Homicídios de jovens na cidade de Fortaleza: práticas institucionais no cotidiano da estratégia saúde da família

Abstract

This intervention-research brings as it’s field of problematization the production of institutional practices in the daily life of workers of the Family Health Strategy (Estratégia de Saúde da Família - ESF) related to the issue of homicides of young people in the city of Fortaleza. Urban violence involving young people, especially homicides against this portion of society, is one of the main ethical-political challenges in the Brazilian scenario. The city of Fortaleza presents the highest rate of homicide in adolescence (IHA) among Brazilian capitals. In addition, 2017 was the most violent year of the city’s history, the highest point of a spiral of violence that began in 2006. Given this scenario, the general objective of this study was to analyze discursive and non - discursive institutional practices produced in the daily life of ESF teams around the problem of youth homicide in Fortaleza. The specific objectives were: 1) to problematize the relationship of ESF professionals with youth segments in their territories of action and the implications of intensifying lethal violence in their daily lives; 2) to map discursive practices in the daily life of ESF professionals about the conditions of youth homicide ocurrence in the outskirts of Fortaleza; and 3) to potentialize collective and intersectoral spaces involving ESF professionals, aimed at problematizing the issue of youth homicide and and the institutional practices that are currently being used to deal with this issue. The work sought the articulation of Social Psychology studies with the studies of Foucault, Deleuze, Guattari, Agamben, Mbembe, and related productions, regarding the theme of violence and youth, establishing cartography as a method of intervention-research. The participants were professionals involved in the ESF teams of the Basic Health Unit Lineu Jucá, in the neighborhood of Barra do Ceará - Fortaleza / CE, a place with high youth homicide rates. The methodological tools chosen were: a) observation and conversation in daily life, with production of field diary; b) discussion groups; c) semi-structured interviews and, in addition, tables and graphs as data. As for the first specific objective, we follow the challenge of taking violence as an object of action-reflection-action by the professionals, understanding it as a determinant factor in health, demanding, then, community and intersectoral actions. We are also faced with the following repercussions: violence as an aggravation, especially in the field of community mental health; violence as a barrier of access for youth victims of lethal violence and violence taken as a risk to health professionals, producing difficulties in working with / in the territory. In relation to the second specific objective, we are faced with a complex network of know-power-subjectivation around the youths that are exterminated daily. According to the professionals' view, death in youth, as a result of territorial conflicts, would become an inexorable destination for most young people. The "implicate" notion as the main justification for these deaths is thus recurrent, ignoring the complex and perverse symbolic production around certain black and poor youths, undermined by mechanisms of criminalization, silencing and exclusion. Finally, in seeking the last specific objective, we tried, with the ESF teams in Barra do Ceará, strategies of prevention and coping with homicide among young people. It is important to stress homicide as an action-reflection-action object; the promotion of access as a prevention strategy and the politicization and collectivization of the homicide problem. The ethical-aesthetic-political paradigm on the group process, approached by Barros (2007), from the group activities, allows us to understand such activities as devices of problematization, deindividuation and experimentation in the territories of Barra do Ceará. This study is expected to contribute to the strengthening of health policies and practices that address lethal violence against young people in urban contexts.