Entre Alma-Ata e a reforma sanitária brasileira: o Programa Nacional de Serviços Básicos de Saúde (Prev-saúde), 1979-1983 / Between Alma-Ata and the Brazilian sanitary reform: the National Basic Health Services Program (Prev-saúde), 1979-1983

Resumo A história do Programa Nacional de Serviços Básicos de Saúde (Prev-saúde) se inicia em 1979, na articulação entre os Ministérios da Saúde, da Previdência e Assistência Social, do Interior e da Economia e a Organização Pan-americana da Saúde. Teve como objetivo reorganizar os serviços básicos de saúde em suas conexões com os demais níveis assistenciais. Internacionalmente, inscrevia-se no movimento deflagrado pela Conferência de Alma-Ata, de setembro de 1978. Em termos nacionais, representava tanto um acúmulo de conhecimento sobre organização dos serviços quanto um movimento que se adequava, em parte, à agenda da reforma sanitária brasileira. O Prev-saúde representou um conjunto de proposições para a reorganização da saúde que, naquele contexto, era consenso técnico entre burocracias e lideranças da reforma da saúde.

Abstract The history of the National Basic Health Services Program (Prev-saúde) begins in 1979 with a joint effort involving the Ministries of Health, Social Security and Assistance, Interior, and Economy, as well as the Pan-American Health Organization. The objective was to reorganize basic health services in their connections with other levels of care. Internationally, it was part of the movement sparked by the International Conference on Primary Health Care in Alma-Ata in September 1978. Domestically, the program represented an accumulation of knowledge about the organization of services as well as a movement that was partially adapted to Brazilian health reform agenda. Prev-saúde was a set of health proposals that represented a technical consensus between bureaucracies and leaders of health reform.

Hitupmã'ax: educação intercultural e atendimento diferenciado à saúde do povo maxakali / Hitupmã'ax: intercultural education and specific health care for the Maxakali people

Resumo Este trabalho analisou um artefato (um livro de saúde) concebido pelo povo maxakali, denominado Hitupmã'ax: curar (2008). Tangenciado o projeto de produção do livro, o objetivo foi entender o processo de negociação da saúde pública no Brasil, dentro de uma perspectiva histórica e intercultural das epistemologias não ocidentais. Constatamos que a construção da obra maxakali representa um esforço para diminuir a distância da percepção e dos cuidados de saúde entre indígenas e não indígenas, e por essa via demonstramos a importância desse projeto intercultural para a efetivação de políticas públicas voltadas para o público indígena em geral e, especificamenete, para a promoção da história, dos saberes e da cultura maxakali.

Abstract This study analyzed an artifact (a book on health) conceived by the Maxakali people, called Hitupmã'ax: curar (2008). Parallel to the project for the production of this book, the aim was to understand the negotiation of public health in Brazil from a historical and intercultural perspective of non-Western epistemologies. It was found that the construction of the Maxakali work represented an effort to bridge the gap in the perception of health and health care between indigenous and non-indigenous people. This was then used to demonstrate the importance of this intercultural project for the shaping of public policies for indigenous people in general and particularly for the promotion of the history, knowledge, and culture of the Maxakali people.

La atención a la salud en Mesoamérica antes y después de 1519 / Health care in Mesoamerica before and after 1519

Resumen En este ensayo se discute la situación de la atención a la salud en Mesoamérica antes e inmediatamente después de 1519. En los primeros 50 años después de la Conquista, los españoles hicieron un uso muy extensivo de la medicina náhuatl. Sin embargo, con el tiempo, el ámbito de influencia de esta tradición se vio limitado debido a la rápida imposición de un sistema de atención muy diferente que poco aprovechó, entre otras cosas, la riqueza terapéutica de la medicina prehispánica.

Abstract This paper discusses the situation of healthcare in Mesoamerica before and immediately after 1519. In the first 50 years after the Conquest, the Spaniards made extensive use of Nahuatl medicine. However, the influence of this medical tradition was limited due to the rapid imposition of a very different medical system which took little advantage of, among other things, the therapeutic wealth of pre-Hispanic healing traditions.

De "culpables" a "víctimas": expansión y profesionalización del sistema de salud en la provincia Mendoza a fines del siglo XIX y principios del XX / From "culprits" to "victims": the expansion and professionalization of the healthcare system in the province of Mendoza in the late nineteenth and early twentieth century

RESUMEN Entre fines del siglo XIX y comienzos del XX, la provincia de Mendoza presentaba un estado sanitario marcado por el crecimiento demográfico y urbanístico, la escasez de los servicios públicos y la destrucción de la antigua ciudad colonial como consecuencia del terremoto de 1861, lo que propiciaba un ambiente favorable para el desarrollo de diversas enfermedades infectocontagiosas. El objetivo de este artículo es indagar cómo se fue profesionalizando y expandiendo el sistema de salud en la provincia de Mendoza a fines del siglo XIX e inicios del XX, y cómo esos factores, junto con las representaciones sobre la enfermedad que predominaban en el discurso de la elite gobernante, incidieron en las políticas públicas para combatir las dolencias de la época. Para ello se consultaron diversos documentos escritos y fotográficos que permitieron analizar las modificaciones del discurso y las políticas públicas implementadas.

ABSTRACT From the late 19th century to the beginning of the 20th, the province of Mendoza presented problematic sanitary conditions due to rapid demographic and urban growth, the scarcity of public services, and the poor state of the old colonial city (destroyed by the 1861 earthquake), which facilitated the spread of various infectious diseases. The objective of this article is to inquire into the ways in which the healthcare system in the province of Mendoza both expanded and became increasingly professionalized from the late 19th to early 20th century. We explore how these factors, along with the predominant social representations of disease that permeated the discourses of governing elites, influenced public policy aimed at combating the diseases of the time. To that end, we consulted a wide range of written documents and photographic material that allowed us to analyze changes in discourse as well as public policy.

Vitor Valla: uma vida de reflexão e militância em educação popular e saúde / Victor Valla: a life of reflection and activism in popular education and health

Resumo O presente artigo busca estabelecer uma narrativa sobre alguns aspectos da trajetória acadêmica e militante do professor e educador popular Victor Valla, tendo como destaque uma problemática assinalada por ele em vários textos e debates, sobre a recorrente incompreensão de alguns pesquisadores e técnicos (assistentes sociais, educadores, médicos, enfermeiros, etc.) sobre as classes populares e suas falas. Valla ressaltava a existência de produção de conhecimento para além do circuito tradicional das universidades e centros de pesquisa, especialmente no âmbito das classes populares, que, para ele, estaria imbricada em suas práticas. Neste sentido, advogava uma nova postura teórica e metodológica para os projetos sociais, educacionais culturais e de saúde junto aos grupos populares, o que seria totalmente coerente e compatível com as premissas de um sistema de saúde democrático e equânime, apregoado pelos envolvidos com a área da Saúde.

Abstract The article explores aspects of the academic and activist life of the teacher and popular educator Victor Valla, particularly his repeated critiques, in writings and debates, about how some researchers and some social workers, educators, medical providers, and others working with the popular classes failed to understand these groups and their discourse. Valla embraced the idea that knowledge can be produced outside the traditional walls of universities and research centers, especially by the popular classes, who embed knowledge production in their very practices. In this regard, he advocated a new theoretical and methodological posture in social, cultural, educational, and health projects among the poor, in total consonance with the presuppositions of a democratic, equitable healthcare system, as supported by those involved in the health sector.

Desde el ISET al InDRE. II. Instituto de Salubridad y Enfermedades Tropicales: madurez y consolidación, 1940-1964 / From ISET to InDRE. II. Institute of Public Health and Tropical Diseases: maturity and consolidation, 1940-1964

Resumen El periodo que comienza en 1940 es crucial para la creación del moderno sistema de salud de México. El Instituto de Salubridad y Enfermedades Tropicales es la institución pionera en investigación en salud y en sus primeras dos décadas logra madurez y consolida líneas de investigación expresadas en casi 1700 publicaciones. También obtiene notoria visibilidad internacional y fue seleccionado como referencia regional para la vigilancia epidemiológica de influenza, estreptococo y salmonela. Su evolución se produjo con ritmo de innovación que iría disminuyendo para el final de ese periodo. Enfrentó limitaciones para renovar líneas de trabajo, investigadores y equipo de laboratorio, sin embargo, su papel en las decisiones de la salud pública del país siguió siendo central.

Abstract The period that starts in 1940 is crucial for the creation of Mexico’s modern health system. The Institute of Sanitary and Tropical Diseases is the pioneer institution in health research and on its first two decades it achieved maturity and consolidated lines of research expressed in almost 1700 publications. It also obtained notorious international visibility and was selected as a regional reference for epidemiological surveillance of influenza, streptococcus and salmonella. Its evolution took place with an innovation rhythm that would be decreasing by the end of this period. It faced limitations to renew lines of research, researchers and laboratory equipment. However, its role in public health decisions of the country remained central.

Gobernanza y rectoría de la calidad en los servicios de salud en el Perú / Governance and stewardship of quality in health services in Peru

RESUMEN El cuidado de las personas y de su salud es una función primaria de la familia y de la sociedad como lo demuestran estudios sobre los humanos primitivos, así como en el Perú prehispánico. La conquista y los siglos posteriores de colonización quebraron la forma tradicional del cuidado de las personas, reemplazando la solidaridad social por acciones de caridad principalmente de órdenes religiosas que propiciaron hospicios luego denominados hospitales. Durante la colonia y hasta principios del siglo XX el cuidado de los enfermos siguió siendo responsabilidad de las instituciones de caridad, como las Beneficencias creadas luego de la independencia. Los derechos sociales como la educación y la salud recién surgen en las primeras décadas del pasado siglo, plasmándose en la Constitución de 1933. Sin embargo, tanto en esa Constitución como en la de 1979 y la de 1993 el derecho a la educación fue reconocido más plenamente, siendo más limitado en salud. La ley de Aseguramiento Universal en Salud del 2009 propone garantizar para todos el derecho al acceso a servicios de salud con calidad, como parte del derecho a la salud en sentido amplio. Las limitaciones actuales obligan a redefinir el derecho de todas las personas al cuidado integral de su salud y la rectoría del Estado para garantizarlo.

ABSTRACT The care of people and their health is a primary function of the family and of society as shown by studies on primitive humans, as well as in pre-Hispanic Peru. The conquest and subsequent centuries of colonization fractured the traditional way of caring for people, replacing social solidarity with charity actions mainly from religious orders that provided hospices later called hospitals. During the colony and until the beginning of the 20th century, the care of the sick continued to be the responsibility of charitable institutions, such as the Charities created after independence. Social rights such as education and health only emerged in the first decades of the last century and were enshrined in the 1933 Constitution. However, both in that Constitution as in those from 1979 and 1993, the right to education was recognized more fully, while the right to heath was limited. The Universal Health Coverage Act of 2009 propounds guaranteeing the right to access quality healthcare services for everybody, as part of the right to health in the broadest sense. The current limitations force us to redefine the right of every citizen to comprehensive care of their health and the State's guidance to guarantee it.

Desde el ISET al InDRE. I. Instituto de Salubridad y Enfermedades Tropicales: génesis y primeros años, 1934-1940 / From ISET to InDRE. I. Institute of Public Health and Tropical Diseases: genesis and early years, 1934-1940

Resumen La visión del gobierno cardenista y el proceso para crear el Instituto de Salubridad y Enfermedades Tropicales, considerado estratégico para la salud pública, fueron congruentes con las acciones llevadas a cabo: el Departamento de Salubridad Pública encargó al científico más relevante de la época, Eliseo Ramírez, el diseño y seguimiento del Instituto, que una comisión del Consejo Nacional de Educación Superior y la Investigación Científica revisó, aprobó y desde su inicio le confirió el carácter de investigación con vocación social y humanística. El Instituto de Salubridad y Enfermedades Tropicales se convirtió en el primer organismo posrevolucionario que nació con plazas bien remuneradas para realizar investigación de tiempo completo en México, ofreciendo servicio clínico y enseñanza y apoyando las campañas sanitarias en la prevención y control de las enfermedades. Sin duda fue un parteaguas en la salud pública mexicana y cristalizó las expectativas de varias generaciones de médicos e investigadores en salud para tener una institución de alto nivel. Es la más significativa institución de salud pública del país, con una nueva etapa como Instituto de Diagnóstico y Referencia Epidemiológicos; sin ella no se entiende la moderna salud pública de México.

Abstract Lázaro Cárdenas government vision, and the process to create the Sanitary and Tropical Diseases Institute, which is considered strategic for public health, were consistent with the actions that were carried out: the Department of Public Sanitary asked the most relevant scientist of those days, Eliseo Ramírez, to design and follow-up the Institute's project. A commission of the Higher Education and Scientific Research Council reviewed and approved the project and conferred this institution its nature of research center with social and humanistic vocation since its foundation. Sanitary and Tropical Diseases Institute became the first post-revolutionary health institution that was born with well-remunerated job positions to conduct full-time research in Mexico, offering clinical services, teaching and supporting disease prevention and control campaigns. It was with no doubt a milestone in Mexican public health and crystalized the expectations of several generations of physicians and health researchers about having a high-level institution. It is the most significant public health institution of the country, with a new phase as Institute of Epidemiological Diagnosis and Reference. Without it, Mexican modern public health cannot be understood.

Violence against women: historical trajectory of a care program (Curitiba - 1997-2014) / Violencia contra las mujeres: la trayectoria histórica de un programa de atención (Curitiba - 1997-2014) / Violência contra mulheres: trajetória histórica de um programa de atenção (Curitiba - 1997-2014)

ABSTRACT Objective: To analyze the historical trajectory and the contributions of the Programa de Atenção às Mulheres em Situação de Violência (Program of Care to Women Victims of Violence) of Curitiba. Method: Research with documentary and local approach, inspired by the Dimension of Political History, to unveil power relations, political representations, symbols and discourses. Eighty-eight sources were used for the period 1997-2014. The data collection was performed in May 2016 and presented in the timeline modality. Results: The historical trajectory of the program indicates intersectoral and interinstitutional experience that has been increasing and originating important innovations in care to women based on humanization and from the perspective of comprehensiveness. Final considerations: Historicizing the Program contributed to the reflection on the construction of practices aimed at confronting violence, the need for intersectoral actions and looks that involve its complexity.

RESUMEN Objetivo: Analizar la trayectoria histórica y las contribuciones del Programa de Atención a las Mujeres en Situación de Violencia de Curitiba. Método: Investigación con enfoque documental y local, inspirada en la Dimensión de la Historia Política, para revelar relaciones de poder, representaciones políticas, símbolos y discursos. Se utilizaron 88 fuentes para el período 1997-2014. La recolección de datos fue realizada en mayo de 2016 y presentada en la modalidad línea del tiempo. Resultados: La trayectoria histórica del programa indica una experiencia intersectorial e interinstitucional, que se ha ido ampliando y originando importantes innovaciones en la atención a mujeres pautadas en la humanización y en la perspectiva de la integralidad. Consideraciones finales: Historizar el programa contribuyó a la reflexión acerca de la construcción de prácticas dirigidas al enfrentamiento de la violencia, la necesidad de acciones intersectoriales y miradas que involucren su complejidad.

RESUMO Objetivo: Analisar a trajetória histórica e as contribuições do Programa de Atenção às Mulheres em Situação de Violência de Curitiba. Método: Pesquisa com abordagem documental e local, inspirada na Dimensão da História Política, para descortinar relações de poder, representações políticas, símbolos e discursos. Foram utilizadas 88 fontes referentes ao período de 1997-2014. A coleta de dados foi realizada em maio de 2016 e apresentada na modalidade linha do tempo. Resultados: A trajetória histórica do programa indica experiência intersetorial e interinstitucional que foi se ampliando e originando importantes inovações na atenção às mulheres pautadas na humanização e na perspectiva da integralidade. Considerações finais: Historicizar o Programa contribuiu na reflexão acerca da construção de práticas voltadas ao enfrentamento da violência, a necessidade de ações intersetoriais e olhares que envolvam sua complexidade.

Máquinas y arte-sanos / Machines and artisanal health workers

RESUMEN Este trabajo discute los modelos dominantes y las tensiones, al interior del campo de la salud, entre la concepción del cuerpo humano (máquina); el proceso de trabajo médico (modelos industriales o artesanales); las institucionalidades (hospitales y centros de salud) y los principales agentes (corporación médica y complejo médico industrial). El análisis se contextualiza en EEUU desde fines del siglo XIX a la actualidad. Se discuten dimensiones económico-políticas, ideológico-culturales y científico-técnicas, que atraviesan la historicidad del campo. El propósito es elucidar cómo se viene transformando el campo de la salud, y qué peso tiene la razón instrumental y el capital financiero en ese proceso, en detrimento de lo relacional.

ABSTRACT This work discusses the dominant models and tensions within the health field regarding the conceptualization of the human body (as a machine), the process of health work (industrial and artisanal models), institutions (hospitals and health centers) and primary agents (the medical corporation and the medical industrial complex). The context of analysis is the United States from the end of the 19th century to the present. Economic-political, ideological-cultural, and scientific-technical dimensions are discussed, which permeate the historicity of the field. The purpose is to illustrate how the health field has transformed over time, as well as the role instrumental reason and financial capital has played in this process, to the detriment of relational aspects.

Archibald Cochrane: evidencia, efectividad y toma de decisiones en salud / Archibald Cochrane: evidence, effectiveness and decision-making in health

Resumen: Actualmente, la Medicina Basada en Evidencia tiene un papel fundamental en la toma de decisiones médicas, ya que intenta, a través de los métodos de la ciencia, justificar las diferentes alternativas que se le pueden ofrecer a un paciente. Para entender la evolución histórica de esta forma de practicar la medicina, es necesario revisar la contribución de uno de los principales participantes en este movimiento cultural: Archibald Leman Cochrane, quien ayudó a definir el marco teórico que ha permitido incorporar la ciencia a la práctica de la medicina. Su papel, al insistir en la necesidad de integrar la evidencia científica y conjuntarla con la experiencia clínica, constituyó un elemento fundamental y decisivo en el desarrollo de una nueva disciplina, la Medicina Basada en Evidencia.

Abstract: Nowadays, Evidence-Based Medicine plays a fundamental role while making medical decisions, considering that through the methods of science, it attempts to justify the variety of alternatives that may be offered to patients. In order to understand the historical evolution of this way of practicing medicine, it is necessary to review the contribution of one of the main participants in this cultural movement: Archibald Leman Cochrane, who helped to define the theoretical framework that has allowed the integration of science into the practice of medicine. Since he insisted in the need of integrating scientific evidence into clinical experience, his role became a fundamental and decisive element in the development of a new discipline: Evidence-Based Medicine.

Cuidados paliativos e histórias de vida: a assistência à saúde na perspectiva dos usuários / Palliative care and life stories: health care from the perspective of users

O envelhecimento populacional associado ao aumento progressivo da ocorrência do câncer tem mudado o perfil da mortalidade da população, o que exige do Sistema Único de Saúde uma organização para o oferecimento de cuidados a pessoas com câncer avançado, em cuidados paliativos. O objetivo deste estudo foi conhecer a assistência prestada a pessoas com câncer avançado e seus familiares, na rede de atenção à saúde de Ribeirão Preto, a partir de suas histórias de vida e na perspectiva dos próprios usuários. Trata-se de um estudo com abordagem qualitativa desenvolvido com pessoas com câncer avançado e seus familiares, cujos dados foram coletados em encontros individuais, previamente agendados, com base na modalidade de história de vida. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa com Seres Humanos da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo (CAAE: 51204015.0.0000.5393). Foram 18 pessoas entrevistadas, sendo que a seleção dos participantes se deu por amostragem "não probabilística", dentre a população atendida pela Associação Brasileira de Combate ao Câncer Infantil e Adulto (ABRACCIA), pelos Núcleos 1 e 2 da Estratégia de Saúde da Família e pelo Serviço de Assistência Domiciliar, de Ribeirão Preto/SP; a seleção dos familiares foi por indicação do paciente, por serem seus principais cuidadores. As entrevistas foram audiogravadas e transcritas de modo literal e integralmente. A análise dos dados foi realizada de acordo com a Análise de Conteúdo Temático. Os resultados foram organizados em duas grandes unidades de análise - uma referente ao sistema de saúde e outra sobre a vivência pessoal e familiar no processo de cuidado. Dentre essas unidades, foram abordados temas como a importância que o oferecimento de um serviço de qualidade acarreta na história de vida das pessoas com câncer e seus familiares, envolvendo tanto questões relacionais e de comunicação, como estruturais e ambientais do próprio serviço onde é cuidado. Embora se tenha observado uma falta de informação sobre possibilidades terapêuticas, como o cuidado paliativo, os relatos indicaram que os participantes sentem-se gratos pela oportunidade do tratamento contra o câncer. Portanto, há a necessidade de que seja implantada uma política de saúde específica de cuidado paliativo, sendo esta de forma eficaz e proveitosa, tanto para os profissionais de saúde como para os as pessoas adoecidas e seus familiares

Population aging in Brazil and the progressive increase in cancer occurrence have changed the mortality profile in the population, which requires the Brazilian National Healthcare System to manage the offering of proper health care to patients with advanced cancer and in need of palliative care. The objective of this study was to gain an understanding of the health care provided to people with advanced cancer and to their families, from their life stories and their own perspective as users of the Ribeirão Preto healthcare network. Qualitative study of people with advanced cancer and their families in which the data collection was based on the life story approach and was carried out in scheduled individual meetings. The study was approved by The Human Subjects Research Ethics Committee from Ribeirão Preto Nursing School - University of São Paulo, under number 'CAAE:51204015.0.0000.5393'. We interviewed 18 subjects who had been selected by non-probability sampling from the population which is assisted by 3 institutions: The Brazilian Association for the Combatting of Child and Adult Cancer (ABRACCIA); The Family Health Strategy Units 1 and 2; and The Ribeirão Preto Home Healthcare Service. The selection of family members was based on the patients' recommendations, since those are their main caregivers. The interviews were audio recorded and transcribed verbatim and in full. Data analysis was conducted by Thematic Content Analysis. The results were organized into two main units - one on the healthcare network and another on the personal and family life in the home care process. Within these units we addressed themes like the impact of the health service quality on the life stories of people with cancer and their families, involving not only the relationship and communication issues but also the structure and environment of the health service itself. Even though we observed a lack of information on therapeutic possibilities, such as palliative care, the reports indicate that the participants feel grateful for the opportunity of cancer treatment. Therefore, a specific health policy on palliative care needs to be implemented and this must be done in an effective and beneficial way for both the health professionals and for the patients and their families

El Sistema de Salud de la ciudad de Buenos Aires en el siglo xix en relación a las enfermedades de transmisión sexual / THE HEALTH SYSTEM IN THE CITY OF BUENOS AIRES DURING THE XIXth CENTURY, RELATED TO THE DISEASES OF SEXUAL TRANSMISSION

The health system of the City of Buenos Aires during the XIX century, related to the diseases of sexual transmission, is presented. The "General Hospital for Acute Diseases Dr. Juan A. Fernandez" of universitary character with a well gained prestige in his influencial zone, accumulates the highest technology in this programmatic area, and is today related with the great epidemic disease of sexual transmission from the XXth. Century: AIDS. Not always is well known the fact that, more than a century ago, this Institution was created to confront also to an epidemic of sexual transmission: syphilis. Is then purpose of this revision to introduce to the reader in the behavioral situation at the time of its foundation, the sanitary problems that conducted to its creation and the history of his former years, all of that related to the evolution of the sexually transmitted diseases at the endings of the XIX century.

A (in)salubridade do cárcere e outras causa mortis na Casa de Correção de Porto Alegre, 1855-1888 / The (in)salubrity of prison life and other causes of death in Porto Alegre Prison, 1855-1888

O artigo analisa o fluxo das sensibilidades penais em relação aos cuidados médico-sanitários dispensados aos presos da Casa de Correção de Porto Alegre entre 1855-1888. São observadas a interiorização e a instrumentalização de conceitos como “humanidade” e “civilização”, sobretudo por parte daqueles indivíduos envolvidos diretamente ou com fortes chances de influenciar transformações concernentes às questões penais. Com efeito, além de gerar opinião pública favorável, as apreciações de governantes e notáveis levavam ao desenvolvimento de medidas e práticas concretas que aumentavam os mínimos vitais oferecidos à massa reclusa. Esse processo, entretanto, esteve longe de ser linear e harmônico como demonstram as doenças e a precariedade do cárcere.

The article analyzes the flow of penal sensitivities in relation to medical and health care provided to prisoners in Porto Alegre Prison between 1855 and 1888. The internalization and the instrumentalization of concepts such as “humanity” and “civilization,” especially by those individuals involved directly or with strong chances of influencing changes pertaining to penal issues, are observed. Indeed, in addition to generating favorable public opinion, the concerns of governing authorities and leading lights led to the development of concrete measures and practices that increased the minimum subsistence offered to the imprisoned class. This process, however, was far from linear and harmonic as witnessed by the diseases and the precariousness of prison life.

Cuidados biomédicos de saúde em Angola e na Companhia de Diamantes de Angola, c. 1910-1970 / Biomedical health care in Angola and in the Companhia de Diamantes de Angola, circa 1910-1970

Pretende-se caracterizar a prestação de cuidados biomédicos em Angola durante a atividade da Companhia de Diamantes de Angola. Uma análise comparativa de políticas e práticas de saúde pública de vários atores coloniais, como os serviços de saúde da Companhia, sua congénere do Estado e outras empresas coloniais, revelará diferenças de investimento na saúde, isto é, instalações e pessoal de saúde, e tratamentos. Este escrutínio bem como as condições de vida iluminarão o carácter idiossincrático e central dos serviços de saúde da Companhia em termos de morbimortalidade em Angola, e a centralidade destes para as representações de um império cuidador.

The scope of this paper is to analyze the provision of biomedical care in Angola during the activities of the Companhia de Diamantes de Angola. A comparative analysis of public health policies and practices of various colonial actors, such as the health services of the Company, its state counterpart and other colonial companies, will reveal differences in investment in health, namely in health facilities, personnel and treatment. This survey as well as the living conditions highlight the idiosyncratic and central nature of the health services of the Company in terms of morbidity and mortality in Angola, and the importance of these representations for a caregiving empire.