Encontros no lugar e o lugar dos encontros: acontecimentos no ambiente e saúde com a política de desenvolvimento regional no Médio Tapajós - PA

Abstract

The main objective of this study was to analyze the regional development policy in the health-environment relation in the Amazon region. We use the theoretical references that deal with regional development, place, socio-environmental transformations and public health policies for the understanding of the self-organization mechanisms of strategies for health promotion. The Integrated Single Case Study model was adopted, with two units of analysis, the Miritituba District and the Public Health Policy in the city of Itaituba in the State of Pará, based on the ecosystem approach in human health. We also use the principles of political ecology to better understand the health-environment interrelationship. The research methodology relied on different techniques, such as interviews with the people involved in the site, direct observations on the daily environment of the place and documentary analysis on health policy. Field research was carried out from March 2017 to August 2018, in four trips to the place. The results show that the recent planning for the Tapajós region has similarities to the planning of the 1970s and 1980s, except when it comes to the political decentralization of planning. In the District of Miritituba, accelerated rhythms have historically coexisted with globally interconnected economic processes, and slow rhythms that mark the conduct of life, characterized by limited infrastructure and structure and the absence of state in the development of the place. The transformative forces increase the impacts in the social and environmental dimension, with the road-borne activity that has generated risk in the daily environment and exposes the people to adverse conditions, involving the restriction of fishing activity, traffic insecurity with the flow of bulk trucks and the quality of the air compromised with the intense dust in the Transportuary way. It was verified that the transformations in the daily life and in the health were not significant with the insertion of the fluvial activity. Likewise, there was no investment by the municipal management to promote the quality of the environment, nor was there any planning for investment in environmental monitoring of the municipality for the period 2018-2021. The health services network maintains and adapts to the possibilities of new demands. Finally, public health policy faces challenges in the process of interrelationship with the dynamics of the place and with the elaboration of actions that seek the promotion of health in the context of constant transformations.