Maria Cecília de Souza Minayo
Coordinator Latin American Center for Studies on Violence and Health
This special issue represents the reflection and research done on the theme of violence and its relationship to the field of public health in Brazil, particularly over the last decade.
The increase in violence as part of Brazilian social reality has made a major impact on the thinking of the country's intellectuals. An earlier bibliographical review we produced showed that some 85% of the academic production on this theme, covering various fields, occurred from the 1980s onward.
The 1980s also witnessed an increase in reflection on the impact of violence on health, concentrating on the classfication of "external causes" of morbidity and mortality. Yet the theme has a tradition, and names of specific authors are associated with it (some of whom appear as authors of articles or are quoted in this issue). Most of these scholars are from the University of São Paulo and the State University in Campinas. The Oswaldo Cruz Foundation had its part in this effort, which it joined through the National School of Public Health when it founded the Latin American Center for Studies on Violence and Health (CLAVES), in 1989. The fact that the Center is devoted exclusively to the theme of violence and its relationship to the field of health has facilitated research dynamics and the exchange between Brazilian and foreign researchers, as well as with popular movements and social and health services.
Despite all this effort by researchers, this focus on the impact of violence on health in Brazil is still in its early stages. Nearly all of the studies are restricted to diagnosing situations and have still not affected health services or planning in an operational sense. However, this observation does not pertain only to researchers. While the field of research is recent, even more so is the interest taken by Brazilian and international health organizations in acknowledging and discussing the theme and considering it a priority. This interest was really only awakened within the Pan-American and World Health Organizations in 1991, and it is culminating now in 1994 with the 1st Inter-American Conference on Society, Violence, and Health, to be held November 16-18 in Washington.
In 1993, the Brazilian Ministry of Health, through the Maternal and Child Health Program, began to focus on violence against children and adolescents. Yet this theme requires a much broader scope, which will no doubt only be reached when there is an awareness of how serious the situation of social violence has become.
This feature issue of Cadernos de Saúde Pública is a synthesis of efforts at reflection in recent years, and it also points to options for debates and proposals. The articles thus voice opinions that are not unanimous. On the contrary, they express the controversy that permeates both the intellectual field and society as a whole.
This special issue is dedicated to Jorge Careli. The Latin American Center for Studies on Violence and Health (CLAVES) is hereby named after him. This young worker, an employee of the Oswaldo Cruz Foundation, suffered a violent death at the age of 32. Kidnapped by the police in a poor working-class neighborhood, he was tortured to death, his body dumped in some clandestine cemetery, without even the right to a burial. His case is similar to that of thousands of poor young Brazilian males, a particular risk group who fill the pages of statistics on violent death.
For us, Jorge Careli is both a patron and a symbol of what we want to exorcize from and exalt in the field of health. We want to exorcize this degradation of life and exalt the human integrity of those who go humbly about their daily existence, working, loving, participating, and struggling to build a health country.