
Recebido em 02.03.2020
Aprovado em 12.05.2020
Avaliado pelo sistema double blind review Editor Científico: Marlusa de Sevilha Gosling
ISSN 2525- 8176
DOI: 10.29149/mtr. v5i2.5912
TOURISM AND HEALTH:Essay on
Deterritorialization, Autopoiesis and the Actuaction
of Health Conditions
Desteritorialization Essay, Autopoiesis and the Actuation of Health Conditions
Maria Luiza Cardinale Baptista (malu@pazza.com.br )
Universidade Caxias do Sul, Brasil

Helena Charko Ribeiro (hcharko@terra.com.br )
Universidade Caxias do Sul, Brasil
RESUMO
O presente texto tem caráter ensaístico e apresenta uma reflexão sobre a desterritorialização, como característica inerente ao turismo, com potencial de autopoiese e agenciamento de condições de saúde. Em termos teóricos, tem base transdisciplinar, envolvendo as áreas de Saúde, Turismo, Epistemologia da Ciência e Estudos de Subjetividade, com a Esquizoanálise. A produção é orientada pela estratégia metodológica Cartografia de Saberes, de Baptista (2014), a partir das trilhas Saberes Pessoais, Saberes Teóricos, Usina de Produção e Dimensão Intuitiva da Pesquisa, com seus respectivos procedimentos operacionais. A reflexão produzida remete à compreensão do Turismo como processo complexo de deterritorialização, em que são acionados e transversalizados ecossistemas. Esse processo, ao produzir a ação de perda de território no e do sujeito, tem forte potencial de produção de saúde, pelo acionamento de uma dimensão mais ampla do corpo, o que, na Esquizoanálise, denomina-se de corpo vibrátil.
Palavras-chave: turismo, saúde, desterritorialização, autopoiese.
ABSTRACT
This text has an essayistic character and it presents a reflection on deterritorialization, as a specific feature of tourism, with the potential for autopoiesis and actuation of health conditions. In theoretical terms, it has a transdisciplinary basis, involving the areas of Health, Tourism, Epistemology of
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Science and Subjectivity Studies, with Schizoanalysis. The
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production is guided by the methodological strategy Cartografia dos Saberes, by Baptista (2014), from the paths Personal Knowledge, Theoretical Knowledge, Production and Intuitive Dimension of Research, with their respective operating procedures. The reflection produced refers to the understanding of tourism as a complex process of deterritorialization, in which ecosystems are activated and transversalized. This process, when producing the action of loss of territory in and of the subject, has strong potential for health production, by triggering a broader dimension of the body, which, in Schizoanalysis, is called the vibrating body.
Keywords: tourism, health, deterritorialization, autopoiesis.
FIRST VITAL SIGNS
To think about Tourism and Health implies an approximation exercise of complex worlds. Each of these worlds presents several bundles of crossings, transversalizations, which sign connections to complex dimensions of life, such as economical, social, psychological, geographic and cultural aspects. The discussion here presented is about researches that are being performed at the University of Caxias do Sul, from the Post-Graduation Program of Tourism and Hospitality, under the theme Health Tourism, more directly by one of the authors and, in a broader perspective, on the character of deterritorialization and autopoiesis, as inherent by the conditions of Tourism by Amorcomtur! Group of Studies in Communication, Tourism, Lovingness and Autopoiesis.
The reflection on Tourism and Health has been present in the life of two researchers, by several paths, but that were crossed in the Post- Graduation work, more recently. One, coming from the area of Social Communication, with experience of working in a psychiatric hospital and hospital consultant, with lectures and workshops, aiming at discussing the environment of service providers, the relations which are established in those environments and the importance of the hosting of subjects, who go to these treatment centers. Within this sense, she has lived much time of reflection over how the

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interactions and care have the potential to help generating autopoiesis, in the direction of producing health.
In case of the other researcher, the experience in Tourism, management, planning and operational actions, has lead to situation of encountering the need to join the displacement of patients, in international trips. This experience has drawn her attention to several aspects and implications which, in general terms, have been called as Medical Tourism (Hernandez, 2011; Godoi, 2009; Fernandes, Fernandes, 2011) or Health Tourism (Godoi, 2009; Fernandes, Fernandes, 2011; Brasil, 2017). The concern, in this essay, thus, is not to discuss terminology, but to reflect on the interface of Tourism and Health, searching to comprehend how inherent aspects of Tourism, such as deterritorialization and autopoiesis, are important health busters.
To get started, we need to consider what Tourism and what Health are, under the perspective that we are reflecting upon. These are our First Signs. Both concepts are considered here, as related to Complex Ecosystems, with characteristics of open and transversal systems with each other and with other ecosystems of life dimension, in a broad sense. It is not possible to isolate them, as in a laboratory, to observe one another. We understand that the discussion always has to be transversal, even because the inflection of this text is precisely considered the mutual implication, specially the result of movement, of subjects in process of deterritorialization. In this sense, the ‘opening’ of the text is by those first vital signs.
It can also be understood that there is a macro ecosystem, in international geopolitics and in internal entanglements, in the several countries, which either facilitates or makes difficult the generation of Tourism and Health, and even more, the production of Tourism linked to the promotion of Health. Those are complex nets and webs, whether for promotion of inherent services to both fields, or for in terms of epistemological-theoretical- conceptual discussions. There is a broad discussion, searching for the more complex
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meanings in both fields and their potential of entanglement and, at the same time, a big machine gear, in the international scenery, which generates directions of actions, organizations, services, institutions, as for the offering of services in the nuances of each area, as for the professional formation and for teaching-learning, needed for the preparation of professional, for society, fro the ecosystem as a whole, for effective results of the performed actions. The proposition of ‘machine gear’ has theoretical basis in the texts of Félix Guattari, Gilles Deleuze and Suely Rolnik, having also been approached in a deeper way in a doctorate thesis, presented to the University of São Paulo (Baptista, 2000). For Guattari, the machine is not a mechanical machine, but represents a group of flows and engendering, concrete and abstracts, in interacting bundles that construct something as a powerful field. These abstract machines may be since an institution, such as a university, until a geographic land, such a country, but imply dimensions that go beyond visible, sayable, the concrete.
Therefore and, because of that, there are multiple and complex interests. This means, to whom it may concern the comprehension that ‘traveling is one of the main health busters’ and it is one of the best medicine, for the pains of soul, and also, for the body? The fact that we live in a big ‘life net’, marked by the logic of Money, take us to comprehend that affirmations such as that, previously highlighted, may be easily dismissed, downgraded, as simple, indicated as needy of demonstrative substrate and sustained statement. Of course, this is the contrary, for example, to a branch of international industry, which treats illness not health: pharmaceutical industry. Beyond this reflection of triage, we understand our ‘conversation’ here as being important, as a result of scientific work, which has guidance and lovingness, as proposed by Maturana (1998), Paulo Freire (2003), Edgar Morin (2003) and Restrepo (1998), the latter in the approach of kindness, among other authors. The sense, therefore, is lovingness and kindness, as ethics of care, relationship and “recognizing the other as legit in the living” (Maturana, 1998). It is

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worth mentioning that we are, yes, talking about Health, but in the sense of group and subjective interest, considering here the subjects being submitted to their own history and, due to that, powerful and autopoetics. Subjects who need to be recognized, in their demands, but who are, themselves, agents of transformation of services which are offered to them, whether in the field of Tourism or Health.
We recognize the force of Capital, in the different ecosystems, in international or national levels, as well as their entanglements, in several life dimensions, among them in Tourism and in Health. Despite that, we have produced Science based ‘backwards’, in this big ecosystemic tissue, which puts us in contact, by the net of life, to remember Fritjof Capra (1997), in the bias of machine gear. We want to discuss, then, how is it possible that productions can be ecosystemic responsible, generators of autopoiesis, as reinvention of themselves, as for the subjects, organizations, institutions, places, tourism destinations, as for the Big Body, the Whole Ecosystem, Gaia, the Planet.
This speak may seem presumptuous, but it is not. It only states the comprehension linked to the notions of Deep Ecology, from Arne Naess (apud Capra, 1997), from the caosmotic entanglements and from studies that showed that we are One, connected by a big cosmic web-path. It is in synchrony with Amazonian knowledge, developed through the course of ten years of partnership, with researchers from Federal University of Amazonas, and in personal process of one of the authors from this essay, in post-doc, in that university. Many articles produced by the researchers of UFAM help comprehend the perspective. We highlight: Media Communication in and from The Amazonia, organized by Maria Ataide Malcher, Netília Silva dos Anjos Seixas, Regina Lúcia Alves de Lima and Otacílio Amaral Filho (2011); Studies and perspectives from communication ecosystems, organized by Gilson Vieira Monteiro, Maria Emilia de Oliveira Pereira Abbud and Mirna Feitoza Pereira (2011); Communication Processes. Time, Space and Technology, organized by Claudio Manoel de Carvalho Correia,
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Ítala Clay de Oliveira Freitas, Maria Emília de Oliveira Pereira Abbud and Maria Sandra Campos (2012); Communication: vision and diversities in the Amazonia, organized by Netília S. dos Anjos Seixas, Alda Cristina Costa, Luciana Miranda Costa (2013). Another scientist who helped us think in this sense is Marcelo Gleiser (2006, 2007), physicist and Brazilian astronomer, winner of the 2019 Templeton award, which proposed to be a philanthropist catalyst for discoveries related to the deepest and complex questions of humanity, Earth and Universe.
Between Tourism and Health, we think here, the process of deterritorialization and autopoeisis. These are close ‘sections’ from our path, reminding, here, as a metaphor, to the path of health institutions (or people whose health need care or who are already in state of illness). The idea, in this sense, is to think about those processes and their potentials, reflecting to their entanglements, such as Tourism and Health. In this case, the reflection has as great theoretical support the assumptions of Squizoanalysis, proposed by Guattari and Deleuze (1992, 1997) and reverberations in the studies of several authors, mainly to the work of Suely Rolnik (1989), in Brazil. To reflect on autopoiesis, the theoretical basis dialogues with Biology of Knowledge or Loving Biology, from Humberto Maturana (1998) and Francisco Varela (1992), as inspiration, which also entangles with authors who discuss the autopoietic machines and their power, such as the squizoanalitics or theoretical linked to the technological dimension, such as Pierre Levy (1999) and Derrick de Kerckhove (1997).
The text follows, then, from these signs, of personal knowledge from the essay authors, with dialogue with the authors and the presentation of information from livings, in the fields of Tourism, health and Communication. As follows, the Triage, with the presentation of the methodological strategy that guides the production of the text and the researches, directly related to this essay.

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TRIAGE OR CARTOGRAPHY OF KNOWLEDGE, TOURISM AND HEALTH
AS METHODOLOGICAL STRATEGY
The Cartography of Knowledge is a methodological strategy proposed by Baptista, due to almost 30 years of teaching Research Methodology, production of research for Master and pHD courses, in the interfaces of the areas of Communication, Tourism, Education, Studies of Subjectivity, as well as guidance of works in all levels of teaching in the several areas of knowledge, in six Brazilian Universities, as well as in the own company of consultancy and supervision of texts for academic papers. In a summary, hundreds of guidance work and supervised in terms of writing and methodological strategy.
The concept of cartography and its association to methodological processes is inspired in Suely Rolnik (1989) and the Cartography Manual, presented in the book Sentimental Cartography. Saying in a simple way, in terms of operational procedures, the idea involves producing a constant ‘map’ of knowledge, information and resources, but considering the differential in cartography, according to Rolnik. To her, while a map limits a territory, cartography registers changes, the “transformation of the landscape”, to use her expression. Therefore, Cartography, as methodological strategy, proposed by Baptista (2014), may be thought as a mutant mapping, constant, in which registers are produced which end up helping to recognize the ‘theoretical-conceptual landscape’, of other psycho-social landscapes, or from the various phenomenon to be studied. Baptista (2000, 2014b) has the studies of Rolnik and the discussion over cartography, as inspiration, but the proposal is different, in the sense of signing four big paths, from which scientific production is performed. Therefore, the announcement of such paths, as signs of the path, in operational terms, directs the way to do,
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according to the plural logic, mobile, mutant, procedural. Those are lines that vibrate, powerful, which produces energy and derivations, expanding rhizomatically.
The concern with methodological challenges and the production of Science, specially with beginner researchers, as well as with the comprehension and completely trans-disciplinary experience are factors that enable the lead researcher of Amorcomtur, to propose a strategy of research production from a net of paths, simultaneous, with emphasis on four of them: Personal Knowledge, Theoretical Knowledge, Production Station and Intuitive Dimension of the Research. Moving on to them, aiming at comprehending the path in these trails, which contributes to the production of this text.
Personal Knowledge. In this trail, the researcher needs to map what he/she knows, what he/she has gathered of knowledge, from the previous path, related to the investigated phenomenon. This trail is regarding to the epistemological character of Science, when relative whys are questioned, relative to the fact of deciding to embark upon each path-theme of the investigation. Which means, if one decides to research something is because one has already lived or thought, studied about it. There are internal motivations and preliminary knowledge about the subject. No one starts from ‘scratch’. It is necessary to systematize information on the previous personal paths of the researcher. In case of this study, the two authors were able to rescue lived experiences, whether at work in clinics, directly with functions linked to Communication and people management, in tourism agencies and project in the area, as well as consultancy, workshops and lectures to the sector. One of the researchers, thus, was responsible for the discipline of Research Methodology for the Medicine area, as well as supervision of texts to multiple thesis from the area of Medicine, as well as papers for the area of Nursing. In operational terms, the rescue was performed with conversations, between the researchers, with the group of research, with written registration

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of memories and systematization, discussed posteriorly, processed and worked.
Theoretical Knowledge. Likewise, to perform the reflections, researchers had to life the trail of Theoretical Knowledge, in which the paths, reflections, thoughts, concepts and theories are aimed, produced by other researchers. For so, the main theoretical-conceptual trails are defined, which in this study are: tourism, Health, Deterritorialization and Autopoiesis. These trails are ran across with cartography (literature review), reading, annotations, production of summary texts. It is worth mentioning here the fact that this trail has as very important procedure the discussion work and systematizing of Conversation groups. We understand that the knowledge learned from theoretical knowledge gathers new nuances, from the discussion. In the conversation, new perspectives arise, it can be noticed entanglements, and this helps and composes a net-script of knowledge in which researchers and authors personal and theoretical knowledge, mix, recreate, reinvent and ‘autopoietize’ themselves.
Production Station. In this trail, the researchers sign, more explicitly, the responsibilities in the research, considering two derived trails: approximations and investigative actions. In approximations, a search is performed, for posterior systematization, something without ‘a priori’. The researcher opens up to the field, to receive clues from it, signs, to help building a systematization lined with actions to be performed. For this study, due to its rehearsal bias, the work at the ‘Station’ is bibliographic, derived directly form two trails of knowledge, previously presented. Indirectly, although this is not the purpose of the presentation of this text, there is also a connection with knowledge produced in the Doctorate program of Tourism and Health from Caxias do Sul University, with approximations and actions, related to patients and supporters from the Public Health System (SUS), in displacement for the city of Porto Alegre. The daily gather job, in interview, with 90 people, in displacement to receive attendance in three major hospitals of
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Porto Alegre, help compose a substrate for the discussions presented here. There is, still, the work of documentation analysis and cartography of productions from the internet, which also give basis to the reflections.
Intuitive dimension of the research. In this trail, the value of intuition, subtle and unexpected aspects are recognized, in the composition of the knowledge of the investigation. There is the recognition of value to this knowledge and signs for the alignment with thinkers such as James Lovelock (1991), Deepak Chopra (1989), and, also, Edvaldo Pereira Lima (2009), among others. In USP, already in the 90’s, an initiative called Plural Project, New Pact for Science, coordinated by Cremilda Medina and Milton Grecco (1990-1991, 1994), reunited researchers from several areas, demonstrating, in broad discussion and connection of researches, that science long extrapolates the rationalist logic, mechanic, Cartesian, reductionist. From operational point of view, in methodological terms, this intuitive dimension goes through the registry of spontaneous and unexpected signs. The Diary of Research here becomes fundamental, as registry of sensitive expressions, in which intuition composes the threads of signs to the production of knowledge. In this text, there are overriding threads from this composition and shared livings in many conversations from shared guidance, in exchange of knowledge, in which intuition has made itself, in the sense of thinking, with profound entanglement between Tourism and Health, considering the deterritorialization in its power of autopoiesis and production of Health.
TOURISM: DOSAGES OF DETERRITORIALIZATIONS AND AUTOPOIESIS
The title of this item, clear, also follows the metaphoric logic of composition of trails from the enunciation of the text. It is about the consultation of the concept of Tourism here, specially under the bias which is being considering, reflection on the high ‘dosages’ of deterritorialization and
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autopoiesis. So, to follow our narrative path, it is necessary to ‘open the prescription’ and read the instructions, which means, to comprehend what is being prescribed here and their implications in the form of use – implications which may, including, cause side effects.
The concept of tourism has been worked on, throughout a historic process of studies, aligned with epistemological-theoretical tendencies, going through the functional, structural perspectives, of critical and systemic thinking, among others. It is the same process that occurred with big concepts, which represent areas of knowledge and that aim at discussing on the composition of scientific fields. The alignment of the concept of tourism, in terms of epistemological discussions that are being performed here, is done with the approached given by Moesch. In this sense, the text published with Mario Carlos Beni (2017), under the title The Complexity Theory and the Ecosystem of Tourism, can be mentioned. The text discusses the epistemological basis of tourism, going through the Cartesian matrix, resuming the steps of the systemic theory in the epistemological construction of tourism, with the role of systemic functionalists and the analytic method. In the historical- reflective digression, the texts gives the proposition of the model Tourism System, the Sistur, which had already prioritized the systemic vision of the interactions.
The authors propose a discussion of the trans-disciplinarity and the association to the complex ecosystemic logic. It is explained that through the relation between open systems and the ecosystem of tourism, from energetic, organizational/informational material order and it is possible to understand the determined random character, at the same time, of the ecosystemic relation.
Therefore, the categories such as time, space, technology, economy, communication, ideology, imaginary, hospitality, fun, among others, constitute in its praxis. Tourism praxis, neither disjunctive, nor linear, but in a dynamic construction, permanently, in which the touristic subject in one’s transhumance moves oneself, constructs in an
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imaginary form, communicates one’s most intimate desires, in flow objective processes (displacement/trip/transportation) fixed (housing, feeding, host and safety) and of pleasure (the cultural encounters, the fun), which can be only established whether there is the encounter provided by the hospitality (Beni, & Moesch, 2017, p. 454)
Since we work under the perspective of sowing knowledge, of rescue of entanglements, constructing the holistic character of Crema Science, 1989, we consider Tourism as a complex process of deterritorialization, in which ecosystems are activated and transversalized, which means, movements of deterritorialization that provide the ‘meeting of worlds’.
In this sense, the following are at stake, the complex process of wishing deterritorializations, involving the activation and entanglement of different ecosystems. In the discussion presented by Turisth, III International Conference of Tourism & History The role of tourism in the historical-cultural valuation of the Ibero-American space, in 2019, in the South of Brazil, it was highlighted, by Baptista (2019), the presumption that the subject who moves is also the subject of transpositions and ecosystemic transversalizations, which agencies the movement and the connection of worlds, of universes of meanings, references, production and consumption. This way, a net of materialities and imaterialities is activated, since the powerful economical-political-social - cultural scripts and service providing, until the subjacent flows of energies from particles, from quantum activation, which also hits the affection levels. With tourism, everything moves and is transformed, at the same time that the movement of deterritorialization in itself, autopoietizes (reinvents) subjects and places, from the ecosystemic dimensions involved.
Dosage of deterritorialization. Respecting the limits of possible dosages in this text, it is important to think over a little about deterritorialization. The term is being used here based on Squizoanalysis, specially in the studies of Guattari, Deleuze and Rolnik. The theoretical squizoanalysis foundation is based on the work of several text from these authors. It can be mentioned, here,
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specially the works of Guattari, The three ecologies (1981); Molecular Revolution. Political Pulse From Desire (1987); The Machinery Unconsciousness (1988); Language, Consciousness and Society (1990); Caosmosis. A NewEthic - Paradigm (1992). From Guattari and Deleuze, What is Phylosopy? (1992); A Thousand Plateaus. Capitalism and Schizophrenia V.1 to v.5 (1995). From Guattari and Rolnik, Cartographies from Desire (1986). From Rolnik, Sentimental Cartography (1989). These authors teach deterritorialization as the first path of desire movements, such as the exit of the territory, not necessarily physical territory, but also abandoning psycho-social territories. Therefore, their studies helped to think Tourism as a resultant of displacement, which are not only geographic, but also imply activating worlds/subjective universes, which ‘detach’, ‘disconnect’, ‘displace’, making the subject, literally, loose contact with the ground of his/her existential and, bold and bravely, puts him/herself in movement, in direction of other ‘contacts’, to meet other Ecosystemic Universes, with subjects of different natures, personality, machinery, energies and several materialities.
Each place visited is, literally, ‘another world’. Before that, however, one lives the storms of the path, in the movement of simulation, when changes start and there still the discomfort of not feeling (yet) at home. For those reasons, even after being reterritorialized in the tourism destination, the subject suffer s more processes of deterritorizaliation, when has to flight back to his/her original territory, which, by the way, will never be the same, it will always be a ‘return’, a double deterritorialization, when territories start to build the subject internally. In practical terms, the subject that returns leaves a little bit of him/herself, in the place where he/she visited, at the same time that carries bundles of meanings from the visited place. Therefore, the presents, the memories, the bought objects, as well as the registries in photo and video, the posts in social media, are elements of this ‘return’ deterritorialized.
In the Amorcomtur studies, the concept of deterritorialization has been treated as wanted deterritorialization, precisely due to the
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squizoanalytical association between concepts and the comprehension that it is inherent to the concept of desire the production of movement, from the intensity of movement from the stars. For this reason, it is understood that, in processes of Tourism, there is high dosage of deterritorialization, comprehending that tourism, in itself, is synonymous of movement, and the movement can only be produced once there is agencying from the subject towards something. It is believed, in this sense, that the actuation of the power of movement, which results in deterritorialization, has autopoeitic force. And this is what we will discuss as follows.
ABOUT THE AUTOPOIETIC CHARACTER....
Tourism, according to the Amorcomtur studies, has been on the counter - edge between development perspectives of the area, with inherent criticism of tourismfication; the paradigms of sustainability and ecoefficiency; and the emergency in the discussion of environmental justice, eco systemic responsibility and lovingness. In this sense, it can also be mentioned the need of facing challenges and conflicts , announced in a turn of the century documentary, called Crosswords. Pain of the Delivery of a new World Vision (Ohayon, 2013). We are literally in a crossroads, even since the end of the century, and in this moment the reinvention and autopoiesis is urgent. The concept was proposed by Humberto Maturana and Francisco Varela, Chilean biologists, who produced studies that constituted the theoretical line of Loving Biology and Knowledge Biology, turned to explaining the origin of living systems, but, more than that, the own organization and reorganization that keep those living beings alive.
The most peculiar characteristic of a autopoietic system is that it is raised by its own strings, and that is constituted differently through its own dynamic, in a way that both things are inseparable. What characterizes the living is one’s autopeitic organization.
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Different living beings are different since they have different structures, but are equal in organization (Maturana, H., Varela, F., [1984] 2007, p. 54)
The question, in this essay, involves thinking about the deterritorizalization process of tourism as autopoietic. Therefore, when one deterrializes oneself one looses the existential basis and, at the same time, activates the power of reinventing oneself, in new relations and entanglements, in the connections with the reference universes found in tourism destinations. When leaving the existential ecosystems that constitute oneself and travel, the subject will be ‘rebuilt’ by livings and entanglements that will be constituted. This is an intense, complex process and that, if well-cared, may be health booster.
HEALTH EXAMS. TOURISM AS PREVENTION AND MEDICINE
To move on here, it is necessary to examine the concept, reflecting on possible entanglements. We start from the etymology, to reflect aspects of the historical process of the concept of health (without any pretension of ending, obviously), until assuming the dimension ‘script’, which characterizes the Amorcomtur! Studies, also inherent to the conceptual presumption ‘health’. Naomar de Almeida Filho (2013) brings broad discussion on the difficulties of the concept health, in text edited by Fiocruz, rescuing the philosophical, theoretical, methodological and pragmatic process on health, disease and correlated notions, as life and quality of life, death, suffering, care and iniquities. It is believed, therefore, to contribute to reflect transversalities and connections between fields of knowledge and conception blossoming, which are inherent.
Etymologically, health, derived from Latin salus, corresponds to “a physical state, salutation”, related to salvus, "salve". This, and only by this, already remits to the discussion on what this “good physical state” is and
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what should be saluted, in this condition of well living. Nuno Cobra, for example, developed a method of physical preparation, which denies the condition of the physical, only by physical, but associates it with other dimensions of life. It is him who states: “I have a vision of a man as a whole and not by the physical. I use, yes, a body as a path to arrive to the mind, to the emotions, to the spirit of people. And it is the movement the key to inner development” (Cobra, 2003, p. 71). It is about, here, of a speech of one of the national and international references of physical preparation of athletes, successful businessman, in their activities and in life, which associates knowledge since the biology of the human body to oriental philosophies, which teach to prepare the emotion for the movement, for the conquests. In this perspective, the salutation is something broader than just the functioning of each organ in the human body, in the system. In this sense, his concept of health is:
Health is the joy of living. It is to be enchanted by life. It is having enthusiasm, energy, vitality, willingness. [...] The enchanted with life person has the brain working in the formation of extreme high quality hormones that will nurture the perfect internal chemical elaboration of billions of reactions that happen in the organism all the time. (Cobra, 2003, p. 62).
Cobra highlights our ancestral nomad condition and the fact that the organic constitution of the human being, nomad by nature, let’s put it this way, has changed very little, throughout times. The author attributes the more natural and constant movement by our ancestral to a more healthy condition. “It was exactly this that made our ancestral to have full development. [...] They were always in motion and, because of that, their hearts were always being demanded, becoming developed and very strong”. (pp. 128-129). Following the speech of Cobra, some clues regarding
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deterritorialization and the autopoeitic character of Tourism, as health buster.
[...] the essence of life is movement. Nothing in the universe is stopped since the big explosion of unimaginable violence that resulted in the origin of the Universe 15 billion years ago. It formed the first chemical compositions – exactly the same chemical composition which the human body is made of, proving that we are particles from this same Universe, star powder. (BRASIL, 2017, p. 129).
In his text, among so many important sentences, Cobra reminds us that we are the Universe and the Universe is in motion. He comments that there was a moment, when man decided, for himself, what would be better and started promotion actions, looking for comfort and commodity. With that, certain territories were fixed and man started to collect materials, aiming at technical devices for the solution to the daily difficulties. The result, according to the author, is that “[...] ended up in this crazy uncomfortable society in the turn of the century” (Cobra, 2003, p. 129). The challenges of the turn of the century are also detailed in the documentary Crossroads: Pain of the Delivery of A New World Vision, already mentioned. With richness of details, the document gives a diagnosis of the existential crossroads of the planet and signs to the possibilities of overcoming or, at least, surviving what is presented in the challenging scenario . (Ohayon, 2013)
Cobra’s vision is very different from the generator of the concept of health, in other moments of history. Interesting, in this sense, the historical rescue of the text from Carlos Batistella (2019), untitled Contemporary Approaches of the Concept of Health. In this text, the author discusses three formulations: health as absence of disease, health as well-being and health as social value, throughout times, until arriving at the articulation of certain determinants to the explication of health phenomenons. The American philosopher Cristopher Boorse’s biomedical model is rescued, which elaborates the negative concept of health, considering it as absence of illness. It also makes reference
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to authors who have criticized the negative definition of health, which is the case of Almeida Filho e Andrade.
In this historical path presented by Batistella, it is interesting the highlight to the approach of Canguilhem, which teaches that health is being able to get sick and leave the pathological state behind. Therefore, health “[...] is understood by reference to the possibility of facing new situations by the ‘margin of tolerance or security that each one posses to face and overcome the environment infidelities” (Canguilhem, 2006, apud Batistella, 2019, p. 56)
In the perspective signed by Canguilhem, health corresponds to the capacity of providing new rules, much more than the simple condition of conformity with the external environment. The conceptual approach seems to help thinking bonding with deterritorialization. This can be verified, since deterritorialization and the loss of reference universes challenge the subject, in a way that puts one in direct contact with discomfort of the deterritorializing condition. It occurs that this same condition produces a kind of pressure, which activates maximum power of the subject, obligating one to survive the loss of the existential territory. There is, therefore, the actuation of the power of autopoiesis, since the overcoming empowers the subject, bringing the power through the access to other worlds, in a feeling of conquest and personal fulfillment. Within this aspect, the alignment of this discussion can be referred to the thought of Hirschmann (1983) about the movement inherent to the desire. The author explains, mentioning Scitovsky, that the pleasure is resultant from the trip from discomfort to comfort. It is about the path and not the final destination. Also in this sense, the concept of desire is found, presented by the psychoanalyst Maria Rita Kehl (in Novaes, 1990, pp. 366- 367):
The joy of desire depends on a certain dose of trust in the real thing, a certain amount of experiences of joy that allow waiting that this external place in relation to psych, where the ‘hunger of the
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world’ is spread, is a place where some kind of pleasure and some kind of confirmation, of placation, at least temporary from my questioning, may occur.
These connections between deterritorialization, desire, pleasure and joy are in synch with the concept of health, presented by Nuno Cobra (2003), at the same time that help thinking about the wanted deterritorialization, inherent to Tourism, as a device of health buster. As well as in the perspective of Canguilhem, from the capacity of dealing with the problems of life, with unexpected situations, and reacting, reinventing oneself, and also in the perspective of producing joy and pleasure, health is bonded to facing a new challenge, inherent to movement, to deterritorialization and the capacity of autopoiesis, of self- production.
For the World Health Organization (WHO) - (2016), health is an inherent social right to the condition of citizenship, which should be guaranteed without distinction of race, religion, ideology, politics or social-economic conditions. Therefore, health is seen as a value of group, which means, a good deed for all citizens. The text mentions: “Health is the state of full physical, mental and social well-being and not only the absence of disease”. Many times qu oted, the concept adopted by the World Health Organization (WHO) in 1948, far from the reality, symbolizes a commitment, a horizon to be followed.
This vision has been criticized for being considered utopia and for supposing full well-being, which several contemporary authors do not associate to health, such as Canguilhem and Caponi (1997). From this critical view and from the mobilization of professionals and Latin-American studies, it was proposed, in the VIII National Health Conference (VIIICNS), which occurred in Brasilia, in 1986, the broad concept of health. “In broad sense, health is the resultant of the conditions of feeding, housing, education, income, environment, work, transportation, job, leisure, freedom of access and land ownership and access to health services.” (Brasil, 1986, p. 4)
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Interesting, to think, here, also about the concept of health, as a right to citizenship, which was expressed in the Brazilian Constitution of 1988, in the articles 196, 197, 198 and 199. These articles present the concept of health in the political, economical and social perspective.
Art. 196. Health is a right of everyone and a duty of the State, guaranteed by social and economical policies, which aim at reducing the risk of diseases and other harms and to the universal and equal access to actions and services for its promotion, protection and recovery. (BRASIL, 2010).
On the other hand, the concept of health in the ecosystemic approach is directly associated to the quality of life, which means, in this case, one can say that health is thought by the dimension of ‘script’, as a complex net of transversalities, which constitute conditions of well-being and quality of life. It is worth mentioning, here, the speech of Minayo (2002, p.174):
[...] the feeling of well-being, the vision of ending of means to reach it and the disposition for, solidarity, amplify the present and future possibilities. Therefore, in the same way that the notion of health, quality of life, within the ecosystemic approach, it is as an umbrella where our shelters of desire of happiness are; our parameters of human rights; our effects to increase our borders of social rights and conditions to be healthy and promoting health.
In this vision of health, we have the approximation of tourism and different existential territories. Minayo explains that the search for “identifying the relations between health conditions and their social, cultural and environmental determinants, in modified ecosystems by work and by human intervention” occurs (Minayo, 2002, pp. 181-182 apud Batistella, 2019, p. 72).
This way, we arrive at those reflection in conditions of discharge, always marked by the comprehension in which the process was “treated”, without
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the pretension of ending it completely. There is always much to be done, after discharge.
CONVERSATIONS ABOUT THE DISCHARGE CONDITIONS
After the path of this text regarding deterritorialization, as inherent characteristic of tourism, mas potential of autopoiesis and actuation of health conditions, before ‘discharge’ per se, it is understood that some punctuation are needed, as conversation, for the passage to other processes.
One can say that, in this text, those deterriotorializating transversalizations and autopoiesis of the relation between Tourism and Health were ‘treated’. After the ‘treatment’, some transformations were understood, some signs of paths, in our cases, if reflection on the theme. It is what was understood here, as ‘signs of discharge conditions’. Let’s describe them.
A first sign is about the fact that the moment of discharge is understood, not as a treatment’s ending, but as a passage to other conditions, in our case, reflective. It is believed that, when rehearsed about the entanglements here proposed, some clues were presented about the power of the interface from these two fields of knowledge and practices of production of life – Tourism and Health.
In addition, it was proposed here a logic relation, in the sense of powerful generator between the existence of wanting deterritorialization, inherent to tourism, and the promotion of Health. This involves, only by itself, the comprehension of theoretical-conceptual fields and service providing, as a complex ecosystemic net work, and, also, as marked by the processual logic and overlapping by both. In this sense, signs of a broad vision were proposed, for both Tourism and Health, in the ecosystemic perspective, as entanglements of the path, from bundles for crossing, involving geopolitical,
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economical, social, cultural factors, in the epistemological-theoretical - methodical dimensions and technique.
It was proposed to highlight the force of deterritorialization, with activation of autopoiesis, in the sense of reinventing oneself, marked by the game of detachment of existential territories and new attachments and bonding in psycho-social universes found in the destinations. It is believed, in this sense, that the movement activates the breath of life, amplifies the power of health production in broad sense, with actuation of what is called Squizoanalysis of vibrating body “[…] body sensitive to the encounter of bodies and their reactions: attraction and repulse, affections, simulation in matters of expression” (Rolnik, 1989, p. 26). It is worth mentioning inspirations such as the thought of Eduardo Galeano, who teaches about the different ways of thinking the body: “Church says: the body is a guilt. Science says: the body is a machine. Publicity says: body is a business. And the body says: I am a party”. In the same line, all Rubem Alves’ approach, in a classic text untitled Variations on the pleasure, in which he states that to look for wisdom of the body and that the body is deep water of knowledge, because it is lived knowledge, in variations/vibrations, not in thoughts.
Therefore, to dialogue with thinkers who help reflect on the interface of Tourism and Health, it is celebrated, specially, the cultivation of health in the dimensions of a vibrating body, the body-party of Galeano, the body of deep water of Rubem Alves, the body that speaks as Pierre Weill, specially the one that moves with power of reinvention of life and of health. It is understood that is precisely in the movement, in the process, in the wanting deterritorialization, which is possible to salute life, promote health. Therefore, in this process, the (potentially) healthy character of Tourism is shown.
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