I’ve been in Barretos for about 6 days now, and I’m starting to get comfortable. I’ve become familiar with the faces and names of my mentors. I’ve learned where to get water and where to go for lunch, and I’ve become comfortable with the short 5 minute walk to and from the hospital from my apartment. I’m just cozy enough to start giving my first impressions of the hospital.
The People
The staff at the hospital is among the most kind-hearted group of people you will ever meet. The hospital’s motto is “O Hospital do amor” – the hospital of love, and the staff we’ve met here have so far embodied that message completely. They love what they’re doing and the patients love them for it. I see little acts of kindness everywhere I look. Just the other day, for example, walking through the full waiting room of the cancer prevention department, we saw the staff organizing a game of bingo where patients could win prizes as they waited to be seen by the physicians. On Friday, an orchestra came to the hospital waiting room and performed for roughly an hour for waiting patients and staff. There are small coordinated activities to improve the quality of life for patients, and they’re really pretty impressive.
These past few days have been a flurry of activity as we’ve been introduced to people around the entire hospital, from the hospital director, Dr. Edmundo Mauad, to Dr. Carlos, a skin cancer prevention doctor, to Naitelle, a nurse who works on clinical research in cancer prevention and many, many others. The staff at the hospital have taken us in wholeheartedly. Honestly, going to a foreign country for 2 months is daunting, but it’s hard to have any doubts with the kind support of these wonderful people.
The Hospital Setup
The hospital itself is set up in an awe-inspiring way. The hospital is funded 25% by the Brazilian government and 75% from private donations, and it provides all of its care to patients completely free of cost. I pushed the doctors here on this, and they went even further, explaining that while some facilities might offer free care (Brazil does have a universal healthcare system, although I don’t completely understand the details of how it operates), Barretos knows that it’s still hard for some patients to come to the hospital when they can’t pay for food and lodging. The hospital actually pays for food and lodging as well while patients are at the hospital to make sure patients get the care they need and are not afraid to travel from afar to receive treatment. It’s pretty amazing.
I asked how the hospital could possibly get enough in donations to fund the work being done here (as I’ll explain in a later post, this is a world-class hospital as far as technology and quality of care goes, and world-class healthcare is expensive), and it seems that there’s a huge culture here of taking care of the hospital. The city is built around the hospital, which provides the best healthcare in Brazil, and the people of Brazil takes it upon themselves to keep the hospital funded. The city has a rodeo every year, the 2nd largest rodeo in the world (2nd to Houston’s), and the proceeds all go to funding the hospital.
The hospital has also attracted several famous singers (Garth Brooks was mentioned) to have charity concerts, and they auction donated items to raise more money. We were told that large food companies donate food so that the hospital can provide free food to patients, and corporations like GE and Avon have donated a lot of their medical equipment.
Working at a place like this raises so many questions just from its dumbfounding success. How can a hospital of this size possibly be funded like this? Yet it’s impossible to deny that it works. Patients are being treated free of cost before my very eyes, and they have been for years.
Could a model like this be exported to another country? To what degree is it a unique product of Brazilian culture and what kind of changes would be needed to sustain this model in another country? Is this model scalable within Brazil? These questions are complicated, and I’m not sure that I’ll have answers anytime soon, but being here is definitely getting me to ask deeper questions and reminding me why global health is such an interesting area.
The success of the hospital’s free service and the love with which it provides care to its patients is inspiring to anyone interested in global health work, but the medical care and technology as well as the research going on at the hospital is equally impressive. Barretos doesn’t act like a hospital in a developing country, and it’s not hard to be reminded of shadowing I’ve done in hospitals in Austin when I am shadowing doctors here. I’ll be sure to go into more detail on the activities being done here in my next blog.