Série SUS Episode 2 Why is the SUS like this? The idea of the SUS is not new: it has been maturing since at least the 70's. Before the creation of the SUS Brazilian people was unsatisfied with the situation of the Health in the country and they started to get organised in their villages, churches, terreiros, social movements and student movements.
During the dictatorship period the quality of the public health care services, which was not good, started to decrease. The medical care was almost entirely made in private hospitals, there was almost no preventive care, but there was a lot of misuse of public funds and corruption. The Brazilian Military Government created the National Institute of Social Welfare, known as INPS [Portuguese abbreviation], which would provide medical care only for the people that contributed to the Social Welfare, i.
e formally employed people. All the other people, if they did not have money, would not have medical care. Informal employees, unemployeds, street vendors, rural workers; None of these people had rights to the public health care services.
The Brazilians were not happy at all with the medical care they were given in the decades of 60, 70 and 80, and they wanted something new, an egalitarian service for all, and a new movement arose to discuss these ideas. This movement was known by the name of The Brazilian Sanitarian Movement, which had strong public participation. These ideas that were arising in Brazil were summed up to the ideas discussed globally by the WHO and the Alma-Ata Conference, which, amongst other things, had the slogan of "Health for all by the year 2000".
All that the Sanitarian Movement could think and do was taken to a historical conference: The 8th National Conference of Health. All of this happened in 1986, and it was when the principles of SUS got defined, those of which, in 1988, were incorporated to the Federal Constitution, and it was written in the maximum law of Brazil that health care is everyone's right and a duty of the State. Thus, in 1990, with the Laws 8080 and 8142, the functioning basis of the SUS are created, which amongst their principles defined how the public participation and the social control should take place.
The SUS is a conquer of the Brazilian people. Before it, the health was thought as "not being sick". Now it is known that to have health it is necessary to have a functioning society; health means having a house, a job, income, freedom of speech, leisure and other rights.
Today the SUS does not focus only in the diagnosis and cure, but also in the health promotion and disease prevention. However, the SUS is not ready. It needs to be perfected in a daily basis.
And then, if we got back in time a little, in 1991, it was created the program of the Community Agents of Health, also known as ACS. The Community Agents of Health are people from the community itself that participate in the health care process. They are responsible for connecting the public health services and the community, and help to gather together the many cultural universes with the vision of the health professionals.
The ACS makes the registration of the families and discovers more easily who are the people in a risky situation, the number of kids, of pregnant women, of people with dengue or with high blood pressure and other factors. This helps to plan the actions in the health and to focus in the areas that need more attention. In Brazil, actually, there are more than 200 thousand Community Agents of Health who daily contribute to the improvement of the quality of life of people.
In the same year of the creation of the community agents, it was also created the network of basic attention in health, the famous "Postos de Saúde", also known as Basic Health Units, and today they are called Traditional Health Units. At first, they had specialist doctors in Gynecology, Paediatrics and General Practice. But today these units are outdated and are being replaced by the Units of Family Health, also known as USF's, which represents a new way of dealing with health, taking part in the primary attention to health.
The strategy of Family Health shows in its name the importance of dealing with the family, and not to see the individual as a heart, or liver or other body parts. The idea is to understand the person as a whole, his/her family, community, and social and economic contexts. The teams of the Family Health strategy are composed by professionals preferably with specialisation in public health and/or family health.
The basic team has a Nurse, a Family Doctor and a Dentist, as well as Nursing Technician, Dentist Auxiliar, ACS and it can have other support professionals as well. They must accompany all the people from the family from babies, kids, women, pregnant women, men, elderly people to people with special needs. Besides these professionals, there can be other support professionals, generally linked to the Core of Support of Family Health, with Nutritionist, Psychologist, Physical Education Professional and others.
And it is your right to have access to good professionals that take care of you, your family and community. And this is the reason that makes important to know the history of our SUS and where we are now.