Emergence
Stories from the frontlines – family physicians around the world responding to COVID-19
- episode 4 - Brazil
A narrative collaboration between the Besrour Centre of the CFPC and CFP
Interview with Dr. Adelson Guaraci Jantsch on April 1, 2020
Brazil
“We Step Forward When the Government Does Not”
It was remarkable timing when we managed to speak with Dr. Adelson Guaraci Jantsch, a lead family medicine teacher and researcher in Rio de Janeiro. Just the week before, the president of Brazil had insisted that COVID-19 was not a pandemic and resisted instating any public health measures at all. Adelson likened it to facing both an infectious crisis and a political crisis all at once.
Coordination of care is key to a pandemic response and the Brazilian health care system is hampered by a lack of support within government. In fact, the drug lords in favelas are coordinating more of a response - reinforcing a curfew and distancing. Coupled with an economic downturn for a number of years, the country is facing devastation.
“Family physicians will see the future that is continuity of care - what will happen in our future if we don’t take the proper measures now.”
The other fascinating piece about Adelson’s interview is his PhD research on the difference family medicine training makes in outcomes. They are stewards of health care resources, result in better patient outcomes, and are cost effective - he intends to prove this. He sites the fact that HIV+ patients are more often identified if they have a family doctor - knowing the community is key. He described how, in the cities, family physicians had created the protocols for COVID-19 based on this experience.
Adelson was also one of the first physicians to highlight the plight of rural communities - a lack of ICU beds and inability to transfer to an overwhelmed urban system. In the cities, teaching centres will be one of the most efficient work environments to contain the pandemic. Again, they created protocols for protecting health care workers based on the way they protect their residents, yet still being able to look after chronic disease so that community care manages as much as they can.
“I can see that family physicians played a very important role in protecting patients and health care workers.”
Experience. Being nimble. Managing resources.
Thank you, Adelson, for sharing with us how - even when politics interferes with a coordinated response - family medicine doctors can provide some level of safety in their communities. Your insights around teaching and learning are particularly valuable.
Dr. Adelson Guaraci Jantsch is a family physician and PhD candidate at the IMS/UERJ, Rio de Janeiro Brazil and Director of the Family Medicine Residency program at the Rio de Janeiro Health Department.
Listen to the podcast here: https://cfppodcast.libsyn.com/covid-19
Dr. Christine Gibson (www.christinegibson.net) is a family physician in Calgary, Canada with a background in justice work, medical education, and global health. A skilled facilitator and speaker, she is engaged in building individual and community resilience. Her writing creates the woven narrative between her interests – wellbeing, trauma recovery, and the power of story.