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Award-winning thesis investigates the genealogy of deafness in health policy in the country

Research analyzes the construction of public policies and achievements of the social movement for people with hearing impairment

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The thesis of doctorate Noises and silences: A genealogical analysis of deafness in Brazilian Health Policy, by Núbia Garcia Vianna, PhD in Public Health from the Postgraduate Program in Public Health at the Faculty of Medical Sciences (FCM) at Unicamp, won the Excellence in Speech Therapy Award for the best thesis in the Public Health category.

The orientation was by Maria da Graça Garcia Andrade and the co-supervision was by Flávia Cristina Silveira Lemos. The award ceremony took place during the closing of the XXVI Brazilian Speech-Language Pathology Congress, III Ibero-American Speech-Language Pathology Congress and VI South-Brazilian Speech-Language Pathology Congress, held in October, in Curitiba.

The study aimed to analyze power and knowledge relations in the field of deafness, taking as a starting point the National Rights Plan for Persons with Disabilities - Living without Limits and its main branch in health, the Care Network for People with Disabilities.

Previous experience as a speech therapist in the area of ​​auditory rehabilitation, associated with studies in the field of Public Health, motivated the researcher to investigate why, in the health policy aimed at this segment of the population, topics such as sign language are not addressed.

“I needed to go deep into the history of deafness and the construction of public policies for people with disabilities to understand the relations of forces, tensions and multiple interests that constituted a condition for the creation of this plan and the current health policy”, he reveals. Nubia.

Photo: Mário Moreira
Speech therapist Núbia Garcia Vianna: rehabilitation is one of the main battle flags

For the analysis, Nubia selected documents such as laws, decrees, ordinances, booklets and reports, as well as interviewed people considered important in the field of disability, deafness and public policies: managers from the Ministry of Health and the Secretariat of Human Rights, professionals from health and entities, researchers and leaders of the social movement for the deaf and people with disabilities.

In the thesis, the author goes through the battles and achievements of the social movement for people with disabilities and legislative advances, until culminating in the creation of the main policy already developed in the country for this population – Living Without Limits.

Viver sem Limite was managed by the Secretariat for the Promotion of the Rights of Persons with Disabilities and monitored by the Casa-Civil, which monitored the actions and the entire process, together with the National Council for the Rights of Persons with Disabilities ( Conade).

“The constant presence of the Civil House is considered decisive for the progress of the Plan, as an issue such as 'Human Rights' tends to be treated with less importance or urgency in the set of ministries' demands”, points out Núbia.

The Viver sem Limite Plan, despite having lasted from 2011 to 2014, left an important legacy: the Care Network for People with Disabilities, a policy that has sought to expand access and qualify health care.

The research reveals that it was as a result of the Plan that the issue of disability entered the agenda of the Unified Health System as a priority, at a key moment in which the Ministry of Health had defined Health Care Networks as a strategy for achieving comprehensiveness and overcoming the fragmentation of care.

“The Care Network for People with Disabilities, therefore, brought innovations in the field of rehabilitation, which aimed to overcome the fragmentation of care induced by previous regulations. Thus, the health of people with disabilities went from being an action, among the various programmatic actions of the Ministry of Health, to a priority topic within the most important ministerial portfolio, an unprecedented fact since the creation of the SUS”, points out the speech therapist from Unicamp.

Nubia emphasized, in its analysis, the issue of deafness in the context of this network, highlighting the contradictions between the achievements and propositions of the health sector for the segment of people with hearing impairment.

“As a policy, the network directs its actions exclusively towards achieving a hearing standard, disregarding the fact that deaf subjects can be multiple”, says Núbia.

The question that arises for any health policy that is guided by the principle of comprehensiveness, according to the research, is how to build a health system capable of meeting the needs of people with disabilities, understanding that their demands go far beyond rehabilitation.

According to Núbia, there are deaf people who want to hear and, therefore, the use of technological resources such as hearing aids and cochlear implants associated with speech therapy will meet their expectations. There are others who do not, as their demands relate more to the use of sign language and that their linguistic rights are guaranteed, including in the field of health.

Núbia also highlights that it is not difficult to imagine that any care practice is, at the very least, difficult when professional and user have different languages, not to mention all other health-care practices that are designed thinking exclusively about a sound world.

“Just try to remember if any of the recent campaigns against HIV/Aids or dengue had information also conveyed in sign language. Hearing deprivation, in itself, is something that, if not considered in the care relationship, will be accompanied by discriminatory attitudes”, explains Núbia.

According to Núbia, rehabilitation has been one of the main battle flags of the social movement of people with disabilities, seen as a pressing need by practically all segments of people with disabilities, except for deaf users of sign language, who demand guarantees access to health in its most general conception.

“This has been a legitimate demand, as full access to healthcare is not yet available”, he concludes.

 

 

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Audio description: in a library, perspective and bust image, woman standing with her eyes turned to the left, speaking while keeping her arms lowered. Next to it, on the left in the image, an extensive iron bookcase with three shelves full of books. He wears a pink sleeveless blouse. Image 1 of 1.

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