The image of a Brazil associated only with football, with the Amazons, with the “favelas” of Rio de Janeiro and with samba, is becoming a thought of the past. The world is now beginning to discover the Brazil that is the 7th largest economy in the world, possesses monetary reserves allowing the country to overcome the global crisis in a much smoother fashion than other countries, has extraordinary petroleum reserves, holds 11% of water supply on the planet, is one of the countries that generates the greatest agricultural production in the world, has an emerging industrial sector and 200 million inhabitants with a purchasing power that grows each day.
Brazil, however, was not founded yesterday. Some of its greatest surprises have been forged over the last decades, or even centuries. This is the case with medicine and health. There are 17 Brazilian hospitals accredited by Joint Commission International (JCI), in three cities; São Paulo, Rio de Janeiro, and Porto Alegre. However this fact does not reflect the lack of quality in the today’s healthcare system.
One of the largest networks of medical educational institutions in the world is based in Brazil, with 181 schools, many of which are connected to hospitals that are more than 100 years old. Brazil has a labor force of more than 350,000 physicians (one for every 549 citizens), many of them specialized abroad.
By comparison, according to the World Health Organization’s Global Health Observatory Data Repository, Costa Rica has 5,200 physicians, Thailand 18,900, and Singapore 8,300, to cite some well-known Medical Tourism destinations.
The number of internationally accredited hospitals in Brazil is a reflection of the acknowledgement of those looking to embrace the medical tourism industry, not necessarily implying all around quality in Brazil’s healthcare system. We see those numbers steadily growing as more providers and healthcare leaders become educated on the opportunities available to them.
This situation begins to change when Brazil enters the international Medical Tourism market, drawing on the pioneering experiences of a number of Brazilian institutions. This is the case with São Paulo’s Albert Einstein Israeli Hospital, inaugurated in 1971 and today is one of the largest and most important health and medical teaching institutions in Latin America with 7,500 staff members and 6,000 accredited doctors. The Albert Einstein Israeli Hospital has already been investing in Medical Tourism for some time.
Another point of reference is the Oswaldo Cruz Hospital in São Paulo, founded in 1897 by German immigrants. Today it has a built area of over 72,000 m2, 1,500 staff members and 2,500 accredited doctors. In Rio de Janeiro the Ivo Pitanguy Clinic has been in operation since 1963.
Doctor Pitanguy became internationally renowned for his work in plastic surgery and is responsible for the growth in this specialty that Brazilians adore. Today, in Brazil, approximately 1,700 plastic surgeries are performed every day.
In Porto Alegre there are institutions such as the JCI-accredited Moinhos de Vento Hospital and Santa Casa, founded in 1803, which encompasses 2 general hospitals and 5 specialized hospitals with 6,300 staff members and 2,500 accredited doctors, as well as a college of Medical Science.
We are aware that medical quality is a basic prerequisite for any country that intends to take part in Medical Tourism, but it’s not all. Brazil is also growing in the other important areas. For example in relation to cost, it is possible to undergo an elective surgery in a hospital with advanced technological infrastructure and highly specialized doctors, spending 50% less than you would spend in the United States. But we also know that there are other important factors beyond the quality of medicine and cost.
STABILITY AND DIVERSITY
Today Brazil is a country with a consolidated democracy and an economic, social and political stability. In the 90s, President Fernando Henrique Cardoso implemented an economic stabilization plan that created the basis for this new period of growth.
President Luiz Inácio Lula da Silva continued the work of his predecessor. The strengthening of social programs has lifted 30 million Brazilians from poverty to middle class, creating an explosion in internal consumption that is allowing the country to take great strides in many different areas.
Brazil is certainly the face of diversity, and as in any other large metropolis in the world, inevitable can exist. Luckily patients and their companion(s) simply need to follow some basic tips in order to have a tranquil stay and they will not be surprised by violent public demonstrations or strikes during their time in Brazil.
Due to this, the patient, instead of just choosing a health institution or a doctor, can choose one of the many other “countries” that exist within Brazil, each with its own culture. To cite some examples, in the Northeast, the patient will discover the Brazil of beaches, of white sands, of high temperatures, and of the joy of dance.
Rio de Janeiro, with its incomparable landscape, is the fusion of the core of Brazil, of its beaches, the heat, bossa nova and cultural life. The patient does not need to remain in the capital. Before or after treatment, depending on the procedure, they can enjoy marvelous beaches throughout the state, such as the famous Búzios. São Paulo, by contrast is the Brazilian California, the locomotive of Latin America. The capital is one of the largest metropolises in the world and there is nothing you cannot find there.
Make a wish and São Paulo grant it; from the most basic to the most luxurious. Porto Alegre, the capital of the far south, has a pleasant climate and a European feel in its architecture, people and culture. It is here that we find the Gaucho Highlands, one of the most visited tourist regions by Brazilians, with its low temperatures, chocolate factories, wines and abundant Italian and German-inspired gastronomy.
DEALING WITH BOTTLENECKS
Despite these unique features, Brazil is still in the process of becoming fully equipped to appropriately embrace the Medical Tourism sector. The Ministry of Foreign Affairs practices what it calls a “policy of reciprocity” in relation to the granting of visas. As the USA demands that all Brazilians apply for visas, all North Americans require visas to enter the country, however not Europeans.
This is a small hurdle, but it does not mean that it is not possible to begin forging connections between the major players in the market. Nevertheless, the Brazilian parliament is considering legislation in order to create a special facilitate growth in this area.
The 2014 FIFA World Cup host country has some other difficulties in tourism in general, and especially for mega events. A great number of the country’s airports are already operating over capacity, precisely due to Brazil’s economic development.
The number of domestic flights has increased in between 20% to 30% annually, which has created an imbalance between the increase in demand and the government’s capacity to expand airport infrastructure, which is all state owned, accordingly. Presently, three airports have been transferred to the private area to see if this can help the country speed up the expansion of these structures.
Many hospitals are in the education process of establishing best practices and their opportunities within the medical tourism industry. This includes developing or qualifying their International Departments, setting up linguistically competent teams to deal exclusively with foreign patients and adjusting aspects of their contracting and systems for payment between countries.
The Federal Government and entities from relevant sectors should keep working to facilitate the granting of visas and a system of quality assurance to ensure that healthcare institutions and professionals who are not adequately prepared to enter the medical tourism market are identified, educated and guided through the process of offering international patients and our local population, the very best healthcare possible.
Nevertheless these are all steps that need to be taken in the development of any new market sector. It is always seems like a long road; however, Brazil already has the most important factors in place: quality in medical and healthcare services. Brazil also has the greatest quality that lies in a different area, which is the joy and energy of the Brazilian people, who love to receive their visitors as well! n
Today Brazil is a country with a consolidated democracy and an economic, social and political stability.
About the Author
Luiz Fernando Schreiner Moraes is a journalist and secretary of Tourism for the city of Porto Alegre, capital of the state of Rio Grande do Sul, Brazil. For 4 years, he’s been president of the Brazilian Association for Municipal Secretariats of Tourism. He is a member of the National Tourism Council, a body linked to the Ministry of Tourism, and is the founder and advisor to Porto Alegre Healthcare Cluster, the first Brazilian organization in the Medical Tourism sector. He is also the architect and founder of the recently created Brazilian Association for Medical Tourism – ABRATUS.