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[Health resort, industrial city: urban space and health policy in São José dos Campos, São Paulo, Brazil].

Cad Saude Publica

June 2007

Faculdade de Medicina, Universidade de São Paulo, Rua José Pereira dos Santos 269, São José dos Campos, São Paulo 12284-484, Brazil.

This study is part of the renewed theoretical and conceptual approach to space in health policies. The key potential of this approach lies in dealing with the organization of space as a product of relations between society and state power, influenced by the economy and enabled by politics. When understood as a social construction, such space provides the material basis for a historical narrative, allowing a better understanding of how policies are formulated and implemented in urban space.

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This article describes Cuba's effort to develop a comprehensive program for control of its human immunodeficiency virus (HIV) epidemic. The program consists of multiple interventions, including blood donor screening, a ban on imported blood and blood products, widespread semicompulsory screening of defined and general populations, research and clinical trials on treatment and diagnostic methods, and health education in the press, radio, television, workplace, and schools. The most controversial of the program's measures has been the treatment of HIV antibody-positive persons (both asymptomatic and clinically ill) through what Cubans term a "sanatorial regimen," consisting of admission into an institutional setting where both preventive and curative treatment is offered, and where residents have limited contact with their families, neighborhoods, friends, and the rest of society.

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The author describes his personal experience in the joint treatment of patients with chronic forms of schizophrenia and patients who were registered in neuropsychiatric dispensaries (for endogenous psychoses in the past, organic brain lesions of a different etiology, etc) in one department and referred during the phase of an unstable remission for the so-called sanatorial treatment. The author comes to the conclusion that departments organized according to this new principle have a possibility of creating an effective system of rehabilitative therapy for mental patients and considers it feasible to organize in mental hospitals sanatorium-rehabilitative departments.

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