Os fios da meada da vida: a coprodução dos cuidados em saúde entre sujeitos usuários de drogas em situação de rua

Abstract

This article aims to understand and reflect on the different forms of co-production of care developed among homeless drug users in Barbacena city – Minas Gerais. We sought to answer some guiding questions, namely: How do drug users living on the streets manage their own care in their street daily lives? What health care is offered by the Psychosocial Care Center for Alcohol and Other Drugs in this city for this specific audience? It was chosen a qualitative research with a methodological path consisting of seven months of participant observation, alternating between day and night periods, between August 2022 and March 2023, supported by a field diary to construct the data, furthermore conducting narrative interviews to answer those questions. Initially, the observation began in conjunction with the Consultório na Rua Team and, thus, it was possible to visit some institutions that carry out actions with the homeless population. In total, twenty-four people were observed during the research and four were selected, for convenience, to participate in the interviews. Furthermore, it was identified that the main demand for health care is related to the need for a qualified and welcoming listening posture from professionals, so that the subjects' sufferings are understood based on their unique stories, mostly due to stigmatization, violence, precariousness and negligence situation. In this sense, it was also noticed that the approaching and coercion coexist in public services and, thus, these contradictions can affect the effectiveness of health care, which is often crossed by moral and prohibitionist perspectives present in the Brazilian Public policies and the society as a whole. Finally, given the complex needs presented by homeless drug users, the notion of 'health care' is expanded to 'life care' by observing a multiplicity of care not exclusive to the health area, which are mixed with the most diverse forms of existence and co-productions of street life permeated by economic, political and social issues in our country.