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Sam Hagan, Observations on the Brazil Protests, Part Two

Thu, October 3, 2013

Part II: Mais Médicos

Editor’s note: Government and Portuguese/Liberal Arts Honors student Sam Hagan is studying abroad in Brazil through the fall semester.  While abroad, he will write a series of articles documenting his observations of the protests and political climate in Brazil. This article is the second in the series.  Previous articles can be read in the News section of the LAH website.

Over a month after the first protest on Avenida Paulista, the slow mechanisms of change continue at their constant imperceptible pace. The size and number of manifestações have decreased, and although it seems as though the movement has lost its luster and appeal, brasileiros continue to debate over the social and economic problems that Brazil faces. While public debate continues, President Dilma Rousseff, the Workers Party, and the rest of the Brazilian government attempt to respond to the protesters' demands with action. Of the issues and controversies raised by the protestors, the public healthcare system of Brazil falls in the crosshairs.

"In Brazil, they have a saying," says Vitor Goulard Nery, law student at Pontifiça Umiversidade Católica de São Paulo; "Brazil is not a poor country, it is an unjust country." At the public hospitals and clinics in Brazil, all Brazilian citizens receive medical care paid for by their government. That being said, having the government pay for healthcare sadly does not mean the people receive the care they need, when they need it.

Throughout Brazil, people are not able to receive medical care from the government hospitals due to limited access, a dearth of resources for even simple surgeries or hospitals that can provide them, and, in areas where they do not suffer from the first two conditions, a congested healthcare system. People have waited days on treatments for common ailments, and for those living in the interior or outside of metropolitan areas like Rio de Janeiro or São Paulo, people drive in bus loads to the nearest major hospital in order to receive medical care.

Because of this, there are some who do receive adequate healthcare. However, it is not always because they are in more urgent need. For Brazilians, it is commonly known that having connections inside the SUS (Sistema Unidade de Saude or Unified Health System) will get someone better healthcare and service than others.

Responding days after the first protests in June, President Dilma has made the failing state of public health a goal for her administration with "Mais Médicos." The objective of this program is to increase the number of doctors in areas of Brazil where they are needed most, primarily in the interior. The program provides good incentives for doctors that take part, paying them a handsome salary of 20,000 reais a month and covering all costs related to relocating to their assigned area. The program primarily seeks to employ Brazilian doctors, but foreign doctors are also recruited for the program.

Despite the best efforts of Dilma's administration to make the program palatable to the public, "Mais Médicos" has drawn considerable criticism. Doctors, or med students in particular, have been to the streets due to the part of the proposed legislation that requires medical students to spend two years in residence with an SUS hospital before being allowed to graduate, increasing the duration of medical school from 6 years to 8. Under pressure from more protests, politicians have stated that they will reconsider this portion of the legislation.

As a public service relevant to the lives of all Brazilian citizens, the SUS maligned both patients wanting to receive care and doctors who are frustrated with a system that does not provide them with resources or sufficient working conditions in hospitals outside of heavily populated cities or states. "We don't need more doctors, we need better working conditions," Luiz Garbin, business student at Fundação Getulio Vargas, explains, "because there are some places that doctors do not want to practice because they don't have the resources, the crew, or the working conditions." Based on where the problems in public healthcare lay in Brazil, congested hospitals, favoritism, lack of doctors, resources, and access, President Dilma's "Mais Médicos" seems to only focus on a singular aspect. However important it may be to increase the number of doctors in poorly served regions (some of which have below the 1.8 doctors per thousand national average of Brazil according to the World Health Organization), these do not appear to be actions taken by a government focused on long term improvements.

For those who participated and continue to be active in politic movements in Brazil, a sluggish, half-measure response by the government is all but expected. "The problem with how things work in Brazil in general," says Vitor, "is that in the system, you think that you are either better than others, or worse than others."


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