A new book has been released set in Sao Paulo.
This week I twisted my ankle while running for a bus. I’m not sure exactly how it happened, whether I lost my footing on the uneven surface of the pavement of whether I simply tottered over on my own accord. I certainly hadn’t been drinking so I’m blaming the terrain.
The pavements of Brazil would be enough to give a British health and safety inspector a cardiac arrest. The concept of English council employees walking around streets with a ten pence piece to check whether the council needs to repair a paving stone or fear being sued is laughable in Brazil.
Brazilian local government officials would need to fill their pockets with loose change to stand any chance of having enough to measure the gaps in the pavements here. Not that a local government official would be that bothered. It’s not the fact that they don’t fear litigation, or that they don’t care, it’s because the responsibility to maintain the pavement in front of a house or a shop belongs to the house or business owner. While this probably saves the council quite a bit of cash it does create a right hotch potch of different designs, styles and heights of pavements – a nightmare for someone rushing for a bus but an impossibility for a wheelchair user. Funnily enough you don’t see many wheelchair users on Brazilian streets.
It’s not just the state of the pavements which highlights the difference between England and Brazil when it comes to matters of health and safety. Not long after I arrived my daughter was invited to a children’s birthday party and I accompanied her. In the front garden was a ten foot trampoline and a swimming pool holding 7000 litres of water which had already turned an interesting colour filled as it was with children wreaking havoc.
Herein lies a basic difference between Brazilians and myself. A Brazilian sees 7,000 litres of dubiously coloured water as an opportunity for fun whereas all I see is a soup of bacteria an infection whose main benefit lies in stimulating my daughter’s immune system. Don’t get me wrong. I’m not anti-fun. We had a trampoline in our own garden in England which I was happy for my daughter to enjoy providing she was securely fastened inside by a sufficiently zipped up safety net.
The trampoline in this particular party did have a net of sorts but it had a gaping opening on one side which, while permitting easy entry and exit, was never fully closed while the infants leapt about inside. I hovered around the opening while my own daughter had her turn, ready to catch her and flinching every time she made the slightest move in my direction. The Brazilian fathers relaxed on the other side of the garden.
Perhaps my nervousness could be attributed to the story of my friends daughter who managed, during the brief period the zip on her trampoline was open, to launch herself through the gap and land on her head. Was it just a freak accident about which I shouldn’t be overly concerned? Does the Brazilian child’s exposure to risk develop their ability to avoid freak accidents? Has my constant mantra of ‘be careful’ turned my daughter into a nervous wreck who is so risk averse that she is unlikely to attempt many of the possibilities that Brazilian children enjoy?
Eventually she too entered the pool of immunisation and played the games the other children played. Once she had her confidence she was difficult to remove. And no-one got hurt. Well that’s not exactly true. A girl did fall through the opening in the net and onto the concrete floor. Thankfully she was not badly hurt.
Saturday nights remind me of the thing I hate most about Brazil. Tuesdays, Thursdays and Saturdays are rubbish collection days so that’s when I have to fill a bag of used toilet paper and take it out to the street.
That’s right. Used toilet paper. The problem being that Brazilian toilets, unlike their users, are so temperamental that even the sniff of a piece of toilet paper will lead to them refusing to accept anything at all and that’s not a situation anyone wants to find themselves.
So tonight was the night I find myself cursing the land of sun and samba on the way to the front gate to drop off my sack of soiled tissue. But there is one resident of Sao Paulo who, if she could, would jump at the opportunity to carry a bag of poo stained paper anywhere and that’s Eliana Zagui.
For the last 36 years Eliana has been confined to a bed having suffered from infant paralysis following a late diagnosis of polio. Despite what many would describe as a debilitating condition, Eliana has managed in 38 years without the use of her limbs what I have failed to achieve in 40 years of full mobility, she has written a book – with her mouth.
Sharing a room with fellow polio victim, Paulo Henrique Machado, to whom she dedicated the book, Eliana has not only learned to read and write but has studied English and Italian and paints as well. In an interview with Veja magazine, Eliana explains that painting is where she opens herself, puts all her emotions, rage anger and acheivements.
She had not been vaccinated against polio as a child because her parents visit to the local vaccination clinic had coincided with fever and flu, a precaution which is now known to have no scientific basis. In early January 1976, after a few days of fever, Eliana’s parents took an uncharacteristically quiet infant from their home in Guariba, 337km from Sao Paulo city, to a better equipped hospital in Jaboticabal. After spending the night at the hospital, doctors recommended they travel another 60km to Ribeirao Preto where she was diagnosed with polio and rushed to Hospital das Clinicas in Sao Paulo city.
In her book she describes the first few hours following her arrival at the Hospital das Clinicas as ‘an intense battle. A war of doctors against the clock’. She had already lost all movement from the neck down and the priority was to prevent the paralysis from reaching her lungs. Her parents were told it was unlikely she would survive the night and that they should go home. Within two hour her respiratory system failed for the second time and at dawn as her exausted parents waited at the side of the road for a bus home, Eliana was fitted into her first iron lung. Her clothes and possessions were burned in an attempt to erase her past.
Sadly Eliana now has little contact with her family due to the distances involved. It was the nurse, Josephine Aparecida Saccani nicknamed the ‘Thin’, who arranged the transport to Sao Paulo who, 25 years later, tracked down Eliana and inspired the autobiography. She began researching her past and, contacting her father, received a nine page letter explaining his version of the story. From that point she began working in ernest and was eventually contacted by a publisher who had heard her story.
The book’s title, ‘Pulmão de Aço’ is inspired by the iron lung, a machine which enables those with paraalysis to breathe. For Eliana the iron lung did not work and a traecheotomy had to be performed to enable her to breathe.
Despite a limited print run, Eliana has already heard stories of those who have been inspired by her story. I, for one, will count my blessings the next time I carry a bag of poo out to the street and I look forward to reading the English edition of ‘Lungs of Steel’.
On one side, large plasma screens showing Barcelona v Santos, on the other a coffee bar selling refreshments. This did not feel at all like the kind of hospital I was used to. Along one side the wall was clear glass behind which stood row after row of cots – each with their own individual web cam.
Filled with tables and chairs, the waiting area was more like the kind of coffee shop you find in an airport than a hospital. This feeling was engendered mainly by the large plasma screen at one end which displayed a list of names highlighted in different colours. Instead of a list of planes, this board displayed a different kinds of arrivals. It was a list of all the deliveries scheduled that day.
On each line was written the scheduled time of arrival, the mother’s name, the doctor in charge of the delivery and the status. Each line was highlighted in a colour dependent on its status, white was ‘scheduled’, yellow was ‘in transit’ to the theatre, green indicated that the caesarean was in progress and blue showed that the mother was recuperating from her anaesthetic.
My sister in law had a c-section schedled and we’d all been invited to witness the event. Those fortunate enough to be able to afford private healthcare in Brazil are able to schedule the birth into their diaries. In this case the birth had been scheduled for the Wednesday but, following tests, the procedure had been brought forward to Sunday.
My own daughter had been born by emergency caesarian in St George’s, Tooting, South London after 48 hours of labour and bucket loads of drugs failed to coax my wife’s cervix to dilate more than 8cm. The combination of my daughter’s elongated cranium and the site of the surgeon massaging my wife’s drug soaked womb, in an attempt to get it back in, left me with the impression that planned caesareans might not be such a bad idea.
I was still marvelling at the arrivals board when the Sunday football on the other plasma screens was interrupted by the hospital logo superimposed over pink cartoon clouds. A group waiting at tables suddenly became quite excited and rushed to the screens with cameras at the ready. There followed a short animation in which a cartoon stalk carrying a pink bundle flew over a cartoon Sao Paulo and dropped the bundle onto the roof of the hospital. Then a live picture of a newborn baby appeared surrounded by pink graphics displaying the names of the baby’s parents together with the delivery time and weight of the newborn – though, in my experience, Brazilian’s are a lot less bothered about discovering the exact time and weight at birth than we are in the UK.
The sight of this group of Brazilians taking photos of a screen displaying images of a baby whom moments earlier had been cosy in its mother’s womb was fantastic enough but what followed was truly jaw dropping.
When the time came for my sister-in-law’s name to change from yellow to green, we left the cafe and took the lift to the floor below where we were shown to a large frosted window next to a large number 1. It was at one end of a narrow corridor which seemed to accommodate frosted windows 2 to 7.
After a short wait the window suddenly became miraculously defrosted revealing an operating theatre just at the moment my neice-in-law was being removed from her mother’s womb in time to be held aloft for the mother and, masked father inside and the photo snapping crowd outside to see.
Unexpectedly the window remained defrosted to enable further photo opportunities with father holding the baby while mother was being sewn up. Mother, apparently had no objection to a sea of grinning faces watching her have her innards shoved back inside. Preferring instead to share the birth of her daughter with family and friends in this way.
According to the Brazilian Association of Nurse Midwives and Obstetrics c-sections account for 70% of deliveries in public hospitals and 90% in private hospitals but if this is true it reveals a dramatic growth in c-sections since 2006 when rates in public hospitals were measured at 30.1% and in the supplementary (private) health sector at 80.7%. Nevertheless, both rates are considerably greater than the World Health Organisations recommendation that the c-section rate should not be higher than 10-15%
In addition to the obvious disadvantages of increased and uncomfortable recover time, risk of scarring, infection or complications a recent Brazilian study has revealed that Caesarean delivery is associated with an increased risk of obesity in adulthood. Nevertheless, the speed and convenience of the c-section is too good to pass up for increasing numbers of Brazilian mothers who choose to have their children delivered this way.