The arrival of the tracks and the development of health attention in Ponta Grossa by Liliam Brandalise

With the arrival of the Paraná Railway in 1984 and the connection to the São Paulo-Rio Grande Railway at the beginning of the 20th century, Ponta Grossa became the main railway junction of southern Brazil.

The city began to receive daily thousands of passengers, immigrants, traders and workers of the railway works and with this rapid and constant movement of people epidemics arose and the urgent need for health prevention and emergency relief for accidents at work on the railways.

Lack of a state health network, At the beginning of the 20th century, civil society, to meet the needy population and travelers passing by the station and with this movement the Santa Casa Mercy of Ponta Grossa was founded in 1912, This is the main pillar of medicine in the city as well.,  to cater specifically to railroad workers and their families, the Staff Relief Association of the Railway São Paulo - Rio Grande, Established in 1906, the October 26th Hospital, in 1931 marking the pioneering of occupational medicine and group medicine within the state

In the middle of the 20th century, with the gradual decline of rail transport and the consolidation of road junctions, Ponta Grossa expanded its hospital park, expanding its network of philanthropic and private hospitals, such as Hospital Vicentino, Hospital Bom Jesus and specialized clinics.

The Government of the State, through the Secretariat of State for Health, headquartered in Ponta Grossa the 3rd Regional Health, centralizing health management for Ponta Grossa, Castro, Piraí do Sul, Telêmaco Borba, Jaguariaíva, among others.

The municipalization of the Unified Health System (SUS) in Ponta Grossa occurred from the 1990s, following the major guidelines of the Organic Health Law (Law No. 8.080/1990) and the decentralization process in Brazil. The transition involved the transfer of health management and budget from the federal/state sphere to the direct control of the city hall.

The organization of the process in Ponta Grossa followed essential steps, according to law no 8080/90, which was the creation of the Municipal Health Council and the Municipal Health Fund and organization of the Municipal Health Conferences.

The municipalization required the transition from the old purely hospital-centric model, inherited from the time of INAMPS railway and social security medicine, to a model focused on prevention, with the expansion of the Basic Health Units (UBS) by the neighborhoods and villages of the city and the implementation of the teams of the Family Health Strategy and the program of community health agents.

As the largest municipality of the Campos Gerais, the municipalization of the SUS in Ponta Grossa was not limited to the care of its own residents, agreeing with the 3rd Regional of Health and with the other municipalities of the region the assistance of specialized consultations and in medium and high complexity.

The municipality faced the constant challenge of underfunding, as regional demand often exceeded the financial ceiling passed on by the federal government. This required increasing contributions of own resources from the municipal budget.

The municipalization in Ponta Grossa transformed the city hall of a mere administrator of vaccine stations into the main manager of the local health system, coordinating from the station of the neighborhood to the hiring and regulation of leitos hospitalares of high complexity for the city and region.

In the last decades, Ponta Grossa has definitely consolidated itself as the health hub of Campos Gerais through three main engines such as academic training through the creation of the courses in the area of health, at the State University of Ponta - UEPG highlighting the courses of Medicine, Nursing, Dentistry and Pharmacy high quality that attracted the medical programs of specialists,

The inauguration of the Hospital Universitário da UEPG and later the Hospital Universitário Maternal-Infantile - HUMAI increased the SUS service capacity in the region, offering ICU beds, first aid and procedures of medium and high complexity. The city has become a regional referral center for serious cases that previously required travel to Curitiba, such as oncology, cardiology and neurosurgery, traumatology and urgency.

The health in Ponta Grossa was born from the urgency of welcoming and treating those arriving by train stations at the beginning of the 20th century. This vocation of welcoming and geographical convergence transformed the city from a point of passage into a great medical-hospital and academic center of the interior of the Paraná.

Liliam Brandalise's article for the book: "PONTA GROSSA: From the Route of the Tropeiros to the Tracks of Innovation"

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