Street Clinic: Experiences of Community Health Care
Authors: Firmino Gilson Gabriel da Silva , Yasui Silvio 
Published: September 2024

In recent times, the growing phenomenon of the homeless population living in urban centers has become a national problem. The civilizing process, which has the urbanization of cities as a central point in its development, has ended up triggering a profusion of demands for the assistance needs of public policies aimed at this population, especially the right to access health care as a right of all and a duty of the State, as provided for in the Brazilian Constitution. In this regard, the Street Clinic is defined as a health facility of the SUS that offers promotion, prevention and care actions in the street territory for users who live on or from the streets in vulnerable situations, mainly due to the abusive consumption of alcohol and other drugs. Composed of a multidisciplinary team, its mission is to bring health to the homeless population, offering access to care that was previously restricted to traditional health establishments. In line with this proposal, the role of the clinical practice of the professionals at the Street Clinic points to great availability, involvement and openness to the street context, as well as adopting the relational factor generated from clinical encounters as an essential element of human diversity in the field of their actions carried out in the daily work routine. Thus, this study aims to bring to the scene the production of health care on the street by explaining some of the offers of the Street Clinic in Campinas SP crossed by the complexity of the territory, which drives an adaptation of clinical practices and health procedures due to the relationship between service users and the context of survival in the caregiver encounters provided as a guiding thread of this process under the support of SUS health policies. Through some guiding questions, namely: How do we notice the signs that come from the street in the production of care? How do users constitute their ways of living? What effects do we gather from the health care actions produced by the service from the perspective of medical and nursing care? Thus, our objectives are to monitor the production of health care at the Street Clinic using images, field diaries and oral sources from service workers, especially doctors and nurses. The involvement of each actor in this process evokes a collective and creative atmosphere woven into the daily challenges of producing health on the streets. At the same time, we construct the analysis of the effects of medical and nursing care in the health field through clinical practices for complex cases developed by the city's health network. The methodology used is cartography as an intervention research methodology linked to highly complex guide cases as enablers for the analysis of health care networks.The provisional results of this qualitative study point to a change in the conception of health care in the dimension of medical and nursing modalities, both influenced by the effects of clinical encounters carried out in action in the territory, thus triggering the resizing of understanding and praxis within the professional core and the collective construction of health production processes. Another highlight is the feasibility of the exercise of autonomy and inventiveness by the collective of professionals of the Street Clinic. Whether through the elaboration and implementation of clinical conducts, alleviating the harshness and rigidity present in most of the health protocols in force in the treatment of users with chronic morbidities, or even in the expression of the importance of the materiality of work as a foundation for the unconditional defense of the reinvention of life, whether in therapeutic terms, as well as in its community, emancipatory and citizen universe.