Medical Students and Community in Southern Brazil: An Experience in Reciprocal Empowerment

Abstract

Brazil’s Unified Health System (Sistema Único de Saúde, SUS) is rooted in the 1988 Citizen’s Constitution. Universal health reforms, inspired by Freire’s legacy of popular education, embody the struggle within Brazilian society against authoritarianism and inequality, and for democratization. “Controle social” (the participation of the public in management and oversight) is a key principle governing the system. It is a broad term that encompasses government accountability to communities, health self-agency, community participation, and local empowerment. “Controle social” is institutionalized through Health Councils, which are set up at the local, municipal, state, and national levels. This article examines the experiences of the Health Education League, a project that brought together medical students from the Federal University of Rio Grande and residents of the Barra fishing community, and used Freirean principles to co-construct knowledge and empowerment in health. It describes the community’s efforts to establish a participatory local Health Council as a means of improving primary care and embedding the right to health. These efforts at empowerment succeeded in establishing a Strategic Family Health Basic Health Unit in the community, however “controle social” through a local Health Council has yet to be fully attained. In this case, popular education represented a qualitative key that “unlocked both sides of the door” to reciprocally empower communities and student health practitioners.