In Brazil from the turn of the 19th to the 20th century, the concern with health, in fact, did not necessarily translate into the issue of social rights or human dignity, but it was linked to the economic interests of the elites in keeping the worker healthy to maintain production, especially in that context agrarian.
The republican ideal was surrounded by positivist values of order and progress, as seen in the national flag itself, and that In this way, the appreciation of science and a European worldview based on the mark of modernity invaded the country, albeit in a contradictory to a reality still marked by the agrarian export regime, by patriarchy, by the tradition of a past slaver. If it is a fact that at the end of the 19th century a process of urbanization and modernization of cities began, albeit in an incipient way. (as seen in the Brazilian capital at the time, Rio de Janeiro), Brazil became an urban country only in the second half of the century XX. In this sense, the old and the modern sought to coexist in the formation of a new Brazil, now republican. Among the novelties was science as the great panacea for a backward country, in which a social type predominated. represented by the ontological figure of Jeca Tatu (created by Monteiro Lobato), stereotype of the rural man in need of care. In this sense, a sick society, affected by tropical diseases, needed to have its diagnosis to be treated. Medicine would have to engage in the fight against the nation's ills
, which would justify the interventionist and authoritarian measures that marked the first years of the Old Republic. There was a concern with rural and urban prophylaxis. Urban reform and sanitation measures in the city of Rio de Janeiro, as well as campaigns to vaccinate the population, marked this period. However, the austere nature of the government measures resulted in events such as the Vaccine Revolt, which took place in 1904.The fight against bubonic plague, yellow fever, tuberculosis and smallpox was declared. Despite this, it is worth pointing out as a legacy of the Old Republic the creation of the General Directorate of Public Health (DGSP; 1897), the Reforms of the competences of the DGSP (Oswaldo Cruz; 1907) and the Retirement and Pension Funds (Eloy Chaves Law; 1923), which meant an incipient health care through social security. Society was still rural, but a period of social transformation was beginning, which would be accelerated in the first half of the 20th century.
After the period of the Old Republic, we arrived at the Vargas Era with the inauguration of another vision of the State, as well as another social configuration that started in the urban centers of the country. From the 1930s onwards, Brazil began a process of industrialization and modernization of the State, trying to reposition itself in the world economy after the 1929 crisis. Considering that until then the Brazilian economy was based on coffee production and exports, it was understood that it was necessary to create conditions for the assembly of an industrial park that would leverage the parents. A process was started later called by some intellectuals late capitalism. Thus, new social actors emerged, such as the urban worker, the worker, and, in this way, new social demands were posed as a challenge to the State. Among them the issue of social security. Thus, as pointed out by Jairnilson Paim (2011, p.14), “the model of intervention of the Brazilian State in the social area dates back to the 1920s and 1930s, when civil and social rights were linked to the individual's position in the work".
The fact is that, as can be seen, care models have become increasingly complex, concurrently with the modernization of the State from the point of view of administrative and bureaucratic. With an iron fist and in a populist way, Getúlio Vargas inaugurated a new era of modernization of national production and the rationalization of the functioning of the State, getting closer and closer to the urban working classes with their speeches (which began with the catchphrase “Trabalhadores do Brasil”) in favor of the rights of this category. In his government, many of the rights linked to social security were instituted, while the actions of the State regarding public health were also improved.
Thus, in the Vargas era, the following facts occurred: Public Health was institutionalized by the Ministry of Education and Public Health; Social security and occupational health institutionalized by the Ministry of Labor, Industry and Commerce; the Retirement and Pension Institutes (IAP) were created to extend social security to the majority of urban workers (1933-38).
However, although these advances have been extremely important from the point of view of social protection and public health, it was only in 1953 that the Ministry of Health was created. From there until the creation of the SUS (Unified Health System), the Brazilian population waited another 35 years. Even today, despite advances from the point of view of care and health care by the SUS, there are many challenges to be faced by the Brazilian State.
Paulo Silvino Ribeiro
Brazil School Collaborator
Bachelor in Social Sciences from UNICAMP - State University of Campinas
Master in Sociology from UNESP - São Paulo State University "Júlio de Mesquita Filho"
Doctoral Student in Sociology at UNICAMP - State University of Campinas
Source: Brazil School - https://brasilescola.uol.com.br/sociologia/o-inicio-das-politicas-publicas-para-saude-no-brasil-republica.htm
