CASO ABARÉ: audiência mediada pelo Ministério Público dá esperança para saúde dos ribeirinhos do tapajós
13 de junho de 2013 por Fábio Pena
Preocupado com a situação dos ribeirinhos do Tapajós, o Ministério Publico Estadual – MPE – vem acompanhando de perto o Caso Abaré, buscando esclarecimentos, agendando reuniões, convocando audiências, entre outras medidas que possam contribuir na busca de soluções para o impasse.
O promotor Túlio Chaves Novaes é quem está na linha de frente do processo. No mês passado, convocou uma primeira reunião com a atual Secretária de Saúde de Santarém, Dra. Valdenira Cunha, para esclarecimentos preliminares. Já nesta manhã do último dia 11 de junho, a audiência foi mais ampla. Além da atual titular da pasta de Saúde de Santarém, participaram também os representantes dos dois outros Municípios da área de abrangência do Abaré, como a Prefeita de Belterra, Sra. Dilma Serrão, e o Secretário Municipal de Saúde de Aveiro, Dr. Marco Aurélio Xavier. A reunião contou ainda com representantes da Secretaria Estadual de Saúde (SESPA) e de outras Instituições como o Projeto Saúde e Alegria (PSA), a Ordem dos Advogados do Brasil (OAB/Stm), além dos assessores técnicos e jurídicos dos Municípios.
Os principais assuntos giraram em torno do cumprimento da Portaria 2.191 do Ministério da Saúde para região do Tapajós, que credenciou o Abaré I em dezembro de 2010 como a primeira Unidade de Saúde da Família Fluvial para atender as duas margens do rio, zonas rurais dos três municípios: Santarém (proponente da Portaria), Belterra e Aveiro, sendo que os ribeirinhos destes dois últimos se encontram sem atendimentos desde o ano passado, foco de insatisfação dos gestores presentes. O outro assunto tratado foi sobre a perspectiva aberta pelo Ministério da Saúde para aquisição em definitivo do Abaré – ainda de propriedade da ONG holandesa Terre Des Hommes, o que gera insegurança na continuidade dos serviços no médio-longo prazos.
Túlio Novaes informou que “a atuação do MPE nesse caso não se resume às reuniões, mas que o Órgão está mergulhado na busca de uma solução para esse problema. O MPE está colocando em prática várias ações visando contribuir nessa discussão da permanência da embarcação em Santarém, e do atendimento eficiente às populações ribeirinhas da região”.
Na audiência, os representantes das organizações presentes puderam apresentar seus posicionamentos e documentações para fundamentar o MPE na condução desse processo de mediação. A Prefeita de Belterra, Dilma Serrão, comentou que “cerca de 740 famílias ribeirinhas da margem direita do Tapajós dependem do atendimento prestado pelo Abaré e que no período que deixou de fazer a assistência àquela população, a situação de saúde ficou precária”.
O mesmo tem acontecido com os ribeirinhos de Aveiro, segundo Marco Aurélio Xavier, Secretário de Saúde daquele município. “Sem o Abaré, nós não temos condições de oferecer um atendimento adequado para a população. As comunidades estão nos cobrando, com razão, uma solução para a volta do Abaré ao nosso município”.
Desde que assumiu a atual gestão de Santarém em 2013, os serviços prestados à bordo do Abaré I vem enfrentando dificuldades. A Secretária de Saúde, Valdenira da Cunha, argumenta que “em nenhum momento a SEMSA aventou a possibilidade de ficar sem o atendimento do Abaré I. Desde janeiro, não estamos medindo esforços na manutenção do serviço. Não tem nenhuma possibilidade de ficarmos sem essa embarcação na nossa região ribeirinha”. Porém, a própria secretária informou que desde o começo do ano apenas duas viagens foram realizadas. “O atendimento da população ribeirinha está sendo feito. Houve uma viagem em maio, está tendo outra viagem agora, saindo dia 3 com previsão de retornar dia 13, fazendo toda a Resex” [zona rural de Santarém].
Na audiência, a Dra. Valdenira confirmou o acordo de aluguel do Abaré com validade de um ano [2013] com a organização TDH, como uma forma de assegurar a embarcação no Município, e que os holandeses não estavam cobrando os pagamentos. Confirmou também que o Abaré estava atendendo somente as comunidades de Santarém, pois legalmente a Prefeitura não podia realizar gastos com os demais municípios. No entanto, foi informada pelo Dr. Fábio Tozzi, que acompanhou todo o processo de construção da política pública ainda como coordenador de Saúde do PSA, que já havia instrumento legal estabelecido desde 2010 junto à CIB [Comissão Intergestores Bipartite], que ampara legalmente o arranjo intermunicipal, caso contrário o Ministério da Saúde não estaria repassando mensalmente as verbas federais há mais de dois anos para Santarém, que por ser o Município-polo é o responsável em administrar os recursos recebidos. E que na ocasião foi inclusive assinado um Termo de Cooperação entre os parceiros que define a responsabilidade de cada um.
Caetano Scannavino, coordenador do PSA, fez críticas não ao acordo em si com os holandeses, mas à forma com que ele se deu, pois teria sido mais prudente se Santarém tivesse se municiado antes das informações e documentações, conversado com Belterra e Aveiro, além do Ministério da Saúde tendo em vista as boas perspectivas oferecidas por Brasília. “Sabemos das dificuldades de inicio de mandato, mas teríamos evitado todo este desgaste, o risco de bloqueio das verbas federais, assim como a interrupção dos atendimentos junto a esses 5 mil ribeirinhos da margem direita do Tapajós se o acordo estivesse em conformidade com a Portaria Ministerial do Tapajós. Mas antes tarde do que nunca, passado quase meio ano, temos que reconhecer alguns avanços no últimos dias e agora é pensar para frente”.
Para isso, um dos encaminhamentos da audiência foi o resgate dessa documentação comprobatória – sobretudo a resolução da CIB – e ao mesmo tempo, o restabelecimento do diálogo entre os três municípios para a repactuação de suas responsabilidades. A Prefeita de Belterra, por exemplo, confirmou o interesse e manter a parceria com Santarém. “Mesmo que nós não tenhamos sido informados sobre o porquê da paralisação dos atendimentos do Abaré em Belterra, nós viemos aqui manifestar nosso interesse no diálogo para continuidade desse serviço, que é fundamental pra nossa população”.
“Estamos verificando de que maneira, pactuando via CIB, o Abaré possa estar prestando serviço a esses dois municípios [Belterra e Aveiro], com cada um com sua responsabilidade fiscal e jurídica, cada um em sua área de atuação”, informou a Dra. Valdenira Cunha.
Quanto à propriedade do barco, visando garantir sua permanência como patrimônio municipal, após as recomendações do Conselho Municipal de Saúde, bem como das manifestações públicas do Ministério da Saúde sobre o interesse na compra da embarcação, houve um importante progresso que foi a retomada do diálogo entre Santarém e Brasília sobre o tema. “Nós estivemos dia 6 de junho no Ministério da Saúde para avaliar a possibilidade de compra ou manutenção da parceria com Fundação Terre Des Hommes. O Ministério vai entrar em contato diretamente com eles para verificar a isso. Havendo interesse, o Ministério tem o recurso para comprar o Abaré e continuarmos prestando o serviço à população ribeirinha”, disse Valdenira.
Para o promotor Túlio Chaves Novaes, “as reuniões tem caminhado muito bem, estamos conseguindo estabelecer um diálogo entre todos os atores envolvidos, os interessados, e eu penso que quem tem a ganhar com isso realmente é a população que é a ponta dessa cadeia toda. O enfoque não é só a garantia do atendimento em saúde aos ribeirinhos, mas também o aprimoramento desse serviço. Que possamos ter uma medicina de ponta prestada na região amazônica para a população carente”.
O coordenador do PSA disse que saiu satisfeito da reunião. “Fico feliz porque instituições como o Ministério Público funcionam nesse país, e esta audiência deu um sinal de esperança. Sabemos que ainda tem muita coisa para acontecer, é importante que as comunidades se mantenham mobilizadas, mas estamos mais otimistas para que o Abaré possa guinar novamente para a saúde ribeirinha nas duas margens do rio Tapajós. Esperamos o restabelecimento imediato dos atendimentos na Flona Tapajós [margem direita] e o início das tratativas junto ao Ministério da Saúde para a aquisição em definitivo do Abaré para que este permaneça na região à serviço dos ribeirinhos, que ajudaram na construção desse modelo, que merecem e tem direito à saúde como qualquer outro brasileiro”.
Outra audiência está agendada para o dia 16 de julho. Até lá, espera-se que os encaminhamentos tomados surtam efeitos positivos para sacramentar o modelo de Saúde da Família Fluvial do Tapajós, por meio do Abaré, não só no atendimento das populações locais, mas também como inspiração para as demais Unidades que estão começando a ser construídas por toda a Amazônia.
Atualização:
Ainda na tarde do dia 11, como previsto na ata da reunião de forma de agilizar a retomada dos atendimentos nas duas margens dos rios, o Projeto Saúde e Alegria encaminhou ao MPE a Resolução 214 da CIB que aprova a parceria intermunicipal entre Santarém, Belterra e Aveiro, datada de 29 de novembro de 2010.
junho 13th, 2013 at 8:55 pm
Fico feliz por ler boas notícias. Até então só surgiam informações desanimadoras. Acho que diferenças políticas não justificam esta falta de ação dos responsáveis no município. Continuo na torcida.
outubro 20th, 2013 at 10:18 pm
[…] Audiência pública sobre o Abaré 1 […]
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