Abstract
Objective
to analyze the circumstances in which the Maternidade de Natal functioned as a military hospital (1941-1950).
Method
a qualitative, social history study, elaborated with documentary and bibliographical sources. Data were organized and analyzed according to thematic content analysis.
Results
the Maternidade de Natal operation required commitment, coordination and strategies from the Hospital Assistance Society regarding financial difficulties, transfer of the building to the Ministry of War, during World War II, and finally, the return and its inauguration. This context transformed the daily life of Natal and, thus, the military hospital cooperated with the course for nurses at the military hospital, creation of the Red Cross – Rio Grande do Norte branch –, volunteer course for boys, internship for official Army Reserve physicians and creation of the study center.
Conclusion and implications for practice
the study contributes to the understanding of care for women and the history of Rio Grande do Norte. From the idealization of the Maternity de Natal to the present day, it was possible to observe the evolution of its profile, initially providing assistance, and today it is a reference center for women’s and children’s health, education and professional training in health.
Keywords:
Nursing; History; Hospitals; Military Personnel; World War II
Resumo
Objetivo
analisar as circunstâncias nas quais a Maternidade de Natal funcionou como hospital militar (1941-1950).
Método
estudo qualitativo, histórico-social, elaborado a partir de fontes documentais e bibliográficas. Os dados foram organizados e analisados conforme a análise temática de conteúdo.
Resultados
o funcionamento da Maternidade de Natal requereu empenho, articulações e estratégias da Sociedade de Assistência Hospitalar quanto às dificuldades financeiras, cessão do prédio ao Ministério da Guerra, durante II Guerra Mundial, e por fim, a devolução e sua inauguração. Esse contexto transformou o cotidiano de Natal e, assim, o hospital militar cooperou com o curso de enfermeiras do hospital militar, criação da Cruz Vermelha – filial Rio Grande do Norte –, curso de voluntários para rapazes, estágio para médicos oficiais da Reserva do Exército e criação do centro de estudos.
Conclusão e implicações para a prática
o estudo contribui para a compreensão da assistência à mulher e da história do Rio Grande do Norte. Da idealização da Maternidade de Natal à atualidade, foi possível constatar a evolução do seu perfil, inicialmente assistencial, e hoje é centro de referência à saúde da mulher e da criança, do ensino e na formação profissional em saúde.
Palavras-chave:
Enfermagem; História; Hospitais; Militares; II Guerra Mundial
Resumen
Objetivo
analizar las circunstancias en que la Maternidade de Natal funcionó como hospital militar (1941-1950).
Método
estudio cualitativo, historia social, elaborado con fuentes documentales y bibliográficas. Los datos fueron organizados y analizados según el análisis de contenido temático.
Resultados
el funcionamiento de la Maternidade de Natal requirió compromiso, coordinación y estrategias de la Sociedad de Asistencia Hospitalaria frente a las dificultades financieras, la transferencia del edificio al Ministerio de la Guerra, durante la Segunda Guerra Mundial, y finalmente, el regreso y su inauguración. Este contexto transformó la vida cotidiana de Natal y, así, el hospital militar colaboró con el curso para enfermeros en el hospital militar, la creación de la Cruz Roja – filial Rio Grande do Norte –, el curso de voluntariado para niños, la pasantía para médicos oficiales de Reserva del Ejército y creación del centro de estudios.
Conclusión e implicaciones para la práctica
el estudio contribuye para la comprensión de la asistencia a las mujeres y la historia de Rio Grande do Norte. Desde la idealización de la Maternidade de Natal hasta la actualidad, se pudo observar la evolución de su perfil, inicialmente asistencial, y hoy es un centro de referencia en salud maternoinfantil, educación y formación profesional en salud.
Palabras clave:
Enfermería; Historia; Hospitales; Personal Militar; Segunda Guerra Mundial
INTRODUCTION
In Natal, capital of the state of Rio Grande do Norte, the founding of the Hospital Assistance Society (SAH - Sociedade de Assistência Hospitalar),11 Fundação da Sociedade de Assistência Hospitalar, Sociedade de Assistência Hospitalar. Ata da reunião realizada no dia 25 de maio de 1927, Natal. Natal: Fundação da Sociedade de Assistência Hospitalar; 1927. Livro 1, p. 6. on May 25, 1927 – a legal and charitable entity – resulted from the internal effort of the Hospital de Caridade Juvino Barreto board of directors, in operation since 1909, to enable the necessary means for its administrative transfer based on the contract to be drawn up with the State Government.11 Fundação da Sociedade de Assistência Hospitalar, Sociedade de Assistência Hospitalar. Ata da reunião realizada no dia 25 de maio de 1927, Natal. Natal: Fundação da Sociedade de Assistência Hospitalar; 1927. Livro 1, p. 6. This document, signed on June 30, 1927, valid for 20 years, renewable, composed through 24 articles, established and ensured the hospital’s operating conditions, healthcare provision and financial, material and human resource management. Among them, Art. XVI is the interest of this manuscript, as it expresses the commitment to create a maternity hospital attached to the hospital.22 Fundação da Sociedade de Assistência Hospitalar, Sociedade de Assistência Hospitalar. Ata da reunião realizada no dia 30 de junho de 1927, Natal Termo do Contrato lavrado entre o Governo do Estado e a Sociedade de Assistência Hospitalar para encarregar-se da Direção e administração do Hospital de Caridade Juvino Barreto. Natal: Fundação da Sociedade de Assistência Hospitalar; 1927. Livro 1, p. 8-11.
At the time, the Hospital de Caridade Juvino Barreto was the only healthcare institution operating in the state intended for general assistance to the population, offering 93 beds, distributed as follows: 64 in the medical-surgical ward pavilions; 18 in the maternity section; and 11 in private apartments.33 Fundação da Sociedade de Assistência Hospitalar, Sociedade de Assistência Hospitalar. Livro diário de anotações. Natal: Fundação da Sociedade de Assistência Hospitalar; 1927. For its operation, it had six physicians, among whom were Ernesto Emílio da Fonseca, responsible for the obstetric clinic, a dentist, an analyst, a group of nuns from Filhas de Sant’Ana (Plácida Possi as Regent Sister), two midwives (Leonor Monteiro da Silva and Generosa Gomes), a nurse (José Lucas do Nascimento) and employees for general services.33 Fundação da Sociedade de Assistência Hospitalar, Sociedade de Assistência Hospitalar. Livro diário de anotações. Natal: Fundação da Sociedade de Assistência Hospitalar; 1927.,44 Diretoria Geral de Estatística (RN). Seção Rio Grande do Norte. Relatório sobre o Hospital de Caridade Juvino Barreto 1927. Natal: Diretoria Geral de Estatística; 1927.
That said, on March 19, 1928, the Maternidade de Natal was founded in a solemn event held at the Teatro Carlos Gomes – now Teatro Alberto Maranhão –, whose program was widely publicized by the local press and was attended by authorities, personalities, religious leaders and populations.55 Maternidade de Natal: realiza-se hoje, à noite, a esplendida festa da sua fundação. A República (Natal). 1928 mar 20; 1(1296):1. Despite its construction, it is known that it occurred slowly due to the scarcity of resources and that, for its completion, help from the Federal Government was of vital importance.66 Conclusão da Maternidade de Natal: o Governo Federal auxiliará os trabalhos. A Ordem (Natal). 1940 jan 18; 18(1296):1. However, close to its inauguration, in the context of Brazilian participation in World War II World War (1939-1945), as a transfer to the Ministry of War, the Maternidade de Natal functioned as a military hospital.77 Contrato entre a Sociedade de Assistência Hospitalar e a Diretoria de Saúde do Exército (BR). Locação do edifício da Maternidade de Natal. Diário Oficial da União, Brasília (DF), 11 ago 1941: Seção 1: 15862.
Therefore, carrying out this study is justified by the importance that this institution has assumed over the years. From the initiative of its construction and operation, the maternity hospital remains in a constant evolutionary process, with the expansion of its care services and as a space for health teaching, research and professional training. Thus, the objective was to analyze the circumstances in which the Maternidade de Natal functioned as a military hospital (1941-1950).
METHOD
This is qualitative, social historical study, drawn from documentary88 Carlos DJD, Bellaguarda MLR, Padilha MI. The document as a primary source in nursing and health studies: a reflection. Esc Anna Nery. 2022;26:e20210312. http://doi.org/10.1590/2177-9465-ean-2021-0312.
http://doi.org/10.1590/2177-9465-ean-202...
and bibliographic sources. The survey of these sources took place from 2017 to 2023. Searches were carried out in the State of Rio Grande do Norte, Public Archive in official registry offices and in the Special Collections section of the Universidade Federal do Rio Grande do Norte Biblioteca Central Zila Mamede (library).
These data were complemented with searches on websites such as the National Library, Hemeroteca Digital section, Virtual Health Library (VHL) Regional Portal, and Scientific Electronic Library Online (SciELO). To favor the search activity, we opted for the associated use of “keywords” (Rio Grande do Norte and Brazilian expeditionary force) and “descriptors” (World War II, military hospitals and nurses), in order to enhance the survey of data.
Studies that met the objective of this study, available in full text, via Federated Academic Community (CAFe - Comunidade Acadêmica Federada) access/Coordination for the Improvement of Higher Education Personnel (CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) journals, in Portuguese, were included. Studies that did not specifically address Rio Grande do Norte were excluded. This selection stage was conducted by two different reviewers, independently, and, in case of divergences, a third reviewer could have been called, which was not necessary.
Once this was done, the data was organized and processed during the Post-Doctoral course, at the Escola Superior de Enfermagem de Coimbra, next to the Health Sciences Research Unit: Nursing, in Portugal (2023). Thematic content analysis guidelines were used.99 Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 12ª ed. São Paulo: Hucitec; 2014. In pre-analysis, text skimming was carried out, with the purpose of organizing the material collected. In the material exploration phase, the categories were decoded, enumerated and elaborated. Finally, in the stage of processing the results obtained and interpreting the data, inferences were made, with a view to chronological ordering of occurrences and enabling the interpretation and systematization of the essential elements for reconstruction of this important history.
Thus, for this study, the initial time frame (1941) and the year in which the building was transferred to the Ministry of War were established, as well as the final year (1950), as it corresponded to the Maternidade de Natal inauguration. It is noteworthy that its development was guided by specific national ethical guidelines for carrying out research with human beings in human and social sciences. The authors, both with experience in qualitative research, chose to adopt the COnsolidated criteria for REporting Qualitative research (COREQ) criteria, with the purpose of providing quality to the study and certifying the absence of conflicts.
This manuscript corresponds to an excerpt from a research project approved by the Research Ethics Committee, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, under Opinion 1.946.320.
RESULTS
Research on the Hospital Militar de Natal (1941-1950) allowed selecting 65 publications, of which 29 were journalistic texts, 11 were publications in the Official Gazette, 11 were scientific articles, seven were books, four were minutes, two were magazines, and a report. The main results gave rise to the categories presented below:
From the Maternidade de Natal construction to its transfer to the Ministry of War
The Maternidade de Natal construction corresponded to one of the developments of SAH’s actions, which, aware of the need for decent assistance to women-mothers from Rio Grande do Norte – as those born in the state of Rio Grande do Norte are called –embarked on the grandiose project of constructing its own building. Its execution required the confluence of forces and the organization of work fronts, with which mobilizations and articulations were carried out to raise resources.
Of this enthusiasm, the transfer of the land by Natal City Hall deserves notoriety. In this regard, it is worth informing that a process was opened with the Land and Patrimonial Sector of the Municipal Department for the Environment and Urbanism (SEMURB - Secretaria Municipal de Meio Ambiente e Urbanismo) Department of Cartographic Information and Heritage, requesting the Land Certificate. It was certified that the property is duly regularized in the register of foreign assets, granted to SAH, in accordance with Charter 1839 of January 29, 1942, Book 10, Page 92. Equally important were the public subsidies arising from state taxes,1010 Lei nº 699 de 29 de outubro de 1928 (RN). Orça e fixa despesas para o exercício de 1929. Imprensa Official, Natal (RN), 29 out 1928: 73.,1111 Decreto nº 79 de 9 de abril de 1931 (RN). Destina 20% dos impostos de caridade e pro-maternidade para o Instituto de Proteção à Infância e à Maternidade de Natal, respectivamente. Imprensa Official, Natal (RN), 9 abr 1931: 118. fairs, charity parties, sales of personal belongings, raffles, various donations and a lot of voluntary work.1212 Gurgel T, Lyra C, organizadores. A memória viva de Onofre Lopes. 2ª ed. Natal: EDURFN; 2007. Its building, furniture, equipment, utensils and supplies for its operation took more than two decades until its complete completion.1313 Souza I. Nova história de Natal. 2ª ed. Natal: Departamento Estadual de Imprensa; 2008.
In conjunction with the Second World War, meeting the 7th Military Region troops’ needs, the Ministry of War created, in the Northeast, two establishments dependent on the Army Health board of directors: the sanitary material and medicine deposit,1414 Decreto nº 7634 de 15 de agosto de 1941 (BR). Cria, a título provisório, um Depósito Regional de Material Sanitário e Medicamentos, na 7ª Região Militar, com sede em Recife. Diário Oficial da União [periódico na internet], Brasília (DF), 1941 [citado 2023 maio 30]. Disponível em: https://www.diariodasleis.com.br/legislacao/federal/141562-cria-a-tutulo-provisurio-um-depusito-regional-de-material-saniturio-e-medicamentos-na-7u-regiuo-militar-e-com-sede-em-recife.html
https://www.diariodasleis.com.br/legisla...
in Recife, the capital from the state of Pernambuco; and the Military Hospital of Natal,1515 Decreto nº 7633 de 15 de agosto de 1942 (BR). Cria, a título provisório, um Hospital Militar de 3ª classe, na 7ª Região Militar e com sede em Natal. Diário Oficial da União [periódico na internet], Brasília (DF), 1941 [citado 2023 maio 30]. 1941 [citado 2023 maio 30]. Disponível em: https://www2.camara.leg.br/legin/fed/decret/1940-1949/decreto-7633-15-agosto-1941-338236-publicacaooriginal-1-pe.html
https://www2.camara.leg.br/legin/fed/dec...
in Rio Grande do Norte. That said, the lease agreed with SAH ensured the transfer of the building and its facilities, on a provisional basis so that the 3rd class Hospital Militar de Natal could be installed for the duration of the conflict.
This contract, signed in the city of Rio de Janeiro, the federal capital, at the time, on August 1, 1941, had as interested parties the physician and Colonel João Afonso de Souza Ferreira, Army Health Service Director, and Januário Cicco, physician-director of SAH.77 Contrato entre a Sociedade de Assistência Hospitalar e a Diretoria de Saúde do Exército (BR). Locação do edifício da Maternidade de Natal. Diário Oficial da União, Brasília (DF), 11 ago 1941: Seção 1: 15862. It consisted of 12 articles, of which the following stand out: monthly rent of eight “contos de reis” (8:000$000); impossibility of making modifications or alterations to the existing construction and divisions; installation of the kitchen, laundry, turbine pump for water supply; completion of electrical installations; assembly of two elevators (one for transporting stretchers or beds and the other for feeding); return of the building in perfect condition; and compensation for material damage caused to the building.
When handed over to the Ministry of War, the Natal Maternity building had the following spaces: ground floor (pharmacy, laundry, kitchen and complete bathrooms); first floor (amphitheater, complete bathrooms, wards and surgical center); second floor (complete bathrooms, wards and apartments); and third floor (three water tanks with 60 thousand liters each). There were completed plumbing and sanitary installations. There was also an absence of elevators, a water pump, and an unequipped kitchen and laundry. On its land, there was a morgue attached to the building with two tables, a tubular well powered by a weather vane, a septic tank and a small shed.1616 Ministério da Guerra (BR), 7ª Região Militar, 2ª Brigada de Infantaria. Termo de entrega do prédio da Maternidade de Natal. Natal: Ministério da Guerra; 1941.
As a summary of their activities, from the time in which they met the Ministry of War demands, we highlight the nursing course at the Hospital Militar de Natal,1717 Hoje, às 20 horas, no Theatro Carlos Gomes, será instalado, solenemente, o Curso de Enfermeiras do Hospital Militar. A Ordem (Natal). 1942 fev 21; 1(1908):1. the installation of the Red Cross, Rio Grande do Norte branch,1818 Fundada, ontem, uma filial da Cruz Vermelha em Natal. A República (Natal). 1942 mar 6; 1(3245):1. the volunteer course for boys,1919 Curso de Voluntários: continuam abertas as matrículas, já sendo elevado o número de candidatos. A República (Natal). 1942 abr 21; 1(3282):1. internship for official Army Reserve physicians2020 Estágio para médicos oficiais da reserva do Exército: seu início nesta capital. A Ordem (Natal). 1942 ago 6; 1(2039):3. and the study center at the Hospital Militar de Natal.2121 Reunião, hoje, do Centro de Estudos do HMN. A Ordem (Natal). 1944 nov 3; 1(2661):4. During this period, the physicians Captain Aníbal Medina de Azevedo,2222 O Capitão Dr. Aníbal Azevedo vem dirigir o Hospital Militar desta capital. A Ordem (Natal). 1941 set 23; 1(1788):1. Major José Arruda Valim,2323 O 1º aniversário do Hospital Militar. A Ordem (Natal). 1942 out 1; 1(2083):1. Major Manoel Felino Tenório,2424 Empossado novo diretor do Hospital Militar. A Ordem (Natal). 1943 ago 12; 1(2334):1. Major Elísio Seixas2525 Assumiu suas funções o novo diretor do Hospital Militar de Natal. A Ordem (Natal). 1946 out 11; 1(3248):1. and Major Elias Seixas da Silva Lopes.2626 Mudou-se o Hospital Militar. A Ordem (Natal). 1948 mar 16; 1(1475):1.
With regard to the nursing course, the material provided made it possible to identify the partnership between the military hospital, the State Government, through the State Department of Public Health,2727 Um curso de enfermeiras no Hospital Militar. A República (Natal). 1942 fev 5; 1(3222):1. and the State Department of Press and Propaganda, responsible for creating a post of information and registrations in the editorial office of newspaper A República.2828 O Curso de Enfermeiras do Hospital Militar e o entusiasmo despertado na sociedade natalense. A República (Natal). 1942 fev 7; 1(3224):1. Rádio Educadora was in charge of dissemination.2929 Curso de Enfermeiras do Hospital Militar. A Ordem (Natal). 1942 fev 12; 1(1900):1. It was structured over two months, with theoretical-practical classes, taught by physicians (military and civilian), as explained in Chart 1, and ten absences would be justification for dismissal.3030 Curso de Enfermeiras do Hospital Militar: a reunião de ontem, na Escola Doméstica. A República (Natal). 1942 fev 14; 1(3230):1.
Still on this course, sources indicate that two consecutive classes were organized, both offered in 1942, which were made up of ladies and gentlemen from different social segments,3131 O Curso de Enfermeiras. A República (Natal). 1942 fev 8; 1(3225):3. The first had 1003232 Entrega de diplomas às alunas da primeira turma do Curso de Enfermeiras. A Ordem (Natal). 1942 abr 25; 1(1957):1. trainees, and the second, 70 trainees.3333 As solenidades de inauguração da nova sede da filial da Cruz Vermelha Brasileira: entrega de diplomas as Voluntárias Socorristas – sessão solene, à noite – aposição do retrato do Presidente Getúlio Vargas. A Ordem (Natal). 1942 out 17; 1(2097):1. Upon obtaining the certificate, its graduates received the name “voluntary Samaritans”.3232 Entrega de diplomas às alunas da primeira turma do Curso de Enfermeiras. A Ordem (Natal). 1942 abr 25; 1(1957):1.
From the return of the Military Hospital to the Maternidade de Natal operation
With the end of the war (1945), SAH embarked on a double journey. It was necessary to recover the building, raise resources to repair the building and equip it. This double undertaking resulted in vast documentation proving the monumental effort, undertaken by sending correspondence to authorities and politicians. Below, Charts 2 and 3 briefly illustrate the work intensity.
Correspondence from the Hospital Assistance Society to recover the Hospital Militar de Natal building.
Correspondence from the Hospital Assistance Society requesting resources for the Maternidade de Natal.
This engagement probably attracted the local press’ attention, given the frequency with which information was reported regarding the return of the Natal Maternity Building, the need to carry out repairs, its equipping and, finally, its inauguration and operation. Below is a sample of this support:
In Natal, the Head of the Engineering Service of the 7th Military Region [...] will deal with the return to the Hospital Assistance Society of the military hospital building.3434 Em Natal o Chefe do Serviço de Engenharia da 7ª RM: tratará da devolução à Sociedade de Assistência Hospitalar do prédio do Hospital Militar. A Ordem (Natal). 1947 maio 22; 1(3435):1.
[...] the Army is true to its word, making every effort to ensure the quickest delivery of the Maternidade de Natal [...] used for almost six years [...] suffered damage that will require large sums for rehabilitation.3535 A cidade. Diário de Natal (Natal). 1948 jan 12; 1(1411):1.
The military hospital [...] moved from the building at Avenida Nilo Peçanha, 522, to its new adaptations between the Barracks of the 16th Infantry Regiment and the 3rd Anti-Aircraft Artillery Regiment, in Tyrol.2626 Mudou-se o Hospital Militar. A Ordem (Natal). 1948 mar 16; 1(1475):1.
As was natural, SAH requested, from the Federal Government, the indispensable compensation for the damage done to the building [...] Cr$ 1,967,344.00 was paid [...] an amount below that budgeted by the engineers.3636 Voltará à sua atividade normal a Maternidade de Natal: autorizado pelo Ministro da Guerra, o pagamento da quantia relativa aos prejuízos causados durante a guerra pelas tropas do Exército. Diário de Natal (Natal). 1949 set 2; 1(1981):1.
Finally, on March 17, 1948, SAH received the keys to the military hospital from the hands of its director, Major Elias Seixas da Silva Lopes.3737 A Cidade. Diário de Natal (Natal). 1948 mar 17; 1(1474):1. As part of this ceremony, Colonel Honório Hermeto Bezerra Cavalcante, official representative of the Army Health Service board od directors, General Florêncio Carlos de Abreu Pereira, delivered a letter to Januário Cicco.3838 Maternidade de Natal. A Ordem (Natal). 1948 mar 27; 1(3671):1. It was a succinct, complimentary text, recognizing the effort, the need to return the building and justifying the delay by waiting for the completion of a small building to house the military hospital, in the Tirol neighborhood, also located in Natal.
Thus, the compensation paid by the Caixa de Economia da Guerra 3939 Uma instituição que esteve à margem das suas finalidades. A Ordem (Natal). 1949 set 26; 1(4111):4. was decisive in completing the services and equipping the Maternidade de Natal. Materials were purchased for the operating and delivery rooms, x-ray equipment, nursery, incubators, linens, surgical and dressing instruments, materials for the laboratory, pharmacy, dental office and kitchen.4040 Adquirido na capital da República os equipamentos indispensáveis ao funcionamento da instituição: instituição de prêmios aos três primeiros pimpolhos que vierem a nascer na majestosa maternidade. Diário de Natal (Natal). 1949 nov 10; 1(2046):1. With part of the resources raised, SAH decided to provide 10 thousand cruises (Cr$ 5,000.00, Cr$ 3,000.00 and Cr$ 2,000.00) to the first three live newborns, respectively, with savings accounts, after inauguration.4141 A espera das indenizações: a inauguração da Maternidade depende do pagamento do Exército. A Ordem (Natal). 1949 maio 3; 1(3994):1.
In parallel, carefully, other measures were taken, as it was categorical to assist the woman-mother from Rio Grande do Norte with quality. With this in mind, SAH organized the elementary specialized nursing course,4242 Curso Elementar de Enfermagem Especializada na Maternidade de Natal. A Ordem (Natal). 1949 set 6; 1(4092):1. with the purpose of preparing future maternity assistants. Women aged between 18 and 30 who could prove vaccinations, physical and mental health, moral integrity, civil registration and completion of a secondary school course or normal or commercial school would be eligible for selection, with tests in Portuguese, mathematics, geography and history. Their graduates would probably be awarded scholarships for the midwifery course under development.4343 Curso Elementar de Enfermagem Especializada da Maternidade de Natal. Diário de Natal (Natal). 1949 set 11; 1(1989):1. Regarding these courses, no further details were found on their offer, organization, classes, subjects and professors.
On February 12, 1950, the Maternidade de Natal was finally inaugurated. The ceremony took place in its amphitheater, becoming an event of great repercussion in the city, worthy of transmission, in real time, on Rádio Poti.4444 Inauguração hoje da Maternidade de Natal: chegou ontem a esta capital uma comitiva de deputados federais. Diário de Natal (Natal). 1950 fev 12; 1(2133):1. In this regard, the SAH Minutes Book,4545 Fundação da Sociedade de Assistência Hospitalar, Sociedade de Assistência Hospitalar. Ata de reunião realizada no dia 12 fev 1950, 2ª sessão extraordinária da Sociedade de Assistência Hospitalar para inauguração da Maternidade de Natal, Natal. Natal: Fundação da Sociedade de Assistência Hospitalar; 1950 fev 12. Livro 1, p. 6. in its 2nd Extraordinary Session, recorded 511 signatures from national and local personalities, prominent politicians, ecclesiastical authorities, military personnel, distinguished visitors, journalists, health professionals and populations. The inaugural program spanned the morning and afternoon shifts, and on that special and festive day, the Maternidade de Natal remained open to visitors until 8:00 p.m.4646 Será domingo a inauguração da Maternidade de Natal. A Ordem (Natal). 1950 fev 8; 1(4219):4.
DISCUSSION
From 1939 to 1945, humanity experienced a war of global proportions, known as World War II, caused by political and ideological differences, which resulted in the grouping of countries into two large sides: axis and allies. Brazil, at that time, was marked by internal tensions arising from the authoritarian and centralizing regime, called Estado Novo, implemented by President Getúlio Dornelles Vargas.4747 Grecco GL. Escribir bajo censura: mujeres, represión y resistencia en Brasil (1937-1945). Cadernos Pagu. 2021;61(61):e216105. http://doi.org/10.1590/18094449202100610005.
http://doi.org/10.1590/18094449202100610...
Due to Brazilian participation in World War II, in the group of allies, the installation of the American air base, in the Parnamirim field, in Rio Grande do Norte, was the result of a bilateral agreement between Brazil and the United States, signed, respectively, by Presidents Getúlio Dornelles Vargas and Franklin Delano Roosevelt, in Natal, on January 28, 1943. This meeting became known as the Potenji River Conference,4848 Siqueira CH. Guerreiros Potiguares: o Rio Grande do Norte na Segunda Guerra Mundial. 2ª ed. Natal: EDUFRN; 2007. and triggered significant social, cultural, economic and political changes in the daily lives of people from Natal. From then on, flights transporting soldiers, equipment, supplies and supplies essential to the supply and maintenance of troops on the war fields intensified. This air base is credited with the largest US technical mobilization outside its territory.4949 Cascudo LC. História da cidade do Natal. 4ª ed. Natal: EDUFRN; 2010. Of course, part of this logistics should be the installation of the military hospital in the Maternidade de Natal building.
Taking the military legislation of the time as a reference, the installation of a military hospital is justified by the existence of one or more local military units. In this regard, before 1942, Natal only had the 29th Hunters Battalion, but, with Brazilian participation in the war, the General Headquarters of the 2nd Infantry Brigade, the 16th Infantry Regiment (with three battalions), the 3rd Anti-Aircraft Artillery Regiment, the Motorized Engineering Company, the Mounted Reconnaissance Platoon, the 24th Recruiting District, among others, were installed.4848 Siqueira CH. Guerreiros Potiguares: o Rio Grande do Norte na Segunda Guerra Mundial. 2ª ed. Natal: EDUFRN; 2007.
About the Hospital Militar de Natal, classified as 3rd class, as it is not bordering, it should have physicians (major, captain or lieutenant), pharmacist (lieutenant), dental surgeon (lieutenant), administrative officer, specialized soldiers, such as sergeants, corporals, nurses, pharmacy and radiology assistants as well as civilians, such as clerks, servants and kitchen assistants and other employees necessary for the service.5050 Decreto nº 1374 de 14 de janeiro de 1937 (BR). Aprova o Regulamento dos hospitais militares, policlínicas e postos de assistência militar. Diário Oficial da União [periódico na internet], Brasília (DF), 1937 [citado 2023 maio 29]. Disponível em: http://www.planalto.gov.br/ccivil_03/leis/l7498.htm
http://www.planalto.gov.br/ccivil_03/lei...
These two achievements, air base and military hospital, can be considered the most concrete actions of the imminent war among the Rio Grande do Norte individuals. In the particularity of the military hospital, this perspective was evidenced through the preparation of the population for eventualities and, therefore, the creation of nurses’ course at the Hospital Militar de Natal, the volunteer course for boys and internships for official physicians from the Army Reserve.
With regard to Brazilian nursing, at the time, it is worth a careful assessment. Its professionalization was incipient, and schools of nursing were concentrated in southeastern and midwestern Brazil.5151 Carlos DJD, Padilha MI, Villarinho MV, Borenstein MS, Maia ARCCR. Escolas de enfermeiras no nordeste brasileiro (1943-1975). Rev Rene [Internet]. 2014; [citado 2023 maio 30];15(2):326-33. Disponível em: http://www.periodicos.ufc.br/rene/article/view/3161/2425
http://www.periodicos.ufc.br/rene/articl...
In the Northeast, the pioneering spirit is attributed to the Escola de Enfermeiras São Vicente de Paulo, founded in Fortaleza, capital of Ceará, in 1943, today attached to the Universidade Estadual do Ceará.5252 Nóbrega-Therrien SM, Almeida MI, Lopes RE, Barbosa ES. Núcleo de História da Enfermagem no Ceará: luta pela guarda, recuperação, preservação e socialização da profissão. Hist Enferm Rev Eletrônica. 2021;12(2):49-60. http://doi.org/10.51234/here.21.v12n2.a5.
http://doi.org/10.51234/here.21.v12n2.a5...
In Natal, nursing care at the Hospital de Caridade Juvino Barreto, now known as Hospital Miguel Couto since 1935, continued to be under the responsibility of Filhas de Sant’Ana nuns, and, among them, there were no qualified nurses,5353 Carlos DJD, Germano RM. A Escola de Auxiliares de Enfermagem de Natal e o Hospital Universitário Onofre Lopes. Rev Rene. 2009;10(1):72-80. http://doi.org/10.15253/2175-6783.2009000100008.
http://doi.org/10.15253/2175-6783.200900...
a name common to professionals trained in schools recognized by the Ministry of Education and Health. As for the professionalization of hospital nursing professionals, it is worth mentioning the SAH’s efforts, first in 1934, with the creation of a school of nursing, and then in 1950, with the transfer of nurse Elita Silveira, by the Ministry of Education and Health, for her foundation.5454 Carlos DJD, Germano RM. Enfermagem: história e memórias da construção de uma profissão. Rev Min Enferm [Internet]. 2011; [citado 2023 maio 30];15(4):513-21. Disponível em: http://www.revenf.bvs.br/pdf/reme/v15n4/v15n4a07.pdf
http://www.revenf.bvs.br/pdf/reme/v15n4/...
Despite these efforts, due to lack of material and human resources, this school did not begin its activities, and nurse Elita Silveira began to perform her duties in the maternity hospital.
Such details help to understand the reasons why those completing the nursing course at the Hospital Militar de Natal received the title of “volunteer Samaritans”. Perhaps, this course has similarities with those carried out by the Red Cross, a traditional agent that mobilizes human resources in times of war and calamity, which is reported to be one of the contributors to the professionalization of military nurses.5555 Rocha EP. Guerreiras ou anjos? As mulheres brasileiras e a Grande Guerra. Rev Estud Fem. 2020;28(3):e61492. http://doi.org/10.1590/1806-9584-2020v28n361492.
http://doi.org/10.1590/1806-9584-2020v28...
This detail is more likely with the founding of the Red Cross, Rio Grande do Norte branch, in 1942.
Concerning the participation of Brazilian nurses in World War II, it is known that it was possible, with the creation of the Army Reserve Nurse Board5656 Decreto-Lei nº 6097 de 13 de dezembro de 1943 (BR). Cria o Quadro de Enfermeiras da Reserva do Exército. Diário Oficial da União [periódico na internet], Brasília (DF), 1943 [citado 2023 maio 30]. Disponível em: https://www2.camara.leg.br/legin/fed/declei/1940-1949/decreto-lei-6097-13-dezembro-1943-416127-publicacaooriginal-1-pe.html
https://www2.camara.leg.br/legin/fed/dec...
of the Brazilian Expeditionary Force Army Healthcare service, in response to American requests, to act in partnership in field hospitals in Italy. Despite discussions regarding ranks, training, salaries, uniforms, language, values (altruism, selflessness, charity, immoral, infamous), professionalization and female participation in the war,5757 Bernardes MMR, Lopes T. Enfermeiras do Exército Brasileiro no transporte aéreo de feridos: um desafio enfrentado na 2a Guerra Mundial. Rev Bras Enferm. 2007;60(1):68-72. http://doi.org/10.1590/S0034-71672007000100012. PMid:17477170.
http://doi.org/10.1590/S0034-71672007000...
,5858 Oliveira AB, Santos TCF, Barreira IA, Lopes GT, Almeida Fo AJ, Amorim WM. Enfermeiras brasileiras na retaguarda da Segunda Guerra Mundial: repercussões dessa participação. Texto Contexto Enferm. 2009;18(4):688-96. http://doi.org/10.1590/S0104-07072009000400010.
http://doi.org/10.1590/S0104-07072009000...
73 nurses5959 Camerino AO. A mulher brasileira na segunda guerra mundial. Rio de Janeiro: CAPEMI Editora e Gráfica Ltda; 1983.,6060 Cansanção E. Um, dois, esquerda, direita: acertem o passo. Maceió: CIAN Gráfica e Editora Ltda; 2003. made up the staff: six of them in the Service Air Transport of Wounded Persons; and 67 of them in the Army Healthcare service. Of this contingent, Elita Marinho6161 Carlos DJD, Morera JAC, Padilha MI. Enfermeira Elita Marinho: uma representante potiguar na segunda guerra mundial. Hist Enferm Rev Eletronica [Internet]. 2012; [citado 2023 maio 30];3(2):190-205. Disponível em: http://www.here.abennacional.org.br/here/vol3num2artigo7.pdf
http://www.here.abennacional.org.br/here...
appears to be the only nurse from Rio Grande do Norte who is a member of the Brazilian Expeditionary Force Army Healthcare service.
It is worth noting that, with the end of the war, nurses and a large part of the troops sent to Europe – except career soldiers – went through the demobilization process. They were terminated while still on Italian soil, making it appear that they had returned or tried to return to their daily life prior to their participation in the war, now full of uncertainty, traumatic consequences and feelings of abandonment.6262 Silveira JX. A FEB por um soldado. Rio de Janeiro: Biblioteca do Exército Ed.; 2001. Thus, as the landings took place in Rio de Janeiro, the Brazilian Expeditionary Force was formally disbanded.6363 Moraes JBM. A FEB pelo seu comandante. Rio de Janeiro: Biblioteca do Exército Ed.; 2005.
At that time, associations of ex-combatants emerged to demand rights and recognition. As for nurses, in particular, they may have been influenced by these associations’ efforts: first, with their inclusion in the Army Reserve Nurses List;6464 Lei nº 1209 de 25 de outubro de 1950 (BR). Inclui na Reserva do Exército as enfermeiras que participaram das operações de guerra dentro do setor de sua especialidade, junto à Força Expedicionária Brasileira. Diário Oficial da União [periódico na internet], Brasília (DF), 1950 [citado 2023 maio 30]. Disponível em: https://www2.camara.leg.br/legin/fed/lei/1950-1959/lei-1209-25-outubro-1950-363505-publicacaooriginal-1-pl.html
https://www2.camara.leg.br/legin/fed/lei...
later, with their re-entry into the Army Healthcare services as 2nd Lieutenant.6565 Lei nº 3160 de 1 de junho de 1957 (BR). Inclui no Serviço de Saúde do Exército, no posto de 2º Tenente, as enfermeiras que integraram a Força Expedicionária Brasileira, durante as operações de guerra na Itália. Diário Oficial da União [periódico na internet], Brasília (DF), 1957 [citado 2023 maio 30]. Disponível em: https://www2.camara.leg.br/legin/fed/lei/1950-1959/lei-3160-1-junho-1957-355300-publicacaooriginal-1-pl.html
https://www2.camara.leg.br/legin/fed/lei...
Returning to Natal at that time and analyzing the chronology of motherhood, starting from the intention expressed in the contract (Art. XVI) signed with the State Government (1927) of its foundation (1928), its assignment to the Ministry of War (1941), the end of World War II (1945), the return of building (1948) and, finally, its inauguration (1950), it is possible to consider that the concreteness of this social dream1313 Souza I. Nova história de Natal. 2ª ed. Natal: Departamento Estadual de Imprensa; 2008. is surrounded by the care of SAH. Part of this dedication is legitimized in the synthesis of the correspondence provided in Charts 2 and 3, and is easily proven by the opportunity to read the material collected for this study. It was a time of many difficulties, but with many achievements.
Thus, on January 12, 1999, the State Government, through the Department of Education, Culture and Sports, in agreement with the process initiated by the Fundação José Augusto, authorized the inclusion of the Maternidade de Natal building in the Rio Historical List Great North.6666 Portaria nº 10, de 12 de janeiro de 1999 (RN). Resolve tombar o imóvel da Maternidade Escola Januário Cicco/UFRN, em Natal. Diário Oficial, Natal (RN), 7 jul 1999.
FINAL CONSIDERATIONS AND IMPLICATIONS FOR PRACTICE
This article is relevant by providing elements that favor the understanding of the organization of maternal and child healthcare in Rio Grande do Norte and the history of health in Rio Grande do Norte. It can be inferred then that the journey taken between the founding of the Maternidade de Natal and its inauguration is due to the leading role of SAH, which persistently overcame obstacles and remained firm regarding the necessary actions.
Given the effort noted, it is to be assumed that the transfer and the delayed return – even if justified by the emergency state of the war – occurred with SAH’s disapproval, after all, decent assistance to woman-mother from Rio Grande do Norte was urgently needed. This assumption becomes relevant when we note the presence of Januário Cicco on only two occasions: at the signing of the contract, in Rio de Janeiro, with the Ministry of War, and at the ceremony of his return, in Natal. In the others, he was represented by a member of the SAH board of directors.
Records point to a period with many developments caused by the global conflict. The city of Natal needed to organize itself for possible accidents. Regarding the military hospital, it can be said that it contributed by mobilizing the population with courses for volunteers (Samaritan nurses and boys) and with the installation of the Red Cross branch.
Today, the Maternidade de Natal is integrated into the Universidade Federal do Rio Grande do Norte, in the Health Sciences Center, as the Maternidade Escola Januário Cicco (MEJC), in honor of the SAH physician-director (1927-1952), an enthusiastic character of this history, health education and health in Rio Grande do Norte. Therefore, it is an institution focused on health education, care, research and extension.
MEJC is, for Rio Grande do Norte, the main and most traditional institution training healthcare professionals in maternal and child care. It is integrated into the Brazilian Health System (SUS – Sistema Único de Saúde), intended for medium and high complexity care. Gynecology, obstetrics, pediatrics, neonatology, family planning, assisted reproduction, milk bank services, among others, operate. Its facilities are used for internships and practical classes for technical and undergraduate students as well as specialization courses in health, multi-professional and medical residencies, in addition to master’s degree in women’s health.
Finally, carrying out studies of this nature necessarily implies taking an obstinate stance in facing difficulties regarding the location and access to sources, the identification of characters and their contributions, the precariousness of archival services, and the availability of updated bibliographic references. These, in turn, can make data analysis difficult or limit or suppress publications.
ACKNOWLEDGMENTS
The Universidade Federal do Rio Grande do Norte, for the authorization to carry out the Post-Doctoral course at the Escola Superior de Enfermagem de Coimbra, together with the Health Sciences Research Unit: Nursing, in accordance with Universidade Federal do Rio Grande do Norte Ordinance 365 of March 1, 2023.
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» https://www.diariodasleis.com.br/legislacao/federal/141562-cria-a-tutulo-provisurio-um-depusito-regional-de-material-saniturio-e-medicamentos-na-7u-regiuo-militar-e-com-sede-em-recife.html -
15Decreto nº 7633 de 15 de agosto de 1942 (BR). Cria, a título provisório, um Hospital Militar de 3ª classe, na 7ª Região Militar e com sede em Natal. Diário Oficial da União [periódico na internet], Brasília (DF), 1941 [citado 2023 maio 30]. 1941 [citado 2023 maio 30]. Disponível em: https://www2.camara.leg.br/legin/fed/decret/1940-1949/decreto-7633-15-agosto-1941-338236-publicacaooriginal-1-pe.html
» https://www2.camara.leg.br/legin/fed/decret/1940-1949/decreto-7633-15-agosto-1941-338236-publicacaooriginal-1-pe.html -
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21Reunião, hoje, do Centro de Estudos do HMN. A Ordem (Natal). 1944 nov 3; 1(2661):4.
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22O Capitão Dr. Aníbal Azevedo vem dirigir o Hospital Militar desta capital. A Ordem (Natal). 1941 set 23; 1(1788):1.
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50Decreto nº 1374 de 14 de janeiro de 1937 (BR). Aprova o Regulamento dos hospitais militares, policlínicas e postos de assistência militar. Diário Oficial da União [periódico na internet], Brasília (DF), 1937 [citado 2023 maio 29]. Disponível em: http://www.planalto.gov.br/ccivil_03/leis/l7498.htm
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52Nóbrega-Therrien SM, Almeida MI, Lopes RE, Barbosa ES. Núcleo de História da Enfermagem no Ceará: luta pela guarda, recuperação, preservação e socialização da profissão. Hist Enferm Rev Eletrônica. 2021;12(2):49-60. http://doi.org/10.51234/here.21.v12n2.a5
» http://doi.org/10.51234/here.21.v12n2.a5 -
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» http://www.revenf.bvs.br/pdf/reme/v15n4/v15n4a07.pdf -
55Rocha EP. Guerreiras ou anjos? As mulheres brasileiras e a Grande Guerra. Rev Estud Fem. 2020;28(3):e61492. http://doi.org/10.1590/1806-9584-2020v28n361492
» http://doi.org/10.1590/1806-9584-2020v28n361492 -
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» https://www2.camara.leg.br/legin/fed/declei/1940-1949/decreto-lei-6097-13-dezembro-1943-416127-publicacaooriginal-1-pe.html -
57Bernardes MMR, Lopes T. Enfermeiras do Exército Brasileiro no transporte aéreo de feridos: um desafio enfrentado na 2a Guerra Mundial. Rev Bras Enferm. 2007;60(1):68-72. http://doi.org/10.1590/S0034-71672007000100012 PMid:17477170.
» http://doi.org/10.1590/S0034-71672007000100012 -
58Oliveira AB, Santos TCF, Barreira IA, Lopes GT, Almeida Fo AJ, Amorim WM. Enfermeiras brasileiras na retaguarda da Segunda Guerra Mundial: repercussões dessa participação. Texto Contexto Enferm. 2009;18(4):688-96. http://doi.org/10.1590/S0104-07072009000400010
» http://doi.org/10.1590/S0104-07072009000400010 -
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60Cansanção E. Um, dois, esquerda, direita: acertem o passo. Maceió: CIAN Gráfica e Editora Ltda; 2003.
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61Carlos DJD, Morera JAC, Padilha MI. Enfermeira Elita Marinho: uma representante potiguar na segunda guerra mundial. Hist Enferm Rev Eletronica [Internet]. 2012; [citado 2023 maio 30];3(2):190-205. Disponível em: http://www.here.abennacional.org.br/here/vol3num2artigo7.pdf
» http://www.here.abennacional.org.br/here/vol3num2artigo7.pdf -
62Silveira JX. A FEB por um soldado. Rio de Janeiro: Biblioteca do Exército Ed.; 2001.
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63Moraes JBM. A FEB pelo seu comandante. Rio de Janeiro: Biblioteca do Exército Ed.; 2005.
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64Lei nº 1209 de 25 de outubro de 1950 (BR). Inclui na Reserva do Exército as enfermeiras que participaram das operações de guerra dentro do setor de sua especialidade, junto à Força Expedicionária Brasileira. Diário Oficial da União [periódico na internet], Brasília (DF), 1950 [citado 2023 maio 30]. Disponível em: https://www2.camara.leg.br/legin/fed/lei/1950-1959/lei-1209-25-outubro-1950-363505-publicacaooriginal-1-pl.html
» https://www2.camara.leg.br/legin/fed/lei/1950-1959/lei-1209-25-outubro-1950-363505-publicacaooriginal-1-pl.html -
65Lei nº 3160 de 1 de junho de 1957 (BR). Inclui no Serviço de Saúde do Exército, no posto de 2º Tenente, as enfermeiras que integraram a Força Expedicionária Brasileira, durante as operações de guerra na Itália. Diário Oficial da União [periódico na internet], Brasília (DF), 1957 [citado 2023 maio 30]. Disponível em: https://www2.camara.leg.br/legin/fed/lei/1950-1959/lei-3160-1-junho-1957-355300-publicacaooriginal-1-pl.html
» https://www2.camara.leg.br/legin/fed/lei/1950-1959/lei-3160-1-junho-1957-355300-publicacaooriginal-1-pl.html -
66Portaria nº 10, de 12 de janeiro de 1999 (RN). Resolve tombar o imóvel da Maternidade Escola Januário Cicco/UFRN, em Natal. Diário Oficial, Natal (RN), 7 jul 1999.
ASSOCIATE EDITOR
Publication Dates
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Publication in this collection
16 Aug 2024 -
Date of issue
2024
History
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Received
25 Aug 2023 -
Accepted
12 June 2024