate, how to join, which axes to choose), politics (knowing what your rights are), cultural (knowing which elements build the identity of the group), reflective (about their practices, generator of knowledge) and ethics (based on the experience or observation of the other, centered on values such as the common good, solidarity and sharing), among others. By experiencing the know-how reported here, it was possible to operate directly with these learnings.
However, there were many difficulties faced. In the development of activities, in practice, the PHM and the universities ended up assuming a very central role, since the other groups were not so proactive, and the execution of the actions was dependent on the availability of the former. The desire was for the FHU and the school to become more autonomous for the development of the work, but that did not happen. The overload of FHU professionals, who were unable to leave the unit to participate in school activities, was notable due to the health care demands within the service. This reflects a difficult reality for FHU teams, which compromises their involvement in collective and community activities, including the PSE. In this specific experience, there was receptivity and enthusiasm from the health team, but they were unable to carry out the work planned.
It is also noteworthy that not all the people involved participated in its systematization, which represents an immense challenge in the scenario in which this intervention is inserted. But, precisely, it is also a symptom of the lack of wills and the disaggregation encountered when arriving at school, and that also needs time to become the desired collective protagonism. At the school in question, at the beginning of the work, the examples of participation were reduced to isolated actions by parents of students, usually with the objective of overcoming the lack of infrastructure and economic deficiencies of the school. However, the concept proposed in the school-community relationship broadened the spectrum of subjects in action, as it presupposed the involvement of parents, teachers, managers, employees, representatives of neighborhood associations and social movements. However, this involvement still proved to be incipient and very dependent on the presence of the PHM and universities. Furthermore, the school context, characterized by long inactive periods - vacations, strikes - and change of the administration, in addition to the aforementioned scrapping, did not favor the subjects’ involvement in a more perennial way.
With regard to social participation, in this experience, the connection between the school and the institutionalized spaces of social participation did not happen, which led to the reflection on other forms of participation arising from the protagonism of the subjects involved in the collective actions of everyday life, and from the experimentation of non-institutionalized forms of participation based on the constant exercise of citizenship and solidarity actions. In this sense, the insertion of the social movement in the school has opened space for creativity, has presented new airs and possibilities, expanding the understanding of the concepts of health and participation.
The set of actions carried out within the scope of the PHM research ‘Civil Society Engagement for Health for All’ at a public school in Porto Alegre has demonstrated that the school can be a significant place for exercising and encouraging social participation, through collective activities that provided solidary experiences and the exercise of citizenship. Still, based on this experience, it was observed that social participation is a way of acting that is learned/experienced in different areas of life and that requires time to be cultivated. The challenge of fostering processes of citizenship, participation and democracy capable of educating active citizens does not arise overnight, but involves, as in working with nature, a time of planting and harvesting, which requires dedication, effort and collective care.
Finally, the idea arises that social participation fits into the concept of health connected with the conceptions of Buen Vivir. Thus, it is possible to understand participation from collective actions in daily life, giving greater emphasis to the exercise of permanent citizenship, detaching it exclusively from instances of social control, a space still very marked by institutionalized ways of acting. We believe that, through actions in the school’s micro space, it is possible to germinate the political performance of young people regardless of the spaces they may occupy in society.
- Financial support: non-existent
- 1Escorel S, Moreira M. Participação Social. In: Giovanella L, Escorel S, Lobato LVC, et al., organizadoras. Políticas e Sistemas de Saúde no Brasil. Rio de Janeiro: Fiocruz; 2008. p. 979-1010.
- 2Brasil. Ministério da Saúde. 8ª Conferência Nacional de Saúde. Relatório final [internet]. Brasília, DF: Ministério da Saúde; 1986. [acesso em 2019 jul 26]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/8_conferencia_nacional_saude_relatorio_final.pdf
- 3Vasconcelos EM. A luta para preservar e construir uma sociedade que permita a todos a realização dos anseios fundamentais do coração. In: Wong Un JÁ, Mano MAM, Vasconcelos EM, et al., organizadores. Estórias da Rua que foi Balsa: Trilhas e intuições na Educação Popular em Saúde. Belo Horizonte: Guayabo Edições; 2016. p. 97-103.
- 4Gohn MG. Movimentos sociais na contemporaneidade. Rev. bras. educ. 2011; 16(47):333-363.
- 5World Health Organization; Fundo das Nações Unidas para a Infância. Declaration of Alma Ata: International Conference on Primary Health Care. Alma Ata; Kazakhstan: WHO; UNICEF; 1978.
- 6Confluencia Nuevo B´aqtun. El Buen Vivir de los Pueblos de Guatemala [internet]. Cidade da Guatemala: Confluencia Nuevo B´aqtun; 2014. [acesso 2019 ago 1]. Disponível em: http://alainet.org/images/Buen%20Vivir%20Guatemala-pdf.pdf
- 7Mollison B. Permaculture: A Designer's Manual. 2. ed. Tyalgum: Tagari Publications; 1988.
- 8Claudio CJ. Conceitos de agroflorestal [internet]. Ipoema Instituto de Permacultura. 2016 dez 23. [acesso em 2019 jul 19]. Disponível em: https://ipoema.org.br/2016/12/23/conceitos-de-agrofloresta/
- 9Jara HO. A sistematização de experiências: prática e teoria para outros mundos possíveis. Brasília, DF: CONTAG; 2012.
- 10Brasil. Decreto nº 6.286, de 05 de dezembro de 2007. Institui o Programa Saúde na Escola - PSE e dá outras providências. Diário Oficial da União. 6 Dez 2007.
- 11Brasil. Ministério da Saúde, Ministério da Educação. Caderno do gestor do PSE. Brasília, DF: MS; ME; 2015.
- 12Giugliani C, Rocha CMF, Antunes D, et al. Ação Comunitária pela Saúde em Porto Alegre. Porto Alegre: Rede Unida; 2016.
- 13Giugliani C, Flores EMTL, Cesa KT. Saúde e cidadania na escola: experiências inovadoras que promovem o bem viver. Saberes Plurais. 2018; 2(3):33-54.
- 14Cesa KT. Dom lixote e o dragão que cospe lixo. Porto Alegre: Marca Visual; 2016.
- 15Sbardelotto M. Sumak Kawsay: uma forma alternativa de resistência e mobilização. UHU-Unisinos. 2010; 10(340):5-9.
- 16Hansted TC. Teatro, educação e cidadania: estudo em uma escola do Ensino Básico [dissertação]. Campinas: Universidade Estadual de Campinas; 2013. 322 p.
- 17Boghossian CO, Minayo MCS. Revisão Sistemática Sobre Juventude e Participação nos Últimos 10 anos. Saúde Soc. São Paulo. 2009; 18(3):411-423.
- 18Brasil. Ministério da Saúde. Secretaria de Atenção em Saúde. Diretrizes nacionais para a atenção integral à saúde de adolescentes e jovens na promoção, proteção e recuperação da saúde. Brasília, DF: MS; 2010
- 19Brasil. Decreto nº 9.759, de 11 de abril de 2019. Extingue e estabelece diretrizes, regras e limitações para colegiados da administração pública federal. Diário Oficial da União. 11 Abr 2019.
- 20Centro de Estudos e Promoção da Agricultura de Grupo. O passo a passo de uma revolução - compostagem e agricultura urbana na gestão comunitária de resíduos orgânicos. Florianópolis: CEPAGRO; 2016.
- Publication in this collection
17 Aug 2020
- Date of issue
03 Aug 2019
29 Nov 2019