Sari Massiotta. Whether it is possible or not to rethink territorial health care policies and care practices from within the institutions today depends principally upon the institutions’ own ability to put themselves at risk: to move through urban life and the perception of the forms of social life that articulate care. Instead of trying to make life orderly and reify health through technical assistance, the workers would become fellow-residents articulating an internal tension, critical of the public institutions’ capacity to act.
Monica Ghiretti. The transformation of the institution also entails the experience of those who, at the threshold between the city and the institution, start experimenting: those who open the doors of institutional spaces, challenge the codes of the institution and therefore their own identities. The worker puts his or her own power at risk, but in so doing doesn't turn away from his or her institutional responsibilities to the city. The worker moves through the territory every day, constructing a practice of health based on initiative rather than a medical system of waiting.
Margherita Bono. The Trieste model’s ability to construct different ways of working derives not only from being inside the complexities of everyday urban life, but rather from the force of disarticulation that invades the institutional character of the institution itself. Breaking down the separations between the different segments of the State, forcing them to talk amongst themselves, to rethink themselves, and to lose themselves in the midst of the problems. If you look closely enough, no one is normal.
Federico Rotelli. The scale at which health takes place is first and foremost an urban scale, determined by the mechanisms of exclusion and discrimination by which social spaces are configured. The practice of health therefore is born first and foremost out of respect and the construction of practices within this complex relationship. Beyond mechanisms of evaluation and measurement, institutional practices have to situate themselves in the impossibility of translation: in the overflow of urban subjectivities. That is where one might develop situated tools rather than deploy abstract protocols.
Federica Sardiello. Against the imposition of the assymetrical and professional relationships characteristic of medical practice, the micro-area aims to upend this model and to think about health principally as a space from which to contribute to the construction of democracy. This means seeking out singular processes of emancipation and empowerment. It also means constructing these processes in such a way that they collectivize and place institutional responsibilities upon a territory, in all its richness and potential. The institutional that sustains the common. The singular within a collective process.
From "Activist Sense and Urban Ecologies of Care": My first gateway into the complex ecology of Trieste is a specific programme that operates within the general healthcare system itself. I will move through it in dialogue with the voices and practices of those who run it, as my thoughts and reflections on the local integrated care program (and on the caring ecologies in general) rely on an ongoing collaboration with Margherita Bono, who works in the Micro Area Programmes and who in the last few years has led action research projects to redefine their functioning.
La tercera semana de marzo de 2017 recibimos en Madrid la visita de los psiquiatras italianos Franco Rotelli y Giovanna del Giudice, compañeros de Franco Basaglia durante la reforma psiquiátrica en Trieste, y después en el resto de Italia, poniendo en práctica la Ley 180 que cerraba los manicomios. El linaje de las transformaciones en salud mental de 1970 se extiende hoy a las prácticas de salud en el territorio, que comparten la concepción basagliana de la salud como un proyecto colectivo a la par que individual, y la tarea de la institución como aquella que es capaz de alinearse con ese proyecto en una lucha cotidiana por abrirse a la complejidad de lo social, produciendo democracia al hacer salud.