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Partner Profile Santa Marcelina Hospital
Historical Background Brazil is a large country of 8.5 million square kilometers, 180 million inhabitants, five geographic regions and 26 states. Of its 5,561 cities, 588 have their boundary limits with Latin America countries, and 66 specifically share borders with Mercosul countries. This geographic situation has inflated the gross bulk population needing medical assistance, and strained Brazil’s already limited health care resources. Brazil was “discovered” by the Portuguese in the year 1500. The country gained its independence in 1822, but became a democratic republic only in 1889. Under Portugal’s domination Brazil was an exploited colony, its economy built on one of the world’s largest slave markets. Extensive sugar cane plantations during the 17th and 18th centuries, mining exploration (gold and precious stones) and, later, coffee plantations in the 19th century led to the Portuguese making huge sums of money — most of which, however, ended up in British coffers to pay off Portugal’s debt to England. All of these enterprises depended upon, and profited from, a mass of slave laborers (Indians and Africans) — a population with no access to education. Even after the abolition of slavery in 1888, this population was neglected by oligarchy policies, such that they remained social outcasts. Today, the Brazilian government is confronting this cultural deficit in the hope of finding a solution to the inequities still borne by this massive population of poor people. This situation, understandably, has placed a great demand on public assistance resources. The Institution Hospital Santa Marcelina was founded in 1961 by the religious philanthropic organization “The Santa Marcelina Sisters,” and operates with some financial assistance from the government of the state of São Paulo. At the time of the hospital’s founding, the district it served, in the eastern part of São Paulo city, had a population of 60,000 inhabitants. Forty years later, the same region has four million inhabitants, most of them of low socio-economic status. Always struggling, because of the lack of resources, and burdened by a mushrooming population, the hospital has survived in the face of escalating public health problems. Not only has it maintained its high quality of health care, but the institution has gained another building, allowing it to expand public access. Meanwhile, both the School of Nursing and the medical residency program (241 specialties) have also been expanded. Santa Marcelina has become recognized as one of the country’s most important institutions in the education of health professionals.
Today Santa Marcelina Hospital is a referral center in Brazil for all medical specialties. The hospital has embraced the scientific approach to medicine thanks to a competent management, an expert medical faculty and state-of-the-art technology for treatment and diagnosis. Its radiotherapy program is one of the most comprehensive in the country; the hospital performs bone marrow and kidney transplants and is planning to introduce heart, liver and cornea transplants. The hospital also provides a valuable resource in the field of neurosurgery; recognized by the Brazilian Neurosurgery Society, its highly trained staff performs an average of 800 operations per year. Unfortunately, under the Brazilian national health insurance plan, which pays hospitals a monthly fee per patient, regardless of the medical care provided, the poor population cannot benefit from state-of-the-art medicine in all specialties. Poor children and adolescents with cancer, however, are able to receive state-of-the-art treatment, thanks to TUCCA (Associação para Crianças com Câncer), a not-for-profit association run by Dr. Sidnei Epelman.
TUCCA provides the necessary funds for equipment, drugs, etc. through private support. Dr. Epelman has devised one particularly successful fund-raising initiative. Invoking “Rouanet Law,” the Brazilian tax incentive designed to promote art and culture throughout the country, TUCCA organizes classical music concerts for adults and children, with the support of corporate sponsorships. Companies that contribute to premier health care resources while enjoying significant tax benefits include Fundação Elijass, Novartis, Itau BBA, Valeo, Credit Suisse/First Boston, Multibank DTVM, Fotóptica, Bradesco, Sadia, Vivara and CBA.
Santa Marcelina Hospital has both a clinical oncology and a pediatric oncology department, both of which participate in the training of residents, fellows and medical students. Its cancer registry is linked to the Cancer Registry of the state of São Paulo. An outpatient clinic for pediatric oncology is currently under construction. As INCTR Brasil’s partner institution, Santa Marcelina Hospital participates in INCTR studies in childhood cancer. Since 2002, Dr. Epelman has played a leading role in a national media campaign to educate the public about retinoblastoma. Throughout the year, he gives radio, television and newspaper interviews to explain the importance of early diagnosis. Additionally, a 30-second film that teaches parents the easiest way to identify ocular tumors is widely shown. “Through this campaign we can save the life and also the sight of a child,” Epelman says. “In 2004, we launched the campaign internationally by offering the film to various Embassies in Brazil (it is now available in seven languages: Brazilian Portuguese, continental Portuguese, English, French, Spanish, Hindu, Chinese and Arabic)”. Cancer in Brazil Cancer is the fourth leading cause of death in Brazil. In 2005, it is estimated that there will be 467,000 new cases. The most common cancers in Brazil are:
Contributed by Sidnei Epelman, President of INCTR Brasil.
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Copyright © 2008 The International Network For Cancer Treatment and Research