Disponible en castellano/ Disponível em língua portuguesa SciELO Brasil w w w .scielo.br/ rlae 1
Advisor, PhD in Nursing, Adj unct Professor, Rio Grande do Sul Federal University, Brazil, e- m ail: clarice@adufrgs.ufrgs.br; 2 RN, e- m ail: fernanda@cefet rs.edu.br
HEALTH AND SELF- CARE AMONG GARBAGE COLLECTORS: W ORK EXPERI ENCES I N A
RECYCLABLE GARBAGE COOPERATI VE
Clar ice Mar ia Dall’Agnol1 Fer nanda dos Sant os Fer nandes2
Dall’Agnol CM, Fer nandes FS. Healt h and self- car e am ong gar bage collect or s: w or k exper iences in a r ecyclable gar bage cooper at iv e. Rev Lat in o- am En fer m agem 2 0 0 7 set em br o- ou t u br o; 1 5 ( n ú m er o especial) : 7 2 9 - 3 5 .
St udy perform ed wit h garbage pickers who organized a cooperat ive t o sort recyclable garbage in Port o Alegre, Brazil, in a shed loaned by the city adm inistration. This activity, which has attracted an increasing num ber of people excluded from the form al job m arket, presents peculiar health risks and patterns of disease. The study aim ed t o learn about t he part icipant s’ concept s and self- care act ions, proposing discussions and j oint ly reflect ion on t heir problem s. I t focuses on t he working environm ent and on at t it udes t owards healt h risks. Through t he focal group technique with ten fem ale subjects, the expression of capacity of situational analysis of those involved was privileged, giving rise to three m ain them es. Each them e discussed was followed by the construction of a plan of action in order to m eet com patibly the m ore pressing needs according to the operational feasibility of the solutions proposed.
DESCRI PTORS: povert y; healt h public policy; com m unit y net works; social condit ions; com m unit y healt h nursing; self car e; focus gr oups
SALUD Y AUTOCUI DADO ENTRE MI NADORES DE BASURA: VI VENCI AS EN EL TRABAJO EN
UNA COOPERATI VA DE BASURA RECI CLABLE
Est udio r ealizado con m inador es de basur a que or ganizar on una cooper at iv a de separ ación de basur a r eciclable en u n galpón de la m u n icipalidad de Por t o Alegr e, RS. Est a act iv idad, qu e h a at r aído u n n ú m er o cr ecient e de ex cluidos del m er cado for m al de t r abaj o, pr esent a r iesgos a la salud y est ándar es peculiar es de enfer m edad. La finalidad fue conocer las concepciones y acciones de aut ocuidado de las par t icipant es, t odas m uj er es, pr oponiendo discusiones y r eflex iones conj unt as sobr e la pr oblem át ica v iv ida por ellas. El foco m ir ó el am bient e de t r abaj o y las act it udes r elacionados a los r iesgos a la salud. La t écnica de gr upos focales con d iez su j et os p er m it ió p r iv ileg iar la ex p r esión d e su cap acid ad d e an álisis sit u acion al, or ig in an d o t r es ej es t em át icos. A cada t em a discut ido se siguió la const rucción de un plan de acción de m anera a com pat ibilizar la at ención a las necesidades m ás dem andadas con la viabilidad oper acional de los encam inam ient os pr opuest os.
DESCRI PTORES: pobr eza; polít icas públicas de salud; r edes com unit ar ias; condiciones sociales; enfer m er ía en salud com unit ár ia; aut ocuidado; gr upos focales
SAÚDE E AUTOCUI DADO ENTRE CATADORES DE LI XO: VI VÊNCI AS NO TRABALHO EM
UMA COOPERATI VA DE LI XO RECI CLÁVEL
Est udo realizado com cat adores de lixo que organizaram um a cooperat iva de t riagem de lixo reciclável, em Port o Alegre, RS, num galpão cedido pela prefeit ura. Essa at ividade, que t em at raído núm ero crescent e de excluídos do m ercado form al de trabalho, apresenta riscos à saúde e padrões de adoecim ento peculiares. O estudo obj et ivou conhecer as concepções e ações de aut ocuidado das part icipant es do est udo, t odas m ulheres, propondo discussões e reflexões conj unt as acerca da problem át ica por elas vivenciada. O foco foi direcionado ao am bient e de t rabalho e às at it udes com relação aos riscos à saúde. Por m eio da t écnica de grupo focal com dez suj eit os, privilegiou- se a expressão da capacidade de análise sit uacional das pessoas envolvidas, dando origem a t rês eixos t em át icos. A cada t em a discut ido seguiu- se a const rução de um plano de ação, porém , de form a a com pat ibilizar o at endim ent o de necessidades m ais prem ent es com a viabilidade operacional dos encam inham ent os propost os.
I NTRODUCTI ON
T
h e in cr ease in gar bage, a pr odu ct of t h e m od er n societ y ’s f r an t ic con su m p t ion , is in v er selyp r o p o r t i o n a l t o e x i s t i n g r e s o u r c e s a n d d e v i c e s
available t o t reat , st ore or elim inat e it . Today, t his is
a p r i m a r y e n v i r o n m e n t a l a n d e co n o m i c p r o b l e m ,
which invariably also affect s sanit ary cont rol. I n som e
regions, garbage is an im port ant variable t o est ablish
h ealt h d iag n oses f or som e com m u n it ies, m ain ly in
t he ur ban cont ex t , as it can ser iously j eopar dize t he
h ea l t h i n ess o f en v i r o n m en t s t h a t j o i n b i g h u m a n
agglom er at ions w it h a lack of basic sanit at ion.
Gar bage- r elat ed pr oblem s h av e m obilized a
w i d e r a n g e o f k n o w l e d g e a r e a s t o d e v e l o p
t e c h n o l o g i e s a n d p r o p o s e a l t e r n a t i v e s f o r t h e i r
m in im izat ion . Th e m ost d issem in at ed , st u d ied an d
st i m u l at ed al t er n at i v e n o w ad ay s i s r ecy cl i n g . Th e
p o s s i b i l i t y o f e x h a u s t i n g r a w m a t e r i a l s a n d
c o n t a m i n a t i n g n a t u r a l r e s o u r c e s a r e t h e m o s t
im m inent ecological prem ises t hat j ust ify t he need t o
r e c y c l e g a r b a g e , a s t h i s m e a s u r e “ c o n s i s t s i n
s u b m i t t i n g p r o d u c t s t h a t e x i s t i n g a r b a g e t o
t r an sf or m at ion pr ocesses, so as t o gen er at e a n ew
product ”( 1).I n order t o perm it and st im ulat e recycling,
l a r g e ci t i e s l i k e Po r t o Al e g r e d o se l e ct i v e w a st e
collect ion, m ak ing t he m at er ial av ailable t o r ecy cler s
a t s e p a r a t i o n u n i t s t h a t c o n s t i t u t e d i f f e r e n t
associat ion s( 2 ).
H e n ce , b e si d e s t h e i m p o r t a n t e co l o g i ca l
aspect , econ om ic an d social aspect s sh ou ld also be
t ak en in t o accou n t . Tog et h er, t h ese t h r ee asp ect s
j ust ify t he pr om ot ion of gar bage r ecycling. How ev er,
t his new w or k m ode ent ails healt h r isks and peculiar
illness pat t er ns. The for m er der ive fr om cont act w it h
t h e g ar b ag e. Du e t o t h e “ d iv er sit y of t r an sm ission
rout es and especially t o t he act ion of - biological and
m echanical - vect ors, t he range of influence and healt h
pr oblem s ar e har d t o ident ify”( 3). How ev er, t he m ost
fr equent m or bidit ies r esult ing fr om dir ect or indir ect
h u m an con t act w it h w ast e ar e d iar r h eic d iseases,
d i r ect l y r el a t ed w i t h h a n d w a sh i n g , a n d d i sea ses
t r ansm it t ed by biological and m echanical v ect or s.
Anot her pot ent ially unhealt hy sit uat ion refers
t o t he r euse of food and ot her obj ect s found in t he
garbage, such as j ew elry, t oys, pot s, ut ensils, et c. I t
should be highlight ed t hat t he nat ure of t he work it self
can com pr om ise w or k er s’ ph y sical in t egr it y, besides
ot h er m ish aps t h at can af f ect h ealt h . I n it self, t h is
problem j ust ifies t he int erest nurses and ot her healt h
p r of essi o n al s( 4 ) sh o u l d d ed i cat e t o t h ese w o r k er s.
Desp it e t h e lack of a f or m al em p loy m en t con t r act ,
t he num ber of workers increases every day and t hey
are client s of healt h services affiliat ed wit h t he Single
Healt h Sy st em ( SUS) .
The condit ion of povert y and social exclusion
t hat affect s people in t hese cir cum st ances needs t o
be consider ed in it s full r ange, t o t he ex t ent t hat it
in v olv es v ar iou s dim en sion s, in clu din g t h ose in t h e
e c o n o m i c s p h e r e a n d p u b l i c h e a l t h p o l i c i e s f o r
ex am ple. Th is can n ot be ign or ed. How ev er, despit e
t h e a d v e r s i t i e s p r o v o k e d b y b r o a d e r s o c i a l
det er m inant s, t her e is a cer t ain degr ee of aut onom y
in t he ways of leading one’s life t hat inst alls bet ween
t hese subj ect s’ singular and collect iv e, so t hat t hey
c a n c r e a t e , e v e n i f m i n i m a l l y, p o s s i b i l i t i e s o f
t r a n sf o r m a t i o n a n d , o n t h e o t h er h a n d , o f so ci a l
r e i n s e r t i o n . S o m e r e f l e c t i o n s i n t h i s s e n s e a r e
p r e se n t e d i n r e se a r ch r e su l t s( 5 ) a b o u t t h e so ci a l
em ancipat ion pr ocess of gar bage collect or s affiliat ed
w i t h t w o r e cy cl a b l e m a t e r i a l co o p e r a t i v e s i n t h e
Sout heast of Br azil.
When t he r esear cher s fir st v isit ed t he place
of st udy - a r ecy clable gar bage cooper at iv e in Por t o
Alegr e - t hey act ually found t hat w ast e cont act and
h an d lin g , as w ell as t h e w or k en v ir on m en t , of f er s
m a n y h e a l t h r i s k s , g i v i n g r i s e t o t h e f o l l o w i n g
quest ions: what is and what is t he im port ance of
self-care in t his environm ent for t hese workers? What are
t he possibilit ies of m aking t he best use of t he garbage
at t he low est healt h r isk ? Based on t hese quest ions,
t h e st u dy obj ect iv e w as ou t lin ed, t h at is, t o get t o
k n o w t h e se l f - ca r e b e h a v i o r s o f w o r k e r s a t t h i s
r ecy clable w ast e cooper at iv e by discussing/ r eflect ing
on t he t hem e and, t hus, support t he elaborat ion of a
j oint act ion plan t o prom ot e self- care pract ices in t he
w or k en v ir on m en t .
METHOD
A qualit at ive research was carried out am ong
g a r b a g e c o l l e c t o r s f r o m a r e c y c l a b l e w a s t e
cooper at iv e locat ed on t he out sk ir t s of Por t o Alegr e,
RS, Brazil, in a shed yielded by t he cit y governm ent .
The subj ect s’ par t icipat ion and analy t ic capacit y w as
e m p h a si ze d , a p p r o a ch i n g t h e p e r sp e ct i v e o f co
-m a n a g e-m en t o f g r o u p s( 6 ) a n d a n a ct i o n r esea r ch
focus( 7). The subj ect s’ act iv e inclusion in all pr oblem
diagnosis phase t hat ident ifies and cont ext ualizes t he
s u b j e c t s t h e m s e l v e s . I t i s n o t e n o u g h f o r t h e
pr of ession al t o iden t if y h ealt h r isk s or pr oblem s as
su ch . I t is f u n d am en t al f or v u ln er ab le su b j ect s t o
p e r ce i v e a n d a sse ss t h e m a s w e l l , d i scu ss t h e i r
co n d i t i o n an d b u i l d so l u t i o n s an d al t er n at i v es, i n
accor dan ce w it h t h eir possibilit ies, w it h ou t ign or in g
t he m isfor t unes t hey ar e subm it t ed t o because t hey
belong t o t he poor est social segm ent s. Hence, dat a
collect ion t h r ou g h t h e Focu s Gr ou p Tech n iq u e w as
p r ov id en t ial. Th is con st it u t ed an im p or t an t t ool t o
assess t he work sit uat ion in t erm s of t he environm ent
an d t h e w or k er s’ at t it u din al r esu lt s w it h r espect t o
t he healt h r isk s.
I n t h e f o c u s g r o u p t e c h n i q u e , “ e a c h
par t icipan t t alk s on t h e basis of h is/ h er v er t icalit y,
t h at is, based on h is/ h er ex per ien ces. How ev er, as
t he individual hist ory is t he heart of t he int errelat ions
t hat ar e exper ienced, t he r epor t s, opinions, posit ions
a r e co n st r u ct s t h a t a r e g r a d u a l l y o u t l i n ed i n t h e
relat ions wit h t he ot her( s) . These refer t o t he groups
o f o r i g i n , m a n i f e s t a t i o n s o f t h e p r e c e d i n g a n d
c o n t e m p o r a r y h i s t o r y. H e n c e , t h e s u b j e c t s a l s o
express t he horizont alit y t hey are included in and t he
d e b a t e i t se l f i n t h e f o cu s g r o u p i s o n e o f t h e se
c o n s t r u c t i o n s ”( 8 ). B a s e d o n t h i s p r i n c i p l e , t h e
in t en t ion al sam ple cr it er ion w as adopt ed, u sin g t h e
sn ow - b all r esou r ce, in w h ich on e su b j ect in d icat es
anot her t o be part of t he group. The person who had
been t he for m al leader of t he cooper at iv e indicat ed
t he first person who, in t urn, indicat ed t he subsequent
subj ect and so on, unt il t en part icipant s were j oined,
a m o d u l e c o n s i d e r e d i d e a l f o r t h e i n t e n d e d
dy nam ics( 8). Fiv e w eek ly sessions of one hour and a
half were held, bet ween Decem ber 2003 and January
2004, in a place t hat belonged t o t he cooperat ive.
Dur ing each gr oup session, t he par t icipant s
were st im ulat ed t o discuss t heir healt h concept ions and
obser v e t heir ow n w or k env ir onm ent w it h a v iew t o
i d en t i f y i n g p r o b ab l e h eal t h r i sk s. Based o n t h ese
discussions, elem ent s w er e sought t hat w ould fav or
t he im plant at ion of im provem ent s for healt h prom ot ion
and disease prevent ion. The debat es were coordinat ed
by on e of t h e au t h or s an d, af t er each f ocu s gr ou p
session, t he coor dinat ion t eam - w hich consist ed of
t he aut hors - m et t o discuss and assess relevant aspect s
t hat em erged in t he group dynam ics, planned t he next
session and so on, unt il dat a collect ion was concluded.
Th e i n f o r m a t i o n w a s t r e a t e d t h r o u g h
discourse analysis( 9). This analysis m ode is not based
on t he quant ificat ion of signifiers - words, expressions
- b u t o n t h e u n d e r st a n d i n g a n d m e a n i n g o f t h e
em er gin g st at em en t s.
As t o t he et hical aspect s, t he st udy com plied
w it h Resolu t ion 1 9 6 / 9 6 by t h e Nat ion al Cou n cil f or
Research Et hics ( CONEP) and ot her det erm inat ions( 10).
Th e p r oj ect on ly st ar t ed af t er t h e ap p r ov al b y t h e
Resear ch Et h i cs Co m m i t t ee at Ri o Gr an d e d o Su l
Federal Universit y, regist rat ion num ber 2003230. The
Cooperat ive leadership also gave it s approval t o serve
as t he research inst it ut ion. Moreover, each part icipant
g av e h i s/ h er au t h o r i zat i o n f o r au d i o - r eco r d i n g b y
signing t wo copies of t he Free and I nform ed Consent
Ter m , guarant eeing: fr ee par t icipat ion and t he r ight
t o c e a s e p a r t i c i p a t i n g a t a n y t i m e , a n o n y m i t y,
confident ialit y of t he infor m at ion and absence of any
i n f l u e n ce s t h a t co u l d i n t e r f e r e i n a cce ss t o a n d
m ain t en an ce of t h e gar bage collect or s’ j ob con t r act
w i t h t h e c o o p e r a t i v e . I m m e d i a t e l y a f t e r t h e
t ranscript ion, t he audio- t aped m at erial was dest royed,
w hile t he t r anscr ibed m at er ial w ill be st or ed for fiv e
years. The cont ent of t he st at em ent s t o com pose t he
t ex t of t he r esult publicat ion w as v alidat ed w it h t he
wom en who part icipat ed in t he focus group, during a
m eet ing specifically held for t his pur pose.
RESULTS AND DI SCUSSI ON
Three t hem es em erged from t he m at erial t hat
result ed from t he discussions held on t he basis of t he
f ocu s gr ou p t ech n iqu e: h ealt h con cept ion accor din g
t o t h e gar bage collect or s; am idst t h e gar bage, t h e
p l a ce f o r m e a l s; t h e w o r k e n v i r o n m e n t a n d t h e
w or k er s’ con du ct : iden t if y in g an d solv in g av oidable
r isk s.
Healt h concept ion according t o t he garbage collect ors
To st ar t t he debat es, t he gr oup par t icipant s
w e r e a sk e d a b o u t t h e i r h e a l t h co n ce p t i o n s. Th e
m a n i f e s t a t i o n s c o n v e r g e d t o w a r d s o n e s i n g l e
cert aint y: being healt hy m eans not cat ching a severe
disease. Accor din g t o t h e f ocu s gr ou p par t icipan t s,
all of w hom w er e w om en, t he condit ion of not being
h ealt h y is dir ect ly r elat ed w it h h av in g diseases lik e
can cer, AI DS, t u ber cu losis, lept ospir osis, et c. Th ese
problem s were evoked on t he basis of sit uat ions t hey
ex per ienced in t he fam ily or v er y closely, due t o t he
For m e, being healthy m eans not having to go to hospital,
not t aking m edicines, if we don’t have t hat we’re healt hy, if we
don’t have anyt hing of a disease... I t hink t hat you should prot ect
yourself from diseases, like AI DS, you know, and ot her diseases
you can cat ch.
The underst anding of healt h rem ained lim it ed
t o t he biological spher e, consider ing t he body as t he
m ain m ar k er of healt h and disease st at es. Alt hough
t he part icipant s appoint ed som e healt h problem s t hat
can be cau gh t by con t act w it h w ast e, t h ey did n ot
m ak e any affir m at iv e asser t ion t hat t hey consider ed
env ir onm ent al influences as incisiv e det er m inant s in
h e a l t h p r o m o t i o n a n d m a i n t e n a n c e( 1 1 ). D e s p i t e
acknow ledging t hat r espir at or y diseases and aller gies
can be caught t hrough t he wast e, t hese diseases were
not m et wit h concern, arguing t hat t hey can be cured
by m edicat ion. I n t he par t icipant s’ concept ion, t hese
diseases go by alm ost unnot iced, what bot hers is t he
fact of dying lit t le by lit t le, w hich w er e t hen associat ed
w it h t h e su f f er in g of can cer p at ien t s. Th at is, t h e
p ossib ilit y of cu r e d et er m in es t h e im p or t an ce of a
d isease t o m ain t ain t h e “ st at u s” of b ein g h ealt h y.
Based on t his represent at ion, t he group perceives it self
as h ealt h y an d , w h en ask ed ab ou t p ossib le h ealt h
r isk s, b y con t act w it h w ast e, t h e on ly m an if est ed
c o n c e r n w a s w i t h t h e r i s k o f c a t c h i n g d i s e a s e s
p ar t icip an t s con sid er sev er e, su ch as AI DS d u r in g
hospit al w ast e handling.
Based on t he debat es, it w as found t hat t he
garbage collect ors assess living and healt h condit ions
in quant it at iv e t er m s, t hat is, t hey r em ain r est r ict ed
t o t h e pr ior it y of h av in g t o gu ar an t ee su r v iv al, an d
not based on a qualit at iv e m easur e, w hich r efer s t o
t he pleasure of living. A sim ilar condit ion was appoint ed
in an ear lier st udy( 4). Being healt hy is closely link ed
wit h t he possibilit y of being able t o work, independent ly
of t h e con d it ion s t h e w or k of f er s. Th is con cep t ion
denounces t he dist ance from t he not ion of healt hiness
t h a t a t t e m p t s t o c o n t e m p l a t e a p p r o p r i a t e w o r k
co n d i t i o n s. Sep ar at i n g w ast e, n o t o n l y d u e t o i t s
in f or m al n at u r e, bu t m ain ly becau se of t h e r isk s it
o f f e r s, i s l e g a l l y co n si d e r e d u n h e a l t h y( 1 2 ). W h e n
look in g b ey on d w or k , it sh ou ld also b e h ig h lig h t ed
t hat healt h r esult s fr om fully at t ended social needs,
in t he sense of obt aining a dignified and high- qualit y
life( 13), w hich is not observed in t hese w orkers’ case.
I n f o r m a l i t y a n d p o v e r t y a r e p e r s i s t i n g
pr oblem s an d t h is w h ole com plex n et w or k in t er act s
w it h t h e su b j ect s’ h ealt h , as it p er m eat es sev er al
dim ensions of t heir phy sical, m ent al and social w
ell-being( 13). What t he work act ivit y is concerned, recycling
solv ed som e p r ob lem s, b u t en t ailed or m ain t ain ed
ot hers. I ncom e creat ion undoubt edly represent s a part
of t he solut ion, a m inim um guar ant ee for one’s ow n
and one’s fam ily’s survival. However, t he risks inherent
in t h is act iv it y, as m en t ion ed in t h e in t r odu ct ion of
t his art icle, inaugurat e a new cat egory of m orbidit ies.
Am idst t he gar bage, t he place for m eals
M a n y o f t h e r e p o r t s e x p r e s s e d t h e
u n d er st an d in g t h at eat in g am id st w ast e w as n ot a
p r o b l e m , a s o n e e a t s w a s t e. Th e e s t a b l i s h e d
b e h a v i o r s, h a r d l y su sce p t i b l e t o ch a n g e s, i n t h e
at t em pt t o solv e t h is specif ic issu e, w ou ld per h aps
find echo in t he bond t hese subj ect s est ablished wit h
t he garbage. The value t he subj ect grant s t o wast e is
s o c i a l l y d e f i n e d , t h a t i s , t h e s e w o r k e r s ’ s o c i a l
condit ions det er m ine t he int ense r euse of w hat has
been r ej ect ed( 4 ).
Du r in g t h e f ir st con t act s w it h t h e p lace of
st u d y, t h e f or m al coop er at iv e lead er sh ip ap p oin t ed
t h e p lace f or m eals as on e of t h e cen t r al p r ob lem
issues, as t his w as locat ed inside t he r ecy cling shed
it self. I n t he at t em pt t o solve t his im passe, a kit chen
w as built on t he pat io t o provide a m ore appropriat e
place. How ev er, du r in g focu s gr ou p debat es, it w as
lit er ally said t hat :
... t hey have m ade t hat kit chen here for us, but we
don’t have breakfast here.
As r esear cher s, im bued w it h t he per spect iv e
of j oin t gr ou p m an agem en t , it w as k n ow n t h at an y
act ion plan t o cope wit h difficult ies would have t o rest
on t he co- part icipat ion of t he people direct ly involved,
and t he fir st st ep w as list ening. I n t his cont ex t , t he
reason for not using t he kit chen environm ent for m eals
w as inser t ed in t he discussions, as it w as t he m ost
a p p r o p r i a t e p l a c e f o r t h i s p u r p o s e . A r g u m e n t s
i m m ed i at el y cam e u p ab o u t t h e i n co n v en i en ce o f
having t o m ove from t he shed t o t he kit chen, as snack
t im e, preset at 20 m inut es, would alm ost be reduced
b y h alf. On e par t icipan t ’s j u st if icat ion , w h o alleged
t hat t here were not enough chairs for all workers was
n ot accep t ed b y t h e ot h er s an d at t r act ed an ot h er
com m en t :
...it is closer t o com e t o t he kit chen t han t o cat ch a
disease and go t o t he healt h unit , which is furt her off.
How ev er, ev en if t h e in t en t w er e t o ev ok e
p r e v e n t i v e a ct i o n , t h i s st a t e m e n t i n d i ca t e s t h a t
discom for t of hav ing t o m ov e t o t he k it chen t han at
act ual pr ev ent ion in t he sense of healt h car e. Lit t le
by lit t le, a cr y st allized at t it u de w as r ev ealed in t h e
group, which resist ed against any argum ent t hat could
br eak t he habit of hav ing m eals inside t he r ecy cling
shed, t o t he ext ent t hat ot her com plaint s were added,
such as t he fact t hat t he access door used t o be locked
d u r in g sn ack t im es, as w ell as t h e f act t h at som e
workers do not feel at ease in t he kit chen.
On a n o t h e r o c c a s i o n , c o n s t r a i n t w a s
expressed about having m eals at t he shed due t o t he
visit s of people who do not belong t o t he cooperat ive,
w h o som et im es cau gh t t h e w or k er s h av in g a sn ack
t her e and com m ent ed on t he lack of hygiene r elat ed
t o t h i s c o n d u c t . W h e n e x a m i n i n g i f t h e g r o u p
considered t he fact as a lack of hygiene, t he following
an sw er w as act u ally g iv en : I t h in k t h at t h ey t h in k
t hat it is a lack of hy giene, r efer r ing t o t he v isit or s.
On t he one hand, t his declarat ion could point t owards
ignorance of t he healt h risks. But what is t he reason
f or h idin g t h is pr act ice f r om t h e v isit or s t h en ? Th e
concern w it h ot her people’s opinions, due t o t he fact
t hat t hey were being wat ched while t hey were eat ing
in t h ese cir cu m st an ces, in dicat ed t h at t h e su bj ect s
knew t hat “ som et hing was wrong”. I n parallel, not ions
o f h y g i e n e c o u l d b e i d e n t i f i e d , t h a t i s , i n t h a t
e n v i r o n m e n t , t h e p a r t i ci p a n t s a ck n o w l e d g e d t h e
m eaning of cont am inat ion.
I know a friend, whose nam e I ’m not going t o m ent ion,
but who does not w ash her hands w hen she eat s. She picks up
som et hing she finds t here, chocolat e, a clean t hing, closed, she
t akes and eat s it , she does not wash her hands [ ...] .
Right , you t ook som et hing closed, OK, but what has t o
be closed? You go t here and t ake it wit h dirt y hands, right , you
open it and eat it wit h dirt y hands, so it ’s no use.
This kind of sit uat ions needs t o be dialect ized,
as p r act iced in t h e f ocu s g r ou p d y n am ics, as t h ey
can co n t ai n a si n g u l ar cap aci t y t o r ev er t ad v er se
sit u at ion s or, at least , t o con sider r ef lect ion s abou t
t h em am on g t h e p eop le in v olv ed . Th e com in g an d
g oi n g of d i al og u es, i n i t i al l y p er m eat ed b y ex p l i ci t
r esist an ce t o adm it t h at eat in g am idst t h e gar bage
could r epr esent a healt h r isk , gr adually changed it s
c o n f i g u r a t i o n . A t a c e r t a i n t i m e , t h e b e l i e f
pr edom inat ed t hat it w ould be difficult but necessar y
t o have one’s colleagues eat in t he kit chen. However,
d u r i n g t h e d e b a t e s, t h e g r o u p s a l l o w e d i t se l f t o
r eco n si d er cer t a i n p o si t i o n t h a t h ad sh o w n t o b e
cryst allized and, as such, blocked learning. This gave
r ise t o t h e in t er est in plan n in g alt er n at iv es t h at , if
in cor por at ed in t o self- car e, cou ld en t ail ben efit s for
healt h. One ex am ple is t he par t icipant s’ init iat iv e t o
m ak e post er s, encour aging m eals in t he k it chen and
inv it ing ever yone for a New Year lunch, as t his dat e
w as n ear. Th u s, t h e p r op osal w as con solid at ed t o
redim ension eat ing habit s as from t he new year, and
t h e sch edu led lu n ch w ou ld be t h e st ar t of t h is n ew
phase. At t hese t im es, gradually, t he gr oup becam e
m obilized in t he const ruct ion of viable solut ions, wit hin
it s r each, as pr oact iv e subj ect s.
As a r esult of t his engagem ent , ot her needs
were unveiled am ong t he part icipant s, who also st art ed
t o discu ss t h e im por t an ce of in t er per son al r elat ion s
at w or k . The conv ict ion em er ged in t he gr oup t hat ,
besides hygiene, t he act of m eet ing at t he shed would
be t he opport unit y t o approach subgroups of workers.
Th is gen u in ely t r igger ed a pr ocess of appr opr iat ion
of r ealit y, in a collaborat ive net w or k .
Th e w o r k en v i r o n m en t an d t h e w o r k er s’ co n d u ct :
ident ify ing and solv ing av oidable r isk s
Am ong ot her aspect s, low adher ence t o t he
u se of g lov es w as f ou n d , lar g ely m ot iv at ed b y t h e
pr ecar ious supply of new ones. This is one pr oblem
t he gar bage collect or s fr om t he cooper at iv e face, as
t hey depend on donat ions by t he nearest healt h unit .
How ev er, t he am ount is insufficient t o at t end t o t he
dem ands of t his j ob. I n t he absence of new glov es,
t he workers rem ove what t hey find in hospit al wast e,
wash and st ore it for fut ure use. This aggravat es t he
problem . Besides t he cont am inat ion fact or t hey expose
t hem selv es t o, t hey ar e confr ont ed w it h t he fr agilit y
of su r gical glov es, easily t or n w h ile h an dlin g w ast e
and ineffect iv e as pr ot ect ion equipm ent .
I n t h e f o c u s g r o u p d i s c u s s i o n s , s o m e
argum ent s em erged in favor of using gloves, such as
av oidin g t h e accu m u lat ion of dir t u n der on e’s n ails
and pr ot ect ing oneself fr om lit t le anim als t hat appear in
t he gar bage, m ainly in sum m er. They r em ove t he lar ger
anim als wit h t heir hands, but are concerned wit h t he
lit t le anim als t hat can get int o us wit hout our perceiving it . One
of t h eir f ear s is t o cat ch r at ’s d isease, r ef er r in g t o
lep t osp ir osis. How ev er, t h e p ar t icip an t s w h o m ost
r esist ed ag ain st ad h er en ce t o g lov es r ef u t ed t h ese
ar gu m en t s, say in g t h at t h ey h ad n ev er cau gh t an y
disease in t heir work wit h wast e and one of t hem said
s h e r e j e c t e d g l o v e s b e c a u s e s h e h a d a l l e r g y,
associat in g t h is p r ob lem w it h t h e f act t h at sh e is
...if I put on gloves it seem s t hat m y veins are gonna
explode.
I n t h e d i scu ssi o n s, i t w as ev i d en ced t h at
m ost w or k er s f r om t h e cooper at iv e act u ally do n ot
u se g l o v es t o h a n d l e t h e w a st e. Ho w ev er, i t w as
ex pr essed t hat , w hen v isit or s ar e pr esent , all w or k er s
p u t t h em o n , ev en t h o se w h o d o n o t u su al l y u se
t hem . At fir st sight , it could be int er pr et ed t hat t he
not ion of r isk is ack now ledged and t hat safe behav ior
occu r s t o p r ot ect on eself ag ain st it . How ev er, t h e
h y pot h esis sh ou ld be con sider ed t h at t h ey ar e on ly
adher ing t o a ” polit ically cor r ect ” at t it ude, in a w ay
sim ilar t o t he sit uat ion m ent ioned ear lier, i. e. hiding
t h e p r a ct i ce o f e a t i n g a m i d st t h e g a r b a g e f r o m
v isit or s.
Ot h er p r ob l em s g r ad u al l y em er g ed d u r i n g
t he debat es an d, t o t h e ex t en t t hat t he par t icipan t s
id en t if ied t h em , t h ey w er e en cou r ag ed t o p r op ose
v iable solut ions, fr om t he oper at ional as w ell as fr om
t h e bu dget per spect iv e, du e t o occasion al f in an cial
co st s t h e su g g est ed m easu r es co u l d en t ai l . Li t t l e
b y l i t t l e , a j o i n t a c t i o n p l a n w a s o u t l i n e d ,
a c k n o w l e d g i n g t h a t e a c h p a r t i c i p a n t ’ s c o n c e r n s
r e f e r r e d t o e v e r y o n e a n d t h a t t h e s e a r c h f o r
solu t ion s w ou ld h av e collect iv e r ep er cu ssion s. Th e
f o l l o w i n g ex a m p l es o f co n cr et e m o b i l i za t i o n s ca n
b e m e n t i o n e d : co n st r u ct i o n o f a w a l l t o p r o t e ct
t hem selv es fr om floods and t o av oid slipper y floor s;
i so l a t i o n o f e l e ct r i c w i r e s i n i m p e r m e a b l e p i p e s,
p r ev en t i o n sh o ck s; co n st r u ct i o n o f a r o o f o u t si d e
t h e sh e d t o p r o t e ct t h e w o r k e r s w h o o r g a n i z e d
m at er ial on t h e pat io fr om su n an d r ain ; m easu r es
i n t e r m s o f p u r c h a s i n g a p p r o p r i a t e i n d i v i d u a l
pr ot ect ion equ ipm en t ( I PE) an d r em ov in g r at s fr om
t h e r ecy clin g ar ea.
Aft er out lining t he plan, t he next st ep w ould
be t o t ake it t o t he cooperat ive leadership t o discuss
t h e v i ab i l i t y of p u t t i n g i t i n p r act i ce. Th e g r ou p ’s
concern wit h t he need for financial resources for t hese
changes st ood out , w it h fear of a salar y discount at
t he end of t he m ont h. Next , everyone reassessed t he
pr oposal it em by it em t o v er ify t he financial v iabilit y
and one of t he par t icipant s suggest ed t hat som eone
w ould w r it e dow n t he plan so t hat not hing w ould be
f o r g o t t e n a t t h e t i m e o f t h e m e e t i n g w i t h t h e
coop er at iv e lead er sh ip .
D u r i n g t h e l a st f o cu s g r o u p m eet i n g , t h e
subj ect s as co- part icipant s got m obilized t o j oin effort s
wit h t he person who had been t he form al cooperat ive
leadership, invit ing her t o get involved in t he group’s
m ov em ent , and t his occur r ed in t he sam e m eet ing.
The group dynam ics and t he act ion plan were explained
b y t h e w om en t h em selv es w h o p ar t icip at ed in t h e
r esear ch an d assu m ed t h e com m it m en t t o b ecom e
m ult ipliers of t he new ideas am ong all workers of t he
coop er at iv e.
CONCLUSI ONS
Now adays, w ast e recycling is appearing as a
new work m odalit y t hat has at t ract ed an increasingly
large num ber of individuals. Every day, new recyclable
w ast e separ at ion cooper at iv es em er ge in big cit ies,
b u t n o sp eci f i c so ci al an d h eal t h p o l i cy h as b een
est ablish ed t o at t en d t o t h is con sider able gr ou p of
w or k er s’ needs( 5, 13, 14).
Du e t o t h e p ov er t y g ar b ag e collect or s liv e
in , t h e pr im ar y obj ect iv e is t o gu ar an t ee t h eir ow n
a n d t h e i r f a m i l i e s ’ s u r v i v a l , i g n o r i n g p o s s i b l e
env ir onm ent al r isk s t hat ar e consider ed as a “ par t ”,
an d n ot as a con seq u en ce of t h e j ob . By d ilu t in g
t h e i n d i g n at i on cap aci t y, t h ey cu l m i n at e i n h i d i n g
a n d , so m e t i m e s, i n i g n o r i n g o n e ’ s o w n f e e l i n g s
w h i c h , t h u s , a r e i n c o r p o r a t e d a n d g r a d u a l l y
con st it u t e t h e t r iv ializat ion of social in j u st ice. Th is
r an g e of social p r ob lem s, w h ich b oils d ow n t o t h e
su b t r act ion of op p or t u n it ies t h ese su b j ect s h ad t o
face in t heir liv es, has it s cent r al ax is in t he econom ic
a sp e ct , d i r e ct l y a n d si g n i f i ca n t l y a f f e ct i n g t h e se
w or k er s’ h ealt h( 1 3 ).
On t he ot her hand, despit e t he bit t er ness of
t he cont ex t , oft en, m anifest and lat ent k now ledge is
found, ready t o be recovered and ( re) const ruct ed wit h
t he subj ect s t hem selves who experience t his sit uat ion.
This st udy allow ed for t his obser vat ion, show ing t hat
m an y of t h ese f av or ab le m om en t s ar e p ar t of
co-par t icipat or y discussion, as int ended t hr ough t he use
o f t h e f o cu s g r o u p t e ch n i q u e i n t h e w a y i t w a s
im p lem en t ed .
But , obviously, in conclusion, it should be t aken
int o account t hat isolat ed knowledge is of lit t le use in
pr act ice if h u n ger is a pr im ar y n eed. Besides f ood,
ot h er pr em ises lik e h ou sin g, leisu r e an d edu cat ion ,
am on g ot h er s, all of w h ich ar e addr essed in h ealt h
t h eor ies, n eed t o b e in t eg r at ed in t h e social car e
net work( 11,13). And t his is not lim it ed t o t he m ere solving
o f t h e m o st i m m e d i a t e n e e d s. To a ch i e v e a ct u a l
r esu l t s, a ch an g e i n t h e l og i c of soci al p ol i ci es i s
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