A Multifaceted Hospital

Being a hospital that provides free service, I’m not sure what I expected as to the quality of care that Barretos Cancer Hospital could provide. I definitely didn’t expect the quality to be as astounding as I’ve witnessed following the doctors around here. I’ll try to keep my summary of the hospital’s many branches brief, but I do want to give you a little picture of life around Barretos.

Cancer Prevention Department

This is where Patricia and I have set up shop.   The facility is large, with hordes of patients coming in to get pap smears, mammograms, in-patient skin cancer surgeries, and many other cancer-prevention related procedures.  They even have two oncogeneticists, who screen underage cancer patients for genetic links and call patient families to get screened if a genetic link is found. 

However, what’s most impressive is the mobile unit program. The Barretos Cancer hospital has the largest fleet of mobile units in the world, at 16 mobile vans. These vans are sent all around Brazil to go to cities and screen patients for cancer. These mobile units will sometimes be gone for 2 months at a time, screening for cancer. Patients who are diagnosed with preventable cancers are then referred back to the main cancer hospital where they are provided with free housing and lodging. It’s really pretty amazing, and the mobile unit program is still expanding. The hospital is actually vertically integrated, with its own mobile unit factory. That allows the hospital to make mobile units at a lower cost than buying them from an outside source, refurbish old mobile units for equipment upgrades or repurpose them for a different area or specialty, and even make and sell mobile units to finance the hospital’s budget. The mobile unit program is actually one of the more exciting aspects of our internship as Patricia and I expect to be traveling on them for a week or longer during our stay here!

Palliative Care Center

The palliative care center is based in the center of the city. When we visited, I expected something quite sad, as there are so many deaths that take place there. I was surprised to see quite the opposite. The staff at the palliative care center are among the happiest staff I’ve seen here, and they have managed to maintain a really positive environment. The palliative care center has many features modeled after European hospice care. Patients are in beautiful rooms with a patio and natural light and they’re offered music therapy. Children in the waiting area interact with a trained psychologist. It’s a really advanced care center, and Patricia and I will be visiting it for more extended time this coming week to do some needs finding.

The Pediatric Hospital

Doctors at the pediatric hospital set their standard for quality at that of St. Jude’s. They showed us survival curves for patients at the hospital up until 2011, saying that their results at that time were high among Brazilian comparables but low against world standards. That being said, they’re aiming high, and they believe that their 5 year update in 2016 will have a much better comparison on a world quality scale.

The Medical School

We also visited the medical school, which had a pretty neat simulation center with actors that helped the medical students learn to interview patients and simulation models that would help medical students practice when it was hard to use a real person.  We actually saw the medical students in gross anatomy, dissecting a cadaver, and my eyes started burning from the chemicals in the air. It was really neat though, seeing medical school students in Brazil learn in what I expect is similar to medical education in the United States. In the past few days I’ve met Tarik, a medical student going into his 3rd of 6 years of medical school here in Brazil, and I’ve also met Tendai, a medical student going into her 2nd year at UNC, here on a research trip that is the same duration of our internship. Talking to both, I’m getting a pretty amazing glimpse at my own future in medical school and how medical education differs (or doesn’t) in countries around the world.

IRCAD

Finally, they have a high tech medical education center – IRCAD – where they hold conferences attended by physicians around the world to teach medical techniques. The hospital has robotic surgery, to give one example of the technology standard they are able to sustain.

The Bar Is High

From my first week here in Barretos, this much is clear: they set the bar high. From a management perspective and a medical care perspective, everything about how this hospital is run is intended to constantly improve, be the very best they can offer. It seems as though every physician here is involved in some kind of clinical research, and many nurses as well, and Dr. Mauad, the director of the hospital mentioned that he and the director of the medical school regularly attend conferences in the USA and Europe to get further ideas for improving their facility. I guess Patricia and I are evidence of the relationship that they are building with Rice University, one among many initiatives intended to improve the hospital’s healthcare offerings and connect the healthcare here with healthcare initiatives around the world.