Capão Redondo is one of the poorest, most violent districts in the outskirts of Sao Paulo. For more than a year, a doctor has been needed in that area of “favelas” for the Unidad Basica de Salud Jardim São Bento (Jardim São Bento Basic Health Unit) , but “no one wants the job due to the dangers it entails and that’s the reason why they turn to the Cubans doctors,” according to a report titled “Los doctores del pueblo,” (The People’s Doctors) published by the Spanish newspaper El Pais.
El Pais correspondent Talita Bedinelli, followed surgeon Luciana Defendi Navarrete, a graduate of the Universidad de Montemorelos in Nuevo Leon, Mexico, to the health center. She works in Brazil with the Programa de Salud de la Familia (Family Health Program), a program that provides treatment and health education to low-income families.
According to Bedinelli, the program, which has 1,103 doctors in São Paulo, would need another 200 doctors in order to treat the district’s population. To deal with the deficit, the Brazilian government created the initiative Programa Mas Medicos (More Doctors Program), that offers jobs to foreign doctors. The majority come from Cuba, thanks to an agreement between both countries that allows the Cuban authorities to keep part of the salary of the participating doctor. According to the article, the deal generated much controversy in Brazil and the first group of Cuban doctors was greeted at the airport by angry Brazilin doctors yelling “slaves.”
OVERWORKED
What are the working conditions for Cuban doctors? (Benedelli says the situation in São Paulo is the same in other poor areas of Brazil). In the Jardim São Bento health center, each of the nine teams that comprise the Family Health Program cares for 3,500 to 4,000 people, an extremely high number, according to Cuban-naturalized Spaniard Barbara Mena, who has been with the program for 2 weeks.
Mena , who was part of the Cuban group that helped Brazil organize its own Family Health Program in 1996, says health teams in Cuba care for only 1,000 people.
EVERYDAY THERE IS SCREAMING
Along with being overworked, there’s a lack of resources and the patient despair sometimes turns into hostility:
“At 7am, the center opens, but activities start earlier. All the chairs in the waiting room quickly fill up. There are two long lines: one, for the people that need blood or urine tests and have no appointment; the other, for emergency dental care. In both cases, the only people that can be seen are the ones that arrive before 8:00. After that, only people with appointments are seen. Getting care as a walking-in can take time.”
“Minutes later, a woman that is running late arrives yelling, outraged. Neither the employees nor the patients look at her, accustomed to this type of scenes. Later, at the reception desk, there’s another incident in which a sick woman finds out that she’ll have to wait 2 months to receive treatment.”
Surgeon Navarrete summarizes her experience: “Everyday there is yelling, insults. ‘That garbage is useless,’ is the patient’s favorite phrase.”
“They don’t understand it’s not our fault. We would need, at least, two more employees, “ she said. In the meantime, for the past 3 years, she has been dealing with a list of daily frustrations. “There’s a lack of everything (…) we don’t have paper to chart a patient’s progress. And prescriptions? How do you write a prescription for a patient if you don’t have a prescription pad?”
DRUG LORDS FIRST
According to Bedineli, the health professionals are escorted to their home visits because the streets are dominated by drug trafficking and their relationship with the drug dealers is a delicate one.
On one hand, they know that criminals believe the health unit is important for the people. However, they also realize it’s necessary to treat the drug lords and their families differently. “Their women are treated immediately, they never get an appointment, says a patient, while two doctors shake their heads in agreement.
“Unfortunately, there is a parallel power. The criminals’ women arrive with an arrogant attitude; they know no one messes with them. Who is going to confront them? Violence is also a health issue,” explains Thiago de Castro Menezes, 31, an administrator with the health unit.
FOR A FEW MORE DOLLARS
At least the doctors from other countries are well paid for the work conditions they encounter. But Cuban doctors, even though they earn more than on the island, receive less money than their counterparts from other nations.
In an article about an interview with Cuba’s Health Minister, Roberto Morales Ojeda, the Folha de São Paulo newspaper published the following:
“While the participants of the Mas Medicos program from other countries receive a monthly salary of 10,000 reales (4,400 dollars) and can bring family members to Brazil, Cubans cannot bring theirs and earn receive only 800 to 900 reales a month (about 300 dollars). The rest of the salary is divided between the employees’ family on the island and the Cuban government, which keeps the larger share.”
El Pais correspondent Talita Bedinelli, followed surgeon Luciana Defendi Navarrete, a graduate of the Universidad de Montemorelos in Nuevo Leon, Mexico, to the health center. She works in Brazil with the Programa de Salud de la Familia (Family Health Program), a program that provides treatment and health education to low-income families.
According to Bedinelli, the program, which has 1,103 doctors in São Paulo, would need another 200 doctors in order to treat the district’s population. To deal with the deficit, the Brazilian government created the initiative Programa Mas Medicos (More Doctors Program), that offers jobs to foreign doctors. The majority come from Cuba, thanks to an agreement between both countries that allows the Cuban authorities to keep part of the salary of the participating doctor. According to the article, the deal generated much controversy in Brazil and the first group of Cuban doctors was greeted at the airport by angry Brazilin doctors yelling “slaves.”
OVERWORKED
What are the working conditions for Cuban doctors? (Benedelli says the situation in São Paulo is the same in other poor areas of Brazil). In the Jardim São Bento health center, each of the nine teams that comprise the Family Health Program cares for 3,500 to 4,000 people, an extremely high number, according to Cuban-naturalized Spaniard Barbara Mena, who has been with the program for 2 weeks.
Mena , who was part of the Cuban group that helped Brazil organize its own Family Health Program in 1996, says health teams in Cuba care for only 1,000 people.
EVERYDAY THERE IS SCREAMING
Along with being overworked, there’s a lack of resources and the patient despair sometimes turns into hostility:
“At 7am, the center opens, but activities start earlier. All the chairs in the waiting room quickly fill up. There are two long lines: one, for the people that need blood or urine tests and have no appointment; the other, for emergency dental care. In both cases, the only people that can be seen are the ones that arrive before 8:00. After that, only people with appointments are seen. Getting care as a walking-in can take time.”
“Minutes later, a woman that is running late arrives yelling, outraged. Neither the employees nor the patients look at her, accustomed to this type of scenes. Later, at the reception desk, there’s another incident in which a sick woman finds out that she’ll have to wait 2 months to receive treatment.”
Surgeon Navarrete summarizes her experience: “Everyday there is yelling, insults. ‘That garbage is useless,’ is the patient’s favorite phrase.”
“They don’t understand it’s not our fault. We would need, at least, two more employees, “ she said. In the meantime, for the past 3 years, she has been dealing with a list of daily frustrations. “There’s a lack of everything (…) we don’t have paper to chart a patient’s progress. And prescriptions? How do you write a prescription for a patient if you don’t have a prescription pad?”
DRUG LORDS FIRST
According to Bedineli, the health professionals are escorted to their home visits because the streets are dominated by drug trafficking and their relationship with the drug dealers is a delicate one.
On one hand, they know that criminals believe the health unit is important for the people. However, they also realize it’s necessary to treat the drug lords and their families differently. “Their women are treated immediately, they never get an appointment, says a patient, while two doctors shake their heads in agreement.
“Unfortunately, there is a parallel power. The criminals’ women arrive with an arrogant attitude; they know no one messes with them. Who is going to confront them? Violence is also a health issue,” explains Thiago de Castro Menezes, 31, an administrator with the health unit.
FOR A FEW MORE DOLLARS
At least the doctors from other countries are well paid for the work conditions they encounter. But Cuban doctors, even though they earn more than on the island, receive less money than their counterparts from other nations.
In an article about an interview with Cuba’s Health Minister, Roberto Morales Ojeda, the Folha de São Paulo newspaper published the following:
“While the participants of the Mas Medicos program from other countries receive a monthly salary of 10,000 reales (4,400 dollars) and can bring family members to Brazil, Cubans cannot bring theirs and earn receive only 800 to 900 reales a month (about 300 dollars). The rest of the salary is divided between the employees’ family on the island and the Cuban government, which keeps the larger share.”