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NURSING PERFORMANCE IN THE BRAZILIAN AIR FORCE HEALTH SERVICE

DESEMPEÑO DE LA ENFERMERÍA EN EL SERVICIO DE SALUD DE LA FUERZA AÉREA DE BRASIL

ABSTRACT

Objectives:

to describe the circumstances related to the creation of the Aeronautics Central Hospital and to discuss the alliances formalized between the Brazilian Air Force and the Anna Nery Nursing School, in favor of the Aeronautics Health Service.

Method:

a historical-social study, whose historical sources are documents located at the Aeronautics Historical-Cultural Institute, the Aerospace Museum, the Central Aeronautics Hospital collection and the Anna Nery Nursing School Documentation Center. The analysis considered unity of the context, that is, it considered the “universe” that influenced the production of the discourse contained in the source, and Pierre Boudieu's concepts of power and symbolic capital were applied in the analysis and discussion.

Results:

when taken over by the Brazilian government in 1942, the School Hospital had its name changed to Hospital Central da Aeronáutica (Aeronautics Central Hospital). That same year, the hospital director, with the Minister of Aeronautics acquiescence, invited the Anna Nery Nursing School to organize the hospital's Nursing Service.

Conclusion:

the nurses who graduated from the Anna Nery Nursing School accumulated symbolic capital, as they had their work recognized in the Military field due to their performance in the aforementioned hospital, which served as a reference in their appointment to assume the other health services of the new Armed Force, in addition to highlighting the quality of the training of these nurses, so that they were selected to fight in the war with the rank of 2nd Lieutenants (Officers), exclusively assisting, the military of the elite Fighter Aviation Group.

DESCRIPTORS:
Nursing; Nursing History; Health services; Military Nursing World War II

RESUMEN

Objetivos:

describir las circunstancias al momento de crearse el Hospital Central de la Aeronáutica y debatir las alianzas formalizadas entre la Fuerza Aérea de Brasil y la Escuela de Enfermería Anna Nery, en beneficio del Servicio de Salud de la Aeronáutica.

Método:

estudio histórico-social, cuyas fuentes históricas son documentos que se encuentran en el Instituto Histórico-Cultural de la Aeronáutica, en el Museo Aeroespacial, en la colección del Hospital Central de la Aeronáutica y en el Centro de Documentación de la Escuela de Enfermería Anna Nery. En el análisis se consideró la unidad del contexto, es decir, el “universo” que influenció la producción del discurso contenido en la fuente, además de aplicarse los conceptos de poder y capital simbólico de Pierre Boudieu en el análisis y la discusión.

Resultados:

cuando su control fue adoptado por el gobierno de Brasil en 1942, el Hospital Itapagipe pasó a llamarse Hospital Central de la Aeronáutica. Ese mismo año, el Director del hospital, con la anuencia del Ministro de Aeronáutica, invitó a la Escuela de Enfermería Anna Nery para organizar el Servicio de Enfermería del hospital.

Conclusión:

las enfermeras egresadas de la Escuela de Enfermería Anna Nery acumularon capital simbólico, ya que su trabajo fue reconocido en el ámbito militar debido a su desempeño en el antes citado hospital, que actuó como referencia para sugerir a dichas enfermeras para asumir el control de los demás servicios de salud de la nueva Fuerza Armada, además de destacar la calidad de su formación académica, a fin de elegirlas para trabajar en la guerra con el rango de Teniente Segundo (Oficiales), asistiendo exclusivamente a los militares del Grupo de Aviación de Caza, grupo de élite de la Fuerza Aérea.

DESCRIPTORES:
Enfermería; Historia de la Enfermería; Servicios de salud; Enfermería Militar; Segunda Guerra Mundial

RESUMO

Objetivos:

descrever as circunstâncias de criação do Hospital Central da Aeronáutica e discutir as alianças formadas entre a Força Aérea Brasileira e a Escola de Enfermagem Anna Nery, em favor do Serviço de Saúde da Aeronáutica.

Método:

estudo histórico-social, cujas fontes históricas são documentos localizados no Instituto Histórico-Cultural da Aeronáutica, no Museu Aeroespacial, no acervo do Hospital Central da Aeronáutica e no Centro de Documentação da Escola de Enfermagem Anna Nery. A análise considerou a unidade do contexto, isto é, considerou o “universo” que influenciou a produção do discurso contido na fonte, e os conceitos de poder e capital simbólico de Pierre Boudieu, foram aplicados na análise e discussão.

Resultados:

o Hospital Itapagipe, ao ser arrestado pelo governo brasileiro, em 1942, teve sua denominação mudada para Hospital Central da Aeronáutica. Nesse mesmo ano, o diretor do hospital, com a aquiescência do Ministro da Aeronáutica convidou a Escola de Enfermagem Anna Nery para organizar o Serviço de Enfermagem do hospital.

Conclusão:

as enfermeiras egressas da Escola de Enfermagem Anna Nery acumularam capital simbólico, uma vez que tiveram seu trabalho reconhecido no campo militar, em função da atuação no referido hospital, que funcionou como referência na indicação das mesmas para assumirem os demais serviços de saúde da nova força armada, além de dar destaque à qualidade da formação dessas enfermeiras, de modo que foram selecionadas para atuarem na guerra com patente de 2º Tenente (Oficiais), assistindo, exclusivamente, aos militares do Grupo de Aviação de Caça, grupo de elite da aviação.

DESCRITORES:
Enfermagem; História da Enfermagem; Serviços de saúde; Enfermagem Militar; Segunda Guerra Mundial

INTRODUCTION

The study focuses on the professional relations between the Brazilian Air Force (Força Aérea Brasileira, FAB) and the Anna Nery Nursing School (Escola de Enfermagem Anna Nery, EEAN), in favor of the Aeronautics Health Service in the 1940s. The FAB was created in 1941 in the midst of World War II and, since then, there has been a need to create a health service and a hospital to serve the military of this new Armed Force and their family members.

In this regard, in 1942 the Brazilian government took over the Itapagipe Hospital, which had been inaugurated in 1934, under the name Hospital Alemão (German Hospital). It belonged to a German philanthropic institution and was located in Rio de Janeiro. When it was incorporated by the Brazilian Air Force in 1942, its name was changed to Hospital Central da Aeronáutica (HCA).

To assemble its effective staff, the hospital had military and civilian physicians specialized in Aviation Medicine. Thus, the medical composition of the hospital initially consisted of 34 physicians from the Army, 10 from the Navy and 05 from the civilian environment, with the aforementioned specialty11. Hospital Central da Aeronáutica. Histórico [Internet]. Brasil: Força Aérea Brasileira; c2014-2022 [cited 2022 Jan 12]. Available from: https://www2.fab.mil.br/hca/index.php/historico
https://www2.fab.mil.br/hca/index.php/hi...
-22. Pereira EGC. Entre saberes e cultura, a arte de curar na Força Aérea Brasileira [Internet]. Rio de Janeiro: Instituto Histórico Cultural da Aeronáutica; 2019 [cited 2020 Jul 18]. Available from: https://www2.fab.mil.br/incaer/images/eventgallery/instituto/Opusculos/Textos/opusculo_saude.pdf
https://www2.fab.mil.br/incaer/images/ev...
. Regarding the constitution of the Nursing staff, also in 1942, Medical Major Edgar Tostes, then director of the Aeronautics Central Hospital, and with the support of the Minister of Aeronautics, asked Laís Netto dos Reys, director of the Anna Nery Nursing School (1938-1950), to create a Nursing service in the recently taken over hospital. In addition to this request, in 1943 the Air Force Health Director, Colonel Ângelo Godinho, supported by the first lady, Darcy Vargas, requested an expansion of the school's participation, covering not only the HCA, but all FAB health services.

It is worth noting that the Anna Nery Nursing School was the official standard school, according to Article 2 of Decree No. 20,109 of June 15th, 1931, which regulated the Nursing practice in Brazil and established the conditions for the equalization of Nursing schools. In addition, since 1937 and by Law No. 452 of July 5th, the school became part of Universidade do Brasil, now Universidade Federal do Rio de Janeiro, as a complementary institution33. Santos FBO, Carregal FAS, Schreck RSC, Peres MAA. Padrão Anna Nery e perfis profissionais de enfermagem possíveis para enfermeiras e enfermeiros no Brasil. Hist Enferm Rev Eletron [Internet]. 2020 [cited 2023 Jan 10];11(1):1-12. Available from: https://publicacoes.abennacional.org.br/ojs/index.php/here/article/view/70
https://publicacoes.abennacional.org.br/...
-44. Peters AA, Peres MAA, Padilha MICS, D’Antonio P, Aperibense PGGS, Santos TCF, et al. Ethel Parsons’ biographical characteristics: leadership in American and Brazilian nursing. Rev Esc Enferm USP [Internet]. 2022 [cited 2023 Aug 02];56:e20220320. Available from: https://doi.org/10.1590/1980-220x-REEUSP-2022-0320en
https://doi.org/10.1590/1980-220x-REEUSP...
. In addition, it would be included among the University's Higher Education institutions by Law No. 8,393 of December 17th, 194555. Kondorfer AP. A Fundação Rockefeller e a formação de quadros para a enfermagem (Brasil: 1917-1951). Nuevo Mundo-Mundos Nuevos [Internet]. 2019 [cited 2023 Aug 02];(19):1-15. Available from: https://doi.org/10.4000/nuevomundo.76226
https://doi.org/10.4000/nuevomundo.76226...
-66. Peters AA, Peres MAA, D’Antonio P. Influences of the Anglo-American Teaching System in Brazil: contributions by the Parsons Mission (1921-1925). Online J Issues Nurs [Internet]. 2020 [cited 2023 Jan 23];25(2):3-11. Available from: http://doi.org/10.3912/OJIN.Vol25No02Man06
http://doi.org/10.3912/OJIN.Vol25No02Man...
.

This position in the Nursing education field conferred symbolic capital, that is, reputation and prestige, to the Anna Nery Nursing School, which was made visible through its leadership in the training of nurses, granting it the status of reference and excellence in the Nursing education field. Certainly, this symbolic capital, constituted by the social and professional capitals raised by the school's leaders, operated as a seal for the inclusion of teachers, nurses and students in unprecedented spaces traditionally dedicated to men.

In addition, since its implementation in 1923 the Anna Nery Nursing School had a prominent performance in crisis moments in the country, such as in the 1930 revolutionary movement, when students and professors provided assistance to the wounded at the São Francisco de Assis Hospital in Rio de Janeiro; in the 1932 Constitutionalist Revolution through the care provided to the wounded in the “War Operations Front”; in World War II, by sending six female graduates who worked with the 1st Fight Aviation Group (considered the Aviation elite), providing those six nurses with an update of their professional and social capitals77. Cezario KML, Santos RM, Costa LMC. A formação em Enfermagem para mulheres brasileiras no pós-1930: uma revisão histórica. Temperamentvm [Internet]. 2022 [cited 2023 Jan 10];18:e18046od. Available from: https://doi.org/10.58807/tmptvm20224848
https://doi.org/10.58807/tmptvm20224848...
. Thus, the question is how the symbolic capital acquired by the Anna Nery Nursing School, in the Nursing education scenario, influenced the formalization of professional agreements with the Brazilian Air Force.

Symbolic capital refers to the prestige, fame, good reputation and even credentials of a given agent (individual, group or institution). The volume and weight of this capital determines the distribution of agents in different social spaces88. Bourdieu P. Coisas Ditas. São Paulo: Brasiliense; 2015.. Holding important positions confers symbolic power, which is represented as a social credit, that is, as the power attributed to those who have obtained sufficient recognition to be able to impose recognition88. Bourdieu P. Coisas Ditas. São Paulo: Brasiliense; 2015..

The study is justified by the need to deepen the understanding of nurses' role in military spaces, especially in contexts of instituted dictatorial regimes, aggravated by the occurrence of a major conflict such as World War II99. Bittencourt RC, Santos TCF, Abreu MSA, Almeida Filho AJ, Peres MAA, Aperibense PGGS. Historical evolution of configuration of the nursing team in a military hospital. Rev Rene [Internet]. 2019 [cited 2023 Jan 12];20:e41557. Available from: https://doi.org/10.15253/2175-6783.20192041557
https://doi.org/10.15253/2175-6783.20192...
-1010. Peres MAA, Aperibense PGGS, Bellaguarda MLR, Almeida DB, Santos FBO, Luchesi LB. Recognition to Anna Justina Ferreira Nery: Woman and personality in the history of nursing. Esc Anna Nery [Internet]. 2021 [cited 2022 Jul 13];25(2):e20200207. Available from: https://doi.org/10.1590/2177-9465-EAN-2020-0207
https://doi.org/10.1590/2177-9465-EAN-20...
. This is because the recognition, development and rise of Nursing are linked to historical moments of war, when socio-political interests are evidenced and discussed. In addition to that, they bring to the present time a history surrounded by positive factors of nurses' inclusion in this social space related to the Nursing practice and visibility in crisis situations1111. Padilha MI. From Florence Nightingale to the COVID-19 pandemic: The legacy we want. Texto Contexto Enferm [Internet]. 2020 [cited 2023 Jan 12]:29:e20200327. Available from: https://doi.org/10.1590/1980-265X-TCE-2020-0327
https://doi.org/10.1590/1980-265X-TCE-20...
-1212. Thorne S. Nursing now or never. Nurs Inq [Internet]. 2019 [cited 2023 Jan 12]:26(4):e12326. Available from: https://doi.org/10.1111/nin.12326
https://doi.org/10.1111/nin.12326...
.

The following objectives were elaborated to guide the study: to describe the circumstances inherent to the creation of the Aeronautics Central Hospital, and to discuss the alliances formalized between the Brazilian Air Force and the Anna Nery Nursing School, in favor of the Aeronautics Health Service.

METHOD

This is a historical-social study of the documentary type, as it is configured as a survey that, when faced with a historical fact, prioritizes as a focus of interest human relations in a given context1313. Barros JD. Fontes Históricas: Introdução aos seus usos historiográficos. Petrópolis: Vozes; 2019.. The time frame comprises the years 1941 to 1943. 1941 is related to the creation of the Brazilian Air Force. 1943 refers to Colonel Godinho's request to Laís Netto dos Reys for the school to assume the Nursing services in all FAB health units existing at the time. It should be stated that such units were located in Rio de Janeiro, then the federal capital city. They were: Centro Médico de Aeronáutica do Galeão, Centro Médico de Aeronáutica dos Afonsos and Hospital Central da Aeronáutica.

The study findings come from direct historical sources represented by written documents that were collected from the of the Aeronautics Historical-Cultural Institute (Instituto Histórico-Cultural da Aeronáutica, INCAER) collection, the Aerospace Museum (Museu Aerospacial, MUSAL), the Aeronautics Central Hospital (Hospital Central da Aeronáutica, HCA) collection and the Anna Nery Nursing School Documentation Center (Centro de Documentação, CDOC). In these collections, notices, ordinances, laws, journalistic articles and a photograph were selected, as shown in Charts 1 and 2. The inclusion criteria corresponded to documents belonging to the time frame and the topic under study. Location of the documentary universe and constitution of the study corpus covered the period from March to August 2022.

Chart 1 -
Documents found in the Brazilian Air Force collections. Rio de Janeiro, RJ, Brazil, 2022.

Chart 2 -
Original documents found in the Anna Nery School Documentation Center. Rio de Janeiro, RJ, Brazil, 2022.

When assembling the appropriate documentary corpus, the relevance, sufficiency, completeness, representativeness, homogeneity and organization of the documents according to nature were taken into account. Reliability of the results was determined through the so-called external and internal criticisms, which analyze the origin of each document and the quality of the information therein contained1313. Barros JD. Fontes Históricas: Introdução aos seus usos historiográficos. Petrópolis: Vozes; 2019..

To comply with the data sorting phase, each document was separated according to the theme to which it was linked, namely: The "political and social context", "Aeronautics Central Hospital", "Anna Nery Nursing School", and later organized chronologically for their analysis.

According to the historical method and with emphasis on studies on the history of Nursing, data analysis took into account unity of the context. In the analysis process, it was sought to apprehend the discourse contained in the texts of the sources used, that is, the "universe" around them was taken into account, which is comprised by social and symbolic structures that influenced production of the discourse contained in the source. In this analysis, the concepts of power and symbolic capital proposed by French sociologist Pierre Bourdieu were used in the discussion of the strategies of rapprochement and alliances established between FAB and EEAN. This analysis enabled identifying the category called “Participation of the Anna Nery School in the Brazilian Air Force Health Service” which was the analysis category chosen for the study.

RESULTS

The Ministry of Aeronautics, created on January 20th, 1941, through Decree-Law No. 2,961 (1), had the collaboration of the Military Aviation (Army aviators) and Naval Aviation (Navy aviators) areas. The appointed Prime Minister was Joaquim Pedro Salgado Filho, graduated in Law, former Minister of Labor (1932/1935), former Federal Congressman (1937) and former Minister of the Superior Military Court (from 1938 to 1941). Before the creation of the Ministry of Aeronautics, the institutions belonging to the National Aviation had the following subordination structure: Army aviators to Ministry of War; Naval aviators to Ministry of Navy; and Civil aviators to Ministry of Transport and Public Works1414. Lavenére-Wanderley NF. História da Força Aérea Brasileira. 2nd ed. Rio de Janeiro: Gráfica Brasileira; 1975..

Therefore, all military personnel of the Army and Naval aviation, including the reserve military, became a single corporation, then called "National Air Forces" and subordinated to the Ministry of Aeronautics. Four months later, on May 22th, 1941, through Decree-Law No. 3,302 (2), it became known as the “Brazilian Air Force”1414. Lavenére-Wanderley NF. História da Força Aérea Brasileira. 2nd ed. Rio de Janeiro: Gráfica Brasileira; 1975..

It is worth noting that creation of the FAB took place during a dictatorial period in Brazil, namely the Estado Novo Dictatorship (1937-1945) and in the midst of World War II, with Brazil declaring war in 1942 on the side of the Allied Countries (United States, England the Soviet Union and the civil-military resistance of countries such as France). The enemy were the so-called “Rome-Berlin-Tokyo Axis Powers”.

With creation of the FAB, with regard to health, on December 2nd, 1941, through Decree-Law No. 3,872 (3), the Air Force Health Corps (Quadro de Saúde da Aeronáutica, QSAER) was created. This corps, aimed at medical officers necessary for health services, foresaw the following as initial staff: 02- Aeronautics Medical Colonel, 06- Aeronautics Medical Lieutenant Colonel, 12- Aeronautics Medical Major, 30- Aeronautics Medical Captain, 30- 1st Aeronautics Medical Lieutenant and 2nd Aeronautics Medical Lieutenant with a variable number. With regard to the number of second lieutenants, Decree-Law No. 3,872/1941 (4) defined that this would be established annually by the Brazilian Air Force Fixation Law, depending on the number of first lieutenant vacancies.

The Air Force Health Service head was then Lieutenant Colonel Ângelo Godinho, Army doctor and specialized in Aviation Medicine, who, with creation of the Ministry, was transferred to the FAB22. Pereira EGC. Entre saberes e cultura, a arte de curar na Força Aérea Brasileira [Internet]. Rio de Janeiro: Instituto Histórico Cultural da Aeronáutica; 2019 [cited 2020 Jul 18]. Available from: https://www2.fab.mil.br/incaer/images/eventgallery/instituto/Opusculos/Textos/opusculo_saude.pdf
https://www2.fab.mil.br/incaer/images/ev...
. The health issue within the FAB shows the need for assistance throughout the national territory, as this Armed Force was responsible for the safety of the entire airspace and, therefore, its military men were distributed in Military Organizations (MOs) across all regions of the country. To this end, it was imperative to have health units of the most diverse care levels to meet the demands of the entire workforce.

In addition to covering health units of the other Armed Forces, namely the Army and Navy, the FAB needed a hospital to provide care to their military and family members. Therefore, an integrated commission was created by Air Brigadiers Heitor Varady and Ajalmar Vieira Mascarenhas and Lieutenant Colonel Ângelo Godinho dos Santos. This committee forwarded the Itapagipe Hospital request to Minister Salgado Filho11. Hospital Central da Aeronáutica. Histórico [Internet]. Brasil: Força Aérea Brasileira; c2014-2022 [cited 2022 Jan 12]. Available from: https://www2.fab.mil.br/hca/index.php/historico
https://www2.fab.mil.br/hca/index.php/hi...
. This request, published in the Ministry of Aeronautics Bulletin on August 31st, 1942 [Ordinance No. 100 of August 27th, 1942 (5)], took place two days after the promotion of Ângelo Godinho to the rank of Colonel22. Pereira EGC. Entre saberes e cultura, a arte de curar na Força Aérea Brasileira [Internet]. Rio de Janeiro: Instituto Histórico Cultural da Aeronáutica; 2019 [cited 2020 Jul 18]. Available from: https://www2.fab.mil.br/incaer/images/eventgallery/instituto/Opusculos/Textos/opusculo_saude.pdf
https://www2.fab.mil.br/incaer/images/ev...
. In addition to the Health Service Head Office, Colonel Godinho would accumulate the Direction of the aforementioned hospital.

Such facts were reported in the Jornal do Brasil of August 28th, 1942, in its 202nd edition, with the following publication entitled: "The German Hospital was requested for the FAB". The text stated that, according to Decree-Law No. 4,008 of January 12th, 1942, the Minister of Aeronautics had decided to request the Itapagipe Hospital, which belonged to Associação Hospital Itapagipe Sociedade Beneficente. The hospital would be evaluated by a military commission and it would be up to the then direction of the hospital to ease scope of the actions of such authorities, under law penalties or other measures that would become necessary for their execution.

Regarding the name change from Hospital Alemão to Hospital Itapagibe, the reason was based on understanding the need to demonstrate German nationality, eight years after its inauguration and six months before Brazil declared war on Nazi Germany.

Regarding the infrastructure, the Aeronautics Central Hospital consisted of a central block with five floors. The 5th floor was built to accommodate the operating room, with windows facing South, where they received direct sunlight. The maternity ward operated on the 4th floor. The polyclinic was on the ground floor, where patients were referred to outpatient clinics or for hospitalization. The perfect equipping of the former German Hospital, together with its administration, turned this hospital into a milestone in the history of hospitals in Brazil. Less than a month after being taken over by the Brazilian government and becoming part of the FAB, the HCA received its first surgical patient, 1stAviator Lieutenant Oscar de Souza Spínola Júnior, from the 1st Fight Group, who had undergone an appendectomy11. Hospital Central da Aeronáutica. Histórico [Internet]. Brasil: Força Aérea Brasileira; c2014-2022 [cited 2022 Jan 12]. Available from: https://www2.fab.mil.br/hca/index.php/historico
https://www2.fab.mil.br/hca/index.php/hi...
.

In November 1942, Colonel Godinho passes the direction of the HCA to another physician belonging to the new Armed Force. This change was published in Jornal do Brasil on November 27th, 1942: "Yesterday, for being exercising these new functions, Medical Colonel Godinho dos Santos, Health Service health, passed the direction of the Central Air Force Hospital to Medical Major Edgar Tostes".

In relation to the composition of the health corps, during the study time frame, the documents highlight the medical staff; however, on inclusion of other health professionals in that hospital, it was necessary to incorporate other specialties, such as pharmacists and nurses. It was imperative to equip the sectors with clinical and care staff in number and quality consistent with the reality of that hospital organization, considering that it had 100 hospitalization beds11. Hospital Central da Aeronáutica. Histórico [Internet]. Brasil: Força Aérea Brasileira; c2014-2022 [cited 2022 Jan 12]. Available from: https://www2.fab.mil.br/hca/index.php/historico
https://www2.fab.mil.br/hca/index.php/hi...
.

At the same time that there was the movement to create the Ministry of Aeronautics and, consequently, creation of the FAB, in the Nursing field, for being considered an Official Standard School, the Anna Nery Nursing School held a privileged position before the government and society of the time, thus raising more symbolic capital.

Although World War II had been ongoing since 1939, Brazil only declared war on the Axis countries in September 1942, effectively entering the war on June 30th, 1944, deploying nearly 25,000 men from the Brazilian Expeditionary Force (Força Expedicionária Brasileira, FEB), 42 pilots and 400 FAB support men. In this context, the Anna Nery Nursing School, already incorporated into the university system since 1937, offers help to the Brazilian government through a letter sent by Laís Netto dos Reys on January 19th, 1942, to the Dean of Universidade do Brasil, requesting that he inform the Minister of Education and Health that the School was available to the country. In the document, Laís points out that institutions such as the Anna Nery Nursing School should be at the forefront of the homeland's service. He asserts that the School is in solidarity with the government and that it would be available for whatever was necessary. She adds that it was an honor to serve the country and that, at moments like the present time, female nurses should be in a vanguard position, and that the duty of Nursing is sacred, especially that of nurses at the Official Standard School (6).

In continuity, two months later, precisely on March 12th, together with the Brazilian Red Cross and under the guidance of the Army Health Corps, the Anna Nery Nursing School promoted a specialization course in war relief for nurses and students. The argument about completion of the course is contained in the text of Official Letter No. 186 of 1942, sent to the Dean of Universidade do Brasil, which once again highlights the ideal of Service to the Homeland as nurses' mission (7).

In July 1942, the School received an invitation to participate in the demonstrations of the organization of the Army Campaign Health Service. The diverse evidence of this important participation can be seen in the acknowledgment letter sent by Laís Netto dos Reysao to General Souza Ferreira, War Health Director, in which he congratulates him on the brilliant demonstration of organization by the Campaign Health Service, which was appreciated by the students and nurses of the School, and thanks them for the kindness of having been offered a lunch.

In this war, the pioneering presence of female Nursing officers stands out. Therefore, Laís Netto dos Reys was commissioned by the Minister of Aeronautics to select six nurses to act in this conflict, exclusively with the 1st Fighter Aviation Group, with the rank of Second Lieutenants. In all, sixty-seven nurses made up the corps of the Brazilian Expeditionary Force (FEB) and the FAB, sixty-one of them hospital nurses and six specialized in air transportation1515. Bernardes MMR, Lopes GT. Enfermeiras do Exército Brasileiro no transporte aéreo de feridos: um desafio enfrentado na 2a. Guerra Mundial. Rev Bras Enferm [Internet]. 2007 [cited 2020 Jul 22];60(16):68-72. Available from: https://doi.org/10.1590/S0034-71672007000100012
https://doi.org/10.1590/S0034-7167200700...
. Six nurses belonged to the Anna Nery Nursing School, two of them instructors of students at the HCA.

Regarding the newly opened Aeronautics Central Hospital, on November 16th, 1942, physician Major Edgar Tostes was appointed director of this hospital. On December 11th of the same year and with the Minister of Aeronautics consent, an official letter was sent to the Board of the Anna Nery Nursing School to organize the Aeronautics Hospital's Nursing Service. Four days later, on December 15th, Laís Neto dos Reys responds to the Head of the Air Force Health Service, Physician Colonel Ângelo Godinho dos Santos and to Physician Major Edgar Tostes, through Official Letter No. 918, stating that the School collaboration in the organization of the Aeronautics Central Hospital Nursing Service is a satisfaction, and announces the appointment of Aurora Gypsophila de Affonso Costa as responsible for it. Laís points out that Aurora is one of the best chief instructors in the school's technical staff (8).

Immediately after creation of the Ministry, the need to intensify personnel training was felt, as the war had already begun and Brazil was about to participate in it. A program was created to accelerate the training of aircraft navigators and specialists. "One of the columnists who wrote in the “Correio da Manhã” newspaper, Pierre Henry Closterman (signing as P. Henry C.), defended the idea of forming a Brazilian air culture, that is, much more than merely developing the air industry (...), it was crucial to create a National Aviation culture, cultivating in all Brazilians a feeling of zeal and identification with the subject matter, as several countries in Latin America had air clubs, and both private and not private institutions raised resources for aviation"1616. Ferreira RFS. Uma História da Campanha Nacional da Aviação (1940 - 1949): O Brasil em busca do seu ‘Brevêt’. Cantareira [Internet]. 2012 [cited 2020 Jul 22];13(17):75-86. Available from: https://www.historia.uff.br/cantareira/v3/wp-content/uploads/2013/05/e17a5.pdf
https://www.historia.uff.br/cantareira/v...
:78.

From the scenario described, a movement for air integration in Brazil is initiated. The idea arises according to a conversation between Assis Chateaubriand - a renowned journalist who wrote for “Correio da Manhã” and founded “O Jornal” - and Salgado Filho, then Minister of Aeronautics. "It was believed that National Aviation could count on the support of sponsors to assist in solving some problems such as the lack of comprehensive Civil Aviation, pilot training and effective monitoring of the Brazilian coast. Then comes the campaign that had denominations such as: ‘National Campaign to Donate Airplanes’, ‘National Campaign to Give Wings to the Brazilian Youth’ and ‘National Civil Aviation Campaign’, among others, until reaching the name currently known as ‘National Aviation Campaign’, or CNA (Campanha Nacional da Aviação). The first CNA plane was donated to the Pesqueira-PE Aero Club on November 1st, 1940”1616. Ferreira RFS. Uma História da Campanha Nacional da Aviação (1940 - 1949): O Brasil em busca do seu ‘Brevêt’. Cantareira [Internet]. 2012 [cited 2020 Jul 22];13(17):75-86. Available from: https://www.historia.uff.br/cantareira/v3/wp-content/uploads/2013/05/e17a5.pdf
https://www.historia.uff.br/cantareira/v...
:78.

Participation of the Anna Nery Nursing School in the Campaign took the form of two important donations for the acquisition of an airplane, as described in the letters sent by Laís Netto dos Reys to the person responsible for it, where Laís mentions the amount donated by the School to acquire the ambulance plane that would be named “Ana Néri”, and wishes the Civil Aviation Campaign success (9).

The plane was also purchased with funds from the Brazilian Rotary Club, being baptized on October 26th, 1943, as the first FAB ambulance plane. The plane was named Anna Nery and Laís Netto of the Reys was its godmother1919. Almeida Filho AJ. A Escola Anna Nery (EAN) no “front” do campo da educação em enfermagem e o (re)alinhamento de posições de poder (1931 - 1949). [Tese]. Rio de Janeiro: Universidade Federal do Rio de Janeiro; 2004. Available from: http://objdi.ufrj.br/51/teses/EEAN_D_AntonioJoseDeAlmeidaFilho.pdf
http://objdi.ufrj.br/51/teses/EEAN_D_Ant...
. The Figure 1 evidences this statement.

Figure 1 -
Baptism ceremony of the Anna Nery ambulance plane.

In the center pf the photograph we see Laís Netto dos Reys flanked by the Anna Nery Nursing School students, teachers and nurses and with the plane in the background. The position of Laís in the photograph shows her prominence, not only due to her position in the School, but because she was chosen as the godmother, for the baptism of that plane.

The links between the Anna Nery Nursing School and the Ministry of Aeronautics have been built since the participation of EEAN in the Aviation Campaign, being signed at the request of the organization of the Nursing service at the Aeronautics Central Hospital, made by Edgar Tostes and Salgado Filho to Laís Netto dos Reys in November 1942, consolidating with the request of the Aeronautics Health Director for EEAN to act in all three units of the Aeronautics Health Service in 1943. It is worth highlighting the intercession by Darcy Vargas (1st Lady) with the School director for the negotiations of this action.

In accordance with the terms then requested by the School, the Minister of Aeronautics and the Minister of Education and Health sign the contract and, on January 15th, 1944, Laís sends a letter to the Miguel Couto Hospital director informing that the School would leave the that hospital due to the need to serve the Brazilian Air Force, and that departure of the students and instructors would be gradual so that there would be no harm to the hospital services, and thanking the entire medical staff and management thereof for their cooperation and support. In the letter, Laís mentions the transfer of nurses Judith Areas and Regina Bordalo to the HCA from February 17th, 1944 (10).

DISCUSSION

The participation of the Anna Nery Nursing School in the Military field is evidenced in this study through the close relationships established between the FAB and the EEAN, as the Aeronautics Health Director requests that the School assume the Nursing service in the FAB health units. This invitation to the School shows FAB's recognition of EEAN's prominent position in the national Nursing field.

Thus, coalitions are established based on factors associated with the School's participation in crisis moments in the country, such as World War II, contributing positively to the greatest conflict in the history of society. Therefore, the female qualities were highlighted, portraying the presence of the figure of women as nurses in these militarized spaces1717. Bernardes MMR, Kaminitz SHC, Maciel LR, Almeida ABS, Oliveira AB, Porto FR. Uma enfermeira da Força Expedicionária Brasileira na Segunda Guerra Mundial: Fundo Virgínia Portocarrero da Casa de Oswaldo Cruz/Fiocruz. Hist Ciênc Saúde - Manguinhos [Internet]. 2022 [cited 2022 Jul 24];29(2):531-50. Available from: https://doi.org/10.1590/S0104-59702022000200013
https://doi.org/10.1590/S0104-5970202200...
.

In this sense, there is an opportunity to discuss Nursing presence in these social spaces in times of crisis or chaos and, in this perspective, to highlight the role of women and nurses in society, as this is usually detailed or symbolically silenced in certain political and social contexts.

In this logic, EEAN ratifies its symbolic capital by offering assistance to the government by promoting the specialization course in War Relief to nurses and students with arguments of service to the homeland, emphasizing the public image of nurses associated with patriotic causes and showing support for the government. On the other hand, the School is recognized when it receives the invitation, in July 1942, to participate in the demonstrations of the organization of the Army's Campaign Health Service.

In this perspective, the School made donations to the “National Aviation Campaign”, participating as one of the sponsors to assist in solving the lack of expanded Civil Aviation, reinforcing the political and social ties that culminated in EEAN occupying this social space. Also noteworthy is the purchase of the first ambulance plane, from which Laís had received the title of godmother, and whose baptismal name was given in honor of the volunteer nurse and war heroine, who also gave her name to the main Nursing School in the country.

From Bourdieu's perspective1818. Grenfell M. Pierre Bourdieu: conceitos fundamentais. Petrópolis: Vozes; 2018., an institutional act, such as baptizing the plane, is validated because the person who performed it is qualified to do so and possesses a symbolic capital recognized by the social agents present at the act in question, which makes it legitimate. Thus, this institutional act conferred symbolic power to Brazilian Nursing at a time of rigid military and political powers that denied the presence of women.

The figure of Laís Netto dos Reys was of paramount importance, as she held symbolic capital in the Nursing education field, being recognized as a woman who had an excellent relationship with Vargas and the Catholic Church. She transmitted all the social and cultural capital she had accumulated, which made her indispensable in the Nursing field, as a link between Church and State. Her role was fundamental, both as EEAN Director and as President of the Nursing Council; strategic positions that enabled various actions of interest to the Church and the State1919. Almeida Filho AJ. A Escola Anna Nery (EAN) no “front” do campo da educação em enfermagem e o (re)alinhamento de posições de poder (1931 - 1949). [Tese]. Rio de Janeiro: Universidade Federal do Rio de Janeiro; 2004. Available from: http://objdi.ufrj.br/51/teses/EEAN_D_AntonioJoseDeAlmeidaFilho.pdf
http://objdi.ufrj.br/51/teses/EEAN_D_Ant...
.

It can be inferred that Laís Netto dos Reys contributed to the capitalization of symbolic profits by establishing these professional relationships and easing the incorporation of nurses in the FAB field, assuring them power and prestige in the military space. This can be evidenced by the name of Anna Nery on the first FAB ambulance plane and, thus, choosing the School Director to be the aircraft's godmother at that time. The fact that the ceremony was published in a widely circulated newspaper at the time, occupying a space in the column on the Ministry of Transport, highlights the links established.

This participation shows the School's engagement and the proximity to the newly created Ministry as a result of recognizing the leading role of the Anna Nery Nursing School in the Nursing education field, which is a product of the symbolic capital raised by the School and its leaders in and by the field. In addition, these strategies to make themselves seen and recognized, mainly by the mobilization to acquire an airplane to be baptized with the Director's name, a war heroine who lends her name to the School, confer visibility to the institution and to Nursing for the society of the time. This visibility certainly contributed to the School being invited to send nurses to FEB to work with the FAB military.

The graduates' professional capital during implementation of the Nursing service at the HCA was expanded, as it gave visibility to the profession both in the civil and military spheres, evidenced by the presence of an entourage of EEAN professors and students, led by Laís, at the baptism ceremony of the Brazilian Air Force ambulance plane named “Anna Nery” on November 26th, 1943, at the Santos Dumont airport in Rio de Janeiro; in addition, in December of the same year, the Aeronautics Health Service head, Colonel Ângelo Godinho, sent a letter expressing his desire to have EEAN in that military service. Thus, Laís was received at the office of the Aeronautics Health Service head and, on that occasion, they defined the formal aspects for an agreement involving both institutions1919. Almeida Filho AJ. A Escola Anna Nery (EAN) no “front” do campo da educação em enfermagem e o (re)alinhamento de posições de poder (1931 - 1949). [Tese]. Rio de Janeiro: Universidade Federal do Rio de Janeiro; 2004. Available from: http://objdi.ufrj.br/51/teses/EEAN_D_AntonioJoseDeAlmeidaFilho.pdf
http://objdi.ufrj.br/51/teses/EEAN_D_Ant...
;22. Pereira EGC. Entre saberes e cultura, a arte de curar na Força Aérea Brasileira [Internet]. Rio de Janeiro: Instituto Histórico Cultural da Aeronáutica; 2019 [cited 2020 Jul 18]. Available from: https://www2.fab.mil.br/incaer/images/eventgallery/instituto/Opusculos/Textos/opusculo_saude.pdf
https://www2.fab.mil.br/incaer/images/ev...
.

In this regard, the nurses who graduated from EEAN accumulated symbolic capital and power, as they had their work recognized in the military field due to their performance at the Aeronautics Central Hospital, which served as a reference for their appointment to assume the other health services of the new Armed Force, in addition to highlighting the quality of the training of these nurses, so that they were selected to act in the war with the rank of 2nd Lieutenants (Officers), exclusively assisting the military men from the Fighter Aviation Group.

It is a fact that symbolic gains were attained by both sides, considering that EEAN sought to spread its name in all spheres of the care field, including the military field, where women nurses gain notoriety in an exclusively male space. At the same time, FAB gained in care quality for its military and family members, as the care would be provided by nurses trained by the reference school in the country at the time.

CONCLUSION

Approximation of the Anna Nery Nursing School to the Brazilian government, not only due to the proximity of its Director to the President and his family but also due to the title that referenced it in the national Nursing field as an Official Standard School, favored its union with the Brazilian Air Force, in the figure of its greatest representative, Minister Salgado Filho, with participation of the School in the National Aviation Campaign, with collaboration to purchase an aircraft that received the name of the same emblematic reference figure of Nursing in the military space, and who also lent her name to the School.

This approach also guaranteed the School and its agents the accumulation of symbolic capital by positioning its students, professors and nurses in the military space through their work in the health field, specifically om the Aeronautics Central Hospital, at the invitation of its Director and the health service head of the new Armed Force, which worked as a credential for occupying all units of the Aeronautics Health Service existing at the time, as well as on the action front line in World War II, together with an elite platoon.

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NOTES

  • ORIGIN OF THE ARTICLE

    Extracted from the thesis - “Symbolic struggles for the visibility of Nursing performance in the Brazilian Air Force (1942-1966)”, presented toe Stricto Sensu Graduate Program of the Anna Nery Nursing School, belonging to Universidade Federal do Rio de Janeiro, in 2023.
  • CONTRIBUTION OF AUTHORITY

    Study design: Batalha MC, Santos TCF. Data collection: Batalha MC. Data analysis and interpretation: Batalha MC, Santos TCF, Queirós PJP Discussion of the results: Batalha MC, Silva CPG, Almeida-Filho AJ, Santos TCF, Queirós PJP. Writing and/or critical review of the content: Batalha MC, Silva CPG, Cavalcanti HCN, Almeida-Filho AJ, Santos TCF, Queirós PJP. Review and final approval of the final version: Batalha MC, Silva CPG, Cavalcanti HCN, Almeida-Filho AJ, Santos TCF, Queirós PJP.
  • FUNDING INFORMATION

    This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). Sandwich PhD Program Abroad, Process 8881.690104/2022-01. National Council for Scientific and Technological Development (CNPq): Research Productivity Scholarship. Case 311632/2021-1.
  • APPROVAL OF ETHICS COMMITTEE IN RESEARCH

    Approved by the Ethics Committee in Research of the Anna Nery Nursing School and the São Francisco de Assis Teaching Hospital, under opinion No. 4,308,458/2020 and Certificate of Presentation for Ethical Appraisal No. 37092720.0.0000.5238

Edited by

EDITORS

Associated Editors: José Luís Guedes dos Santos, Maria Lígia Bellaguarda. Editor-in-chief: Elisiane Lorenzini.

Publication Dates

  • Publication in this collection
    20 Nov 2023
  • Date of issue
    2023

History

  • Received
    18 May 2023
  • Accepted
    10 Aug 2023
Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
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