Brazil is a great country, but what if something goes wrong and you end up in a (public) hospital?As fantastic as the rest may be, health care in Brazil hasn’t exactly got the best image in the world.
So far, since I moved here in Jan. 2009, there have been two occasions where I had to be rescued by the bombeiros (firefighters) but unfortunately they took me to a public hospital on both occasions…
So, is it really as bad as they say? As with almost everything on this planet, it all depends on how much you can afford to pay for it. In Brazil, health care is a public service and free of charge, but usually you will get what you pay for, and the picture of the public sector is looking kind of grim…
The public health care sector, especially in the bigger cities is struggling to keep up with demand. Hospitals are unable to cope with the amount of patients. There aren’t enough beds, medicine and medical material and supplies, and not surprisingly, even medical staff, doctors as well as nurses are in insufficient numbers.
This can lead to potentially life threatening situations, where people have to wait for hours, sometimes even days to get the treatment they need. The lack of space and beds leads to people being treated in hallways, in questionable hygienic conditions, on stretchers and, in some cases, even on a mattress on the ground, and with no privacy whatsoever.
Another evil arising from the dire situation, is the large number of fake, unlicensed doctors, who even perform surgeries and in some cases have been responsible for people dying.
My own experiences with Brazilian hospitals are related to two accidents I had in 2010 (yup… 2010 was not my best year :))
The first time was when I took a dive with my mountain bike at 80km/h and hit the asphalt hard. I was rescued by the local bombeiros (firefighters) and taken to the local public hospital of Soccorro-SP, where I was staying with my family at that time.
I have seen the inside of a few hospitals in Belgium, so I have some reference to compare with the ones here, and immediately, the look and feel of the place was very different. It’s kind of hard to describe, kinda like the inside of a federal office building… kind of “gray”.
I was wheeled to the X-ray room where they took pictures from my neck, chest, foot and shoulder, and I remember it took like forever for someone to come back with the results. All the time I was lying on the hard metal table of the X-ray machine.
At one moment, I started to shake uncontrollably (hypothermia/ shock). Probably because I was in a air conditioned room, still wearing my wet (sweat) mountain bike clothes and there was no blanket. I also wasn’t allowed to drink any water (I guess that was part of the protocol, but man I was so THIRSTY!!!).
After the x-rays came back, it took another two hours before a doctor was available to examine them and decide what to do.
During those two hours I was waiting for the doctor, a nurse cleaned the many abrasions I had all over my right side (arms, shoulder, leg, hip). She actually did a very nice job. I also got a few stitches in my head.
After that, I was moved into a room and placed in a bed. the first thing I noticed is that the mattress was VERY thin, which was not very comfortable, especially when you’re all broken.
After what seemed like another eternity, yet another doctor (than the one who examined the X-rays) came to confirm that I had a broken heel, three broken ribs and my collarbone was in three pieces… I would need surgery on my foot, but not on my collarbone… He told me that someone would come to put a cast on my foot and fixate my collarbone and he left. All this time, I didn’t get any painkillers or anything… Swell.
I didn’t get any food either that evening. They told me I couldn’t have any food before the doctor said I could, and by the time the doctor said I could, the kitchen was closed, sorry…
The only thing they gave me to eat, was two crackers and a cup of tea. I had just done 75km of mountain biking that afternoon and could eat a horse at that point, but there was no way I could get more food.
I spent almost the entire night wide awake. There was another patient in the room and he snored so loud that I would have been kept awake by that if I would have been able to sleep at all in the first place with all the pain I had.
the next morning there was breakfast: Crackers and tea… Yay… Around 10 am another doctor (he said he was a doctor but didn’t look like one) walked in and told me that I would need surgery on my collarbone, but my foot would be fine… So he told me the exact opposite from what the first guy had told me… How’s that for confusing?
I decided to get the hell out of there and had to sign a declaration (waiver) to be released, since they were planning on keeping me there in observation at least another night. Back in Volta Redonda, I went to see a private doctor and this guy told me that I wouldn’t need any surgery… Both fractures healed, but I cannot say I’m happy with the result.
My second time in a Brazilian hospital was in December 2010. Due to insufficient signalization and one second of distraction, I crashed my motorcycle into a van that was parked in the left lane of one of the busiest highways in Rio de Janeiro State.
According to the regulations, the signalization of road works on that highway should have been at least 1,5 km and there should have been at least one guy with a flag, but instead they had only 15 meters of cones. Of course, after I almost died, they put up the extra signalization…
Ok, so I was rescued by the bombeiros, again, and taken to the nearest hospital, which was in Itaguaí. This hospital had the same look and feel as the one in Soccorro, and the emergency room was kind of packed. Lying on my stretcher, I could see many people sitting on chairs or lying on the floor, waiting for treatment.
Same procedure… X-rays of head, neck shoulder, pelvis… wait a century for the results…
After a while the doctor (I guess it was the doctor, because he wasn’t really dressed like one) came back and told me that I had an “open book” fracture. (Never heard of that one I must say) and a broken shoulder and on a smaller note, one broken rib.
Then the most painful part was about to start... the doctor said that they were going to perform a “reduction” of the fracture. Let me explain to you how they did this:
- take two strong guys and put them on either side of the bed
- tie a sheet (not necessarily clean) around the patient’s pelvis
- warn the patient that he can yell, scream, curse or shout in whatever language ha wants, but that this is going to hurt big time but they will do it anyway.
- Tell the two strong guys to each take one end of the sheet and to pull as hard as they can…
- Ouch… That hurt!!
They took me for a new set of x-rays and then send me to a room, where again I was put in a bed that was so uncomfortable that I wasn’t able to find any position where I didn’t feel a lot of pain. At least this time they were giving me painkillers but these didn’t really help a lot…
The emergency doctor (I still don’t believe he was a real one) came to the room, showed me the second x-ray and said: “thank God man, it’s all fixed… Look! it’s closed again (yeah, right… tie me up in a sheet and then tell me it’s all fixed?)… In three days you’re going to walk out of here… graças a deus”. Well, that gave me some piece of mind
The first night in Itaguaí was a complete nightmare. I spent about 2 hours to turn myself on my side, trying to find a position where I had the least pain. Ironically that position was on my left side, lying on my broken shoulder…I had no pillow and when I asked for one, they gave me a folded blanket, which I ended up putting under my lower back to release some of the pressure there.
I found out the hard way, that if you need something luxurious, like a pillow, your family needs bring it to you, but since I was 150 km from home, that wasn’t very likely to happen.
The next day, the chief orthopedist came in and gave me some bad news… I had a serious fracture (Mortality rate: 55% – glup), and I would need urgent surgery, only, this hospital didn’t have the means to do this kind of operation and I would have to be transferred to a better one. I asked him how he would go about that, and his answer was very simple: “Me? I’m just telling you that you need surgery… you need to find a hospital and arrange your transfer”.
So there you are, all broken, unable to move, let alone get out of bed and you need to start looking for a better hospital and arrange your transfer. If I would be there all by myself I would be screwed big time, but I was lucky that I could call Fernanda (my wife) and she was the one who had to go through all the administrative mumbo jumbo to get me to a good hospital in Volta Redonda.
First they had to find a surgeon who would be able to operate… depending on the surgeon, I would be taken to a certain hospital. Once the surgeon found, it was time for the money talk. To even get admitted to the hospital, I had to deposit 10.000BRL (about 6500 Usd) into their account. This is an illegal practice, but who cares.
Then I had to deposit another 6.200 BRL in another account for the surgeon and the anesthesiologist. After that, Fernanda had to come to Itaguaí with a document that had to be filled out by my doctor to request me being transferred. This whole procedure took about 3 days, and on December 23rd, I took a ride home in an ambulance and on December 24th I was operated on.
The situation in the private hospital was day and night… I had a suite for myself with TV and an extra bed for someone to stay during the night. The staff was polite and very professional and the food was great. After the 3 days in the public hospital in Itaguaí, this was almost like being in heaven (ok… I’ve never been there, but they say it’s pretty good up there).
Here’s a few pictures of what they did to me:
If you have a medical issue in Brazil, try not to end up in a public hospital. Although I had the feeling that the staff was doing the best they could, the material used is usually old and in bad condition, and the risk of medical errors and malpractice (that is kind of the same thing, right?) or catching some kind of hospital infection is a lot higher.
I’ve seen stories in the Brazilian media that boggle the mind. A man’s wife disappeared after checking into a hospital for a regular procedure. 3 days later, a friend of his, who works in that hospital, finds the woman in the morgue. The woman had died during the medical procedure and nobody had informed her husband.
A newborn baby girl, that needed brain surgery, came out of the operating room with burns all over one of her legs. Afterwards, the leg was amputated, but the girl died a few weeks later.
In Brasilia, the capital of Brazil, more than 100 brand new ambulances are unused because nobody seems to be taking care of the procedure to get a license-plate on the vehicles.
A guy who broke his upper leg was taken to a hospital in Niterói and waited there in a hallway for 8 days without being diagnosed, let alone receiving any treatment. Without any consent from the family, he was then transferred to a hospital in Paraiba do sul, 125 km from where he lives. His family doesn’t have the financial means to go there and visit him.
In another article on-line, I read that the X-ray room in the hospital in Itaguaí (yes the one I stayed in) burned down in February 2011
These are just a few examples of the precarious situation of some hospitals in Brazil. The situation is usually a lot worse in the more populated areas. Smaller cities have much better medical facilities (if you’re not too badly hurt that is). On another motorcycle trip, I drove through a barbed wire that was stretched over the road and almost cut my throat, and went to a “posto de saúde” in Itamonte, and there I was received very friendly and efficiently.
Did you ever experience a hospital nightmare? Leave a comment and let me know