A profilaxia e o tratamento das enfermidades do oeste paulista: o Serviço Sanitário e o tracoma no princípio do século XX / Prophylaxis and treatment of diseases in western São Paulo state: the Sanitation Service and trachoma in the early twentieth century

Resumo Em 1906, Emílio Ribas reorganizou o Serviço Sanitário e centralizou na capital os serviços de saúde pública do estado de São Paulo. Nesse projeto, a campanha de combate ao tracoma, uma enfermidade oftálmica, foi implantada. Este artigo analisa essa campanha que atendeu os enfermos das propriedades rurais em um processo que antecedeu ao Código Sanitário Rural de 1917. O material empírico foi composto por relatórios governamentais, decretos, periódicos médicos e jornais. Concluímos que Ribas, ao criar uma estrutura que unificou os esforços dos distritos sanitários com as equipes de atendimento das Comissões do Tracoma, buscou formar um complexo aparato para combater as enfermidades presentes tanto nas áreas urbanas quanto na zona rural.

Abstract In 1906, Emílio Ribas reorganized the Sanitation Service and centralized São Paulo state public health services in the state capital. A campaign to combat trachoma, an ophthalmic disease, was implemented as part of this project. This article analyzes this campaign, which provided care for the sick living on rural properties in a process that predated the 1917 Rural Sanitary Code. The empirical data was obtained from government reports, decrees, medical journals and newspapers. We conclude that Ribas, by creating an organization that integrated the efforts of the sanitary districts and the Trachoma Commission medical teams, sought to form a complex apparatus to combat the diseases present in both urban areas and the countryside.

Regional cooperation and health diplomacy in Africa: from intra-colonial exchanges to multilateral health institutions / Cooperação regional e diplomacia sanitária na África: dos intercâmbios intracoloniais às instituições multilaterais de saúde

Abstract Tracing the pathways of cooperation in health in sub-Saharan Africa from hesitant exchanges to institutionalized dimensions from the 1920s to the early 1960s, this article addresses regional dynamics in health diplomacy which have so far been under-researched. The evolution thereof from early beginnings with the League of Nations Health Organization to the Commission for Technical Assistance South of the Sahara and the World Health Organization's Regional Office for Africa, shows how bilateral dimensions were superseded by WHO's multilateral model of regional cooperation in health. Alignments, divergences, and outcomes are explored with respect to the strategies and policies pursued by colonial powers and independent African states regarding inter-regional relations, and their implications for public health and epidemiological interventions.

Resumo Trilhando os caminhos da cooperação sanitária na África subsaariana, de intercâmbios incertos a dimensões institucionalizadas dos anos 1920 até início dos anos 1960, este artigo aborda a dinâmica regional na diplomacia sanitária que, até o momento, carece de pesquisas. A evolução, desde os primórdios da Organização da Saúde da Liga das Nações até a Cooperação Técnica na África Subsaariana e o Escritório Regional da África da OMS, demonstra como dimensões bilaterais foram substituídas pelo modelo multilateral da OMS de cooperação sanitária regional. São analisados alinhamentos, divergências e resultados de estratégias e políticas empregados por potências coloniais e Estados africanos independentes em relações inter-regionais, bem como suas implicações em intervenções epidemiológicas e de saúde pública.

Conflitos, assistência e redes de poder em torno da fundação da Santa Casa de Misericórdia de Campos dos Goytacazes, 1786-1795 / Conflicts, welfare, and power networks in the founding of Santa Casa de Misericórdia of Campos dos Goytacazes, 1786-1795

Resumo O artigo propõe uma discussão a respeito da fundação da Santa Casa de Misericórdia de Campos dos Goytacazes e seus desdobramentos na sociedade local, além de um breve estudo sobre os dois primeiros provedores e suas redes (1792-1795). A instituição foi inaugurada em 1792, no auge das transformações ocorridas na Europa. Em Portugal, o intendente-geral da Polícia de dona Maria I, Diogo Inácio de Pina Manique, planejava reformas à frente da administração da saúde pública. Analisam-se, dentro desse contexto, as questões que motivaram a instalação da referida Misericórdia e suas relações com as dinâmicas sociais e políticas típicas de Antigo Regime, ainda enraizadas na sociedade colonial e que adentrariam o século XIX.

Abstract A discussion is proposed concerning the founding of Santa Casa de Misericórdia of Campos dos Goytacazes and its ramifications in local society, as well as a brief study of its first two directors and their networks (1792-1795). The institution was opened in 1792 at the height of upheavals in Europe. In Portugal, the chief of police under Maria I, Diogo Inácio de Pina Manique, planned reforms for the public health administration. An analysis is proposed of the issues that motivated the founding of said institution and how it related to the social and political dynamics typical of the ancien régime, which were still deep-rooted in colonial society, and which remained intact into the nineteenth century.

O que foi a polícia médica? / What were the medical police?

Resumo Este artigo busca novas possibilidades de interpretação do conceito de "polícia médica", usado no Ocidente nos séculos XVIII e XIX. Recorreu-se aos próprios tratados escritos em Alemanha, Reino Unido, França, Espanha e Portugal, o que possibilitou outras maneiras de compreender o que foi a polícia médica na Europa, diferentes das de George Rosen e Michel Foucault, os pensadores do século XX que mais estudaram o assunto. A documentação aponta que esses tratados não foram um fenômeno exclusivamente alemão tampouco seriam uma regulação estatal da profissão médica apenas: eram tratados bastante abrangentes sobre como o Estado deveria gerir a saúde pública, em cada localidade, com suas peculiaridades e exigências próprias, fossem institucionais e/ou políticas.

Abstract The article presents new ways of interpreting the concept "medical police," which was used in the West in the eighteenth and nineteenth centuries. Alternative understandings of the medical police in Europe, distinct from those offered by George Rosen and Michel Foucault, the preeminent twentieth-century thinkers on the topic, were derived by studying related treatises written in Germany, the United Kingdom, France, Spain, and Portugal. Records indicate that these treatises were not an exclusively German phenomenon nor did they constitute State regulation of the medical profession alone. Rather, they were broad-ranging treatises on how the State should manage public health in each location, according to its specific features and demands, whether institutional or political in nature.

Os mosquitos e o Estado no relatório do chefe do Serviço de Saneamento e Profilaxia Rural da Bahia, 1922 / Mosquitos and the State in the report by the head of the Rural Sanitation and Prophylaxis Service of Bahia, 1922

Resumo Em 1923, o doutor Sebastião Barroso, chefe do Serviço de Saneamento e Profilaxia Rural da Bahia, apresenta um relatório das atividades desenvolvidas no ano anterior. O documento reúne informações sobre as iniciativas coordenadas pela autoridade no tocante às epidemias e à profilaxia rural, acompanhadas de uma compilação dos relatórios dos profissionais responsáveis pelos postos de profilaxia rural e de tabelas contendo dados sobre os trabalhos nas diferentes regiões do estado, as notificações recebidas e as despesas realizadas. O trecho desse documento aqui apresentado permite uma aproximação das discussões em relação ao papel do Estado no enfrentamento dos problemas de saúde pública, num contexto marcado pela recorrente eclosão de surtos epidêmicos, dentre os quais se destacam os surtos de febre amarela.

Abstract In 1923, Doctor Sebastião Barroso, head of the Rural Sanitation and Prophylaxis Service of Bahia, submitted a report on the previous year's activities. The document contains information on initiatives coordinated by the entity on rural epidemics and prophylaxis, accompanied by a compilation of the reports by the professionals responsible for the rural prophylaxis units and tables containing data on the different regions in the state, notifications received, and expenses. The section of this document presented here enables us to investigate the state's role in addressing public health issues in a context marked by recurring outbreaks of epidemics, especially yellow fever.

Reinicio de la especialidad en Organización y Administración de Salud: respuesta a una necesidad identificada / Resumption of the health organization and management specialty in response to an identified requirement

La intención de esta carta está en referencia al artículo publicado en la Revista Cubana de Salud Pública, número Julio/Septiembre del 2012 titulado: La especialidad en Organización y Administración de Salud Pública y la Escuela Cubana de Salud Pública, de la autoría del profesor Dr. Luis Suárez Rosas.1 Aunque esto ha sido de nuestro interés desde su publicación, no es hasta la primera graduación de la especialidad Organización Administración de Salud (OAS) -después de reiniciada- que nos sentimos en disposición de dirigirnos a usted a este respecto.Las cartas al director son una forma valiosa de comunicación científica como un proceso de revisión externo y abierto de un artículo previamente publicado.2 En este caso el remitente intenta resaltar cuan acertadamente, en su artículo el autor expone la necesidad de reiniciar la especialidad de OAS en la que no se ingresaban nuevos residentes desde que fue tomada esa decisión para el curso 1989-1990,1 además, relacionar el reinicio de la especialidad con los acertados argumentos expuestos, sobre todo desde la perspectiva histórica y la seguridad que manifiesta el autor en este reinicio. Anteriormente en el 2011 el Profesor Rojas Ochoa en una fundamentación de la Especialidad en Salud Pública hace referencia a sus diferentes nombres y alega la existencia en el ámbito nacional, de cierta corriente de dudas al respecto, no formalizada pero que hizo pertinente demostrar...(AU)

Los determinantes sociales: base para la elaboración de políticas públicas de salud / Social determinants: basis for the development of public health policies

Este artículo describe la importancia de la elaboración de políticas públicas de salud considerando losdeterminantes sociales de la salud. Hace una revisión histórica de los orígenes y evolución de ésteimportante tema. El enfoque de determinantes sociales de la salud registra sus orígenes desde laantigüedad, con un auge en la década de los 60-70, sin embargo, cada día cobra mayor importancia yrelevancia, producto del crecimiento y desarrollo económico que en muchas ocasiones vieneacompañado de la inequidad. Se plantea la necesidad de elaborar políticas públicas saludables queaborden las causas de los problemas de salud y no sus consecuencias; que se generen políticas destinadasa disminuir la inequidad y favorecer un desarrollo económico y social sostenible. La distribucióndesigual, a nivel mundial y nacional, del poder y los ingresos afectan las condiciones de vida de lapoblación (acceso a la atención sanitaria, educación, condiciones de trabajo, vivienda y tiempo libre), queen su conjunto son perjudiciales para la salud. Necesitamos abordar los problemas de salud, con uncrecimiento económico acompañado de políticas sociales adecuadas que aseguren que sus beneficiossean equitativos y contribuyan por ende a la equidad sanitaria.

This article describes the importance of developing public health policies considering the approach tosocial determinants of health this is a historical review of the origins and evolution of this importanttopic. The focus of social determinants of heal three cords from ancient time to origins, with a boom inthe decade of the 60´s-70´s , but each day becomes more important and relevant, the product of economicgrowth and development that often comes with inequality. This raises the need to develop public policies that address the causes of health problems and theirconsequences, to generate health policies to reduce inequality and promote sustainable economic andsocial development. The uneven distribution, global and national of income affect the living conditionsof the population (access to health care, education, working conditions, housing and leisure), whichtogether are harmful to health. We need to address health problems, with economic grow that accompanied by appropriate socialpolicies to ensure that it benefits are equitable and this contribute to health equity.

La salud pública vista desde el contexto de la localidad palmera / The public health viewed from the context of Palma municipality

Este trabajo trata el tema de la gestión de salud pública desde el contexto de la localidad del municipio de Palma Soriano (provincia de Santiago de Cuba), para propiciar conocimientos al estudiantado de las carreras en tecnologías de la salud, con una visión cercana a los valores autóctonos de su pueblo, historia, cultura y pleno desarrollo socioeconómico, que contribuyan a la formación integral y perfeccionadora de los futuros profesionales de la asistencia médica.

This work deals with the topic of the public health management from the context of Palma Soriano municipality (Santiago de Cuba province), to provide knowledge to the students of the health technologies careers, with an approximate vision to the autochthonous values of its town, history, culture and full socioeconomic development that contribute to the integral and perfectioning training of the future professionals of the medical care.

Uma história da Secretaria Municipal de Saúde de Niterói (1975-1991) / An history of the Municipal Health Secretary of Niterói (1975-1991)

Para escrever esta tese, que relata a criação, em 1975, da Secretaria Municipal de Saúde de Niterói, e sua evolução até 1991, valemo-nos de pesquisas realizadas em fontes primárias num período que abrangeu os últimos 60 anos. Foram pesquisados planos, programas e relatórios de secretários de Saúde, Diários Oficiais da União e do Estado do Rio de Janeiro. Esses documentos primários, que constituem nossa maior fonte de pesquisa e montam a mais de 600 páginas, são apresentados nos anexos da tese. Também pesquisamos em fontes secundárias, como teses, dissertações, livros e periódicos. Destacamos na área da Saúde em Niterói, no início desse período, a implantação do Projeto Niterói, que hierarquizou e integrou as unidades de saúde no município de Niterói e implementou as Ações Integradas de Saúde, e ao seu final, em 1991, a realização da Primeira Conferência Municipal de Saúde de Niterói, a implantação do Conselho Municipal de Saúde, da Fundação Municipal de Saúde bem como a realização do Primeiro Concurso Público do Município de Niterói destinado a profissionais da área da saúde. Essas ações constituíram uma referência regional e nacional da integração dos serviços de saúde nas três esferas do Poder Executivo: o municipal, o estadual e o federal. No município de Niterói, forjaram e sustentaram a política pública de saúde municipal, implementando as prescrições constitucionais do Sistema Único de Saúde.

A inserção do MRE na saúde / The introduction of the MRE (Foreign Relations Department) in health

Busca documentar o período épico da transferência da capital federal do Rio de Janeiro para Brasília, a implantação dos dois ministérios, Saúde e Relações Exteriores, hoje vizinhos na Esplanada dos Ministérios, ontem funcionando no mesmo edifício, a atual sede do Ministério da Saúde.

Chang Sei Kim's Activities on Public Health in Colonial Korea / 의사학

After graduating from Severance Medical College in 1916, Chang Sei Kim went to Shanghai to work as a missionary in a adventist hospital. The establishment of the Korean Provisional Government led him to participate in the independence movement. Educating nurses to assist the forthcoming war for independence, he seemed to realize the fact that the health of Koreans would be a key factor for achieving independence. He left for the U.S. to conduct comprehensive research on medicine. Chang Sei Kim was the first Korean to receive a Ph. D. degree of Public Health, graduating from the Johns Hopkins School of Hygiene and Public Health in 1925. He then gained an opportunity to work for Korea as a professor at Severance Medical College. His objective was the 'Reconstruction of the Korean People In Terms of Physical Constitution.' He pointed out that Koreans' weak state of health was a major reason for Korea's colonization. To gain independence, he emphasized that the Korean people should receive education on public health in order to improve the primitive conditions of sanitation. There is little doubt that Chang Sei Kim's ideas developed Heungsadan's views on medicine in terms of its stress on cultivation of ability, especially considering the fact that he was a member of the organization. As a member of the colonized who could not participate in the developing official policy, Chang Sei Kim was not able to implement his ideas fully, because an individual or a private organization could not carry out policy on public health as large a scale as the government did. Never giving up his hopes for Korean independence, he rejected requests to assume official posts in the Government-General. That was why he was particularly interested in the Self-Governing Movement in 1920s Korea. If the movement had attained its goal, he might have worked for the enhancement of sanitary environment as a director of Sanitary Department. His application for funding to establish a hygiene laboratory in Korea was rejected by Rockefeller Foundation, as the policy of foundation was to finance only government institutes, not private ones. Resigning his position at Severance Medical College in 1927, Chang Sei Kim went to Shanghai to work as a Field Director in the Council on Health Education. The council was affiliated with the Rockefeller Foundation and was founded to ameliorate the hygienic situation in China. He was well fitted to the job, because China, like Korea, shared the aim to achieve independence by promoting better health for its people and because he could be appointed as a public officer which could not happen in colonial Korea. To solve the ever-serious problems with tuberculosis in China, he went again to the U. S. to conduct research and raise money for the establishment of a sanitarium. Chang Sei Kim passed away there in 1934 at the age of 42.

The Making of Hygienic Modernity in Meiji Japan, 1868~1905 / 의사학

This article is based on conceptual and methodological understanding of hygienic modernity in the nineteenthcentury Western countries: one is the concept of modern hygiene in the context of modern state and the other is methodological relation of modern hygiene to scientific theory of germ. While modern state calls for the institutionalization of medical police as an administrative tool for consolidating the governmentality what Michel Foucault calls, scientific 'invention' of germ may be considered as 'logical, philosophical and historiographical.' Furthermore, the Meiji medicine men preferred Koch's to Pasteur's laboratory framework, not because the former was scientific than the latter but because Koch's programs were more compatible with imperial needs. The objective of this paper is to investigate four ways in which hygienic modernity had been established in Meiji Japan; (i) how Meiji imperialists perceived and managed to control Japanese hygienic condition, (ii) how Meijileading doctors learned about the German modern system of hygiene to consolidate Meiji empire; (iii) how modern germ theory functioned as the formation of imperial bodies in Meiji period; and (iv) how modern military hygiene contributed to Japanese defeat of Russia. Although I try to contend that modern hygiene was adopted as one of the most significant strategies for intensifying and extending the Meiji empire, this paper has some limits in not identifying how Japanese perception of infectious diseases were culturally adaptive to sciencebased hygienic programs the Meiji administrators had installed.

The Gurhigae Jejoongwon: its size and activities / 의사학

This article explores the location, size of the site, and medical activities of the Gurhigae Jejoongwon. Relevant documents such as reminiscences, diplomatic notes, newspaper accounts, maps, and photographs were referred for this study. The Gurhigae Jejoongwon located on a hill that, at present, covers the area from Ulchi-ro to MyungDong Cathedral. Its main entrance was towards Ulchi-ro. Real estate including the buildings of the Gurhigae Jejoongwon was returned to the Chosun government in 1905, and the estimated size of its site varied from 1,810 pyung to 5,036 pyung. The site of the Gurhigae Jejoongwon was 2 - 5 times larger than the 862.16-pyung-site of the Jejoongwon in its Jaedong days. With such larger size, the Jejoongwon could take care of more patients. Dr. Avison started medical education again. The Gurhigae Jejoongwon took the central part in medical treatment activities for public in Seoul, as it carried out the prevention activities against Cholera in 1895. The Chosun government highly recognized its medical treatment activities for the common people.

Evolución del pensamiento sanitario durante el siglo XX / The evolution of healthcare thinking during the 20th century

Se revisa el desarrollo del pensamiento sanitario a lo largo del siglo XX. Se parte de la premisa de la existencia de un pensamiento sanitario, identificable por el enfoque colectivo y social adoptado por los autores. Se divide el período en grandes etapas, preferentemente determinadas por acontecimientos históricos y políticos: los principios o la primera mitad del siglo, el período posterior a la 2ª guerra mundial, las décadas del 50 y 60, las del 70 y 80 y, finalmente, la década del 90. Se discuten los rasgos salientes de cada etapa, haciendo hincapié en los modelos predominantes de organización sanitaria de cada momento, en la posición desde la cual se ubicaban las sucesivas generaciones de sanitaristas, en los instrumentos de gestión preferentemente empleados y en los principios lógicos que sustentaron las acciones de salud desarrolladas. Se rastrean los orígenes conceptuales en que se inspiró la corriente de calidad predominante en los '90, evocando aportes de Avedis Donabedian publicados en los '70. Se concluye que el pensamiento sanitario fue cambiando su punto de enfoque a lo largo del siglo

Development of National Institute of Health Korea / 의사학

The National Institute of Health(NIH) under the Ministry of Health and Welfare of the Korean Government was established in 1963 integrating four institutes; National Institute of Health National Chemical Laboratories National Laboratory of Herb Medicine and National Institute of Public Health Training The root however goes down to the Bacteriology Laboratory opened in 1912 with the function for microbiological testing and pox vaccine development which was absorbed into the former National Institute of Health in 1948 when the government of the Republic of Korea was inaugurated. The Institute opened a satellite office the Masan Branch in 1977 and was further expanded adding the Divisions of AIDS and Biotechnology in 1988. In 1996 as a part of restructuring the Government organizations Korea Food and Drug Administration(KFDA) was founded by expanding the Toxicology Research Institute to which all the functions of testing and certifying foods and drugs were transferred Simultaneously a new department the Department of Biomedical science was organized which currently consists of five divisions; the Divisions of Cancer Research Degenerative Diseases Cardiovascular Diseases Metabolic Diseases and Genetic Diseases. In 1999 in order to provide a rapid and effective disease control the Department of Communicable Diseases was newly founded merging the Division of Disease Control and Prevention from the Ministry of Health and Welfare. With these steady and significant changes the NIH together with the training of health manpower has become the national organization for research prevention and control of various diseases of public health importance in Korea.

Korea's Health Care Policy of the Twentieth Century / 의사학

This article analyzes the social transformation of Korea's health care policy in the twentieth century from a historical perspective. The whole period under the research is divided into four stages. In the first stage(1900-1945), two major health care policies, public hygiene and population control, were a part of political strategy for consolidating Japanese colonial dominion over Korea. The second stage(1945-1960) is characterized by the division of Korean peninsula and Korean war that resulted in the vicious cycle between massive poverty and social disease. In the third stage(1961-1991), military governments considered the health care system as a 'carrot' for enhancing national security and reinforcing legitimacy of the regime. In the final stage(1992-1999), the state and civil society have been influential agents in shaping forms and contents of health care policy, with the organized medicine relatively neglected. Globalization will have more influence on the arena of health care policy in which three agents would have to negotiate one another. In addition, the organized medicine will have to consider a variety of non-governmental organizations(NGOs) as an inevitable counterpart of policy-making process. in harmonizing the conflicts between public deliberation and professional interests. In the next century, health care policy, along with social welfare, environment and labor policy agendas would constitute a health-related policy regime in which all the participants have to accomplish not medicalization of life but socialization of health care and to diminish the inequity in health among a variety of social class.