Abstract
IntroductionBrazil and South Africa share many sociodemographic and health features that provide many learning opportunities. Brazil’s national health system, the Sistema Único de Saúde (SUS) prioritises primary health care since 1994, the year democracy came to South Africa. Two family physicians from these countries met in Rocinha favela in Rio de Janeiro, a densely populated area where poverty, danger, drugs, tuberculosis and mental illness are the focus of the health system.Maria do Socorro Family ClinicCentral to the SUS are the Family Health Teams, consisting of community health workers, nurses, doctors and allied health workers. This clinic in Rocinha has 11 teams, caring for 2700 people each, all visited monthly, preventing illness and promoting health. Patients with mental illness are cared for in a therapeutic residency, with an onsite psychiatrist, psychologist and social worker. The relationships between the health carers and the clinic and the community are collegial and equal, sharing care. Larger than life photos of patients from the community line the walls.TrainingA culture of learning is evident, with 18 family medicine residents, student nurses, a small library and a learning centre at the clinic. Local authorities compensate trainees in family medicine more than traditional specialties.ConclusionBrazil has made massive progress in providing universal health coverage over the last 20 years. South Africa, with not too dissimilar challenges, is embarking on this road more recently. The lessons learnt at clinic and community level in this inner-city clinic could be very useful for similar settings in South Africa and other countries.
Highlights
Brazil and South Africa share many sociodemographic and health features that provide many learning opportunities
Following the 21st World Conference of Family Doctors held in November 2016 in Rio de Janeiro, the authors, fellow family physicians on either side of the Atlantic Ocean, reconnected
Since the introduction of the SUS, prioritising primary health care (PHC), the country has consistently shown an improvement in the major health indices, with life expectancy at birth being 74 years and child deaths under 5 years of age standing at 14 per 1000 live births in 2013.1,2 The comparable indicators for South Africa were life expectancy at birth of 60 years and child deaths under 5 years of age standing at 45 per 1000 live births in 2012.6 http://www.phcfm.org
Summary
South Africa and Brazil share many sociodemographic and health features that provide many learning opportunities. Following the 21st World Conference of Family Doctors held in November 2016 in Rio de Janeiro, the authors, fellow family physicians on either side of the Atlantic Ocean, reconnected. Dr Goldraich is the descendent of German–Polish immigrants during the Second World War. Dr Goldraich is the descendent of German–Polish immigrants during the Second World War He lives with his wife, a family doctor and mother of their 11⁄2-year-old daughter, in the city of Rio de Janeiro. He has worked as a clinician and family physician supervisor for the last six years in Rocinha, the largest favela in Rio city, and invited his South African counterpart (first author) to visit the clinic where he works. With a reminder that not all clinics in Brazil look alike, the work happening at this clinic that opened nearly seven years ago is remarkable and needs to be shared with a wider audience (Figure 1)
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