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Print version ISSN 1807-5932On-line version ISSN 1980-5322

Clinics vol.60 no.2 São Paulo Apr. 2005 



Partnership between universities and the local healthcare system to benefit the town of Buriticupu, a poor community in the state of Maranhão, Brazil



Marcelo El Khouri; Leandro Savoy Duarte; Janos Valery Gyuricza; Carlos Eduardo Pereira Corbett



The Faculty of Medicine, University of São Paulo (FMUSP) in partnership with the Brazilian Ministry of Health, the local healthcare system and the Federal University of Maranhão (UFMA), took the Bandeira Científica project to the town of Buriticupu, located in the state of Maranhão, Brazil (Fig. 1). The Bandeira Científica project consists of an annual expedition, each year to different part of Brazil, directed by FMUSP faculty members and executed by FMUSP medical students. Objectives are to train medical students in primary healthcare to deprived communities and to offer such primary healthcare as well as educational lectures. The Bandeira also performs epidemiological studies. On this occasion, Buriticupu, in the backlands of the state of Maranhão was selected as the target town.





Buriticupu has a population of 50,059 inhabitants, but lacks basic sanitation and education, the latter provided mainly by an insufficient set of public schools. Illiteracy is predominant in adults over the age of twenty. The last Demographic Census, collected in the year of 2000 indicated illiteracy rates of 63,8% among children over the age of 10.

UFMA provides basic medical support to combat the four most endemic diseases (malaria, Hansen's disease, leishmaniasis and tuberculosis) in the form of diagnosis, follow up and treatment, including distribution of medication provided by the Brazilian Ministry of Health.

The medical assistance offered by Bandeira Científica focused on general practice, but some specific areas such as dermatology, pediatrics, infectology and psychiatry were also contemplated. Consultation was by appointment, organized by local healthcare workers. Patients were triaged according to their initial complaints, followed by an interview consisting of demographic questions, which preceded medical consultation. This was performed by medical students under constant supervision from experienced physicians and faculty members. Medication was distributed after consultation if necessary.

In this manner 21 rural areas of the town were covered, totaling 3,428 interviewed patients. Laboratory tests were performed, including 340 blood tests for a Hepatitis B and C research program. A total of 46 biopsies and 219 Papanicolaou smear tests were also performed. The most frequent diagnostic findings were parasitic intestinal infestations (12% of prevalence), vulvovaginal infections (10,2%), muscular pain (9,5%), headache (8,4%) and scabies (7%).

Furthermore, 7 classes were given to the local heathcare workers and to the general population. Attendants received certificates provided by Bandeira Científica. Classes covered malaria, Hansen's disease, tuberculosis, leishmaniasis, parasitic intestinal infections, water care and sanitation, dengue fever, contraceptive methods, cancer prevention, first aid, pre-natal care, drugs, smoking and STD/AIDS.

The project lasted 10 days, which was considered less than necessary to satisfy local demand, but enough to develop an awareness about healthcare rights and duties, to stimulate local leaderships towards improvement and optimization of resources. Regions with a shortage of healthcare workers were visited and our contact was often a unique opportunity for citizens to have contact with a medical professional.

Students participating in the Bandeira Cientifica project are invariably challenged to cope with some of the difficulties inherent to these poor communities; upon returning home to São Paulo, a new set of concepts occupies their minds. As in other occasions, this issue of the Bandeira Cientifica provided a reasonable health evaluation of the needy inhabitants of the backlands of Maranhão.

A number of actions were adopted in order to try to maintain the health care procedures introduced during the Bandeira Científica:

1- a data bank was constructed, comprising information of all attended patients;

2- a written report with the results of all exams was delivered to Secretary of Health of Buriticupu;

3- a proposal was submitted for the restructuring of the healthcare system according to Brazilian Family Healthcare Program and Healthcare Workers Program;

4- a donation of materials and medications was made;

5- a proposal was submitted for the rebuilding the local hospital;

6- proposals were submitted for the implementation of a rural internship system for medical students of UFMA, to maintain the medical support prevalent during the Bandeira Científica;

7- a schedule was organized for the return of doctors from UFMA, in order to establish a monthly visit to patients, including those attended during the Bandeira Científica.

Thus, the partnership between FMUSP, UFMA and local health authorities of Buritipucu achieved some measure of success in its goal of enhancing the local healthcare system structure and strengthening the link between public university and community, bonding professors, students and local residents with respect to a voluntary system of welfare practice.

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