Inaugurada nova Unidade Fluvial de Saúde da Família pelo Ministro Alexandre Padilha
20 de outubro de 2011 por Fábio Pena
No último dia 14/10, aconteceu no terminal turístico na Orla de Santarém, a inauguração da 2a Unidade Fluvial de Saúde da Família que funcionará à bordo do catamarã Abaré II, construído pelo Projeto Saúde & Alegria (PSA) com financiamento do Banco Nacional de Desenvolvimento Econômico e Social – BNDES. O serviço vai atender 42 comunidades ribeirinhas do rio Arapiuns com a atenção básica de saúde. A Unidade foi entregue à comunidade santarena em cerimônia que contou com a presença de representantes do PSA, das comunidades, da Prefeita de Santarém, Maria do Carmo, do Ministro da Saúde, Alexandre Padilha, entre outras autoridades.
O lançamento desta 2a Unidade Fluvial de Saúde da Família na região é resultado da iniciativa exitosa desenvolvida pelo Projeto Saúde & Alegria e as Prefeituras de Santarém e Belterra no atendimento à saúde das populações ribeirinhas do rio Tapajós por meio do Barco ABARÉ, com apoio da Fundação Terre des Hommes. Após alguns anos de experiência, se tornou a primeira Unidade beneficiada pela Portaria 2.191 de três de agosto de 2010, inspirada também no próprio Abaré, que instituiu critérios diferenciados de implantação, financiamento e manutenção da Estratégia Saúde da Família Fluvial, visando beneficiar as populações ribeirinhas da Amazônia Legal e Mato Grosso do Sul.
Na cerimônia, a Prefeita Maria do Carmo, afirmou que foi graças à parceria com o PSA, que este modelo deu certo. “O Saúde e Alegria não é só um parceiro, foi o verdadeiro idealizador e entusiasta que construiu juntamente conosco esse projeto. Decidiram batalhar por um recurso para tornar realidade o Abaré I, que veio e mostrou ser possível levar saúde de qualidade aos ribeirinhos. É um exemplo de política comunitária. Não fomos nós que ousamos com esta proposta, foi uma ONG que não tem ninguém do governo, mas que conseguiu com que o Governo Federal ouvisse, e transformasse essa experiência em politica pública. É uma política pública criada aqui no Tapajós, que agora o Brasil está vendo se transformar em política nacional”.
O Ministro da Saúde, Alexandre Padilha, acompanhou a trajetória da experiência ainda como médico na época em que trabalhava em Santarém. “Muita gente achava que o os irmãos Caetano e Eugênio Scannavino eram loucos quando saiam com um projeto debaixo do braço, com a idéia de que era possível e necessário um barco que levasse atendimento em saúde para as comunidades ribeirinhas, além da necessidade de ter implantação de pedras sanitárias, formação de agentes comunitários e lideranças, conselhos locais de saúde”, lembrou o Ministro.
A idéia deu certo e avançou com o funcionamento do Abaré desde 2006, atendendo 70 comunidades do rio Tapajós, beneficiando mais de 15 mil pessoas que hoje têm acesso regular aos serviços básicos de saúde. Porém, até 2010, o serviço era sustentado basicamente com recursos captados pelo Projeto Saúde & Alegria junto à cooperação internacional e não tinha garantias efetivas de continuidade.
O Ministro Alexandre Padilha, afirmou que “lá atrás, no inicio, comentava que o projeto só seria sustentável se pudéssemos convencer os governantes locais, os gestores, comprometendo o conjunto do SUS para que se tornasse uma política pública de verdade”.
É o mesmo pensamento que tem o coordenador do Projeto Saúde & Alegria, Caetano Scannavino. “O papel de uma organização não-governamental como nós não é substituir a função do governo, mas sim somar esforços para construir soluções que melhorarem a vida das pessoas mais necessitadas e sejam ao mesmo tempo referências replicáveis como políticas públicas, o que dá uma nova escala ao trabalho. Com a Portaria, o que se semeou no Tapajós poderá gerar benefícios para toda Amazônia e Pantanal. E o primeiro exemplo disso já é Abaré II na região do Arapiuns”. A outra diferença é que a politica pública é perene, e os projetos de ONGs tem inicio, meio e fim, dependem de recursos, nem sempre assegurados”.
Por meio da Portaria da Saúde Fluvial, desde janeiro de 2011, a Prefeitura de Santarém passou a receber diretamente os recursos do Governo Federal para sustentar a logística e pagar as equipes que atuam à bordo do Abaré I, assumindo a responsabilidade plena do serviço de atendimento da população. O Projeto Saúde e Alegria continuou como parceiro no desenvolvimento das ações educativas e no controle social. É o que vai acontecer com a nova unidade, o catamarã Abaré II.
“O que estamos fazendo hoje, não é apenas inaugurando mais um barco, mas escolhemos Santarém, para reforçar o Programa Nacional de Unidades Básicas de Saúde Fluviais lançado ano passado. Entendemos que todos brasileiros que moram nas comunidades ribeirinhas da Amazônia e Pantanal, merecem ter o mesmo tratamento de qualquer outro brasileiro. Experiências como a do Abaré nos influenciam numa decisão muito clara do Governo da Presidenta Dilma, de escolher a atenção básica, a partir da comunidade, perto de onde as pessoas vivem, numa grande prioridade da saúde em nosso país. Por isso, lançamos o programa com 40 unidades, e já temos mais 60 propostas recebidas, e vamos chegar a 100 unidades fluviais até 2014”, explicou Alexandre Padilha.
O lançamento do programa é uma resposta importante à uma das maiores maiores reivindicações das populações que vivem em regiões de floresta e ribeirinhas, onde doenças simples, de origem primária, tornam-se graves devido à falta de intervenção efetiva e adequada. Na região Norte, apesar dos avanços, a implementação do Sistema Único de Saúde – SUS ainda é um grande desafio, sobretudo nas zonas rurais. Com municípios do tamanho de países, longas distancias, populações dispersas de difícil acesso, baixo investimento em saneamento, dificuldades de transporte e de comunicação, a rede pública tem alcance insuficiente, agravado também pelos altos custos logísticos para interiorização das equipes de saúde sem que houvesse mecanismos de financiamento público compensatórios e apropriados ao contexto amazônico. “Trata-se de um importante aprimoramento do SUS que ainda tem muitos desafios, principalmente pelas desigualdades sociais e geográficas do país. Mas o desenvolvimento de uma experiência como essa comprova que é possível aprimorar o sistema para que ele chegue efetivamente na ponta, para quem mais precisa”, comenta o médico Fábio Tozzi, um dos coordenadores do projeto.
A 2a Unidade Fluvial de Saúde de Santarém possui estrutura física com pronto atendimento, farmácia, consultório médico, sala de Coleta de PCCU/sala de enfermagem, gabinete odontológico, laboratório, sala de vacina, área de espera, banheiros para usuários e servidores, camarotes masculino e feminino, refeitório, espaço para redes, copa e depósito de materiais.
Após a inauguração, uma equipe composta por 15 servidores da SEMSA (médico, enfermeiros, odontólogo, TSB, técnicos de Enfermagem, técnico de laboratório, Agentes Comunitários de Saúde, Agentes de Endemias e tripulação), já partiu para para a região da RESEX/Arapiuns, para realizar assistência em 42 comunidades até o dia 21 de outubro, ofertados os serviços de consulta médica, consulta de enfermagem, atendimentos odontológicos, imunização, coleta de PCCU, atendimento dos grupos de HIPERDIA, pré-natal, exames laboratoriais, educação em saúde e todos os programas preconizados pelo ministério da Saúde.
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