thinking about health once again : programs and territories

1Doctor en Salud Colectiva. Director del Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina * ABStrAct this article, of a conceptual nature, uses critical theory to discuss the programmatic logic within the sociosanitary field as a technical answer without any questions, provided to territories or spaces with questions awaiting translation. The purpose is to put programmatic logic, which is the legacy of public health planning and an expression of instrumental reason, into discussion, and in this way examine the temporal-spatial conception as an axis for thinking and acting within the complexity of the social world, recognizing other knowledge and practices. The questions, answers, knowledge and actions in the sociosanitary field constitute the focus of a reflection rooted in concepts that seek to deconstruct the ideological project represented by health programs through an analysis of their scientific basis (the epistemological component of the technical), which is antagonistic to any emancipatory project. KeY WOrDS Epistemology; Social Planning; Health Programs and Plans; time Perception; uncertainty; Social Environment.


iNtrODUctiON
Intellectuals are, as holders of cultural capital, a (dominated) fraction of the dominant class.Pierre Bourdieu (1) this text is structured around the following questions: Why is it that policies in the sociosanitary field tend to be expressed through programs?Are programs the best State response to the needs of social groups, in terms of amplifying rights and reducing inequalities?Is the knowledge of workers in the sociosanitary field sufficient to face the complexity of the social world?Do they need to know more, or unlearn much of what they have learned?Is this only a political conflict, or is it also an epistemological one?
The purpose of these questions is to put into discussion, using critical theory, (2) social planning and programming as an expression of instrumental reason (3,4) and, from there, understand the territory as the space of the singular and the site of action, where the expression of the relational and symbolic is marked by capitals and fields that exceed the epistemological simplicity of programs. (5,6,7,8)this dynamic demands a permanent cartography that diachronically accompanies the territory, which is not static but rather is in permanent reconfiguration. (9)In this way, we are able to question the ideological project represented by programs through the analysis of their scientific basis -the epistemological component of the technical -which we understand to be antagonistic to any emancipatory project. (10)e propose searching for questions, not repeating answers, and therefore we look to different concepts, using theory as a toolbox, (11) with the intention of once again thinking about health beyond the sphere of biomedicine. (12,13)

ScieNce DOeS NOt tHiNK AND tHe lAZiNeSS OF tHe PHilOSOPHer
Mario testa highlights the absence of theoretical frameworks that go beyond biological determinants in the five great arenas of technical power in health: teaching, research, health services, health administration and the population. (13)that is, professionals as well as technicians, specialists and the greater population are mired in biological conceptions that displace the social in the health-disease-care process, which facilitates medicalization and the expansion of biopolitics. (14)hen Heidegger says "science does not think," he is highlighting that science does not operate in the philosophical dimension; although it depends on that dimension, science forgets to think and in this forgetfulness sacrifices the passion represented by the question.When there is a lack of questions, the instrumental dominates and, blinding with its glitter and lights, produces "blinks." (15)p.98)p.20)p.47)In accordance with the reflexive exercise proposed by Bourdieu, it is worth reexamining the concept of elucidation formulated by Castoriadis: "know what one thinks and think about one does," (19) so as to think from a founding praxis, given that the justification does not affect the transformation, and to found and to justify are not synonyms, (20) in the same way a player and game commentator are not synonymous.In this way, it is necessary to differentiate among discourses, practices and the impacts of those practices, so as to not choose the wrong path.
The question is central to thinking, and therefore we must renounce "laboratory answers."Asking, thinking and doing in the sociosanitary field are the central themes of reflection in this work, which obliges us to think about ourselves in the context of latin America, to avoid scientificism. (21,22)

Historical roots
In the 20th century, the Welfare State developed three superposing elements to control poverty and exclusion: target populations, a set of rules and payments, and a body of specialized workers.It was necessary to identify target populations -their statistical, legal and administrative constitution -then establish rights and allowances, and finally create a body of specialized social workers to manage the system. (23)this logic lost legitimacy as it was demonstrated that knowing is not the same as understanding and, no matter the knowledge applied to the population, it is not always sufficient to understand singular, personal and/or collective trajectories.An overabundance of statistical information with increasingly complex methods and techniques cannot prevent the construction of heterogeneous societies marked by inequalities. (23)lanning dates back to the 1960s in latin America, in the framework of the Alliance for Progress. (24)Its conceptual references were the structural-functionalist sociological currents (25) and the developmentalist economic theories.the implementation was marked by the polemic between development and dependency, centered on whether the issue of growth was economic or of a political and social nature. (26,27,28)It is not necessary to point out which of these two positions won.Planning was consolidated as a result of the theoretical work carried out by the Economic commission for latin America (EclAc).the dominant conception was that of the State as a place of power concentration and a sphere of rationality with internal consistency and capacity for handling the entire management process.these ideas were shown to be false, but they were, and are, functional to the idea of planning as a technique with which to solve social problems.In this way, attention was focused on economic growth and not the social question.Proposals were based on the idea that the social would be solved after the economic development was achieved, through "spillover."This hypothesis, once again, was proven to be false, as processes of accumulation are not the same as those of distribution.the research of thomas Piketty, (29) which show that in the last two centuries the countries with the greatest economic development were those that most widened inequalities within their societies, was as of yet unknown.
the objective of economic development abused planning as a technique.Its primary error was reducing the social to an administrative approach to problems, understood as the administration of things, and thereby underestimating the governance of people.Planners took the path indicated in the 19 th century by Saint-Simon, for whom it was necessary to go from the governance of people to the administration of things. (30)In this way, problems were conceived of as issues of reproduction and growth, while change was not thought of as a problem. (13)his led, in the first place, to a structuralfunctionalist approach and later, to general systems theory, (31,25) which tends to objectify the social. (32)lanners thought that workers would carry out what was stipulated in the norms and plans designed within the central levels, to organize a future that was understood to be predictable.the kingdom of instrumental reason had no ideological limits (4) and real socialism was defeated by this siren's call.the emphasis was placed in the development of techniques and tools.It was not necessary to think; such hope in the instrumental led Freud to classify the modern man as a prosthetic god. (33)

epistemological roots
p.18)p.12) the world is understood to possess an order that must be deciphered: everything must contain reason, there is no room for uncertainty, knowing the order that governs the object allows it to be transformed, and in this way allows for the domination of nature and history.In this framework, truth appears as a product of the enunciation of the cartesian subject.reason presents itself as the great organizer of a system that sees itself as totalizing and, at the same time, reducible to the single unit (the single that explains the whole).p.4) In this sense, Boaventura Santos indicates that modern science reduces complexity by conceiving that to know it is necessary to divide and classify, so as to then establish relationships. (10)this way of understanding science founds the basis of belief in the infallibility of knowledge, the solidity of scientific discourse and truth, in which man appears reduced to consciousness, ideology replacing mythology. (34)Santos classifies this rationality -which Horkheimer and Adorno call instrumental -with the adjective of indolent, for resisting changes in its routines and transforming hegemonic interests into true knowledge, which scholars tend to repeat as universal truths without recognizing that they often only represent the "European truth," expressing the colonization in their thinking. (10)niversity graduates have, in general, a reduced view of problems; nevertheless, they feel able to formulate programs that take on social complexity.they do not know that the program will consider, at best, the dimension of the problem related to the specificity of their knowledge, but not the totality of dimensions that make up the problem.the persistence in latin America of the so-called "forgotten diseases" -tuberculosis, Chagas, malaria, syphilis, and so on -as well as the chronic housing deficit, the worsening of the environmental situation and/or the existence of important percentages of the population without water and sewer systems, despite the international declarations regarding 100% coverage that have been made since the second half of the last century, are some examples that show the permanence of problems despite the multiple programs in existence.this situation demonstrates that beyond the technique for the solution of these problems, political-economic and ideological-cultural dimensions are at play that establish them as complex problems that surpass the simplification that instrumental reason makes of them. (4)holastics and the university universities emerged in Europe between the 7 th and 8 th centuries in the framework of scholasticism, a medieval philosophical and theological school of thought, the methodology of which centered on the principle of authority based on the idea that a proposition could be accepted only if it were affirmed in a text considered to be true.And as these texts were the sacred writings, they served as ineludible references for the interpretation of reality and its problems.From this perspective, problems should adapt to what was already written, that is, reality was wrong if it contradicted the text.knowledge came to be understood as universal and objective and, therefore, it was not necessary to contextualize it.these ideas, incorporated by Saint thomas in the catholic church, constitute the matrix that structured the universities of the western world and Eurocentric thought.
Scholasticism also established the foundations for natural law, the ideas of which are expressed in four propositions (9) : 1) a thing is defined by its essence; 2) defining that essence generates competence among the wise (the church, the prince or the wise man) who are the voices authorized to define it; 3) natural law cannot be traced to a state that precedes society; 4) duty comes first (the idea of law does not exist).Scholasticism contrasts action with passion, and possesses a static representation of reality which dominates modern reason. (36)this naturalizes a temporal-spatial conception that persists to the present, upon which planning, and therefore the planning of programs, rests.
to escape scholastic logic it is necessary to invert it, in a such a way that the problems provoke the texts: instead of textualizing problems, problematize the texts. (37)From these new practices other texts could emerge, not in the sense of universal truths, but rather in the sense of situated knowledge. (38,39)this means working with problems based on questions, and not using answers to unknown questions; it means prioritizing not only scientific truth, but the social importance of the application of knowledge. (40)We have taken a great deal of time to learn that the scientific disciplines do not always coincide with problems and that, at best, they cover only part of their complexity. (41)But, even still, we continue to negate that the world of experience is greater than the world of knowledge, (10) which shows that there is an urgent need for other epistemologies.

Planning and modern reason
Planning expresses the epistemological principles of modern reason -rational actors, development and progress -which relates to an idea of time that tends to amplify the future and reduce the present. (10)In this way planning contains an ample ideologicalpolitical spectrum that attempts to make the behavior of subjects simple and predictable (certainty).this strength, also present in programming, is at the same time its greatest weakness, given that social problems -in their majority -are characterized by their complexity, their relational and situational character, and, therefore, their singularity.From this stems the uncertainty that characterizes the social.
Planning appears as a magical formula that, once applied, by simple evolution leads to the desired situation.It takes from scholasticism the idea of ubiquity, that is, the ability to find oneself in more than one place at once.In this way, as a technique, it achieves wide coverage within the disciplines, and no less conceptual confusion.It is ignored that part of the essence of a plan is that it fails, and, given complex problems, results are situational: good for some and bad for others. (41)lanning inherits logic from the Discourse on method and the normative spirit of the thought and work of Descartes. (42)lanning is based in mathematics, the pillar of rationality that founded science, which allows for the construction of a method to search for certainties.Hence its obsession with counting, based in arithmetic, but not recounting, as in narrating.reason appears as a road towards truth, and in this way the world and the body will be understood as machines hidden behind equations that can be defined algebraically. (4)thought, associated with mathematics, separates the subject from the object as a premise of abstraction.the imperative is that reason must confront tradition, and so decontextualized knowledge and practices are produced.Enlightenment will reduce science to calculation criteria and that which does not fit will be under suspect as unscientific.It is in this sense that Adorno and Horkheimer consider Enlightment to be totalitarian. (4)he problem of planning can be discussed as one of an epistemological nature or one of an instrumental nature (techniques and methods).the predominant vision is instrumental, which has sought success through the perfection of techniques and methods while ignoring the underlying epistemological problem that sustains it.In Figure 1 the historical-conceptual axis that spans from normative planning to strategic planning is represented, an axis from which Mario testa separates himself through the enunciation of strategic thinking (relational thinking). (43)The figure would be incomplete if we did not point out the prior existence of instrumental reason, corresponding to the absence of an epistemological reflection is the problem with planning -and a great part of science -which ends up becoming a prison (13,44) for scientists, by dragging them into a theoretical "dead end" in which knowledge becomes dogma and the capacity for asking questions is lost because answers abound.Indeed, Nietzche highlighted over a century ago that all convictions are prisons. (20)arlos Matus and Mario testa sustain critiques of planning as epistemological and methodological questions, a position first upheld in an international seminar (45) in which both thinkers participated and which influenced later publications that reflected upon the crisis in planning and looked more deeply at the government of institutions and society. (46,47,48)Both testa and Matus, in their last works, abandon the idea of planning.criticisms of planning go beyond the sociosanitary field.Henry Mintzberg, Canadian economist and professor at Mcgill university, one of the great management gurus internationally, highlights the downfall of strategic planning when he describes it -ironicallyas the formal system that the companies have of elaborating and operationalizing strategies they already possess.Within planning, Mintzberg criticizes the lack of knowledge regarding strategies such as emergent patterns, connected to a process-based logic, misunderstood as the ability to foresee the future as planners intend.Mintzberg does not believe that strategy can be formalized, as he considers it to be creative and not adjusted to formulas, capable of enclosing complex, sophisticated, subtle and even unconscious processes at the individual and/or social level.At the same time, he highlights three fallacies of strategic planning: the fallacy of prediction, the fallacy of detachment, and the fallacy of formalization. (49)

Program planning
It is not incidental that programs proliferate in territories marked by inequalities: the political-economic and cultural-ideological project they represent is antagonistic to the reduction of inequalities, especially as they are chronified over time because, given their nature external to the local, they increase the institutional weaknesses of the State, right where the State is most needed.Program logic is functional to four things: strong social inequalities (23) ; low levels of citizenship; low governance capacities among local, regional and national State agents (32) ; and the epistemological obstacles university graduates face in understanding the social game. (8,50,51)overnment actions, because they are in the hands of university graduates, can be reduced to the content of their implementers' knowledge, which implies structuring answers without questions in the form of programs and negating consciously or unconsciously the political.this is the reason that the ideological differences observed in an election among the political parties that participate in the democratic game are reduced when the parties reach power.Is this situation just a question of power resources or are there also epistemological questions at stake?The question takes us to the articulation between politics and policies: politics (the ontological level related to power) represents a set of values and principles that can be obfuscated by the design and execution of policies (the ontic level, related to the empirical). (52)echnical experts "don't know that they don't know, and so they do what they know," says Matus (41) when he highlights how that specific knowledge which constitutes the specialty of the professional is insufficient when faced with the complexity of the social.For this reason, the only responses that can be imagined are "programs," designed using a synchronic and decontextualized knowledge that constitutes a limited view with respect to the complexity of the territory.Instrumental reason is dominant in universities, and has little to do with the questions/problems that emerge from the territory itself, so that disciplinary knowledge becomes hypnotized by answers that appear as magical solutions.
conceiving of planning as a technical issue led to innumerable adjectives: administrative, economic, regional, rural, urban, social, sectoral, anticyclical, centralized, decentralized, compensatory, democratic, economic, structural, flexible, imperative, indicative, global, comprehensive, normative, operative, participatory, in stages, strategic, situational. (41,53)these adjectives seek to mask what is impossible to hide.technical specialists know, but in general don't think, so they take the instrumental as an explanatory whole.In this way they possess -and desire ever more -tools for managing objects, which they consider to be inert, but they are not concerned about obtaining knowledge regarding how to govern people and work with complex and interlocking problems, so they continue to think they are playing a solitary game.
the planning culture consisted of -and it still does -planning at a central level, identifying unilaterally the problems and their answers, and administering programs in which the plan is disaggregated at the local level.the referential text in the health field in Latin America regarding the planning method was a publication by cENDES [Centro de Estudios de Desarrollo, center for Development Studies] and oPS [Organización Panamericana de Salud, Pan-American Health organization] called Programación en salud. (54)In this way, programming was defined using a mechanical, infallible and flawless conception, like a true machine that permits a linear dynamic: Program planning is the conceptual reproduction of the activities and tasks that must be carried out in order to achieve a previously defined result -a product -and their corresponding sequences.A program is the result of this elaboration with the allocations -in terms of resources and administrative responsibilities -that guarantee the viability of the proposal. (43) integrated plan, schema or ordered set of actions, activities, methods, and procedures directed at achieving an objective (resolution of a problem or attainment of a result).Actions oriented at predicting and disposing of the resources for reaching certain ends.All planned activities that are broken down into stages and then into operations. (55)health program is made up of a set of resources brought together and applied to provide a defined population specific services organized in a consistent way in time and space so as to attain the determined objectives with respect to a certain health problem. (56)ciosanitary programs -and their form of reasoning -have been around for over 50 years and, given the persistence of the problems they seek to address, would not seem to be the most effective or efficient way to solve them.They might, however, be the most comfortable and functional to the rationale of academics and professionals.Programs multiply within the organizational charts of a government, following the names of university departments or the curricular structure of predominant degree programs; similarly, in the health ministries, the anatomy of the human body is followed (systems, organs or parts of organs) or certain diseases are focused upon.on average we find between 25 and 50 programs within each health ministry, at both the national and provincial levels in Argentina.the health program is a vertical insertion into the territory, a response at the individual level and a parceling of reality that presupposes classification as a condition for knowledge, unaware that this is not knowledge, as knowledge has the potential to dissolve the classification. (4)pon analyzing the administrations of different governments we can see that programs end up being the most developed expression of policy, hence the obstruction of the political that these programs represent.People receive "answers" that are more or less similar to those of the previous government and far removed from campaign promises.the program, as a technique that determines action, eliminates the political -the value that gives meaning to action -and coverts it into a neutral and universal policy, in this way transforming hegemonic interests into true knowledge. (10)one of the many examples in this sense is found in the work of Marcia Agnell, (57) former Editor-inchief of the New England Journal of Medicine, in which she highlights the falsehood of scientific objectivity by demonstrating the economic interests of the pharmaceutical industry in the construction of evidence.
given the failure of social and economic planning in latin America, both Mario testa and carlos Matus (among others) recognized the unbridgeable distance between the rational models of planning and the social game. (13,32,41,43)this discussion is no small matter in the countries of this region, where the proposal continues to be to follow plans and/or execute programs as if they were magical solutions.

the fragmentation of subjects, territories and problems
Programs are proposed as answers to "technical diagnoses" that in general come pre-canned from international organizations.the majority of these proposals are ephemeral fads, but they accumulate within State institutions like geological layers and persist as rationalities -forms of knowledgethrough techniques, discourses, work processes and/or organizational dynamics.the only things that do not change over time are the problems themselves, which not only increase in quantity, but also become more singular and complex.In synthesis, the programs never depart from the paper they were written on and promises never become solutions.the subjects of science cannot always understand that "technique fads" constitute the problem and not the solution.
Programs were, and are, types of responses on the part of the State regarding the problems and/or demands of social groups.In their origins in the health field they had greater impact, given than they were aimed at epidemiological situations marked by infectious diseases that required high coverage as a criterion of effectiveness; this meant responses carried out through programs centralized at the national level, for example vaccination campaigns against the poliomyelitis epidemic in the 1950s.But as the epidemiological situation of social groups has become more complicated -the poorly termed "epidemiological transition" (58) -it was necessary to include other dimensions that proposed changes, such as aspects related to intersectoral actions and ways of life and, therefore, the criteria for effectiveness required including the issue of the territory and the social management of problems.At that point, programs had to confront sociocultural dimensions and lost effectiveness given the impossibility of translating the different knowledge and worldviews put in play by the different actors/agents.this signals the limitations of modern epidemiological thought centered on the axis of personplace-time, incapable of replacing it for the axis territory-history-society. (59) Modernity installs the idea that, in the relationship among science, technology and society, science deals with issues of nature, while politics handles issues of society. (60)In recent times, this relationship presents other challenges, given that the "new" problems of the social question have broken the boundaries between science and politics and appear as hybrid objects, (60) mixing together dimensions of nature and society and challenging both political and scientific knowledge and practices.these hybrid objects involve both science and politics, as we can see in issues such as violence, assisted reproduction, new parenting structures, stem cell banks, genetics and its applications, and so on.these are some of the examples that enter into conflict with the old conceptual devices centered on planning, that are directed vertically at the territory without differentiating among cultures or social processes and that assign very little capacity for having/producing knowledge at the local level.In this logic, problems are fragmented, and the material resources and technical staff dedicated to problem resolution become inefficient and ineffective, with the collaboration of the different components of the program: normative structures, evaluation and information systems, "experts," manuals on procedures and good practices, scientific evidence and clinical guides, and so on.
the unfurling of program-based strategies is carried out under the discourse of constructing "State policies," pasteurizing the social and conceptualizing it as free from conflict.The distribution of economic resources, materials, and the personnel that carry out the programs, in their different levels and functions, generally contrasts with the needs of the communities on the ground, in which the relational occurs according to dynamics that are very different from those of the programs.In this way, we have two types of logic that do not enter into dialogue: that of the programs, conceived of like a Venn diagram, and that of the territory, taking the shape of a Borromean knot. (61)he perspective of the program is reductionist, as it ignores those singularities and cultural aspects that are in play in each territory.In this way, the social is objectified and is simplified on the basis of a "solution" that comes from the rationality of the technical experts that, in general, live far from where the program is implemented.the duplication and/or superposition of actions among different programs is a show of the inefficacy and inefficiency that, in general, is not discussed, given that their technical staff rarely come into communication and often do not even know one another.
Programs and their training meetings, seminars, conferences, and so on, produce a cascade effect that affects the operative: the national level calls upon the personnel at the provincial level, the provincial level calls upon the municipal staff and the municipal level upon those in charge of the institutions in each territory.the encounters tend to be characterized by people holding different knowledge and experiences, with different technical and symbolic capacities and working in dissimilar territories.Nevertheless, it is assumed that they will understand and apply the same norms to achieve the same results: a truly magical thought.the meetings are scheduled as if thousands of officials and workers at the municipal and territorial level were to attend, when in reality attendees are very few or, more accurately, it is always the same people who take it upon themselves to carry out tasks and travel to the meetings, who then return with different norms, information systems, guidelines and trainings.the professionals who respond to these calls do not always share with their colleagues the new knowledge because they know that it is generally not well received.All the effort might be recompensed with money that enters at the local level through the conditional Money transfer Programs put in place by international organizations, (62) or by access to trips -concealed forms of scientific tourism -to domestic or international destinations, travel stipends or salary bonuses that complement income, although these privileges often produce fragmentation in the worker collective.As each program creates its own administrative logic, procedures and forms, language and codes, it becomes Programs atomize the inhabitants of the territory, who are reduced to problems, lacks or diseases that, not unfrequently, are the only identities they hold for the State.
Are programs the only relationship possible between the State and social groups?
We understand the answer to be no, as programs represent an obstacle in the reduction of inequalities by fragmenting problems, territories, and subjects and fomenting an assistance-based logic in which there are no rights, only an offer imposed on the basis of an external diagnosis.the program can only be justified as part of urgency, but never part of what is important.the persistence of programs over time signals their failure to solve problems.If we analyze countries with the least amount of inequalities, we will see the scant development of programs there given that "the game" is centered on institutionality and the exercise of citizenship.In this way, we could affirm that the number of programs in existence is inversely proportional to the levels of citizenship existing in that country.

territOrieS AS qUeStiONS
Programs are answers without questions.The specialists "know," and formulate answers to problems that are not based in questions but rather certainties.Programs bear the marks of scientific colonialism within university knowledge.Nietzsche's warning is relevant here: "The desert grows, and woe to him who conceals the desert within him!" (15 p.41)In this way, programs reproduce, while the territorial is reduced to social participation, to local health agents or promoters.the programmatic logic offers up like unveiled truths the ancestral knowledge that science appropriated from the communities themselves, for example worker cooperatives, breastfeeding, natural birth, commensality, care of elder adults, productive models based in the family, community gardens, and so on.
In the year 1937, ortega and gasset called university professionals modern barbarians, in the sense that they increasingly know more about less. (63)Santos affirms: "Modern science produces knowledge and lack thereof.p.88) these affirmations reach university graduates as epistemic subjects, beyond their ideology or party affiliation.
Scientific knowledge is necessary and very useful in certain cases, but the territory needs -and has -other knowledge that is not always based in science, hence the importance of an ecology of knowledge in permanent processes of translation. (10)the territory does not need plans and programs but rather citizenship and workers in the sociosanitary field who develop care relationships based on the artisanal nature of their work, in relational processes mediated by the symbolic. (10,65,66,67)these workers have rich practices imbued with the "chaos" that the social presents them with, confronting their rationalities structured in logics of order and classification.This epistemic configuration produces malaise and discomfort, because we suffer that which we do not understand.to install new praxes we must be faithful to Paulo Freire: "where the feet step, the head thinks." (68)The difficulties in understanding the territorial and moving within a relational dynamic, in scenarios of growing complexity and/or chaos, induce a centripetal logic which reproduces more than it produces, and leads professionals to bunker themselves into their institutions as a way of defending themselves against that uncomfortable and destructuring "outside" that is increasingly difficult to understand, as the problems are increasingly complex and further removed from their epistemes.
the territory shows us that the epidermis is not the boundary of the individual and that if we look beyond each person's skin we can transcend risk factors and think in terms of social interaction and the social game, discover social vulnerabilities and logics of power (both macro and micro), as well as the underlying potency of the territory.Working in these terms does not imply thinking using the categories of planning with which the majority of university graduates are trained to interpret the social.
Questions mark the path of thought, and the possibility of formulating them is related to the richness of the epistemic and theoretical framework.confronting that which was not contemplated, and accepting the shattering of certainty, allows for the asking of questions and avoids the common roads of naturalizing, complaining, and anecdotal storytelling.For this reason we should not fear abandoning the known that has not proven useful, to venture into the unknown in a voyage without certainty of success, deciding where to place our stakes and being faithful to those decisions, inscribed in a logic of the event in which the objectives are not predicted but rather recognized when looking back and acknowledging all that was built, likely far from what was ever thought/imagined, especially while it was happening. (69,70) priori, we assign to the territory, and the questions that arise there, supremacy over any theory, in the sense of inverting scholasticism and problematizing texts.In this way, we search for clues that allow a conceptual framework to be created that respects technical knowledge that has proven effective, but that goes beyond such knowledge, to allow for thinking, understanding, interpreting and acting when faced with the fortuitous, the discontinuous, the different, the random, the disseminations and multiciplicities that take place in the territory.For this is it necessary to overcome false dichotomies installed in our thinking: history/nature, conscious/subconscious, body/soul.
In the following paragraphs we seek to reprioritize questions as the starting place for thought, so as to produce encounters and events.We do not seek to construct new iron cages (43) nor infallible formulas.the purpose is to once again think and, in so doing, develop praxes that become spaces of freedom, reducing inequalities, developing citizenship and constructing new institutionalities in the territories.Doing this demands the use of categories very different from those used by planning and programming; we will describe such categories so as to dispute the worldview that has been imposed by universal science.

territory and place
critical geography differentiates between place and territory.The first concept -the more traditional one -is understood as the geographic location of people in a determined time while the second sustains that through their actions, populations modify the physical environment in interactions with other groups and construct -with relative autonomy -the place in which they live. (5)Milton Santos, Brazilian geographer and grandson of slaves, understands the territory as an area of solidarity-based happening, marked by the contiguity of the subjects and their processes of interrelation that build identity within social groups, in which the territory intervenes to try or facilitate those interrelations.the territory is not synonymous with violence but rather with complexity and chaos, submerged in structures that are structuring but also structured by the actions of individual and/or collective subjects. (5,6,7,8,71)he territory is dynamic in nature, and therefore should be understood with a processbased logic, fruit of the actions produced by actors and objects.recognizing the social value of objects means accepting that objects are not "things" but rather products of social action.(5,6,59) For Harvey, the territory is a construction that -through historical processesexpresses the conditions and ways of life of social groups, marked by power relations.(71) the territory is a kaleidoscope that becomes increasingly complex as we approach it and, faced with that which at a distance appears to be homogenous, the singular gains relevance.this look at the territory simply describes the labyrinth-like configuration of the social, crossed by the political-economic and ideological-cultural dimensions that we recognize both in the macro and the micro.Viewing the territory as singular does not mean reducing it to its materiality, but rather understanding it as the sphere of the relational-symbolic, in which capitals and fields act that are created and recreated and that can exceed the territory's boundaries.Bourdieu differentiates between the social space and the geographical space, recognizing that social agents -like objects -construct symbolic capital according to their position in the social space, and in this way social structures end up becoming mental structures and preference systems that express hierarchies and social distances.He calls this translation of the social space into the physical space "site effects."(72 p.119) We recover the territory, not from a romantic conception but rather recognizing, as Milton Santos suggests, (7) that it can be a home or a prison to a subject, and for this reason must be considered comprehensively and seeking to understand the technical demand as situated knowledge without forgetting the ideological-cultural and economic-political components that make up all problems.the territory is a human construction, unfinished and in permanent movement and transformation. (7) timeand space changes in the ideas about space and time are central to understanding modernity and its stages, and how they have affected productive processes, individual values and social processes and, therefore the production of new subjectivities, (73) as well as how social power is created and legitimated (10) and the central role of hegemonic science.In 1915, Albert Einstein -in the realm of physics, with the general theory of relativity -produced a change in the spacetime conception.But art tends to anticipate science: the book Alice in Wonderland, published in 1865, (74) or the movie Matrix (75) are some of the examples that offer other visions of space-time.
Scholasticism understands time as the number or measure of movement, according to a before and an after, a condition of temporal beings.For kant, it was a priori a form of pure reason: space and time are categories with which society is organized. (76)or Heidegger, space is almost insignificant, a background in which the temporal is what perishes. (10,77)time has importance as a mystery in which existence takes place, in the process of becoming. (77)arshall Berman understands modernity a way of experiencing time and space, (78) concepts interpreted differently according to the time period, in both private and public life.In modernity both concepts appear, based in common sense, exempt from conflict and ambiguities, subordinately accompanying progress. (78)n the narration of modernity, the future appears as a promise of progress, and the past as what was left behind by progress; the present is irrelevant because it is "fleeting."It is assumed that the future is predictable and in this way it will be possible to control nature and assure progress.this temporal logic is found in planning, ignoring the old chinese proverb that affirms: "the art of prediction is very difficult, especially if it's about the future." For Walter Benjamin, the future is empty and homogenous, and so he formulates the concept of "now-time," which understands the present as the past of the future and as the future of the past, (79,80) assigning a central relevance to the present.We can find similar ideas in Nietzsche who, in his work Thus Spoke Zarathustra, considers the three phases of time from now until eternity as the continuous present. (81)the conceptions of Benjamin contradict the idea of time predominant in Eurocentric rationality, which compresses the present, considered fleeting, and turns it into something almost inexistent, all while expanding the future through a linear representation of time.Boaventura de Sousa Santos recovers from Ernest Bloch the following reflection: if we only live in the present, we do not understand it as ephemeral.p.151) Benjamin's idea of "now-time" reinforces the concept of action that, translated to the territory, breaks with the hypothesis of an external solution, putting in play social forces to face problems. (79,80)Given the question of when, modernity answers the future, but for Benjamin the answer is the present, with the idea of "now-time" constructing a conceptual bridge for action.this process demands a subject capable of formulating questions that lead to action, which we understand as an interaction that is not necessarily rational nor composed of elements of reason, desire and culture in uncertain combinations.Working in the present tense as the time of action does not mean denying the importance of the past nor of the future, which we reference through the questions of why, to encounter meanings in the past, and for what purpose, to find meanings in the future, (82) without understanding the future to be predictable but rather accepting the projection of desire.
Santos highlights two central procedures in his Epistemologies of the South, a work in which he identifies the influence of Benjamin's idea of "now-time."In this way he defines the present as an incomplete past and the future as an unfulfilled present at the moment of not being fulfilled, proposing a double task for the present: as an incomplete past or an unfulfilled present.
Benjamin, Bloch and Santos assign centrality to present, given that actions take place in the present and not the future. (10)antos proposes inverting the dominant logic and postulates expanding the present and reducing the future to create a space-time that makes room for the infinite social experiences in existence, in a translation process that does not sacrifice identities. (10)In this sense, Catoriadis understands that "time is nothing or it is creation." (83)antos takes from Bloch the concept of "not yet" (10) as an alternative to the binary thought of all/nothing which expresses the static.The concept of "not yet," which is not the "all" or "nothing" of the static dimensions of western thought, does not have meaning or direction and, therefore, can end in hope or disaster. (10)he dominant conception of time leads us to signal the tension between urgent measures and civilizational changes.(10) Sergio Arouca, referential figure of the Brazilian sanitary reform, affirmed that the reform was a civilizational project and not a technical-managerial one, as the values needed were those of human civilization.(84) the idea of time should not be confused with the urgent, where no one can stop to think, where the pace accelerates, blinds and drags everything along with it: the urgent displaces the important.That "craziness" that deprives the subject of freedom leaves as its consequence anxiety, depression and stress.Paul Virilio sustains that speed rules and destroys everything and, in that destruction, generates oblivion, so that the view of space comes into crisis, threatened by time.(85,86) It is this urgency and the illusion of the future that leads one to plan what is never done and to do what was never planned. ther is more oblivion than memory given that the objective is to define the future, that very future that the sacred texts of Judaism forbid exploring as property of the messiahs.today everything happens very quickly, there is no time to think, just to do -unreflexively -and for this all cartesian subjects demand tools, searching for an instrumental solution, incapable of rethinking themselves, forgetting the systematic failures of instrumental action in the social field.
In a totally modern society, the tragedy of modernization -including its tragic hero -naturally arrives at its end.p.62) Objectives and processes the idea of objectives is central to planning and brings with it a notion of linearity, causality and certainty, appropriate for simple problems but not for complex ones.For the latter the notion of processes is necessary, which in general involve different actors, objectives and interests in a becoming marked by uncertainty, reason, desire, culture, conflicts and chance.The idea of processes is more pertinent for the territory than that of objectives, given that the latter, as a normative formulation, requires for its fulfillment a high concentration of power and/or cultural hegemony, and even so presents degrees of uncertainty.The idea of objectives -the dominion of the static -is closer to western culture, while the notion of processes -the dominion of the dynamic -is closer to eastern culture.
Process does not have as an end nonfulfillment, but rather is oriented at realization, without ignoring the diachronic condition of the social game. (87,88)In the territory, the diagnosis is of little use given that the photo is never the movie, so we must allow ourselves to play.The "ought to be" of normative planning ignores the game and celebrates the diagnosis, and therefore should not be taken as the starting point but as the point of arrival, which will initiate -most certainly -other processes, marked by uncertainty, with the exception of simple problems, upon which technical knowledge often has a stronger impact.But those are not the problems that dominate the social game within the territory.
After his experience with normative planning, Mario Testa reflects on the CENDES/OPS method and affirms "we assigned a value of 0 to a variable which could never have a value of 0." And what was that variable?Power, and therefore conflict.Years later, in Montes claros, state of Minas Gerais, Brazil -cradle of the process that would culminate in the Brazilian Sanitary Reform -while Mario Testa was carrying out health consulting work along with Mario Hamilton, a doctor said to him: "it's not about fixing norms but rather triggering processes."Years after that, testa completed the phrase by asking himself why should processes be triggered?His answer was "to create new social actors."Faced with yet another why, he affirmed: "to install new items of discussion in the State agenda."these notions are central to his thought and reflect his self-criticism regarding his time as a planner. (12,89,90,91)or the homo academicus, the idea of thinking in terms of processes, and not objectives, represents a strong epistemological obstacle, as his history of socialization structured the idea of meeting objectives and this is the basis of his worldview (plane of transcendence).Although if we ask him to reflect, he will recognize that, in general, he meets very few of the objectives he sets.And if we ask him to analyze retrospectively his work and life history, and consider whether his achievements were part of a logic of objectives or of processes, he will discover a reality never contemplated that structures him, in which the majority of his achievements are part of processes related to desire, more than reason (plane of immanence) and that the majority of his unfinished works are related to objectives. the idea of becoming and the role of desire in actions are far from being contemplated by the cartesian subject, although they are central to the subject's practices.guattari associates the idea of becoming with what Ilva Prigogine called "dissipative processes," which break with the traditional idea of linearity and equilibrium. (87,88)

Potency and chaos
In modernity, the works of Baruch Spinoza and Friedrich Nietzsche were pioneering in their treatment of the concept of potentia or personal potency (20,92) which was not -nor is it currently -part of the paradigms of "normal" science, (93) even though the subjects who live in the territory express in their relationships not only power but potency and chaos.
the idea of potentia is found in Aristotle in relation to the idea of actus, to the point that the concepts of potency and possibility are used interchangeably.only on the basis of action can potency be understood.the relationship potency-action is understood as the passage from less developed entities to those more developed, which expresses the dynamicity of the relationship. (36)p.2863) the act precedes potency, which is a capacity to be enacted.Nietzche discusses potency as the will to power in an act of freedom and overcoming.For Nietzsche, all wanting is a wanting to be more. (20)For Deleuze, subjects are potencies in both actions and passions, and are not defined by essences, nor by the judgement of the wise, as is the proposal of natural law. (9)he territory does not always represent an established game, it often expresses chaos, unpredictability, which is not synonymous with disorder.chaos was not the object of science, that with its deterministic and linear conception of phenomena banished chaos to preserve "order and progress," key phrase of positivism.only with the development of chaos theory and the theory of complex systems, understood as dynamic systems sensitive to changes in their initial conditions, was chaos elevated to scientific status.chaos expresses how small variations in initial conditions can imply large differences in future behavior, which makes prediction impossible.these concepts are the antithesis of planning, which seeks to predict the future.
Health workers recognize chaos as part of the territory but cannot understand it given that their epistemic configuration makes doing so impossible because it arrives coded -endowed with meaning -by culture (including science).this coding, expression of the colonial, substitutes experience.p.88)For this reason, each worker will read reality using a "symbolic closure" that operates in that moment, while science and the media carry out an industrialized process of the construction/fabrication of reality. (94)n this line of thinking, programs act like symbolic closures upon the subjects' perceptions of reality, and draw them away from the ideas of potency and chaos with which they coexist in the social game.Deleuze highlights that the book, as a mirror of the world, expresses the triumph of scholastics. (9)this demonstrates the exportation of ideology from the center to the periphery and the need to become conscious of the meaning of the ideology that was and is received by the peoples of the global south from the central systems of power. (95)ason and desire: programs and cartographies Deleuze and guattari develop the idea of territory along with the concepts of deterritorialization and reterritorialization. (9) For them, the territory is not just the space of lived experience by also a perceived system, in which processes of agency coexist that can break with coded or overcoded logics, spaces and structures that do nothing but create worries and deformations instead of furthering desire machines. (87,88)Desire, in their texts, goes beyond the place that Freud assigned to it, the limits of the family as the private sphere; to the contrary, they consider it an immanent beginning, thus the notion of desiring production, in the sense that desire is what causes and incessantly enacts the overlapping of continuous flows and partial objects (fragmentary and fragmented). (9,87,88,96)he territory can only house chaos or provisional harmony, affirm these authors who understand territories as out of our reach, as they are being traced and, for that reason, we are nothing more than a line; we can only map the strategies of desire in the social field and the production of subjectivities that emerge there.(9,87) they understand that the territory is traversed by flows of different intensities and directions.(9,88) In it strata -captures -are configured that imprison intensities or fix singularities, constituting molecules that can come together in molar structures.(9,88) For Deleuze and guattari, individuals and groups are constituted by three types of lines that define and compose them: line of rigid or moral segmentarity that delimits objects, subjects, representations and that, with its systems of reference, corresponds with the organizational plane and therefore marks, delimits and plans; line of supple or molecular segmentarity that corresponds with flows, becomings, transitions, intensities, new compositions that do not exactly coincide with the segment, as it moves forward through thresholds and constitutes becomings.Line of flight or deterritorialization -within which the other lines oscillate -that is segmentary, abstract; it has no prior existence but rather is traced, composed, and it is never clear if it will serve as a line of flight, or what might intercept it.(9,87,88) Axiomatic logic (that of planning and programs), instead of tracing creative lines of flight and processes of deterritorialization, blocks all lines and submit them to a particular system.In this way it is able to stop and crystalize the creation of action as novelty, reducing it to mere repetition.(9,88) Planning represents, in the territory, lines of rigid segmentarity that deny becomings.Nevertheless, these are the lines that define the need for mapping, so as to begin to interpret the social which is produced and reproduced therein.
For Deleuze and guattari, territoriality is a characteristic central to agency, as agency is created in the territory, in a movement of deterritorialization and reterritorialization that is repeated incessantly. (9,88)Agency is the minimum unit, it is not a word, idea or concept, nor is it significant in the territory. (9)It is a broader notion than those of structure, system or form and it has heterogeneous components -of the order of the biological, social, machinic, gnoseological, imaginary, etc. -that put into connection certain multiplicities of belongings among different orders. (9,88)there are very different agencies -map-tracings, rhizome-rootswith varying coefficients of deterritorialization. (9) Agency is essentially libidinal and unconscious, it does not produce goods but rather mixes bodies, in a set of representations that lead to behaviors, to investments, to social, cultural, aesthetic and/or cognitive times and spaces. (9,87,88)attari reveals that, in industrial societies, a series of micronetworks of power and discipline exist that make up an invisibilized and "miniaturized political regimen" that forms part of the common sense of individuals.Everything is political and at the same time everything is macropolitics and micropolitics, this is the way the territory expresses the struggle for -or resistance of -transformation; it is the space of micropolitics in terms of affects and conversations that expresses the multiple and the relational. (96)Micropolitics does not know of "conditions," it is all becoming in the plane of immanence, it is the space of living labor and its relations. (9,65,96)he hegemonic organizational models of the industrial world are antagonistic to the dynamics of the territories, in which arboreal and rhizomatic designs coexist.this allows us to think about workers is the territory as artisans in a "being there," submerged in the world, that -not infrequently -have to think what no one else has thought, immersed in the game of micropolitics, in which the individual and the collective, the conscious and the unconscious, desire and reason, come into play, all elements undeniable from the human point of view as they make up relational processes.these mechanisms are far removed from organizational charts, which come from the Prussian army and are based in the Apostolic roman catholic church and the roman centurions, and as an organizational design represent the arborescent vertical (treeroot), which is hierarchical, with centers of significance and subjectivation, that are given by the place each person occupies.(9) thought is not arborescent and when it becomes so it simply follows traces or copies and winds up not thinking.(9) In the territory other dynamics are produced that oblige us to also think in terms of rhizomes.(9) the capillarity and porousness of the territory allows for the invention of what is possible, while the arborescent marks the institutions and power apparatuses and move in a centered-genealogical logic, of binary relationships that always set a point, an order.(9,88) At the same time, the rhizomatic develops a decentered logic made up of lines, as opposed to the structures that are defined as a set of points and positions, of binary relationships among the points and biunivocal relationships among positions.the rhizome is the combination of a point with any other point, it cannot be reduced to the single or the multiple, it is not made up of units but rather dimensions, it does not have a beginning or an end and it can establish transversal connections without being centered or censored, it has multiple points of entry, exit and lines of flight.(9 p.13) there is a relationship of tension and complementarity between the tree-root and the rhizome, they are not two models that oppose one another, given that one acts as model and transcendental copy, while the other acts as an immanent process that destroys the model and traces a map, even making its own hierarchies.For this reason rhizomatic lines can be recognized in trees, and arborescent points in the rhizome.(9 p.26)In occidental culture arboreal thinking is dominant, which relates to the dominion of the plane of transcendence as a representation of an external reality -which transcends the subject.In oriental culture the plane of immanence predominates, as a psychical phenomenon immanent in the subject, that does not transcend because it is inherent in him and is inseparably united with his essence, although it can be rationally distinguished from his essence.(9) to the contrary, the plane of immanence is the plane of events, of singularities and intensities in constant motion.(9,88) the idea of rhizome allows us to understand other configurations in the territory, as it is not about cultures to vanquish or territories to occupy, but rather working within the diversity of cultures the territory brings with it, that produce and accumulate through forms of tree-root and rhizome, in processes of agency that signal the presence of micropolitics and desire.(9,88,96) the concept of place supports the map without problems; both represent static situations and so can enter into dialogue without conflict.However, for the territory the map is insufficient, it demands to be mapped in real time so as to take into account the dynamics and transformations, the creation of new meanings and new worlds, the lines of flight, the forming of desire, as well as those mechanisms which have become obsolete.cartography becomes theory by tracking the intensities that seek expression to understand the dynamics of the territory, the agencies, the molecular and the molar, the macro y micropolitics, the treeroot and the rhizome, the macro and micro powers, the potencies, etc.In this process of mapping there are no protocols possible as the practice is resolutely mircopolitical and singular.In this light, the only overruling imperative is to intervene, to play, to trigger processes without certainties, faithful to the desire and the risks that are generated, attempting to make actions into a bridge between potency and power.(9,87,88,96) An ecology of knowledge in the territory the concepts developed up to this point conflict with the notion of programs and signal how programs "program" their executers to respond the same way to different problems, in different places and times.the success of programs is turning workers into robots?
Accepting the ecology of knowledge (10) implies a reformulation of the epistemic bases of the dominant knowledge of the universities and of the majority of professionals, independently of their specialty, political ideology, age and gender.
In the logic of planning and in that of territories we can identify interlocking concepts that are not necessarily dichotomous: one of the occidental worldview, formed by the concepts of power, reason, plan, program, objective, technique, justification, organizational chart; and the other alternative, more related to the oriental worldview, made up of the concepts potency, desire, action, becoming, process, culture, foundation, rhizome.
the separation between theory and practice, inherited from scholasticism, differs from the invitation of Santos to think that the western comprehension of the world that constitutes us as epistemic subjects is very limited when faced with the diversity of knowledge and "other worlds" that are invisibilized by the symbolic closure carried out by hegemonic knowledge. (10)For this reason, we must face and overcome the thought that naturalized within us -as epistemic subjectsuniversalism and recognize that we learned a general theory that is unreal, functional to negating the work of translation of the different knowledges found in the territory. (10,34)o break with the inheritance of modern reason and western thought it is necessary to approach other epistemological proposals.In this way Santos highlights the ecology of knowledge and intercultural translation as a thought based in practical experiences, social struggles and fieldwork, trying to avoid "epistemicides," a process that explores beyond scientific knowledge and makes it so that the intercultural translation becomes the procedure that facilitates understanding among the diverse experiences of the territorial.(10) Santos highlights that we live in a time of strong questions and weak answers, given that critique has lost nouns and been left with adjectives.this overabundance of adjectives and annulation of nouns is a clear expression of the "homo academicus" crisis that is transported to society, (97) and expresses that "epistemological conflicts are always, inseparably, political conflicts" (98 p.15) that in our continent, mark a colonial matrix.
Social experience is much more ample than that which is validated by scientific tradition and the occidental philosophic, or even by social science as we know it.Another model of rationality is needed, which Santos calls cosmopolitan reason, in counter position to indolent reason, which is modern reason as we have been describing it. (4,10)Santos justifies his proposal in three sociological procedures: the sociology of absences, the sociology of emergences and the work of translation.In this way he tries to go beyond the western understanding of the world, related to a singular idea of space and time.For this, he proposes expanding the present (sociology of absences), contracting the future (sociology of emergences), and in this way, creating the spatial-temporal situation necessary to recognize and value the experiences of the territories and avoid the waste of singular practices that cannot be interpreted by a general theory, but can be translated without losing their singularity. (10)he sociology of absences proposes amplifying the present, uniting the existing reality with what was extracted by reason and produced a wasting of experiences.It seeks to expand the field of social experiences available and multiply them through the ecology of knowledge.It proposes transforming the absent in present, the impossible into the possible and in this way return to real experiences that are alternative to the hegemonic.This requires substituting the monoculture of knowledge for an ecology of knowledge that liberates social practices from their residual character and permits opening spaces to the possibility of difference, recognizing the multiplicity and diversity of social practices, and recovering the local by deglobalizing it.the sociology of absences is an argumentative knowledge that rather than demonstrating persuades, convinces, it is not rational, it is reasonable.(10) the sociology of emergences proposes expanding the field of possible experiences and in this way contracting the future and substituting the void that is the future with the plural and concrete, utopic and realistic possibilities that are constructed in the present through care activities that act upon possibilities (potentiality) as well as capacities (potency).In this way, the mechanical idea of determination is substituted for the axiological idea of care, which replaces the mechanics of progress and the idea of planning.the subjective element is constituted by anticipatory consciousness and nonconformity, which seeks a more balanced relationship between experiences and expectations, and therefore gives importance to "signs" and "clues," recognizing in them the seeds of what could be decisive in the future.The "not yet" is the way in which the future is inscribed in and expands the present.(10) the translation proposed by Santos (10) is based in the impossibility of a universal theory.translation should allow for communication and reciprocal intelligibility among experiences, without ignoring the alternative in each of them, as well as their non-replicable artisanal components.this translation process includes theories and practices that demand deconstructing the Eurocentric, colonial and neocolonial epistemes that we produce and/or reproduce conscious and/or unconsciously.Doing so requires not only technical labor, but also emotional, political and intellectual labor that raises the questions such as: What should be translated, among whom, when?Who translates and with what objectives?(10) Everyday work in the territory is centrally micropolitics, in which workers participate through living labor in action; they therefore have the potentiality to invent their day-today by making wagers.(65,66) For the technical specificities that the territory requires, teams should have specialized matrix support.(99) In synthesis, compressing the future to amplify the present is what is proposed to allow for more action and less planning, that is, less prediction and more wager-making, which means more action centered in founding and less in justification.All of this requires making the present present, more "now-time," more "not yet" and more processes.

tO cONtiNUe tHiNKiNG
We live in paradoxical times: while on the one hand we are overcome with sentiments of urgency regarding the need to change reality and we demand that something be done now, and on the other hand, there is an almost totally opposite sentiment that the transformations needed are longterm, related to cultural and civilizational dimensions.that is to say that it is not possible to change everything now and it is not sufficient to simply take power; to the contrary, it is necessary to first transform this modern State, whose crisis is the product of neoliberalism.It is about creating or refounding another State without forgetting history, in a process of founding practices in institutions and in the territory, (10,32,50,100) because discrediting programs does not imply discrediting the problems in the territory. (10)erritories are fertile fields for questions.Nevertheless, we repeat the answers both in our practices and our discourses.they say there are two ways to fail, thinking without acting and acting without thinking, and it is not infrequent for both situations to come to pass.Let us stop thinking.Why? (15) can we allow ourselves the exercise of questions so as to think once again?
It is necessary to understand that there is no method or technique with which to intervene in the social game of the territory.this text expresses the effort to escape rationalist models that dominate the ways of working with and thinking about the social, so as to move on to dynamics marked by the game, the becoming and the uncertainty that are inherent to the social.We locate ourselves from this perspective so as to end this work in an open way, without formulas or recipes, and with more questions than when we started writing.We are sure only of the need to once again think about health beyond the biomedical, and in this way encounter the questions that make up that infinite game that constitutes the social as a whole. (101 SAluD colEctIVA.2016;12(2):149-171.doi: 10.18294/sc.2016.976Salud colectiva |creative commons Attribution-Noncommercial 4.0 International | BY -Nc a cartesian subject, which is larger than planning and forms the basis upon which planning rests.

Figure 1 .
Figure 1.The limits of planning: an instrumental or epistemological problem?Source: Own elaboration.