Telemedicine in Brazilian favelas: The medicine of social isolation transforming public health

This article was exclusively written for The European Sting by Ms.Fernanda Clara da Silva, a student of the fourth period of Medicine of Universidade do Estado do Rio Grande do Norte-UERN. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Modern advances in systems technology have caused a revolution in the world and impacted on all areas of knowledge, including medicine. As a result of this progress, telemedicine has gained a prominent role with the proposal of guaranteeing medical services and care even from a distance and in places of difficult access, expanding the reach of information and communication with patients. However, what no one expected is that during this cautious debate about technological development and whether telemedicine would be really useful, the world would be hit by a pandemic due to the new coronavirus (COVID-19), making all health perspectives rethought. Starting from a global social isolation that demands new measures, telemedicine is now seen as a fundamental tool to face the contemporary shock in universal health systems.

With this, investigating the Brazilian context, the Unified Health System (SUS) is a network that guarantees a wide coverage that offers basic and complex services in a multidisciplinary way in health, with free national and universal quality. However, although SUS represents an advance in public health in the country, the poorest population does not always have this access guaranteed because of social inequalities. Thus, be it due to the lack of services close to the housing of this most needy population and the difficulty of access to transportation and also due to the overcrowding of the units, long waits for care or lack of professionals, this population is marginalized in the coverage of SUS. Furthermore, with the new pandemic caused by Sars-CoV-2, this system has been seriously shaken, further increasing the impacts on the poorest population.

Now, with the advent of regulated telemedicine in the country, some initiatives have emerged, such as the Non-Governmental Organization (NGO) SAS Brasil, which conducts free basic medical consultations and guidance for residents of favelas in different cities in Brazil. With these services, it was possible to see that they were useful not only to maintain isolation and reduce the spread of coronavirus, but also to bring quality medical care to communities with low access and who previously had no contact to health. In this way, consultations of various specialties such as pediatrics and geriatrics and even psychological therapy are being carried out and showing a very positive benefit for residents in favela, that are better oriented now.

However, it is noteworthy that even with the benefits, this new service model needs a better evaluation of effectiveness, in addition to considering access to digital media that is not always satisfactory in the poorest population. But, in any case, it is clear that the effects on primary health care in these communities are transformative and necessary, showing that sometimes, even far away and in social isolation, the doctor can make all the difference in a patient’s life, promoting universalization, equity and integrality, the guiding principles of SUS.

References

MALDONADO, J.M.S.V.; MARQUES, A.B.; CRUZ, A. Telemedicine: challenges to dissemination in Brazil. Cad. Saúde Pública [online]. 2016, vol.32, suppl.2 [cited 2020-07-23], e00155615. Available from: <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2016001402005&lng=en&nrm=iso&gt;. Access on 22. Jul. 2020.

PENTEADO, M.R.; SILVA, R.M. Telemedicina, pandemia e desigualdade. Jornal da Universidade de São Paulo (USP). Available from: <https://jornal.usp.br/artigos/telemedicina-pandemia-e-desigualdade/> . Access on 22. Jul. 2020.

Sistema Único de Saúde (SUS): estrutura, princípios e como funciona. Ministério da Saúde, Brasil. Available from: <http://www.saude.gov.br/sistema-unico-de-saude&gt;. Access on 23. Jul. 2020.

Telemedicina em favelas facilita atendimento a moradores durante pandemia. UOL, São Paulo. Available from: <https://noticias.uol.com.br/saude/ultimas-noticias/redacao/2020/07/20/ong-cria-servico-de-telemedicina-em-favelas-durante-a-pandemia.htm>. Access on 23. Jul. 2020.

About the author

Fernanda Clara da Silva is a student of the fourth period of Medicine of
Universidade do Estado do Rio Grande do Norte-UERN. Vice president of the
academic league of pathophysiology of clinical emergencies. Coordinator of the Elderly Health Incentive Group extension project. Local Secretary General (LSG) of the IFMSA Brazil-UERN. Participant of the Collective Health Study Group. She believes in a world with medical students capable of transforming public health.