A saúde no Campo: das políticas oficiais à experiência do MST e de famílias "bóias frias" em Unaí, Minas Gerais - 2005

Abstract

The present paper characterizes the official health policies for the rural population in Brazil, by comparing the historical context, principles, objectives, strategies and their results. The concrete elements that enabled the implementation of those policies were investigated, as well as how the experience of settled and squatting MST and temporary rural workers families (bóias-frias) can contribute to assess this process. The documental analyses of the official policies (1960 to 2005) and of the MST experience (1998 to 2005) were performed. A discussion group with the MSTs National Health Sector contributed with new elements to characterize that experience. A comparative study was conducted in three communities by means of a survey applied to 202 families, structured observation and group discussions. Historically, rural health policies in Brazil have been associated with economic interests aiming to ensure healthy labor to exploit natural resources. Even so, the greatest advances in these policies occurred in historical periods in which rural workers were better organized. The States response to these pressures could beperceived as strategies of legitimization before society and cooptation of social movements. Through the discriminating factor analysis, the three communities produced an average of 89% correct classification, reinforcing the hypothesis that they were different from each other. Thetemporary rural workers showed a high level of food insecurity (39.5%), almost double that of the squatting MST families and four times that of the settled MST families. With a varying and low income, they are also more exposed to pesticides (85.2%) if compared to the settled andsquatted families (26.9% and 9.5%, respectively). The livestock production of all the settled families was a remarkable characteristic, unlike the families of temporary rural workers who virtually could not count on that possibility in the cities and towns. The public health service(SUS) has not met the health needs of almost 70% of the families settled and squatted that were studied in Unaí, MG, with lack of access appearing as a major issue. For most of these families, the only way for the system to meet their needs is after petitions and pressure on thegovernment. In the notion of health presented by the MST, intersectoriality and equity are key principles, thus expressing a broad concept associated with a project of transformation of the Brazilian society. Their action is different in its organizational process and in principles thatrescue the politization of health, valuing popular promotion and participation. The MST has put pressure on the State in the process of designing and executing public policies and has beeninstrumental in the creation of the Grupo da Terra (Earth Group) and in the changes in the calculation of the Piso de Atenção Básica PAB (Minimum Basic Assistance), which benefits the settled population. The agenda of social movements like the MST has required that theMinistry of Health take measures to build a policy for the rural population which has never been so participatory. This policy may provide an opportunity for a new SUS cycle, towards a fairerand more democratic society.