The challenges of the universalization of the health system in Brazil. What can we change?

This article was exclusively written for The European Sting by Ms. Carina de Oliveira Gregório and Ms. Gessica Kathelen Coelho dos Santos. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

---

In Brazil, health is offered through the Unified Health System (SUS), which has as one of the doctrinal principles universality, which aims to offer health services to all, without distinction or restrictions, offering all necessary attention and at no cost. However, the country faces difficulties in meeting its high population demand. In addition, to receiving continuously many immigrants, mainly from other countries in Latin America. This population group, for the most part, lives in unhealthy conditions that lead to more diseases, such as Tuberculosis, which affects, for example, many Bolivians living in clusters on the outskirts of the city. This process, in turn, has a direct impact on the primary care that is faced by patients from another culture and language, which damages the doctor-patient relationship. In this context, primary care should be the first sector to be restored to accommodate these new patients. At this level of attention, the role of community agents is fundamental, since they, through home visits, will direct the health unit to the homes that need more care and also link patients to the health unit. In addition, the presence of at least one professional who dominates the main languages, such as Spanish and English, is essential in basic health units, as well as waiting rooms that clarify the native population the importance of respecting and helping immigrants. This, in turn, in addition to improving the reception, creates ties between the community, which promotes greater adhesion of immigrants to basic health units. However, health professionals should receive training on how to follow up on consultation with foreigners, even without knowing the language. Another point that should be adopted is the use of pamphlets, posters or any other type of media used in order to promote prevention measures, be translated into the main languages, and the use of figures that are self-explanatory. In this way, there will be a greater effectiveness of the communication between the units of health and the immigrants. One of the greatest obstacles is found in tertiary care, in which it concentrates the largest public expenditure, so it is necessary to act on the relations of bilateral agreements between Brazil and the countries of origin of this population group, in order that so many Brazilians living abroad may have the health of the country in which they live. So these should be the first steps to take. In addition, in the long run it should be governed by a larger law, which guarantees resident immigrants the same rights as Brazilians. About the authors Ms. Carina de Oliveira Gregório is an academic doctor at the Christus University Center (Unichristus) since 2017. Member of the IFMSA Bazil since 2017. Member of the SCORP since 2018. Ms. Gessica Kathelen Coelho dos Santos, is an academic doctor of the Christus University Center (Unichristus) since 2017. Member of the IFMSA Brazil since 2017. Member of the SCORP. LPR-D IFMSA Brazil Unichristus 2018-2019.