BW of Brazil: The question of health and access to health care are two indicators of the quality of life for any given society. These questions become more complicated when dealing with demographics and the possibility of unequal treatment of citizens according to categories such as race, age and gender. Health and health care as it pertains to the black Brazilian population and the need for specific policies for this population that has been historically discriminated against and excluded in many realms of Brazilian society has been a consistent focus on the BW of Brazil blog. The stories below, one from the northeast region of the country, the other from the southeast, are just a few more examples of why this is so important.
Blacks badly treated in hospitals
Farmer Joacir da Silva Santos, 30, is black. He works on a sugar cane in Alagoinha, in the agreste (1) region of the state. On November 26, 2012, he was cutting cane when the knife slipped and almost cut off one of his toes. He was treated first at a health post in Pesqueira, also in the agreste, and transferred to the Getúlio Vargas Hospital two days later. “The social assistance I received here was very precarious. No one can even called an ambulance for me to go back home,” he lamented. To improve care for these people, the Secretaria Estadual de Saúde (Secretary of State of Health or SES) conducted a study that will serve as basis for the implementation of public policies aimed at hospitals that serve the black population.
The data were revealed through an epidemiological profile of the population of Pernambuco, with a profile dedicated to blacks. Conducted by SES, the data include racism, prejudice, intolerance and discrimination within the public hospitals in the state; facts that favor social inequalities. “The study is as a mapping of points that are sensitive in the state’s public health in order to improve customer service and reduce social and historical inequalities,” said the state coordinator for Atenção à Saúde da População Negra (Health Care of the Black Population), Miranete Arruda. At the end of each year, she said, there will be a comparative balance sheet to see if the actions are having an effect.
According to the survey conducted by SES, blacks represent 74% of the users of the hospitals under the Sistema Único de Saúde (Sistema Único de Saúde or Unified Health System). There were 442,000 against 146,000 whites hospitalized between 2008 and 2010. According to SES, homicides, suicides and accidents are among the leading causes of death of blacks in the state. Circulatory diseases and cancer are also part of the list.
Josefa dos Santos, 81, is preparing to amputate her right foot. Her first appointment was set at the UPA de Paulista in the Greater Recife area. From there she was sent to the Getúlio Vargas Hospital. She spent Tuesday to Wednesday night in the hallway. Josefa is being accompanied by her son, the cook José Barbosa, 39. “I don’t know if her color was an influence. But, because she is elderly, I thought that she would receive more appropriate treatment than sleeping on a stretcher in the middle of the hallway of the hospital,” complained José Barbosa.
Data from the Ministry of Health indicate that black women are treated differently. In childbirth, for example, while 47% of white women were accompanied by their husbands or a family member, only 27% of black women had the same rights respected. In addition, they have difficulty in accessing prenatal consultations, anesthesia and postpartum care.
62% of the population of Pernambuco is negro (black) and pardo (brown)
74% of users of public hospitals in Pernambuco are black
24.6% are white
69.7% of blacks were treated because of violence in public emergency services in Brazil, in 2010
26.2% of whites were seen in the same period
The maternal mortality rate of black women is seven times higher than in white women
The epidemiological profile of people from Pernambuco based the on the category race/color was conducted to identify social inequalities in order to combat racial prejudice
São João de Meriti in state of Rio de Janeiro implements technical committee for the treatment of the black population
35 years ago, getting treatment for sickle cell anemia, a hereditary disease that victimizes mostly black people, an accounts clerk, Cristiano Soares da Cruz, 38, needed to go four times a week from Praça da Bandeira, in São João de Meriti to the Pedro Ernesto University Hospital in Vila Isabel. That’s because he didn’t find any unit in the city that offers treatment for the disease.
Cristiano’s routine could begin to change. The city will be the first of the Baixada region to have a Technical Committee on Health of the Black Population. The action is part of the Pro-Health National Mobilization of the Black Population, which have been part of debates and strategic actions across the country.
“Here they only treat me in the Emergency Room and when the crisis is not strong. I have been to several hospitals in the Baixada, but they always refer me to Rio,” says Cristiano. (Note: The city of São João de Meriti is about 15 miles or 24 kilometers from the city of Rio de Janeiro)
According to the superintendent of the Promotion of Racial Equality of Meriti (Suppir Meriti) Williann Lyra, the committee will monitor health services.
“In the city, the sickle cell program is geared towards children. One of the roles of the committee will be to determine the prevalence of the disease, investigate the number of people who are treated outside the municipality and suggest the expansion of the program here to Department of Health.
Besides suggesting programs and disseminating those that already exist, the committee will ensure the self-declaration in health care services, identify the health needs of the black population and use them as criteria for planning, and conducting training and education of health workers. Although the municipality is the first to participate in the Baixada region to participate in the national mobilization, the member of the executive committee of the National Network of Social Control and Health of the Black Population – that promotes initiative in the country – Joseph Marmo, shows understanding in relation to the other cities in the region.
“The national policy of the black population is very new. When São João sets the example, I believe that other cities will follow. I’m optimistic.”
1. Scrub region in the Brazilian northeast between the coastal rain forest and the arid interior
2. The Sistema Único de Saúde or Unified Health System is Brazil’s publicly funded health care system. SUS was created after the Brazilian Constitution of 1988, which assured that health care is a “right of all and an obligation of the State”. See a discussion on health care and racism in the medical industry here.