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Cadernos Brasileiros de Terapia Ocupacional

On-line version ISSN 2526-8910

Cad. Bras. Ter. Ocup. vol.26 no.2 São Carlos Apr./June 2018

http://dx.doi.org/10.4322/2526-8910.ctoao1182 

Original Article

The reach of occupational therapy in local development1

Ricardo Lopes Correia1 

1Departamento de Terapia Ocupacional, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil.


Abstract

Introduction:

The questions of local life comprise a scheme of meanings produced daily and are taken by socio-economic processes that produce vulnerabilities as threats to the cohesion of networks of participation. Projects in Local Development can facilitate participatory engagements that take into account the collaboration between civil society and public power to address these issues.

Objective:

Analyse the reach of the occupational therapy in the orientation of projects and actions in Local Development.

Method:

This is a qualitative documentary research in which documents produced from a university extension project between January 2011 and July 2015, in the municipality of Itapeva, state of São Paulo, and content analysis procedures were discussed. Results: A sociohistorical matrix was extracted that comprised four large dimensions of knowledge in occupational therapy: daily, human activities, mediation skills, and collective life projects, all operated by the teaching methodology in participatory local development.

Conclusion:

Occupational therapy can directly reach the structures and political functions for Local Development, through processes that take into account the construction of networks of actions that mobilize the participatory engagement of local agents. These processes are based on the foundations of occupational therapy, demonstrating contributions to new research and assistance insertions.

Keywords: Community; Local Development; Participation; Occupational Therapy

Resumo

Introdução:

As questões de vida local compreendem uma trama de significados produzidas cotidianamente, tomadas por processos econômico-sociais que constituem vulnerabilidades que ameaçam a coesão de redes de participação. Projetos em Desenvolvimento Local podem facilitar engajamentos participativos que levem em conta a colaboração entre sociedade civil e poder público para o enfrentamento dessas questões. Objetivo: Analisar o alcance da Terapia Ocupacional na orientação de projetos e ações em Desenvolvimento Local.

Método:

Trata-se de uma pesquisa documental qualitativa em que foram resgatados documentos produzidos em um projeto de extensão universitária entre janeiro de 2011 e julho de 2015, no município de Itapeva, interior de São Paulo, e tratados sobre procedimentos de análise de conteúdo.

Resultados:

Foi extraída uma matriz socio-histórica que compreendeu quatro grandes dimensões de fundamentos em Terapia Ocupacional: cotidiano, atividades humanas, habilidades de mediação e projetos de vida coletiva, todas operadas pela metodologia de ensinagem em desenvolvimento local participativo.

Conclusão:

A Terapia Ocupacional pode alcançar, de forma direta, as estruturas e os funcionamentos políticos para o Desenvolvimento Local, por meio de processos que levem em conta a construção de redes de fazeres que mobilizem o engajamento participativo de agentes locais. Estes processos assentam-se nos fundamentos em Terapia Ocupacional, demonstrando contribuições para novas inserções de pesquisa e assistência.

Palavras-chave: Comunidade; Desenvolvimento Local; Participação; Terapia Ocupacional

1 Introduction

This article addresses the dimensions of knowledge in Occupational Therapy in the local development achievement, while observable effects on the ways of operating political transformations on local life issues.

The theoretical axes for this research pervade the issues of development and Occupational Therapy in the social field through socio-economic processes. For that, a documentary research was outlined in which documents of an extension project were rescued in a city of the interior of São Paulo. This type of research allowed the reconstitution of the socio-historical processes of the project, aiming the construction of a matrix, informing implicit data for the understanding of the elements of the area of knowledge in Occupational Therapy, which reached the policy of Local development of the city to a certain extent.

1.1 Development issues and the production of local life issues

Economic growth or economics was placed as a paradigm of development through political-economic models of countries such as the United States and England after the First World War when the need to reconstitute national security and boost their devastated economies began to be observed. The path taken was the strong implantation of multinational industries, the control of the dollar in the regulation of the exchange of imports and exports (BRESSER-PEREIRA, 2009) and the consequent power over the economic growth aspects of Latin American, African and Asian countries (FRANCO, 2004; BAUMAN, 1999).

In Brazil, the awareness of this paradigm started only in the early 1950s, when urbanization processes in large cities, such as São Paulo and Rio de Janeiro, became necessary to leverage late industrialization (VALLADARES, 2005). Between 1940 and 1960, the processes of institutionalization of the Social Sciences in Brazil were verified, which corroborated to strengthen the models of development of the cities, based on the belief that economic growth would bring them together (catch up) of the most industrialized and dominant countries (BRESSER-PEREIRA, 2009), as well as safeguard the quality of life of the population.

During this period, there was a strong invasion of US, English and French researchers in Brazilian territory, “worried” about investigating the transition processes of rural and tribal areas in the cities. For sociologists and anthropologists at that time, this transition threatened the stability of the Anglo-Saxon countries, with great political interests in the Brazilian natural reserves, and a local contingent was needed for its maintenance and exploration. Also, Oliveira and Maio (2011) point out that fear of violence, corrupt governments and the misery that plagued both Brazil and other southern countries posed a threat to the development of cities, implying the political-economic ordering of north countries.

In this way, the political division between community and society was established in Brazil, motivated by the investigations by foreigners. The first theorist to make such a distinction was Ferdinad Tönnies (D’AVILA NETO, 2002), who understood communities as the grouping of people, through primitive, traditional and mutual-aid bonds, and societies as more complex processes of organization, with strong aspects of individualization in activities and dispersion in social structures. In the Communities’ Studies supported by the theoretical conceptions of Tönnies, the consolidation of the Social Sciences was consolidated, allowing the incorporation of the ideologies of the transformations of communities into societies as an invention of their object of study (VALLADARES, 2005).

The operationalization of the development paradigm was taken by governmental agencies such as the International Labor Organization (ILO) and the United Nations Development Program (UNDP), based on the proposed Community Development (CD) project in Brazil, as in other countries of Latin America and Africa, under the discourse of improving the quality of life of these nations. The CD saw the ideology of strengthening and expanding the economy of dominant countries, with the “undeveloped” and “developing” countries as marginalized supporters for a globalized economy (OLIVEIRA; MAIO, 2011; D’ARAUJO, 2010; VALLADARES, 2005; BAUMAN, 1999; SOUZA, 1987).

The first time the terms “undeveloped and developing” were used to denote the understanding of the different realities of the less industrialized countries, it was in the speech of President Harry Truman, in his 1949 possession in the United States, to establish the counterpoint of development between the Northern Hemisphere and the Southern Hemisphere, where the Southern Hemisphere was treated by the President as the haven for the progress of the Northern Hemisphere (SOARES, 2010).

According Azevedo (1998), the CD model was strongly influenced by the US program Peace Corps, which consisted2 of recruiting students who voluntarily carry out intervention plans - methods and activities, to socially organize poorer sections of the South overcome violence and poverty; two complex and multifaceted phenomena captured by the US, under the naturalized discourse of underdevelopment.

The Peace Corps was created by John Kennedy, as early as his 1961 US presidency, according to his Protestant and progressive government religious references, as well as, alarmingly, from a 1958 novel written by Willian Lederer and Eugene Burdick , called Ugly American, which tells the story of an engineer who relinquishes his concern for the personal appearance and good manners of a bourgeois class to develop a program of assistance to poor people in Southeast Asia. The character teaches the poor a series of techniques for generating income in production and consumption chains, recreational and cultural activities, coming from their country; he observes the effects generated, having how the American culture can save the humanity as moral of the story, removing people from the zone of primitive, undeveloped to the level of developed ones (AZEVEDO, 1998).

The understanding of the Peace Corps that the instability of peripheral countries, sustained and motivated by corrupt governments, threatened the centrality of US economic power, as well as its national security, reinforces another important aspect highlighted by Báez (2010) - the memorization of Latin American countries.

Memorization is a conscious and planned practice by the dominant countries, especially the American (USA), English, and French3 (not excluding the colonial processes of Spain), which aimed at exterminating the cultures of colonized peoples since the beginning of the sixteenth century (BÁEZ, 2010). The cultural destruction of the memory, knowledge, and productions of a particular native people in its territory is the most efficient way, as the author affirms, of establishing economic and political power and influence4.

In this sense, it is necessary that a colonized nation feel that its culture is despicable, as well as barrier to its development, having to “be guided” by the culture of the colonizer. The Peace Corps continued the processes of memorization in Brazil, bringing in their baggage the missionary value of the favelas of Rio de Janeiro, the Northeastern Backwoods and the traditional people and communities of the Amazon region by Ugly American.

With the process of re-democratization of the Latin American countries in the mid-1980s, the projects of CD and Peace Corps (1961-1981) were overthrown regarding the questions and criticisms denounced by social movements, more politically engaged, especially the movements of literacy and popular education, motivated by the theories and experiences of Paulo Freire, who ended the involvement of the population with the colonizing pedagogies.

The works of the Brazilian sociologist Florestan Fernandes, especially Community and Society in Brazi in, 1975, also contributed within the Brazilian academic field to motivate questions about the emergence of colonial critique on development models and community studies in Brazil (OLIVEIRA; MAIO, 2011). However, Valladares (2005) argues that the ideological context of mission generated by the CD, operated by the Peace Corps, perpetuated stigmatizing representations, still today, in the reasoning and strategies for overcoming poverty and violence, as in the policies of Social Assistance and Health, as well as in university extension and research.

The dichotomy between community and society was then placed as an important reading key for understanding the economic paradigm of development in Brazil in the early 1940s - the first wave of development. In the early 1990s (SOMEKH, 2008), based on the very questioning of UNDP, the World Bank and the ILO on the misplacement of Anglo-Saxon models in Latin American, African and East Asian countries, Ugá (2011), acknowledged the responsibility for the serious accentuation of the inequalities generated.

Besides the advancement of information technologies, the economy has become more than monetary production, but the ability of industrialized nations established economic flows of investment, control, and power over the market - institutions of operation and mediation of access to consumer goods (D’ARAUJO, 2010; BAUMAN, 1999).

For Ávila (2008), contradictory economic flows, unequal as a second development paradigm - second wave, take daily life, producing subjectivities and ways of establishing relationships. For this reason, to deal with the economic-social aspects in the present time is to realize their forces in the daily life and their influences in the mediation between desires and consumer markets (BAUMAN, 1999).

Capitalist processes in Latin America, in the second wave of development, deepened the problem of poverty (UGÁ, 2011), placing it as the central social issue of this region. For Baquero (2013) and Montaño (2012), poverty has become more evident in the last 50 years as the multifaceted set of elements that act as barriers to human and social development, with colonization, poor income distribution, structured unemployment, low education levels, undemocratic policies, violence and the violation of human rights as important markers of the threats of social cohesion.

D’Araujo (2010) argues that the more institutions, whether public or private, they seize the values of contradictory flows, in independent and lucrative interests exclusively in markets. Thus, more vulnerabilities in social cohesion networks are found, producing subjects less supportive, more individualized and little concerned with collective actions.

From the perspective of Sen (2000), the factors that produce the phenomenon of poverty prevent the conversion of human abilities into capacities, that is, they detract from the possibilities of people to operate the structures and the meanings of their life trajectories with autonomy and interdependence. This means overcoming the understandings of previous decades that poverty is a natural and figurative fact in certain individuals, as expressed in the first-wave discourses of development by US missionary policies.

The globalization of the economy as a recent process that designates the internationalization of political-economic power (BAUMAN, 1999) is immaterial. It is an ideology to motivate the reduction of the distance between desires and consumer markets. However, the path to this decline, particularly to the poorer and emerging nations, is a series of vulnerabilities, injustices and non-democratic participation in everyday life and politics, which add values of segregation and stigma around the production of social goods.

The understanding of contradictory globalizing flows, as pointed out by Ávila (2012) and Bauman (1999) is power over the production and operationalization of assets or capital, that is, physical, economic, human, social and cultural assets that enable, more or less, the emancipation and independence of individuals and collectives. According to the authors, physical assets are structures, such as urban architecture, public and private facilities; the financial circuits, the circuit of investments, profit, capital turnover, and consumption. Human assets are skills and individual characteristics and social assets are networks of interpersonal relationships built on the basis of ordinary everyday activities. As is pointed out by Bourdieu (2004), cultural capital is a symbolic asset of a group’s knowledge and practices, which shape its identities within a given social field.

Poverty is one of the phenomena that produce the segregation of social space (MARQUES, 2010) and, from its territorialization, it exposes the barriers that prevent the production and use of assets. For D’Araujo (2010) and Valladares (2005), the territorialization of poverty is what allows the perpetuation of stigmatizing social representations, since it works as a category of analysis of development in the dynamics and structures between spaces and populations. At this point, the understanding of community as a poor territory, which gives the tone and macro-social visibility in government policies, is identified in scientific discourses, especially in the Social and Health Sciences, as triggered by Fragoso (2005).

According to Ribeiro (2005), in 1990, political and academic re-significations about development issues began to emerge, aiming to overcome the economic and missionary paradigm as a factor for raising the quality of life of colonized and marginalized populations. For that, the perspective of more endogenous theoretical-practical structures of rescue, valorization and recognition of the local knowledge, as cultural, dialogical and critical processes in relation to external cultures for the formation of networks of cooperation was placed as necessary. In this way, Development came to be understood as an expansion of freedom (SEN, 2000), experienced by individuals and collectives insofar as substantial, political conditions are offered, created and exploited to operate life.

Thus, local development (ÁVILA, 2000) was established with great force in the countries of Latin America as a model that privileges the symbolic and micro-territorial dimensions of social relationships, from which emerge strategies that can produce, influence and modify the assets expressed by the global dimension through their networks of meaning, values, structures and dynamics, without the local dimension being suppressed, which, are defined as glocal mutual movements by Somekh (2008).

In this perspective, the place is understood as a relational and symbolic dimension (CORREIA, 2017; AKERMAN, 2005; COSTA, 2008; SANTOS, 2014) with spatial, temporal, sociocultural and resistance to dominating foreign colonization characteristics (MIGNOLO, 2013), constituted by the ideological and community-sense networks (COSTA, 2008) between subjects who identify each other by the activities they produce in their daily lives (CORREIA; ROCHA, 2016).

The senses of community include a critical ideology of colonial processes (MIGNOLO, 2013) that proposes to overcome the dichotomous relationship between society, understanding it not as a territory, a locus, but as a device that emerges from coping strategies in the processes of domination, pauperization and memorization of cultures dominated, which threaten their social cohesion, that is, the community is an expression of social issues (D’AVILA NETO, 2002).

According to Correia (2017), Ávila (2012, 2000), Costa (2008), Franco (2004) and Souza (1987), an ideological understanding of community is the relationship immersion-identification, that is, when a collective becomes aware of threats that jeopardize the cohesion of their very existence as a social unit, certain common actions and projects can only be carried out by engaged, active and conscious collective action. Thus, the collective is activated as a community by processes of immersion-identification.

Several approaches under the model of Local Development have been used for the process of critical awareness on the issues that are expressed in local life. One of them is participatory local development (PLD) (FÉLIX et al., 2009; ÁVILA, 2000). It is an educational approach that illuminates the paradigm of participation as a means and end in practice in mutually constructed projects between local and external, public and private, for the construction of interpersonal networks of activities with socio-cultural values ​​for development as freedom (CORREIA; ROCHA, 2016).

Correia e Rocha (2016), Félix et al. (2009) and Ávila (2012, 2008, 2000) argue that PLD occurs through teaching-learning processes between local agents of different segments and external agents. In this experience, educational strategies can be created and exploited to put into practice participatory activities to confront local issues of life.

The practical and concrete operation of the PLD is the construction of collective life projects, which allows the production of communities (FRANCO, 2004), through scheduling of local demands, creation and exploitation of shared strategies and commitment and mutual support between the agents of civil society, public power and public and private institutions and the third sector (CORREIA; ROCHA, 2016).

According to these assumptions, PLD processes are then a political-educational practice in which the community is an ideology and purpose that is expected to emerge in the processes of participation for Development that according to Bauman (2003) and Franco (2004) it is a possibility of a third wave of Development, in which the paradigm is understood as community.

1.2 Occupational Therapy and Local Development: the expressions of economic-social issues in human occupation

The human occupation is one of the meanings about the object of knowledge in Occupational Therapy, being the modes of participation of individuals and collectives in the activities of daily life. Occupational therapist is the professional who engages in a relationship with people, to create and explore joint facilitation strategies to participate in activities that structure and give meaning to life.

As Costa (2008), argues, far from consensus, what makes common sense about the object of knowledge in Occupational Therapy is the relationship that people make throughout life with the world and the environment that surround them, allowing, as exposes by Guajardo (2012), historical-social processes on their identities and activities produced daily.

The activities are produced and performed by corporeal, social, cultural, economic, gender, racial, ethnic and historical crossings, among others, that can be understood as forces that constitute fields (BOURDIEU, 2004) approaching and distancing paradigms, coexisting in explanatory and comprehensive attempts at the relationship between people and their environments and the products of this relationship.

Illuminating the fields as forces that cross the senses on the object of knowledge in Occupational Therapy allows advancing and expanding visions on the diversity of the ways in which human participation occurs. For this, it is important the exercise of comings and goings, inside and out, of the object of knowledge.

On the interest of this research in the economic-social processes as forces that conform the human occupation and reveal paradigms on Development that express themselves on it, there is an attempt to bring the construct into the social field, as proposed by Ghirardi (2016, 2012). In this perspective, for Occupational Therapy, the social question is placed as a paradigm of its actions in the collective, composing and proposing

[...] strategies for facilitating participatory pathways which, if successful, they should create conditions for moving beyond the recipient of care services and moving towards the position of producer of goods and social values (GHIRARDI, 2016, p. 72).

The facilitation paths of participation in daily activities focus on the communicative action (GHIRARDI, 2016) of agents involved in the socio-economic-therapeutic-occupational processes and their

individual and collective capacities to produce their own solutions to everyday problems [...] as ways of overcoming limitations of social participation (GHIRARDI, 2016, p. 76).

On the therapeutic-occupational processes, the author mentioned that “it would be naïve to think that the occupational therapy can contribute to the generation of income for the economically peripheral populations” (GHIRARDI, 2016, p.74). reproducing the economic and politic wave of domination, pauperization, and memoricide as ways of raising the quality of life. According to the author, generating income is not a technical assistance assignment, in fact, Occupational Therapy can contribute to the people who experience the threats and vulnerabilities of their existence, from the expressions of contradictory globalization flows, and generate.

[...] social value, insofar as it can establish collective dynamics that foster common reflexivity, the recovery of confidence in themselves and in others, and the valorization of collective know-how (GHIRARDI, 2016, p. 47).

Studies that demonstrate the contributions of Occupational Therapy in the perspective of Development are almost non-existent. However, we find a series of other productions in the area that allow approaching categories that exert structural functions in their foundations and enable to broaden dialogues around the issues of interest here presented - Local Development. As foundations of the area of knowledge in Occupational Therapy, these productions and categories have already advanced much on the logic and ideologies of the status quo of social practices, knowledge and social function of Occupational Therapy. With this, it is already understood, with special dedication to the studies of Ghirardi, that Occupational Therapy has long ignited economistic paradigms and, according to the author, it is moving towards the production of networks of senses and practices common to collectivities.

On this aspect of the production of networks of actions and modes of participation, they are understood as Human Occupation, which can contribute, to some extent, to a broader discussion of the fundamentals of the area of knowledge in Occupational Therapy for achievement in local development.

2 Method

This is a qualitative documentary research that includes the document as an object and field of research (SÁ-SILVA; ALMEIDA; GUINDANI, 2009). Thirty-one documents produced in a university extension project involving six higher education institutions (IESs) were collected between January 2011 and July 2015, in the municipality of Itapeva, in the southwest of the state of São Paulo.

The documents are records not previously inferred or scientifically treated (KRIPKA; SCHELLER; BONOTTO, 2015), from the experiences of students from different undergraduate and local levels of the municipality, who understood civil society and public power. The coordination of the project was carried out by a professor in Occupational Therapy who, through his constant throughout the project, introduced contributions of the knowledge of the Occupational Therapy area, understood as frontier, that is, shared among all the involved agents, and the development of actions in local development in the municipality.

The documents were read in full, in-depth, and cataloged based on the documentary analysis procedure (PIMENTEL, 2001), which consisted in extracting their types, natures and thematic units that informed the central ideas of the project and the contributions used. Explanatory tables have been constructed in historical lines, on the extracted information, both descriptive and imagery to guide the construction of categories. In the documentary research:

The information or data collected can be obtained and analyzed in various ways depending on the objective to be achieved. In a qualitative study, the search for data in the research leads the researcher to follow different paths, that is, he uses a variety of procedures and instruments of constitution and data analysis (KRIPKA; SCHELLER; BONOTTO, 2015, p. 57).

Thus, the Content Analysis approach was used (BARDIN, 2016), to then emerge the possible categories of analysis. For that, three procedures were used: a) categorical analysis; b) analysis of enunciation and c) relationship analysis. The first procedure allowed the themes extracted from the Documentary Analysis to be approximated to structures proposed in the theoretical framework and transformed into major key themes or “cores of meaning” (PIMENTEL, 2001, p. 190). The themes guided a second reading in depth, identifying descriptive and imaginary enunciations that exemplified them, forming a set of related statements according to the socio-historical contextualization, that is, the dialectical construction between the events occurred (FREITAS, 2002), which allowed identifying the activities developed and the senses as answers to the research objective, from the origin of the project insertion in the city of Itapeva: what is the scope of occupational therapy in local development? It was possible to extract categories engendered among them, between the knowledge and the tasks of Occupational Therapy in the extension project, and a socio-historical matrix was elaborated, a graphic scheme capable of translating the dimensions of fundamentals in Occupational Therapy in the project of extension in local development to orient the discussion and the results in an objective way, without losing the complexity that the socio-historical processes apprehend.

3 Results and Discussion

3.1 Gold-digging: the information extracted from the documentary analysis

Thirty-one imagery, printed and online descriptive documents of the types: activity records, action projects, final reports, reports, network mappings, letter of service, regulations, and laws were identified. In this set, 51 activities (Table 1) were denominated Collective Life Projects (CLP), developed in an average period of nine consecutive days per semester between January 2011 and July 2015, totaling eight insertions of the extension team. In January of 2013, there were no activities for administrative reasons of the municipality.

Table 1 Local development activities in the municipality of Itapeva. 

Period Activities Locations and subjects involved Collective Life Projects Strategies
1. June/2011 Forerunner travel Center of Itapeva Not included Meetings and pacts for action
2. July/2011 1. Family Educational Actions Areia Branca District Basic Health Unit Disclosure in the media
2. Professional training Home Visits
3. Income generation Structured interview
4. Organizational strengthening and popular participation Meetings
4. Mobilization of the community aiming at social inclusion and citizen training Talk circles
3.January/2012 5. Health circuit Areia Branca District Basic Health Unit Educational groups
6. Legal promoters of citizenship Individual assistance services
7. Football Championship
8. Who stands still is a statue: gymnastics for the elderly
9. Revealing Your Kitchen: Economic Revenue for Sale and Consumption
10. Health and citizenship fair
4. July/2012 11. Survey of the support social networks of the remaining quilombo of Jaó Quilombo remnants of Jaó Expansion of perceptions about local social support networks and registers of sociabilities Ecomap
12. Legal promoters course of citizenship Health, education, social, safety and cultural professionals Home Visits
13. Open Group “Citizen Galley” Young people from the Quilombo do Jaó Immersion
14. Prevention and care of diseases Elderly people from Vila Dignidade Talk circle
15. Sociocultural activities with the elderly Workshops
16. Oral health education with schoolchildren Groups of educational and cultural activities
17. Dental care in the Quilombo do Jaó
18. Survey of training demands in clinical analyzes and laboratory demands
5. July/2013 19. Master plan of the remaining quilombo of Jaó Quilombo remnants of Jaó Master plan Brainstorm
20. Training on “Drugs and Adolescence” Jardim Kantian Participation and empowerment of women in local development processes Photos
21. Immersion in GCM Health, social, education, culture and security workers Drug and adolescent empowerment Cell phones for photographic records
22. Plan of Action and Integration of Vila Dignidade Secretaries of the city hall Mapping sociabilities and supporting social networks Conversation circles
23. Healthy food and medicinal vegetable garden: Jaó quilombo - “Integrating and Emancipating Women” São Camilo/Vila Dignidade Neighborhood Mapping social media support Identification of local representatives
24. Immersion in the Kantian neighborhood Jardim Kantian PLD training and strategic planning Meeting of representatives
25. Training in local development and strategic planning Ata
Workshop
Expository class
Talk circles
Formulation of questions
Movies
Targeted texts
Group Dynamics
Home Visits
6. January/2014 26. Master plan of the Quilombo do Jaó Quilombo remnants of Jao Master plan Local Immersion
27. Cultural agenda of the Quilombo do Jaó São Camilo/Vila Dignidade Neighborhood Youth cultural agenda Dialogue with leaders
28. Visit to the Family Health Unit of Quilombo do Jaó Jardim Kantian Mediation for effective social media support Inventory of objectives achieved and problems identified
29. Building support networks in Vila Dignidade Professionals in health, education, culture, social, management GCM approach with other sectors of the municipality Talk circles
30. GCM local development agenda Secretaries of the Itapeva city hall Strengthening the participation of local agents in the Residents Association - Construction of the memorial Institutional mediation
31. Memorial of the Kantian Garden Health, social, education, culture and security workers Strategies for implementation of the public policy of harm reduction Partnership document
32. Strategies for the implementation of the public policy of harm reduction GCM Participatory public management Text workshop
33. Participatory Public Management Workshop Secretaries of the city hall Stock Disclosure Strategies
34. Course of Active Teaching Methodologies Participation in everyday activities
Support social network mapping
Workshop building on the objectives and strategies
Previous Ecomap and Check Changes
Brainstorm
Memory and narrative workshops
Recreation games
Dynamics
Group
Expository class
Activity group and questioning
Thematic workshop
Case study on local issues
Work Groups
7. January/2015 35. Oral health in the neighborhood of Jaó Quilombo remnants of Jaó Oral Health Anamnesis
36. Meeting with Secretary of Health Areia Branca/São Roque Castration of dogs and cats Basic
37. Health of the elderly Santa Maria Neighborhood Mapping social media support Odontological Attendance
38. Castration, vaccination and anthelmintic treatment of dogs and cats São Camilo/Vila Dignidade Neighborhood Memories of life Oral Health and Education Activities
39. Visit to agrovila and landfill Civil Guard Metropolitan Room service
40. Course on active teaching methodologies Immersion
41. Local Agenda GCM Meeting
42. Immersion in the Santa Maria district Surgical procedures of castration and vaccination
Activities workshops
Construction of documentary
Collection of narratives in-home visits
Photography
Leisure and sports activities
Talk circles
8. July/2015 43. Project of coexistence area in Jardim Kantian Jardim Kantian Space and Leisure Space Project Immersion
44. Follow-up of Vila Dignidade São Camilo/Vila Dignidade Neighborhood Evaluation of actions Talk circles
45. GCM Agenda Civil Guard Metropolitan Follow-up of previous actions Home interviews
46. City Council of the City City Councilors of the City Structuring and return of activities of the City Council of the City Data Tabulation
47. Accompaniment of the remaining quilombo of Jaó Quilombo remnants of Jaó Evaluation of actions Mediation between residents and public authorities
48. Areia Branca Community Radio Areia Branca District Community radio Minutes
49. Construction meeting of the Sorting Center of the Santa Maria district Santa Maria Neighborhood Virtual monitoring networks
50. Castration campaign for dogs and cats Ecomap
51. Clinical care Home Visits
Workshops

The project was coordinated by a professor in the area of Occupational Therapy and involved an average of 28 students in each period, totaling 150 students from six different IESs5 from several undergraduate areas. Most of the students (72) were from the health area (64.2%)6.

The city of Itapeva is 289 km southwest of the city of São Paulo and has an estimated population of 93,145 inhabitants, with 50.7% women and 49.3% men. Among the general population, 70.3% self-declared as white (INSTITUTO..., 2016). In 2014, Itapeva was named the fifth administrative region (AR) in the state of São Paulo, which means that it is a propeller of the economic and social development of a region that involves 32 cities (ITAPEVA, 2016).

In the last 26 years, the municipality of Itapeva registered something around 11% of population growth and significant changes in its human development index (HDI), from 0.458 in 1991, 0.745 in 2000, falling to 0.732 in 2010 (PROGRAMA..., 2010). Between 1991 and 2013, according to information from Doc. 01 - Itapeva, a precursor trip, Itapeva received a strong insertion of medium and large industries, in particular, logging, promoting a large population emigration of poorer municipalities in its surroundings, as well as other states, especially in the south and center-west of Brazil. In association with the difficulties of planning for the structural reception of these, such as work, housing, health services, education and social assistance, it was observed a rise in living costs in the city, resulting in asymmetrical indicators of local vulnerability, as verified in the last release of the São Paulo index of social vulnerability (ÍNDICE..., 2016), in which 24% of the population of the municipality were at high vulnerability in urban areas and 13.1% were under the same conditions in rural areas, higher percentages when compared to state of São Paulo, of 11.1% and 1%, respectively.

The measurement of the level of development of the municipalities of the state of São Paulo is made by the São Paulo Social Responsibility Index (IPRS), which includes gross data on economic wealth, education, and longevity. It is an indicator similar to the Human Development Index (HDI) of the United Nations Program, which informs the quality of life of the population of São Paulo (ÍNDICE..., 2014). The indicators are combined, allowing a more complex and expanded understanding of development. Thus, municipalities are organized by administrative regions and distributed into five groups, which comprise the highest level of economic wealth with good social indicators, to low economic wealth with unsatisfactory social indicators. Between 2010 and 2012, Itapeva was related to group 4, which comprises low wealth, with intermediate education level and longevity.

Currently, according to IBGE data (INSTITUTO..., 2016), not released by IPVS, the poverty line in Itapeva reaches 29% of the population, with 84.5% female heads of household, with children and without spouses, and 10.2% of children between 10 and 17 years old, inserted in systems of unpaid labor (slave), such as agriculture. Also, Itapeva is considered a city with a high HDI, taking 370th place in the total ratio of the state of São Paulo (PROGRAMA..., 2010).

It is easily identifiable the temporal mismatch between information of each index, not being considered also more endogenous information about the local realities of the municipality, what forms fragilities in these indicators for the knowledge of the local reality and the processes and orientations for its development.

3.2 Content analysis

The general objective identified in the documents of the extension project expressed more accurately in Doc. 27 - Itapeva 07 of July/2015, was to support local agents - civil society and public power - to build coping strategies for local life issues. The organization of the work of the teams each semester occurred by the election of districts of the municipality identified since the data collection of the first action of the project Doc. 04 - Itapeva visit precursor in January/20147, with the Planning and Works Secretary of Itapeva. In the absence of official information about each neighborhood, the team and the secretary gathered to collect data from the Secretary of Health, Education, Finance, and Planning, as in the IPVS and IPRS, to draw local indicators of vulnerability (Figure 1).

Figure 1 Vulnerability indices in percentage of neighborhoods selected for the project in the city of Itapeva compared to the municipality indicator and the state of São Paulo, based on IPVS, 2014, and IPRS, 2014 (Doc 04 - Precursor Visit, January 2014). 

Considering the three main axes, income, education and longevity, the districts indicated by the indices for the actions were São Camilo (18.3%), Santa Maria (37.2%), Jardim Kantian (27, 3%), Quilombo do Jaó (41.5%), Bela Vista (23.5%) and Distrito de Areia Branca (26.3%). The graph shows that four of Itapeva’s six districts elected for the project had high vulnerability indexes, higher than those of the municipality and the state of São Paulo.

It is important to emphasize again the differences in the indices, in which only by the municipal data guidelines do not conform information about the vulnerabilities experienced by the populations in their neighborhoods, which makes them invisible in public geography. However, the construction of this information imprecise methodologically did not follow suggested patterns, such as those indicated by the Institute of Applied Economic Research (IPEA), but rather, it served as a guide to local activities, making them visible in this research.

The methodology identified for the operationalization of actions in the neighborhoods was the teaching in local participatory development (CORREIA, 2017), which is a social educational practice for the creation and exploration of strategies for the apprehension of local contents. The contents were identified as the historical processes of the sites, the narratives about individual and collective experiences about social support networks, daily activities, and their issues. They were debated between local and external agents from various segments to elaborate content systematization strategies and then engage in tasks organized in proposals called collective life projects that objectively comprehend the coping strategies of the issues of local life.

The teaching in participatory local development is a methodological combination between teaching (ANASTASIOU, 1998) and participatory local development (PLD) (ÀVILA, 2000). About the teaching, it is a term coined by the educator Léa Camargo das Graças Anastasiou in 1994, supported by the theories of Paulo Freire, to configure a complex social educational practice that includes both the actions of teaching and of apprehending. For this, educators must develop mediating skills between learners and critical contents of reality, overcoming the traditional methods of teaching to take classes, which comprises the dialogic processes of critical and everyday teaching-learning (ANASTASIOU, 1998).

In the set of documents investigated, it was also identified that the term strategy was used to designate the ways of operating in reality through the reasoning of the teaching in participatory local development. Strategy is a term for the creation and exploitation of possibilities and conditions for the apprehension of contents (ANASTASIOU; ALVES, 2004) and involves resources, techniques, theories, and tasks that will be proposed, created and operated in reality on participatory thinking. In the project, this reasoning was identified as Local Development. As identified in Tabela 1, the strategies allowed extracting contents from reality for the collective debate, expanding critical and dialogical perceptions about them and their referrals as collective life projects.

One of the strategies most used and deserving of attention for its simplicity of purpose was the conversation circle, which aims to bring people together so they can dialogue, debate and expand perceptions about certain previously organized contents (ANASTASIOU, 1998). Also, the mapping strategy on local life issues, which includes the registration of support networks and meaning of local contents (CORREIA, 2017) could include territorial maps, interviews, drawings, iconographies, etc.

The contents produced between the conversations circles and mappings were re-launched on circles as themes, allowing the most critical, ample and organized contact of local agents, so scheduling strategies were created, which consisted in materializing goals (objective) and activities for the process, which were called collective life projects (CLPs) (Table 1), which are nothing more than a participatory agenda that guides and organizes local collective action (CORREIA, 2017), also known as projects in community (FRANCO, 2004). Students were encouraged to engage in mediation skills between local actors - civil society and public authorities, facilitating the elimination of barriers in communication and direct linkage, so the CLPs were effectively participatory.

Throughout the operation of the CLPs, maps, called brainstorms (Figure 2) were periodically constructed, which consisted in recording the trajectories of actions of agents involved during the actions graphically. All strategies were flagged, which agents or groups of agents involved, and the advances and challenges, always retaking the initial goals and highlighting the new strategies that would come up during the process. This contributed to broaden the perceptions and meanings among local agents that these processes constituted local development, because, while local agents mobilized to create and explore strategies around local life issues, it allowed the formation and support of a network of mutual aid knowledge and practices that offered the conditions to face their questions, which were solved (Table 1) by the projects of collective life.

Figure 2 Synthesis of the socio-historical matrix of the brainstorms of the local development project of the city of Itapeva. 

The synthesis of the brainstorms was called a socio-historical matrix, as a graphic and objective translation of historical and social processes, as argued by (PIMENTEL, 2001), hence the memory of the knowledge and actions involved in the centrality and conduction of Occupational Therapy in the Local Development project, a kind of spine.

From the matrix, it was possible to identify four large dimensions extracted by the Content Analysis procedures, which include: Daily Dimension, Activity Dimension, Dimension of Mediation Skills and Dimension of Collective Life Projects, as shown in Figure 3. Such dimensions are characterized by constructs, or foundations, identifiable in the area of knowledge in Occupational Therapy, that were implicit in the documents, as well as theoretical contributions as well as methodological-practical processes that enabled the scope of the Local Development policy of Itapeva.

Figure 3 Dimensions of the knowledge of the area of Occupational Therapy for Local Development. 

3.2.1 The dimension of everyday life: immersion in local life

Immersion is understood as the face-to-face involvement between local agents and external agents, as proposed by Granovetter (2007), contextualized in their historical processes. In in the immersion, the categories of meanings are identified and understood as a network of daily sustenance that gives meaning to life.

The place is a pathway for this immersion since it understands the relationships between the activities produced by local agents, their exchanges, their communications and common projects. The territorialization of the place is dependent on these constructs and is not limited to simply physical demarcations, but by the Cultural Order (CORREIA; ROCHA, 2016) that structures and dynamizes time and space. Thus, the place is produced by the perceptions of its agents by feelings of identification with what they do, with the places they go and with the people they relate. According to Akerman (2005), it is a symbolic production of political dimensions.

Félix et al. (2009) and Ávila (2012) emphasize that the notion of place is closely related to the notion of daily life since it understands social practices in time and space as layers of meanings that produce and put identities in motion. According to Franco (2004, p. 79), this everyday-local understanding is also identified as a community, not in the common sense of “place” or “physical space” but in the networks of immersion of mutual meanings between people emerging during life.

The place may be a region of several counties. Its boundaries are given by the scope of a development process. That is why it is said that the place is only defined at the end because it depends on the ‘size’ of the community project.

The day-to-day is a category, or unit of analysis, regarding the understandings about the production of knowledge in Occupational Therapy, as argues by Galheigo (2003). For the author, on both sociological and philosophical perspectives, everyday life is understood as a temporal and spatial dimension, in which historical facts, subjectivities, actions, relations of mutual help and solidarity, power relations and individualities and collectivities have heterogeneous forms, between singular and generic structures and processes, which is close to what Somekh (2008) discusses about local mutual relationships.

However, if the daily life of man is produced by this singular and generic human being, then the forms of production are not exhausted. The state, institutions, and corporations are tenacious producers and controllers of everyday life. In contemporary capitalist societies, the maintenance of the constant production of consumer goods leads to the constant production of desire (GALHEIGO, 2003, p. 106).

The monetary extravasation of global financial and contradictory flows (ÁVILA, 2012) or economic and social processes as emphasized by Ghirardi (2016), takes daily life producing meanings that conform the modes of participation of people, as a fragility of political power in decision-making and asset management to guide collective and individual lives.

The daily or local immersion appears in the processes of teaching in local participatory development as a reach to the Local Development policies to understand face to face the singular and generic - local/everyday networks of signification, which impress meanings for the understanding of reality and the consequent creation and exploration of strategies for coping with local life issues.

3.2.2 The dimension of the activities: strategies of contents apprehension

According to Anastasiou and Alves (2004), when teaching the creation and exploitation of strategies are always sets of activities, understood as actions that result from the relationship between people and their environments. Besides signifying the existence of this relationship, it also allow its continuity, serving as mediator of processes.

On the local perspective, the activities are filled with contents derived from daily reality, and therefore serving both for the cohesion of local networks and for their disaggregation. Activities are discourses, forms of communication, tasks, and attitudes operated by reasoning: worldviews and paradigms that try to get closer to the senses and contents of reality.

For Anastasiou and Alves (2004), on the understanding of teaching, the activities should not be reduced to the notion of resources, positivist notion, still identified in many practices in Occupational Therapy. For the authors, the activities are complex social dynamics between people and their universes, as also Costa (2008), argues, and that allow the construction of knowledge and ways of existing. However, resources and techniques are important in the materialization of certain dynamics, to operate objectively the contents of reality, but must be contextualized by networks of local significance in a strategic way.

The idea of strategy should be brought closer to the notion of human activity as a “fundamental element for the construction of existence” (LIMA; OKUMA; PASTORE, 2013, p. 246). This notion “corresponds to a motivation of the agent and whose basic component is the action that transforms this motivation into reality (DE CARLO, 1991 apud LIMA; OKUMA; PASTORE, 2013, p. 246) and, therefore, the activities can be operationalized through strategies, material and immaterial.

For Lima et al. (2013), human activities are centered on the constitution of the professional field and the area of knowledge in Brazilian Occupational Therapy. For the processes of Occupational Therapy in teaching in participatory local development, human activities are understood as socio-historical dynamics of daily life and through them, it is possible to understand the contents of reality that give meaning to life, allowing, through critical perception, visualization of questions of local life and the engagement in new dynamics for its confrontation.

If human activities are processes and products of the interaction between people and their environments, as Costa (2008) affirms, they will also be the foundation of strategic reasoning in Local Development.

3.2.3 The dimension of mediation skills: the articulation of participation networking

The articulation of participation networking generally comprises bringing together local and external actors, through the creation and exploitation of strategies, to jointly discuss, dialogue, make decisions and engage in collective actions that address issues of local life.

For this, it is necessary that occupational therapists first operate in local immersion, including networks of everyday meaning, to create and explore strategies for identifying, mapping and collecting data on key people in a given local context, official information on vulnerabilities, narratives singular places of the population, accessible places to gather people together in conversation, allow for a critical and productive dialogue about the common good and the forwarding of demands and projects that meet the wishes of local agents in an objective way.

These and other dynamics of the teaching process in participatory local development require skills called here as mediation, which comprise aspects of objective and fluid communication, as well as assertive and proactive attitudes around processes. AsAnastasiou and Alves (2004) argue, it is also about cognitive abilities, since it is essential that the person who plays this mediation between agents and their contents be sensitive and able to read between the microsocial and macrosocial dimensions.

3.2.4 The dimension of Collective Life Projects: building communities

Collective Life Projects (CLPs) are collective desires as already highlighted, translated into objectives and activities that will engage local agents in the practice of coping with local life issues (CORREIA; ROCHA, 2016).

The initial recognition of issues in a collective way and the critical dialogues about them allow greater engagement of agents, as well as facilitating the articulation of networks between the different social segments.

The evaluation identified in the construction of the maps, or brainstorm, of the trajectories of the processes, leads local agents to feelings of effectiveness of actions, as well as identification of conflicts that will depend on the same structures of engagement for their solution.

Collaborating for the construction of life projects, whether individual or collective, is the fundamental commitment of occupational therapists in any contexts of action. It is a question of putting into operation reasoning that facilitate participation in activities that give meaning to life and permeate a vast repertoire of theoretical references, models, paradigms, and approaches; the teaching in participatory local development is just one more component of this repertoire.

The dimension of the CLPs comprises a practical sense about the object of knowledge in Occupational Therapy as a human occupation. This sense is treated as the modes of participation of the people in the activities of daily life and that, through participation, produce meanings. CLP is the purpose of the teaching processes in participatory local development. Thus, there are a series of activities and trajectories mutually composing the projects to be conformed, as well as a series of forces that affect it.

It will be up to occupational therapists to identify in what way their personal-theoretical contributions will allow, to a certain extent, the engagement and participation of people effectively in the activities of life, so as Sen (2000) proposes, they can operate their trajectories in freedom. From the perspective of Local Development, CLPs are expected to be able to conduct networks of actions to build communities.

3.3 The reach of Occupational Therapy in local development

The way in which the dimensions of the area of knowledge in Occupational Therapy have been organized as a socio-historical matrix of the project conforms a methodology, already called teaching in participatory local development, which aims to contribute to Local Development, as in the example of Itapeva, and occupational therapists find a potential field of action.

In Doc. 27 Itapeva 07, July/2015, it was verified that this methodology was used by the Itapeva city hall to begin the construction of permanent forums of projects for the development of the city. Thus, the municipal bill that instituted the City Council of the City (CMC), which since 2011, had been registered only on paper, was resumed. With this, calls were made to elect members to compose the CMC, choosing coordinators of local forums, direct or indirect people in the local leadership. The tasks of the coordinators were to propose immersions of technicians of the Planning Department in the daily life of the neighborhoods; talk circles were used to bring these residents´ agents together to understand and discuss local life issues and to map their issues and their local networks. Next, collective life projects were created and taken to the Municipal Conference of the City of Itapeva, held in 2016, in which CLPs were widely debated, having chosen macro demands for the city, respecting the specific demands of the places.

The residents associations and their leadership were organized in a participatory way, as operators, articulators, and observers of the progress of CLPs, in close relation with the public power.

Thus, it is possible to identify the extent of Occupational Therapy in the local development of Itapeva neighborhoods, through the construction of the teaching processes in participatory local development, based on the dimensions of the area of ​​knowledge in Occupational Therapy.

The Reach from the perspective of the generated effects is procedural, but also observable, as the increase of the participation of the residents in the dialogue with the public power through the organization in associations of residents; the effective responses of the CLPs as in the Quilombo do Jaó, where in the first year of the project, the demands related to the organization of the residents and the physical structure of the neighborhood were met with the construction of the headquarters of the residents association, paving the main access roads of the Quilombo, public lighting, treatment of artesian wells, creation of two bus lines linking the Quilombo to the center of Itapeva, among others. The achievement of CLP objectives allowed local actors to critically recognize the force of collective action to address local life issues and the cohesion of their networks.

[...] it is a question of proposing an occupational therapy interested in describing ways to intensify polyphony, participation in common situations, in the actions that make up the daily life of the social sphere, in a less personalistic and systemic approach to doing. This collective dimension of seeking similarities in doing, rather than differences in being, of collective positivities, rather than individual negativities, demands a shift in the practice of occupational therapy by recognizing that, in one way or another, living in society and that the participatory and social dimension of public life is not reducible to the individual and private sphere of daily sufferings. There is the recognition that people organize ways of doing and, at the same time, are organized around the activities necessary for the life of that community (GHIRARDI, 2012, p. 18-19).

The direct and purposeful sharing of the methodology of the project by the team with agents of the public power was an important highlight for the scope of Occupational Therapy in the local development of Itapeva neighborhoods (Table 1). The mayor and secretaries of diverse sectors and professionals from diverse segments participated in two workshops on the Participatory Strategic Planning (Doc 10. Itapeva 03 - January/2013) and Strategies in Participatory Local Development (Doc. 17. Itapeva 04 - january/2014).

These processes in the project matrix can be understood as a kind of communitarization, as Higgins (2005) argues, a network of participatory relationships that are structured and operate for the production of the common good. For the author, communitarization is a meaning about social capital as a network of relationships between people, their activities, and places that conform the substratum of support, inventiveness, and projection of collective needs, desires, and dreams.

For D’Araujo (2010), the greater the involvement of people in common actions around their local dimensions, the greater the social capital offering possibilities for them to operate life in the way they think they want to live, in a positive way, by expanding their freedoms in mutual aid relationships.

The good functioning of public affairs, according to the author, as demonstrated in the studies of Robert Putman and James Coleman depends on social capital. This good functioning is the same as governance, that is, the power shared between civil society and public power in the management of everyday life. In this way, capital or assets, physical, financial, human, and cultural intersects with one another, producing development.

4 Conclusion

Through documentary research, it was possible to understand the scope of Occupational Therapy in local development in the city of Itapeva. Such Reach encompassed the dimensions of daily life, human activities, mediation skills and collective life projects, which are identified in the area literature as approximations and foundations of its constitution as a profession and area of knowledge, contributing to local development projects.

There are limits recognized in this research, especially for the documentary nature, which prevent the longitudinally of the results and the current state of the processes from being extrapolated for various reasons. However, the information investigated here and the results produced leave open paths for the continuity of research in Occupational Therapy and Local Development.

Thus, Occupational Therapy can achieve the structures and political functions for local development, through processes that consider the construction of networks of actions that mobilize the participatory engagement of local agents.

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Notes

1 This is an original and unpublished article as a result of the Ph.D. research in Health Sciences, entitled “Teaching processes in participatory local development: community articulation and the production of frontier knowledge as social capital”, defended in the area of Collective health, in the line of research in Social Determinants and Public Policies of the Medicine School of ABC. Project approved by the Ethics Committee of the Medicine School of ABC, under the opinion 1,516,433, of April 27, 2016.

2 The program is still active in the USA.

3 Spain is placed in this group, a nation that had a strong colonizing expansion between the sixteenth and seventeenth centuries.

4 For Báez (2010), more than 60% of the artistic and cultural works of Latin American people, before and after colonization, are today immoral-illegal in countries like France, England, USA, Italy, among others. This immorality is what author calls plunder, that is, theft, looting and destruction of a people’s productions to decimate their social memory and insert their political-economic power.

5 Medicine School of ABC, Pontifícia Universidade Católica de São Paulo, Mackenzie Presbyterian University, Universidade Metodista de São Paulo, University of Santo Amaro and Federal University of Rio de Janeiro.

6 The courses involved were: Occupational Therapy, Medicine, Nursing, Veterinary Medicine, Biomedicine, Nutrition, Pharmaceutical Sciences, Physiotherapy, Psychology, Biological Sciences, Dentistry, Administration, Law, Languages, Digital Media Communication, Public Relationships, Engineering, Design, and Philosophy.

7 The first action occurred in January 2011, but the document was only disclosed in 2014.

Received: June 30, 2017; Revised: November 14, 2017; Accepted: February 06, 2018

Corresponding author: Ricardo Lopes Correia, Departamento de Terapia Ocupacional, Faculdade de Medicina, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, s/n, Bloco K, Sala 17, Cidade Universitária, Ilha do Fundão, CEP 21910-590, Rio de Janeiro, RJ, Brasil, e-mail: toobiis@gmail.com; ricardo.lopes@medicina.ufrj.br

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