Monday, May 9, 2011

Day 21


Just to catch everyone up to speed, we are in our final city of Fortaleza, Ceara, Brazil. We caught a very early flight on Sunday to the capital of the state of Ceara, called Fortaleza. We spend Sunday with our host families doing low key activities and family time for of the occasion of Mother`s Day.

Back to 'work' today! This morning, we met one of the Brazilians heading on exchange to Canada next month. Carlos was our guide for the day. We began with some change in plans. Originally, we were suppose to visit some government facilities but that fact that three of our four team members were wearing shorts prevented us from participating. Strangely, jeans are a very acceptable dress code for everything, including work. We explained to our host that jeans are rarely every worn to work in Canada. Potato, potato.

We did have an opportunity to visit a political history museum. We learned about the changing political environment here in Brazil and the basics of their governance. No matter what country of the world you are in, someone wants to run it.

We then had the opportunity to meet with The Federacao das Industrias do Estado do Ceara. In English, a branch of the state federation of industries. Eduardo de Castro Bezerra Neto and Paulo Studart Filho spent time with us discussing international trade agreements and how their state and federal federations of industry try to increase trade with other countries. We learned about the main exports (shoes, fruit) and imports (wheat) to and from the state of Ceara. In this ever changing economic climate, growth is heavily sought. Of particular interest of our hosts was developing trade with Canada, as it experiences the least exchange compared to the USA or Mexico. Any interested persons should contact Keith for more information, as my business savvy ends with three bananas for a mango.

After a delicious lunch at the Coco Bambu (big thanks to Carlos for helping with the menu selection), we headed to a public hospital for a tour. Now, I must thank my team members for the patience while I asked a million questions about healthcare. We had a tour at a public hospital. Very interesting and surprisingly similar and different than Canada. I won't rehash my thoughts on dual system health care. Our tour host is a radiologist at Fernades Tavora Hospital in Fortaleza. I am slightly embarrassed as his name is escaping me and that is unfortunate as he was wonderfully patient and provided a wealth of information.

At any rate, we had the opportunity to see the imaging department. The hospital has two portable Xray machines, two standard Xray machines, one CT scanner and three ultrasound machines. The bed capacity of the hospital is 175. All examinations are preformed by specialist. Completely different than in Canada. Most people have had some exposure to the healthcare system at home. In Canada, exams such as CT, MRI, US and Xray are preformed by very skilled technicians and sonographers and then the reports are interpreted by radiologist. We explained how our system differs and the concept of cost effectiveness. Is one better than the other? Too hard to say. In Winnipeg, the current wait time for a non-emergent MRI is 6 months. The idea of a wait time was foreign in Brazil. Again, potato, potato.

We also toured the adult ICU and Dialysis units. I had the opportunity to discuss the healthcare challenges that Canadian's experience. It is interesting to note the similarities (hypertension, diabetes, cancer) and the vast differences (equipment, tiers, cost). One area that I noted a particular difference in is the idea of preventative care. In Canada, we spend roughly 5% of healthcare dollars on preventative medicine. That includes screens like mammograms, colonscopy, pap tests, routine bloodwork, immunizations, education. We talked about the importance of this type of medicine, the two physicians agreed that this is an area lacking in Brazil. People do not often screen for issues before they are problems. I often use the analogy of pulling people out of a river downstream but never going upstream to see why they are falling in. Why not prevent a problem instead of trying to fix one that exists?

In short, I really enjoyed the opportunity to discuss healthcare. Gaining an understanding, however small, of what healthcare means to people in other parts of the world only stand to improve my ability to provide care... plus, I love to talk so bonus!

Jennifer

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