WEBVTT

00:00:07.607 --> 00:00:09.175
A lot of people ask me: \"So Ms.

00:00:09.175 --> 00:00:10.710
what you are?\".

00:00:11.277 --> 00:00:13.613
\"Oh, I\'m a family and community doctor,

00:00:13.613 --> 00:00:14.547
with great pride.\"

00:00:15.448 --> 00:00:17.784
And then they frown and say:

00:00:17.784 --> 00:00:20.053
\"Family doctor? What is this?\"

00:00:22.155 --> 00:00:23.656
\"What are you an expert at?\"

00:00:23.757 --> 00:00:25.191
\"I\'m an expert on people.\"

00:00:25.692 --> 00:00:27.894
I am an expert in the territory I work in.

00:00:30.163 --> 00:00:33.433
See some local realities

00:00:34.200 --> 00:00:36.536
it hits me as a person.

00:00:38.471 --> 00:00:40.106
I went for a home visit

00:00:40.774 --> 00:00:41.808
and the house

00:00:41.808 --> 00:00:43.877
didn\'t have a wall.

00:00:43.877 --> 00:00:46.046
I asked, \"Where is the bathroom?\".

00:00:46.913 --> 00:00:48.715
Then he said: \"No, there
is no bathroom here\".

00:00:48.715 --> 00:00:50.150
I said: \"But what do you
mean there\'s no bathroom?\".

00:00:50.650 --> 00:00:54.954
My population lives 100%
of the Health Unic System.

00:00:55.121 --> 00:00:56.856
It is the most inclusive,

00:00:57.357 --> 00:00:58.558
democratic

00:00:59.192 --> 00:01:02.295
and successful system that
our country ever had.

00:01:29.589 --> 00:01:30.757
It\'s in the Constitution

00:01:30.757 --> 00:01:34.027
Health is everyone\'s right
and a duty of the State.

00:01:34.027 --> 00:01:36.463
One can even complain
that not all Brazilians

00:01:36.463 --> 00:01:37.964
can be taken care of,

00:01:37.964 --> 00:01:41.167
but the law guarantees universality.

00:01:47.140 --> 00:01:50.743
At the age of 3, I already told my parents

00:01:50.743 --> 00:01:52.412
that I wanted to be a doctor.

00:01:53.012 --> 00:01:56.082
And I grew up with this
desire, with this vocation

00:01:56.282 --> 00:01:57.417
inside of me.

00:02:08.161 --> 00:02:08.962
Good Morning!

00:02:16.469 --> 00:02:18.338
During my training as a doctor,

00:02:18.338 --> 00:02:20.540
at university, I met a

00:02:20.540 --> 00:02:24.077
doctor specialist in family medicine.

00:02:24.410 --> 00:02:26.379
she saw in me

00:02:26.613 --> 00:02:28.982
a gift of being MFC,

00:02:28.982 --> 00:02:31.985
a vocation to be a family
and community doctor,

00:02:32.385 --> 00:02:34.087
which, until then, I had not seen.

00:02:47.200 --> 00:02:49.169
You be empathetic, charitable,

00:02:49.202 --> 00:02:52.705
to recognize the need of
a person who suffers,

00:02:52.705 --> 00:02:55.408
without necessarily that
person coming and telling you

00:02:55.408 --> 00:02:56.910
that is suffering.

00:02:56.910 --> 00:03:01.814
This vocation of you
seeing beyond a pathology,

00:03:01.814 --> 00:03:03.783
this goes beyond an emergency board,

00:03:03.917 --> 00:03:06.519
but you will be to follow

00:03:06.519 --> 00:03:10.223
a community, accompany a population.

00:03:42.322 --> 00:03:43.323
when i was little

00:03:43.323 --> 00:03:45.892
my mother used to take us
to a doctor\'s appointment,

00:03:46.192 --> 00:03:48.528
we used to wait in line for a long time

00:03:48.695 --> 00:03:50.463
to get a form

00:03:50.530 --> 00:03:51.798
until dawn.

00:03:52.599 --> 00:03:54.267
And that gave me agony.

00:03:54.267 --> 00:03:56.135
I said: \"Why do we have
to come so early?\".

00:03:56.135 --> 00:03:57.704
We woke up very early.

00:03:57.804 --> 00:03:59.906
And we went to the slums,

00:03:59.939 --> 00:04:02.976
to the communities visiting the people,

00:04:02.976 --> 00:04:04.544
take basic food basket,

00:04:04.744 --> 00:04:06.846
see what those people needed.

00:04:07.647 --> 00:04:10.316
-Good morning people!
-Good Morning!

00:04:10.883 --> 00:04:12.518
I saw a lot of sick people,

00:04:13.353 --> 00:04:15.255
and they couldn\'t get a doctor,

00:04:15.255 --> 00:04:17.523
couldn\'t take the exam
couldn\'t get medicine

00:04:17.523 --> 00:04:18.658
they couldn\'t handle it.

00:04:18.958 --> 00:04:20.460
I talked to my mother like this:

00:04:20.460 --> 00:04:22.428
\"I\'m going to study,
I\'m going to be a doctor

00:04:22.428 --> 00:04:25.131
and I will work in these communities,

00:04:25.131 --> 00:04:26.866
I want to be a doctor for these people\".

00:04:33.206 --> 00:04:35.775
I did a residency in
gynecology and obstetrics,

00:04:35.775 --> 00:04:37.744
in Belo Horizonte for three years.

00:04:37.810 --> 00:04:39.679
But I noticed there

00:04:40.880 --> 00:04:44.317
that I couldn\'t just be a
gynecologist and obstetrician,

00:04:44.751 --> 00:04:47.353
because women went there suffering

00:04:47.353 --> 00:04:49.856
because of their husbands\' alcoholism,

00:04:50.256 --> 00:04:52.725
women who had sexual complaints,

00:04:53.092 --> 00:04:55.094
because they were raped,

00:04:55.328 --> 00:04:59.365
women who had their
children who were starving,

00:04:59.365 --> 00:05:02.802
sometimes, because of
the misery, the difficulty.

00:05:03.036 --> 00:05:06.139
And I couldn\'t just be
their gynecologist, right?

00:05:06.773 --> 00:05:08.941
It was much more comprehensive than that.

00:05:09.108 --> 00:05:10.843
These are the patients we have to attend

00:05:10.843 --> 00:05:13.179
this morning. Let\'s go.

00:05:15.782 --> 00:05:18.618
The 1988 Constitution, called \"Citizen\",

00:05:18.985 --> 00:05:21.387
provides for various public
policies, among them,

00:05:21.387 --> 00:05:22.088
the health.

00:05:22.422 --> 00:05:25.858
The Health Unic System starts
to be implemented in 89/90.

00:05:26.859 --> 00:05:28.328
Officially, from 90.

00:05:29.862 --> 00:05:32.398
...college, for the area
of ​​public health policies.

00:05:32.765 --> 00:05:35.535
The project that creates
the Health Unic System

00:05:35.535 --> 00:05:39.038
is inspired by European experiences

00:05:39.038 --> 00:05:41.207
to have a public health policy

00:05:41.207 --> 00:05:42.842
that guarantees universal rights,

00:05:42.842 --> 00:05:44.277
that the service is free

00:05:44.277 --> 00:05:45.912
and that it is integral, that is,

00:05:45.912 --> 00:05:49.015
that has all levels of
service, all types.

00:05:49.682 --> 00:05:51.718
From primary care,

00:05:51.718 --> 00:05:53.786
to intensive care, transplantation.

00:05:53.786 --> 00:05:56.389
Our primary care is family health.

00:06:10.303 --> 00:06:13.072
I have been working with riverine medicine

00:06:13.072 --> 00:06:14.107
for three years.

00:06:14.607 --> 00:06:16.876
As I am a university doctor,

00:06:17.910 --> 00:06:20.246
I have, more or less, eight interns

00:06:21.481 --> 00:06:23.916
accompanying me in my routine.

00:06:28.588 --> 00:06:30.890
The riverine medicine strategy

00:06:30.890 --> 00:06:32.792
within family and community medicine

00:06:32.792 --> 00:06:35.161
has a very peculiar feature,

00:06:35.795 --> 00:06:38.498
which is to deal with
the Amazonian reality,

00:06:38.498 --> 00:06:39.966
intrinsically.

00:06:47.106 --> 00:06:48.508
The Amazon is, in fact,

00:06:48.541 --> 00:06:50.943
dimensionally giant.

00:06:52.044 --> 00:06:57.049
So our area of operation also
gains this proportion.

00:07:00.153 --> 00:07:02.922
With a locomotion issue,

00:07:02.922 --> 00:07:07.226
of housing very typical of the region,

00:07:07.593 --> 00:07:11.464
different from what you
find in an urban area,

00:07:11.531 --> 00:07:13.966
that even though you are
in the North of Brazil,

00:07:13.966 --> 00:07:16.569
it tends to resemble

00:07:16.569 --> 00:07:19.539
with a big city,
with a large metropolis.

00:07:19.672 --> 00:07:21.574
But not the riverside population.

00:07:21.574 --> 00:07:24.143
It completely diverges from that reality.

00:07:26.679 --> 00:07:29.015
In the North region, mainly in Para,

00:07:29.015 --> 00:07:30.917
we joke that it has two seasons:

00:07:31.217 --> 00:07:32.618
the winter and the summer.

00:07:32.885 --> 00:07:35.788
In winter, it rains all day.

00:07:36.456 --> 00:07:38.624
And in summer, it rains every day.

00:07:39.292 --> 00:07:42.595
This also greatly influences
the issues of care,

00:07:42.595 --> 00:07:44.730
as well as the issue of the tide.

00:07:45.198 --> 00:07:47.834
So depending on how the
tide is on the day,

00:07:47.834 --> 00:07:50.536
will influence whether we can, in fact,

00:07:50.536 --> 00:07:52.305
visit or not.

00:08:02.949 --> 00:08:04.784
They made a point here.

00:08:05.585 --> 00:08:07.119
Do you still have it? I want!

00:08:07.520 --> 00:08:08.921
There\'s still a piece.

00:08:12.658 --> 00:08:16.095
Brother, honestly, I don\'t know
what I\'m going to do.

00:08:26.639 --> 00:08:28.174
we just got here

00:08:28.174 --> 00:08:30.443
in the home of one of our patients,

00:08:30.443 --> 00:08:35.414
who has great difficulty to access

00:08:35.414 --> 00:08:38.084
the physical structure of the unit,

00:08:38.451 --> 00:08:41.587
due to his pre-existing pathologies.

00:08:46.225 --> 00:08:48.094
Good Morning!
Good Morning.

00:08:48.628 --> 00:08:50.263
She was born nine, wasn\'t she?

00:08:50.530 --> 00:08:52.999
She was born, prenatal all ok, wasn\'t it?

00:08:53.132 --> 00:08:56.035
So she is a patient that we
are already following up

00:08:56.035 --> 00:08:57.970
for some time now, she is a child

00:08:58.004 --> 00:09:00.940
we follow up, both the development,

00:09:00.940 --> 00:09:03.009
and malnutrition.

00:09:03.876 --> 00:09:06.345
With us, with the nutrition team too.

00:09:06.579 --> 00:09:07.880
Is she convulsing?

00:09:08.147 --> 00:09:09.615
Not.

00:09:09.749 --> 00:09:12.051
Is she taking Clonazepam and Fenobarbital?

00:09:12.919 --> 00:09:14.554
How many drops of each?

00:09:14.820 --> 00:09:15.721
I don\'t know.

00:09:16.222 --> 00:09:18.958
And we come here at least monthly,

00:09:18.958 --> 00:09:20.893
visit, see how she is,

00:09:20.893 --> 00:09:22.595
because it is a patient who presents

00:09:22.595 --> 00:09:25.031
respiratory tract infections.

00:09:25.298 --> 00:09:26.866
So, sometimes, we need to get in,

00:09:26.866 --> 00:09:28.634
do something with her.

00:09:29.335 --> 00:09:33.205
So we keep tracking weight gain, weight loss,

00:09:33.272 --> 00:09:35.408
to also monitor the situation of malnutrition.

00:09:36.342 --> 00:09:39.612
And it is also a family that has a social status

00:09:39.612 --> 00:09:42.114
well weakened.

00:09:42.315 --> 00:09:44.317
Now, for her age, it\'s malnutrition.

00:09:44.317 --> 00:09:45.117
OK.

00:09:46.485 --> 00:09:48.621
There was a decrease in infant mortality,

00:09:48.621 --> 00:09:49.422
under one year,

00:09:49.422 --> 00:09:53.426
under 5 years old, over 50 years old,

00:09:53.426 --> 00:09:54.660
60 years, decreased,

00:09:55.194 --> 00:09:58.664
by the set of care programs that
the Health Unic System has.

00:10:00.399 --> 00:10:02.568
Research indicates that
the Health Unic System

00:10:02.568 --> 00:10:04.637
is the main factor responsible

00:10:04.637 --> 00:10:06.739
for an increase in life expectancy.

00:10:07.340 --> 00:10:09.575
The average age of men and women in Brazil,

00:10:09.575 --> 00:10:13.112
increased 12, 15 years, in 30 years.

00:10:36.902 --> 00:10:37.670
Perhaps

00:10:37.670 --> 00:10:40.373
turn off or turn the television down?

00:10:41.374 --> 00:10:41.941
Hi!

00:10:44.410 --> 00:10:45.745
Good morning people!

00:10:46.779 --> 00:10:48.080
Good Morning!

00:10:48.481 --> 00:10:51.684
Before we start the
individualized service,

00:10:51.784 --> 00:10:54.453
we\'re going to talk
a little bit with you

00:10:54.453 --> 00:10:58.024
about some care that
the community has to have.

00:10:58.124 --> 00:11:01.994
So today nurse Liliane and
I are going to talk a little bit

00:11:02.094 --> 00:11:04.864
to you about two diseases
that are closely linked

00:11:04.864 --> 00:11:07.033
to the rainy and flood season.

00:11:07.600 --> 00:11:10.770
One of them, have you ever
heard of leptospirosis?

00:11:11.003 --> 00:11:14.373
This health center is
made up of a community

00:11:14.373 --> 00:11:18.844
of approximately 11,000
to 12,000 users.

00:11:19.211 --> 00:11:20.846
we are three teams

00:11:21.113 --> 00:11:24.583
and the differential of this health
center of ours is that the three of us

00:11:24.583 --> 00:11:26.452
We are family and community doctors.

00:11:26.585 --> 00:11:28.554
OK. we are available

00:11:28.554 --> 00:11:30.456
and will start the service, ok?

00:11:30.856 --> 00:11:32.124
Gael Vicente.

00:11:33.092 --> 00:11:36.796
We work connected to an assistance network

00:11:37.263 --> 00:11:40.599
where we have individualized care,

00:11:40.599 --> 00:11:44.270
care shared with nursing.

00:11:44.270 --> 00:11:45.838
In our unit,

00:11:46.138 --> 00:11:48.574
we have a physical therapist,
physical educator,

00:11:48.574 --> 00:11:50.609
social worker, speech therapist,

00:11:50.876 --> 00:11:53.946
pharmacist, nutritionist, psychologist.

00:11:54.280 --> 00:11:56.849
It is a multidisciplinary work.

00:11:56.982 --> 00:11:58.651
The invention of primary care

00:11:58.951 --> 00:12:00.886
in the twentieth century,
in the last century,

00:12:00.886 --> 00:12:02.521
was as important as the vaccine

00:12:02.521 --> 00:12:04.590
against infantile paralysis.

00:12:04.757 --> 00:12:06.892
Good Morning!
How are you?

00:12:07.326 --> 00:12:07.760
Alright.

00:12:07.960 --> 00:12:10.262
The hospital, Camila, called us

00:12:10.262 --> 00:12:12.231
when you were still hospitalized
there, right?

00:12:12.531 --> 00:12:15.835
-Yea.
-To make the responsible discharge.

00:12:15.835 --> 00:12:16.702
So they called...

00:12:17.069 --> 00:12:19.171
Have you already received
the appointment date?

00:12:19.438 --> 00:12:22.007
They invented a team outside the hospital,

00:12:22.074 --> 00:12:24.443
that was the invention, a
multi-professional team.

00:12:24.777 --> 00:12:27.179
There is a doctor, a nurse,
but there is a visitor,

00:12:27.179 --> 00:12:28.414
a health educator,

00:12:28.414 --> 00:12:31.517
and that makes prevention,
orientation, education and health

00:12:31.517 --> 00:12:32.918
and clinical assistance.

00:12:33.219 --> 00:12:34.386
Takes care of the sick,

00:12:34.987 --> 00:12:37.289
makes the diagnosis as soon as possible,

00:12:37.656 --> 00:12:39.725
avoid hospitalization,

00:12:40.059 --> 00:12:43.963
it stretches people\'s lives
and lowers the cost.

00:12:44.096 --> 00:12:46.098
Today we will evaluate
together with the nurse

00:12:46.132 --> 00:12:48.768
to see if it\'s yellow...

00:12:49.101 --> 00:12:51.537
Looks like he got jaundice
in the hospital, huh?

00:12:51.971 --> 00:12:53.939
-Yea.
-Did he take a light shower?

00:12:54.006 --> 00:12:56.509
In the exchange of knowledge,
in the knowledge

00:12:56.809 --> 00:12:59.378
that one category passes to the other,

00:12:59.779 --> 00:13:03.449
this expands the integrality
of care and assistance.

00:13:06.652 --> 00:13:11.390
So here we do, mother, a
visual exam, apparently,

00:13:11.390 --> 00:13:13.659
then we will do a touching exam

00:13:13.659 --> 00:13:16.462
so that we can see the issue of yellow,

00:13:16.462 --> 00:13:17.830
to see if it returns,

00:13:17.863 --> 00:13:19.732
to see the need to forward him

00:13:19.732 --> 00:13:21.300
for the photo bath.

00:13:21.567 --> 00:13:24.637
The importance of primary health care

00:13:24.870 --> 00:13:27.406
it\'s because we are the gateway

00:13:27.406 --> 00:13:28.774
for Health Unic System.

00:13:28.974 --> 00:13:31.243
Quality primary care,

00:13:31.610 --> 00:13:32.978
with investment,

00:13:33.179 --> 00:13:39.251
with the lightweight technologies
it needs to perform,

00:13:39.351 --> 00:13:42.621
it is able to solve around 80-85%

00:13:42.621 --> 00:13:45.090
of the demands of the population
of that territory.

00:13:45.291 --> 00:13:47.159
You can rest easy, okay, mommy?

00:13:47.393 --> 00:13:49.595
Any questions, you come back with him.

00:13:49.595 --> 00:13:50.963
OK.
Fine?

00:13:51.030 --> 00:13:52.898
Goodbye. God be with you.

00:13:53.199 --> 00:13:54.500
You finish mentoring her, right, Lilian?

00:13:54.934 --> 00:13:55.467
Ok.

00:13:56.235 --> 00:13:58.904
The baby is fine, he is
exclusively breastfeeding,

00:13:58.938 --> 00:14:01.707
the mother did not bring
any specific complaint, right?

00:14:02.274 --> 00:14:04.944
And jaundice is in regression.

00:14:05.010 --> 00:14:07.379
So it is not necessary for
her to return to the hospital.

00:14:12.084 --> 00:14:15.721
The number of people who
will get sick and need

00:14:15.721 --> 00:14:16.755
to go to a UPA,

00:14:16.755 --> 00:14:18.591
which is an Emergency Care Unit,

00:14:18.591 --> 00:14:23.796
will reduce and only those more
complex cases will get there,

00:14:23.796 --> 00:14:25.397
more serious

00:14:25.397 --> 00:14:26.966
that could not be resolved

00:14:26.966 --> 00:14:30.102
in primary care, which is around 10%.

00:14:32.137 --> 00:14:36.508
And the UPA, having a smaller
volume, is able to provide a

00:14:36.508 --> 00:14:38.677
quality emergency

00:14:39.178 --> 00:14:40.980
and that, sometimes, will be able to solve

00:14:40.980 --> 00:14:43.048
without having to hospitalize this patient.

00:15:21.587 --> 00:15:23.088
For the Federal Constitution,

00:15:23.088 --> 00:15:25.958
Health is everyone\'s right and a duty of the State.

00:15:25.991 --> 00:15:28.727
With the Magna Carta, three decades ago,

00:15:28.727 --> 00:15:30.562
the Health Unic System.

00:15:30.896 --> 00:15:34.366
The model, even today, is a
reference in several countries,

00:15:34.800 --> 00:15:38.103
but why, despite being
praised internationally,

00:15:38.103 --> 00:15:40.272
the Health Unic System faces so many...

00:15:42.942 --> 00:15:44.209
How are you?

00:15:44.443 --> 00:15:47.579
I came to see you and your husband.

00:15:49.682 --> 00:15:51.450
So it is. I\'m here.

00:15:51.483 --> 00:15:53.285
Your leg is more swollen, huh?

00:15:53.285 --> 00:15:55.287
Yeah, but it\'s not even deflated now.

00:15:55.487 --> 00:15:57.723
Your pains? Yeah, okay.

00:15:58.190 --> 00:15:59.725
That night, it hurt a lot.

00:15:59.725 --> 00:16:00.859
It\'s all painful.

00:16:00.859 --> 00:16:03.495
I give priority to patients

00:16:03.495 --> 00:16:06.332
in serious condition, the
most critical patients,

00:16:06.966 --> 00:16:10.002
followed by older patients,

00:16:10.002 --> 00:16:12.104
or with limited mobility.

00:16:12.538 --> 00:16:17.042
Then I give priority to
children and pregnant women

00:16:17.042 --> 00:16:19.244
and the ones we call runaways.

00:16:19.578 --> 00:16:24.650
These are those patients who should
undergo regular treatment of pathologies,

00:16:24.650 --> 00:16:26.885
of diseases, and they don\'t.

00:16:30.789 --> 00:16:32.458
Good Morning!

00:16:36.895 --> 00:16:39.298
Are you getting very tired?

00:16:40.499 --> 00:16:42.801
We are doing palliative care,

00:16:42.801 --> 00:16:46.872
due to other complexes,
infection, liver abscess.

00:16:46.905 --> 00:16:49.742
So we came to visit him
to see the conditions,

00:16:49.742 --> 00:16:51.577
see what he needs,

00:16:51.577 --> 00:16:53.479
to give maximum comfort

00:16:53.579 --> 00:16:57.483
and see with the family
what they have needed too,

00:16:57.483 --> 00:17:02.187
his wife, his daughter,
who are his caretakers.

00:17:03.122 --> 00:17:05.691
The interns are following up with us too

00:17:05.691 --> 00:17:08.093
and it\'s a very delicate case,

00:17:08.093 --> 00:17:10.462
we treat with palliative care.

00:17:11.230 --> 00:17:12.598
It\'s pretty swollen.
OK.

00:17:13.098 --> 00:17:14.600
We\'re going to increase his dose.

00:17:14.600 --> 00:17:16.201
We are going to increase Furosemide today,

00:17:16.201 --> 00:17:18.037
for every 12.

00:17:19.071 --> 00:17:22.641
And let\'s see how the
auscultation and pressure are

00:17:22.641 --> 00:17:24.309
to see if we need to
change his Carvedilol.

00:17:56.008 --> 00:17:58.277
Is it 119?

00:17:59.211 --> 00:18:01.113
The community health worker,

00:18:01.113 --> 00:18:06.151
in my opinion, it is the cornerstone
of the family health strategy.

00:18:06.285 --> 00:18:08.587
He\'s got his foot in the
ground all the time,

00:18:08.687 --> 00:18:11.390
he brings the demands to us,

00:18:11.657 --> 00:18:13.592
brings the needs of action,

00:18:13.592 --> 00:18:15.761
brings the intervention needs.

00:18:17.529 --> 00:18:20.866
The community health agents
here at our post lead,

00:18:20.866 --> 00:18:23.669
coordinate operative groups
together with us.

00:18:23.669 --> 00:18:25.504
You, empowered by knowledge,

00:18:25.504 --> 00:18:28.474
you take it to the territory
and reproduce it.

00:18:28.674 --> 00:18:30.142
Excuse me!

00:18:32.444 --> 00:18:34.146
Good evening!

00:18:34.279 --> 00:18:35.614
And how are you?

00:18:35.614 --> 00:18:38.984
Your treatment, how is the treatment?

00:18:39.384 --> 00:18:41.220
primary care,

00:18:41.220 --> 00:18:43.288
without the agent, which
does not use the agent

00:18:43.288 --> 00:18:44.923
it\'s an outpatient clinic,
it\'s bureaucratic.

00:18:45.524 --> 00:18:46.658
The result is much smaller.

00:18:46.792 --> 00:18:49.328
You need to treat tuberculosis,
treat it for two months, leave,

00:18:49.328 --> 00:18:50.362
nobody goes after,

00:18:50.362 --> 00:18:51.897
Nobody talks, nobody does...

00:18:52.531 --> 00:18:54.500
There is an elderly person
who needs to take insulin,

00:18:54.666 --> 00:18:56.535
cannot come to the basic unit,

00:18:56.635 --> 00:18:58.003
will end up in the emergency room.

00:18:58.337 --> 00:19:00.772
On a daily basis, we visit the territory,

00:19:01.106 --> 00:19:05.043
we accompany the most vulnerable families,

00:19:05.511 --> 00:19:07.146
and we take it to the health center

00:19:07.146 --> 00:19:08.113
for those demands.

00:19:08.213 --> 00:19:11.150
And the doctor identifies
with us at the team meeting

00:19:11.183 --> 00:19:13.952
and we promote some actions.

00:19:14.086 --> 00:19:16.722
And we come up with a
strategy for this territory,

00:19:16.788 --> 00:19:18.357
in the most needed demands.

00:19:18.457 --> 00:19:19.925
Are you able to feed?

00:19:20.359 --> 00:19:20.893
I am.

00:19:20.926 --> 00:19:21.793
And the appetite?

00:19:22.327 --> 00:19:24.530
-Appetite is good.
-Fine?

00:19:24.763 --> 00:19:25.831
And insulin?

00:19:26.999 --> 00:19:29.501
He\'s taking it periodically,
he\'s getting better.

00:19:29.501 --> 00:19:30.169
Yes?

00:19:31.270 --> 00:19:34.940
Do you have his glucose measurements?

00:19:35.073 --> 00:19:37.142
Most elderly mortality

00:19:37.142 --> 00:19:40.212
in Brazil, in the world, is cardiovascular disease.

00:19:40.212 --> 00:19:42.214
The main ones are diabetes and hypertension,

00:19:42.214 --> 00:19:44.049
what the Health Unic System
is champion in dealing with.

00:19:44.149 --> 00:19:46.485
Family health has insulin
for those who need it,

00:19:46.485 --> 00:19:49.521
have all medication, various
types of medication

00:19:49.521 --> 00:19:50.689
for hypertension, for diabetes,

00:19:50.789 --> 00:19:52.257
has a multi-professional team,

00:19:52.257 --> 00:19:53.792
that health insurance plans do not have.

00:19:53.892 --> 00:19:56.428
So much so that 80-odd %
of Brazilian diabetics

00:19:56.428 --> 00:19:58.096
regularly use the Health Unic System.

00:19:58.430 --> 00:20:00.265
Have you ever heard that when Mohammed

00:20:00.265 --> 00:20:02.100
does not go to the mountain,
the mountain goes to Muhammad?

00:20:02.868 --> 00:20:03.669
Ever heard?

00:20:04.436 --> 00:20:05.537
Yes.

00:20:05.938 --> 00:20:08.340
Let Dr. Eder take a look at the teeth,

00:20:08.340 --> 00:20:10.209
to see what we can do to help?

00:20:10.342 --> 00:20:12.711
How do you criticize someone you love?

00:20:12.878 --> 00:20:15.414
How do you defend the Health Unic
System and at the same time

00:20:15.414 --> 00:20:16.882
admit the problems?

00:20:17.049 --> 00:20:19.251
The Health Unic System is
super important for most

00:20:19.251 --> 00:20:20.619
of the Brazilian population,

00:20:21.153 --> 00:20:23.155
increasing our life,

00:20:23.155 --> 00:20:24.923
relieving our suffering,

00:20:25.290 --> 00:20:27.459
generates a lot of queue,
a lot of disrespect,

00:20:27.459 --> 00:20:30.262
a lot of unnecessary bureaucracy.

00:20:30.729 --> 00:20:34.032
Much of the queue in the Health
Unic System is a management problem.

00:20:34.800 --> 00:20:37.336
People esteem today, economists,

00:20:37.336 --> 00:20:40.405
health workers, that the Health Unic System

00:20:40.405 --> 00:20:42.307
has half the minimum resources needed.

00:20:42.307 --> 00:20:44.076
If we compare with other countries,

00:20:44.076 --> 00:20:45.644
spending per capita, per person,

00:20:45.677 --> 00:20:48.814
of the Health Unic System is 1/3, 40%, 50%.

00:20:48.814 --> 00:20:52.217
Even here in South America,
Argentina, Uruguay,

00:20:52.217 --> 00:20:55.053
spend more per person than
the Health Unic System.

00:20:58.657 --> 00:21:00.492
When you don\'t invest in public health,

00:21:00.492 --> 00:21:02.561
when there is no investment
in primary care,

00:21:03.428 --> 00:21:05.264
when you start to run out of medicine,

00:21:05.264 --> 00:21:07.966
when it makes it difficult

00:21:07.966 --> 00:21:10.235
referring these users
to focal specialists,

00:21:10.235 --> 00:21:11.536
who need to help us,

00:21:12.004 --> 00:21:15.240
this greatly limits our work.

00:21:15.240 --> 00:21:16.408
our population

00:21:16.408 --> 00:21:18.277
is extremely vulnerable,

00:21:18.543 --> 00:21:20.846
she is 100% Health Unic System dependent.

00:21:21.947 --> 00:21:26.351
So, the demand is very high for service,

00:21:26.785 --> 00:21:29.087
by qualified listening.

00:21:29.454 --> 00:21:30.088
Good bye.

00:21:30.088 --> 00:21:32.224
-Jesus bless you.
-Amen.

00:21:32.324 --> 00:21:34.092
You don\'t disappear, no. Go there, see?

00:21:34.426 --> 00:21:35.961
-Bye, Lillian.
-Goodbye. Thanks.

00:21:35.961 --> 00:21:36.762
All the best, see?

00:21:36.762 --> 00:21:38.297
Anything, you talk to Shirley

00:21:38.297 --> 00:21:39.665
or else, go there and look for us.

00:21:39.798 --> 00:21:40.966
-Okay, you can leave it.
-OK?

00:21:40.999 --> 00:21:44.169
-Are you going to the psychologist?
-Yes. Yes I am.

00:21:44.569 --> 00:21:45.637
So it\'s. God be with you.

00:22:02.321 --> 00:22:06.425
My population lives 100% of the Health Unic System.

00:22:06.425 --> 00:22:10.362
Those minimum human requirements,
they no longer have.

00:22:10.962 --> 00:22:13.198
Imagine you stop to...

00:22:14.066 --> 00:22:16.201
provide private healthcare.

00:22:20.238 --> 00:22:21.473
Excuse me.

00:22:24.376 --> 00:22:25.243
Hey!

00:22:27.112 --> 00:22:28.146
I came to see you.

00:22:28.914 --> 00:22:30.282
Hi my dear!

00:22:30.816 --> 00:22:31.750
Everything ok with you?

00:22:32.084 --> 00:22:35.253
The population that uses the
Health Unic System more,

00:22:35.253 --> 00:22:38.724
75% is the same population
with lower incomes.

00:22:40.125 --> 00:22:42.527
It is a predominantly black population.

00:22:42.527 --> 00:22:44.229
If you take among the black population,

00:22:44.629 --> 00:22:46.365
86% only have the Health Unic System.

00:22:46.498 --> 00:22:48.333
Will first treat the urinary tract infection,

00:22:48.333 --> 00:22:50.168
because it can influence this result.

00:22:50.168 --> 00:22:52.437
-OK.
- Then we do the treatment

00:22:52.437 --> 00:22:53.739
After it\'s done, we\'ll take it.

00:22:53.739 --> 00:22:56.441
Did you see, Miss Celsa? I miss you lady.

00:22:56.942 --> 00:22:58.110
Our chats.

00:22:58.577 --> 00:22:59.578
Our laughs.

00:23:01.012 --> 00:23:01.646
Yes?

00:23:01.646 --> 00:23:03.448
I\'m going to give you a kiss.

00:23:04.683 --> 00:23:06.184
No need to get up, no.

00:23:07.652 --> 00:23:08.954
-Fine?
-OK.

00:23:08.987 --> 00:23:10.322
-God be with you!
-Amen.

00:23:10.322 --> 00:23:11.790
-OK?
-Thanks.

00:23:18.563 --> 00:23:20.298
You have to be a good technician

00:23:20.298 --> 00:23:21.967
has to be well formed

00:23:22.501 --> 00:23:24.403
but we cannot lose humanity.

00:23:24.403 --> 00:23:25.804
Never.

00:23:25.804 --> 00:23:27.339
And that bruise on the knee?

00:23:28.273 --> 00:23:30.242
-And this one in the head, here?
-It\'s a wart.

00:23:30.308 --> 00:23:31.376
Also?

00:23:31.810 --> 00:23:33.879
We counted stars.

00:23:33.879 --> 00:23:36.348
Oh, if you count a star, does it give a wart?

00:23:36.815 --> 00:23:39.251
Each Health Unic System
disassembly increases mortality.

00:23:39.251 --> 00:23:41.253
In the last three years,
Brazilian epidemiologists,

00:23:41.253 --> 00:23:43.355
along with English, etc.,

00:23:43.355 --> 00:23:46.324
saw that after 20-odd years of falling

00:23:46.324 --> 00:23:47.659
in infant mortality,

00:23:47.659 --> 00:23:50.362
we have an increase in infant mortality again.

00:23:50.462 --> 00:23:53.932
There is the recession, but there is the
dismantling of part of the Health Unic System,

00:23:53.932 --> 00:23:54.733
silent and progressive

00:23:54.733 --> 00:23:55.867
the deconstruction.

00:23:56.134 --> 00:23:57.235
Vaccines are missing.

00:23:57.235 --> 00:24:00.505
You\'ll see, they cut funds two years ago,

00:24:00.505 --> 00:24:03.475
three years for Fiocruz, for the Butanta Institute

00:24:03.475 --> 00:24:05.677
for vaccine production,
which is all national.

00:24:05.844 --> 00:24:07.913
If you privatized the Health
Unic System, closed it,

00:24:07.913 --> 00:24:11.783
mortality, in 10 years,
would regress 10, 15 years.

00:24:11.783 --> 00:24:15.220
We hospitalized 80% of people
with bronchopneumonia,

00:24:15.220 --> 00:24:16.354
mainly children and old people.

00:24:16.521 --> 00:24:18.023
Today we hospitalize 2 or 3%.

00:24:18.890 --> 00:24:20.892
So it\'s better and it\'s cheaper.

00:24:22.093 --> 00:24:23.595
The dismantling of the Health Unic System,

00:24:23.595 --> 00:24:26.164
for most of the Brazilian population,

00:24:26.164 --> 00:24:26.832
it\'s a disaster.

00:24:27.265 --> 00:24:29.167
That\'s why we talk: the Health
Unic System or barbarism.

00:24:32.704 --> 00:24:35.240
If I didn\'t believe in this system,

00:24:35.240 --> 00:24:39.511
I wouldn\'t dedicate my
professional life to it.

00:24:39.711 --> 00:24:43.048
I think the Health Unic System
is a great asset for our country

00:24:43.048 --> 00:24:44.816
and that we have to fight a lot

00:24:44.816 --> 00:24:47.319
for it to be a heritage of Brazilians

00:24:47.319 --> 00:24:49.888
and that no one destroys

00:24:50.088 --> 00:24:52.724
and that we do not allow it
to be destroyed.

00:24:58.663 --> 00:24:59.731
Sometimes we get tired of this

00:24:59.731 --> 00:25:01.500
one-hour crossing, of round trip.

00:25:01.533 --> 00:25:03.535
Nothing that after a rest,

00:25:03.535 --> 00:25:06.905
we cool off, and a new day,

00:25:06.905 --> 00:25:09.007
a new beginning and it all comes back...

00:25:09.007 --> 00:25:10.976
There\'s a character from a medical series

00:25:10.976 --> 00:25:13.345
which says: \"Today is a
beautiful day to save lives\".

00:25:13.512 --> 00:25:17.582
And then you reinvigorate your strength and go,

00:25:17.582 --> 00:25:19.451
\'cause you know there\'s gonna be a crowd

00:25:19.451 --> 00:25:20.852
needing you.

00:25:34.733 --> 00:25:45.410
Despite having a system like the Health Unic System, Brazil is
the only country in the world where 56% of health costs are
private and attend only 25% of the population.

00:25:47.212 --> 00:25:57.422
88% of the interviewed believe the Health Unic System should
be kept as in a universal, integral and free acess assitance model.