Nísia Trindade is a woman and competent leader of the reconstruction of the SUS, which due to its qualities has been suffering constant attacks at the head of the Ministry of Health
Nísia Trindade's attempt at frying is not surprising. Although the majority of the health workforce is female, she is the first woman to hold the position of Minister of Health in the country. She has a solid research curriculum in the area of Public Health and the experience of successful technical management in the Fiocruz. So much professional qualification in a woman causes many people to tantrum.
These people I'm referring to have become accustomed to accepting women only as subordinates to perform health care, whether in nursing and other professions, or as domestic caregivers for the bedridden and elderly. It's a group that goes from being a little uncomfortable to out of control when women take on command positions. He says that “women changing diapers and giving baths are fine. Leading is already too daring.”
These same people insist on political appointments for leadership and management positions, and not just in health. It flatly refuses to change the paradigm for career appointments and promotions based on technical criteria. Not even that there are dramatic and recent examples of illness, permanent sequelae or deaths from COVID-19, dengue fever, meningitis, spotted fever and malnutrition. Fact: IQ policy, the old and poorly done Who Indicates, also kills or incapacitates.
But not only. Nísia Trindade was appointed by a President of the Republic hated by a large part of our middle and upper classes – white and urban. A President attacked for any reason or for no reason at all, daily and without shame, by powerful press outlets, members of religious groups, businesspeople, digital influencers, science deniers and WhatsApp activists. This hatred has an incredible capillarity and spills over into everything and everyone related to the President.
Despite the underfunding of Health, an issue ignored by the President's critics along with the CPMF and the government's spending ceiling, the budget of the Department led by Nísia Trindade is still one of the largest. In a year of municipal elections, the appetite for a little of this money tends to increase in the country's 5568 electoral districts. This may be one of the reasons for the sudden intensification of the campaign to wear out the Minister. The downturn may just be beginning.
Why don't the moralists on duty throughout the national territory commit themselves with the same energy to correct distortions and eliminate loopholes for corruption in all administrative spheres of the SUS? After all, SUS professionals are not required to dedicate themselves exclusively to public service, nor quarantine after dismissal to take on management positions in clinics, hospitals and companies – their own, their relatives or those owned by them – many of which have contracts with… the SUS.
Thus, the public and private sectors are intertwined. Sometimes, blind spots in health even involve organized crime, and become a matter for the police and Public Prosecutor's Office. It is enough to refresh the collective memory about the suspicions of illicit enrichment involving managers of some Brazilian philanthropic hospitals and Social Health Organizations (OSS) in the last decade.
The lack of transparency in accountability and allegations of irregularities were so serious that, by State Law no. 8.986 of August 25, 2020, OSS will no longer be able to assume the management of health units in the State of Rio de Janeiro without a public, objective and impersonal qualification process. They will also be required to publish the summary of the management report and balance sheet annually in the Official State Gazette.
There is strong evidence that Minister Nísia Trindade is the target of base attacks because she upsets prejudiced people, denialists and those involved in conflicts of interest with deep roots in the health sector.
But the Minister is not alone. She is the commander-in-chief of millions of doctors, nurses, nursing technicians and assistants, physiotherapists, occupational therapists, speech therapists, gerontologists, nutritionists, biologists, biomedics, physical educators, physicists specializing in medical physics, biomedical systems technologists, pharmacists, psychologists, dentists, veterinarians, radiology and orthopedic immobilization technicians, community health agents, social workers and ambulance drivers who take care of the lives under the responsibility of the SUS. Also in this backline are: administrative, information technology, hospital hotel staff (reception, cleaning, laundry, kitchen) and building maintenance for the SUS.
Several of these professionals received applause for their uninterrupted and courageous performance during the COVID-19 pandemic. Afterwards, they were once again treated with the usual indifference or contempt by many SUS managers. Others remained invisible to politicians and managers even during the pandemic. Now, we have the historic opportunity to repair these and other injustices with Minister Nísia Trindade as the competent leader of the reconstruction of the SUS.
It remains to be seen whether the country is up to this leadership.
*Aracy PS Balbani é ENT doctor. She works as a specialist exclusively in the SUS assistance area in the interior of São Paulo.
References
Brazil EBC Agency. TCE prohibits the state of Rio from hiring OSs for field hospitals. Published on 09/06/2020.
CREMERJ. CREMERJ files representation at the MPT-RJ against OS ISG for delay in doctors' salaries. Published on 02/06/2023.
https://www.cremerj.org.br/informes/exibe/5732
State Law no. 8.986 of August 25, 2020. Provides for the qualification of non-profit entities as social organizations, in the context of health, medical management contract, and other provisions.
http://alerjln1.alerj.rj.gov.br/CONTLEI.NSF/c8aa0900025feef6032564ec0060dfff/c8d2df9a2566fd0e83257911005f4c7a?OpenDocument
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