Transplante de Medula Óssea e lógica invertida do SUS: desafios para a prática profissional

Abstract

This study was conducted from the experience lived in the multidisciplinary residence in oncology at the National Cancer Institute José Alencar Gomes da Silva (INCA). The insertion as Social Worker, in one of the units, at the bone marrow transplantation center (BMT), allowed the reflection and the study about the social worker performance in face of the complexity of the reality of the bone marrow transplant users. We aim to analyze the inversion of the logic of SUS in the materialization of BMT, addressing the role played by the social worker who opts for the professional ethical-political project, in the face of contradictions, limits and possibilities put to practice in health, in a transplant unit. To this end, we address the need for bone marrow transplantation for the recovery of the user's health, the real socioeconomic conditions for maintaining the quality of life of the transplanted user and the limits and possibilities of acting against the reality of public policies today and health trends. The way to achieve these goals is to identify the routine and impacts suffered by users after bone marrow transplantation, post-transplant survival and mortality, the cost of BMT and the analysis of social policies in the current conjuncture and trends assumed mainly in the health area. The research is qualitative and was conducted, through semi-structured interviews, bibliographic and documentary research. Data interpretation was performed using the Hermeneutic-dialectical methodological approach. The analysis was supported by the method of social theory and dialectical historical materialism. In the field work, data collection was used, with documentary analysis, through medical records of users who were participants of the research, as well as interviewees. Thus, we sought to classify the major impacts and changes in lifestyle suffered by users, in an attempt to identify how much the disease and especially the treatment of BMT impacts on new needs and weaknesses in the lives of workers using SUS. Our study reveals that, with the almost exclusive priority of performing BMT, without guaranteeing the socioeconomic conditions for the user to support the transplant and survive and / or do not need a new transplant, the SUS logic is reversed. , that is, inversion of what is ensured in the legislation, in relation to the principle of integrality of health, expressly announced in art. 198, item II (CF, 1988): comprehensive care, with priority for preventive activities, without prejudice to care services.