So, Guillaume has had a painful rash on his neck and has been trying to see a dermatologist. He went to the University Hospital and the secretary said that the dermatologist comes só no sábado até uma hora (only on Saturdays up to 1PM). OK, that's chill. We went back on saturday and when we asked about the possibility of seeing the dermatologist she laughed, saying that there are only 23 spots available and they were gone already just after the dermatologist arrived at 7 AM. OK...
A few days later, we had to go to the Medicina do Viajante (Travel Doctor) to organise for our trip to Amazonas, so we decided to go to the public hospital Clinicas just afterwards. We spent the whole day in the hospital for five minutinhos with a dermatologist. (I have come to understand that when Brazilians tell you you will need to wait '[X] minutinhos' or in 'little minutes', it is more likely a sign that you will be waiting a long time, i.e. in 'big minutes' -- BUT! In this case, they really were 'minutinhos'.)
Can I endure the mental pain to be incurred by recounting the process of seeing a doctor in the Brazilian Public System at Hospital das Clinicas in São Paulo? Let's try:
You walk past the sign 'AMBULATORIOS' (Walk-ins) into a kind-of-outdoor-but-undercover waiting area, where you line up to get your senha (piece of paper with a number). You wait in the plastic seats (for about an hour only, if you are lucky) for your number to appear on a screen, so that you may go into a room for someone to see what your problem is and to get another little piece of paper (after, of course, waiting half an hour in the little room) and then you walk to another part of the hospital where, in our case, the dermatology section is (meanwhile, confused by the earlier nurse's statement that "não se preocupe, vai ser atendido hoje!" [don't worry, you will get to see a doctor today!] - What does she mean? Is there ever any doubt of not being attended to on the same day that you enter the clinic? Hoje? There are still eleven hours left in this day..). There, you wait in another long line to get your little paper 'checked' (this is questionable: Guillaume was marked as 'SEXO: F' on his paper) and another senha, to have the privilege of sitting (again, if you are lucky) with fifty other people out in a long line in the corridor. You wait there for three, four hours, and just as you are falling into your 1000th 30-second-nap for the day, a lady calls out your name to announce the good news: you have permission to leave the corridor and go into the fila da parede (line at the wall) in another room. Then you play musical chairs for one more hour until you reach the end of the fila da parede and can see the doctor. Meanwhile, you die. "How To Kill One Day In Brazil". It is now dinnertime.
However, I must admit - I did owe Guillaume - and quite specifically, at that - a day at the hospital. More on that in another blog, hah.
OK, that was one of my few visits to public hospitals here in Brazil.
After that visit I came home exhausted and perturbed: I realised that I had never seen any sign in Brazil ever indicating a general practice. Does everyone here just go to the hospital every single time they have a small ailment? I have seen plenty of signs for dentist offices but never for doctors. Despite my friends protests, I have concluded that general practitioners in Brazil must work in secret, dark, hidden places, or do not even exist; and I will not believe otherwise unless I actually see a doctor's office here (I'm not hopeful about the chances of this).
That evening I also figured out something which has been puzzling me for some time since I arrived: the lack of (normally) integral parts on public toilets here. It is not uncommon to see the flush button on the toilet a simple screw. Did they not finish building it?, you think to yourself the first one, two, three, four times... but you never end up inquiring about this, because, generally, trips to the toilet are not memorable conversational material; it remains a mystery. Next: Where are the toilet seats? This appears even more vital to the toilet than the flush button! Normally, I use the squat-method myself, so no problems, but there come times when this is not a viable option, i.e. perhaps when you are IN THE HOSPITAL and too weak to hold up your own body weight...
Rafael said: Oh, é por causa de vandalismo! It's because of vandalism!
Like it was so obvious....
Heheh, it is so funny seeing people facing the Public Health system for the first time in all its glorious chaos. :) To clarify a few things:
ResponderExcluir- When the nurse said, "don't worry, it will be today" she meant it as a reassurance, because, yes it is common for people to go there and not get attended on the same day. Lack of doctor's, lack of space in the hospital and other ailments of a country that despite all the money that has, still have some place where it behaves like a poor third world country. Brazilian's SUS is wonderful on paper, but due to corruption, lack of funding and people being jerks it doesn't work;
- Yes, those who do not have private insurance (which works ridiculous better compared to the US for example) usually goes to the hospital for anything. There is, theoretically again, a three tiered system, where people would first see a general practitioner on a UBS (Basic Health Unit) and only in some cases be transferred to a Regional Hospital and only then, if the case is critical, to a Central Hospital like Clínicas. All that complains you had about line here, line there, you were luck, because you were in one of the 3 best Public Hospitals in the country, it could have been much worst.
- As I told you on Facebook, one of the reasons you don't see much advertisement for private doctors is that most do so through the health plans. It is rare, specially in São Paulo were land is at a premium, to see doctor houses around (and don't forget the Cidade Limpa law, which prohibits a bunch of type of ads in the city). Most will either join together in a Clinic or they will hire a room on a building and that's where you would have to look for. For example, if you go to Paraíso, close to the Hospital do Coração, there is a bunch of commercial buildings there, if you go inside you will see lots of doctors with offices, and their names\specialties on the wall.
- About the buildings, yeah, Rafael is right, vandalism is the normal answer. People do not understand here that the public assets are theirs to care, there is no widespread sense of community, so they simply don't care and destroy. Couple that with the lack of funding (due to corruption, money laundering, etc) and people destroy things that do not get fixed.
Just for you to understand our timing system;
ResponderExcluir"minutinhos" doing something cool = very little minutes, very, very "inhos."
"Minutinhos" doing something awful = eternity, a millenium, death row waiting.
I only go to the hospital if I'm on a very bad situation, otherwise I can take by my own rs.
But you know, if our government could only invest in our health and education system rather than in a world cup, I would be much, much happier... ¬¬'