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Segura del Pozo J. Madrid Ciudad de los Cuidados. Metas Enferm mar 2018; 21(2):3
Javier Segura del Pozo
Subdirector General de Prevención y Promoción de la Salud. Coordinador del Plan Madrid Ciudad de los Cuidados. Madrid Salud. Ayuntamiento de Madrid
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Versión en Español
Care has always been a distinguishing feature of Nursing, highly aware of its importance for health and social wellbeing (1). However, this care has not occupied a central place within Medicine priorities, where cure has always been more valued. This distribution of professional roles between Medicine and Nursing has been obviously based on a distribution of gender roles, reproducing the dichotomy prevailing in society between the productive and the reproductive areas. From this care function, with less prestige bestowed upon in the professional setting, Nursing came into contact with the daily life of patients, their emotions and living conditions. To this aim, nurses have felt a higher need to become trained in knowledge and abilities within Human and Social Sciences, and have been more drawn towards the professional setting of community health.
But this peripheral and downgraded world of care, that has even been considered invisible and feminine, has now become a topical and strong matter, and demands to occupy a central place not only within healthcare but also in the social and political agenda. Care has become the banner for different social and political movements: from feminism demanding shared responsibility of care at individual, family and social level, to social and supportive economy, which highlights care as a source of paid and worthy jobs. This also includes care for public spaces within social city planning, and the different forms of collective care that have appeared in our districts in order to face the impact of the current crisis (the Platform for Persons Affected by Mortgage (PAH) against eviction, food banks, support groups against healthcare exclusion, etc.). There is a public outcry for new governance, which places life sustainability and good life, instead of the generation of economic benefits, in the centre of political action.
Since 2015, in the setting of the so-called Cities for Change, new alternative options for public policies have been generated, some of them under the name “City of Care”: the city of Madrid is the one which has better defined this. The Madrid City of Care Plan is a new strategy for cross-sectoral action that places life sustainability in the centre of municipal action, intending to have a new relationship with citizens from the ethics of care, at the same time focused on community empowerment and respect for the autonomy and diversity of people. Care is articulated into four settings: a) care for public spaces and a feeling of community; b) a city that manages with care; c) care for discomfort in daily life, and d) care in the productive system. This has been developed within nine pilot projects, transversal and “hybrid” (a public-social alliance), including such varied matters as care for the school environment (transformation of playgrounds), prevention of undesired loneliness, end-of-life care (compassionate communities), or care for discomfort in daily life, among others (2). These community projects have already started in various districts in Madrid, and they are inserted within the community orientation developed during the past decade by the municipal centres for community health (“Centros Madrid Salud”) (3) in Madrid (“Strategy for Healthy Districts”) (4).
Nursing occupies a privileged position in this effort for thinking, designing and managing a city from the point of view of care, because it has been fostering for many years not only the knowledge and methodology of care, but also the empathy with carers and those who need care, that is to say, with all human beings .
- Delgado Rodríguez J. Cuidados interculturales, un reto para la Enfermería. Metas Enferm may 2012; 15(4):65-9.
- Plan Madrid Ciudad de Los Cuidados [internet]. Madrid: Ayuntamiento de Madrid; noviembre 2017. [citado 13 feb 2018]. Disponible en: http://www.madridsalud.es/pdfs/plan.pdf
- Segura del Pozo J, Martínez Cortes M, Pla Naranjo A, Gil Nebot M, Vivas Toro F, Miguel García A. El proceso de reorientación comunitaria de los Centros Madrid Salud. Revista Comunidad. PACAP [internet] 2011 [citado 13 feb 018]; 23-6. Disponible en: http://madridsalud.es/pdf/publicaciones/saludpublica/Comunidad13-CMS.pdf
- Botello Díaz B. Entrevista a Javier Segura del Pozo. Comunidad. Noviembre 2017;19(3):6.