A Discussion with Cleide Maria Vieira, Resident, Recife, Pernambuco, Brazil

With: Cleide Maria Vieira Berkley Center Profile

June 23, 2014

Background: As part of the Education and Social Justice Project, undergraduate student Adam Barton interviewed Cleide Maria Vieira and her family. Vieira lives in the Engenho do Meio neighborhood of Recife, Pernambuco with her four children, five nephews, brother, sister-in-law, and parents. In this interview, Ms. Vieira reflects on her experience with Pastoral da Criança and healthcare in Brazil.
Can you tell me a little bit about you and your family?

My name is Maria Vieira Cleide, and I am a native of Recife. I worked for a long time as a baker in a cake factory, but have since become unemployed. There are 12 children in total, but right now we just have my four kids and five from my brother, who lives here with us along with his wife and my parents. My oldest child is 11, and my youngest is one.  

Can you tell me a bit about the health care system in your community? 

The healthcare system in my community is poor, very substandard. We have a clinic, but we might as well not even have it at all. There is a shortage of medicine, there is no doctor; we need one, if only to pass along a prescription to buy necessary medication, but we do not have one. We try to go to the emergency room to get seen, but the emergency room sends us right back to the clinic. 

My mother had to be taken to the emergency room last Thursday, saying that she was dying, and this is what they told us: “If she is not dead, we are not going to see her.” She began to cry, as she was in desperate need of care, and we had to take her to the emergency room across the city in order to get her seen. 

Health is in a precarious position here; all the way from the clinics to the hospitals, it is horrible. 
 
Tell me about your experience as a pregnant woman in your community. 

Back two years ago, we were attended to well. Pastoral helped a lot in that regard. I began with Pastoral around the time I got pregnant with my second child, and the leader who followed me was there for every little thing, giving me cards to show where I was in my pregnancy and what I could expect. It was great; I had all the monitoring, all of the structure I needed, and was able to get prenatal care at the hospital.

Could you tell me more about what services are working well in your community and what is still needed?

As of now, nothing is working in my community. Every part of the system is failing: the pharmacy is missing medication, it is impossible to make appointments in the clinics because there are no secretaries to answer your calls, physicians come here and leave running after less than 15 days. Doctors are horrified by the community and the care that we receive, but no one sticks around to fix it. 
 
We are certainly lacking dentists, gynecologists, pediatricians, and the like. But, much more urgently, we need general practitioners who are able to care for our basic needs. I have been waiting years to make an appointment for a general checkup for myself, but there are simply no doctors. 

How did your family come to know Pastoral da Criança?

We were actually the first family in this community to inaugurate Pastoral, and in that way we are incredibly privileged. 

How it happened was all very sudden. The leaders came to visit our community and arrived at that house there across the street. The family there is evangelical and did not want Pastoral services, so they sent them across the street to “the house with lots of kids.” When the leaders arrived, they saw this whole gang here and wanted to register them all. It was a very sudden thing, but it changed our lives.  

And what did the leaders say that convinced you to join Pastoral? 

They did not have to say much. They just came in and talked about Pastoral, which was just beginning here, and about how they would monitor the children’s weight and development, that they would be there for us at every step of the way if we had any doubts about health or education or childcare. The leaders said “Let’s go!” and we followed.

We are always in church, listening to the word of God and being comforted. But sometimes we look around at what is going on in the day-to-day and become saddened. Pastoral is there to evangelize, to be that word in the outside world and to comfort those in need. 

What does it mean to be followed by Pastoral?

Being followed by Pastoral is like being followed by a doctor, a friend, a counselor, and a person of God all at once. The leaders bring comfort and experience to our lives—they are indispensable companions. They are very important for the day-to-day, for the soul, and for our health. We are always happier when Pastoral is nearby.

They are so important to me; I do not even know what to say. 
 
Can you tell me a bit about the differences between services offered by the government and those offered by Pastoral, and why you chose to be followed by Pastoral in that context?

The only advantage of those governmental programs is money, because there is no functional structure behind them. There is no education or aid. They just throw some money at you and tell you to take care of yourself. 

Pastoral, in contrast, supports us in everything; they dedicate themselves to us and, at the end of the day, make us better people. They are there to monitor, to talk, to counsel. They do not impose anything on you religiously, but instead teach you to listen, reflect, and pass on the blessings that you have. Pastoral offers structure and support to the family, not just services. 
 
What are the most useful services offered by Pastoral for you and your family? 

They give us everything that we would not receive if we were to go to the clinic. It is like have a doctor in your home—not to just throw medications at you, but rather to come, get to know your situation, ask how you are and what is going on in your family. They weigh our children, check up on our vaccines, and visit us to ask how our mothers and children are, if they have been sick and how they have been treated at the clinic. 
 
Everything that Pastoral does is done well, and done with love and dedication. 
 
Can you tell me about your experience learning from Pastoral leaders? What was their teaching like, and how did it work for you? 

So, for my first child, I was not followed by Pastoral, and all my knowledge came from the clinic. Because I received no education on how to breastfeed or anything else, I ended up with badly damaged breasts—to the point that I would cry in pain whenever my son tried to nurse.    

With my second pregnancy, however, I had all the support of Pastoral behind me. They gave a detailed handout that I still have today, and sat me down to explain the stages of pregnancy in a way that I could understand. After that, they came with more and more educational materials to explain everything from nursing to burping to how to use leftovers; they would sit me down every month and advised me, answered any questions I had. This monitoring and training was something that I could not get anywhere else, and it made all the difference in my pregnancy. 
 
Are there any other health organizations serving your community?

We have those community health agents that pass by sometimes, but they just do so for us to sign a document so that she can collect her salary, nothing more. We have sewer water passing through the gutters in front of our houses, making our children sick; we have a health clinic that is on the verge of closing…and no one does anything. 

Like I said, we are being failed here. Here, we are a forgotten people. 

Is there anything else that you would like to share with me?
        
Back in the day, when we were allowed to go directly to the hospital, things were better. It took forever, but we did get seen, and we would leave with a diagnosis. But now they invented UPAs [unidades de pronto atendimento, emergency care units], and we cannot help but feel that it was to exterminate the communities—to kill people. 
  
Two of my neighbors have already died by going through UPA—one had a cardiac arrest and died as she waited 20 minutes to be seen, and the other died 15 days after surgery from an unattended cardiac arrest. At UPA, they do not see you, they diagnose you incorrectly, they give you the wrong injection.    

It is this type of thing that I see every day, and I ask myself how it is that we keep hearing that healthcare in Brazil is improving—improving for whom?    
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