“Ao subir, abaixa o farol”: uma etnografia com agentes comunitários de saúde (ACS) sobre o tráfico de substâncias psicoativas ilícitas em uma cidade de pequeno porte

Abstract

The community health agents (ACS) are professionals who act as intermediaries between the healthcare system and the community. Their role is fundamental in promoting health and preventing diseases especially in vulnerable and hard-to-reach areas. The aim of the present research was to understand the social significance of psychoactive substances for the ACS. The study is characterized as an ethnographic-based study in which interviews and field immersions were conducted. Eleven months of fieldwork were undertaken, including two months of interviews; three months of returning to the field, visits to health units, and inviting ACS to accompany them in their rounds; and six months of immersion in the territory. Two interviews were conducted with ACS from a medium-sized university city, and thirteen interviews were conducted in a small town. There were numerous difficulties in accessing the initial field planned for the research. Therefore, immersion in the territory and the majority of the interviews were conducted in the city of Macondo, which eventually became the main city of this research. These interviews were used in the work for comparison and hypothesis development regarding the difficulty of accessing the field. The thirteen interviews were conducted across three UBS (Basic Health Units) in the town: five ACS were interviewed at the Estrada Real Unit, six at the Inconfidentes Unit, and four at the Bandeirantes Unit. Additionally, three interviews were conducted in a small university city where the research was initially intended to take place. Conducting a study on drug trafficking territories in a small town was challenging. The difficulty in finding literature on ACS and drug trafficking territories, as well as trafficking in small towns, made the detailed description of this ethnography even more essential. It was possible to understand discretion as an essential mode of action in healthcare by ACS in drug trafficking territories. The relationships established by these professionals with trafficking and actors – traffickers and couriers – were permissive and punitive in nature. However, the relationships with the trafficking figures in Macondo were complex and involved more than just fear and risk. The ethnographic description of walking through the territory was done in a detailed manner so that the accounts of the interlocutors were fully highlighted.