>> 3rd
Monthly health guidance tours by ship
"Bon je a!" The children greeted the group with expressions of pure curiosity. HANDS staff members used a model of the inside of a mouth to teach the children how to use a toothbrush.
According to the school's director, Joaquim Cabaucante da Silva (31), who was born in Igarapezinho, there are 56 families and 302 students living here. There are 106 students, most of whom are from overseas.
Grazis Cidade Tellis (38), a teacher at the city's remote education bureau, uses exaggerated movements as if performing a monologue to get the students to recite repeatedly in unison, "Wash fruit that has fallen on the ground before eating it," "Wash your hands before eating," "Wash your hands after using the toilet," and "Always brush your teeth after eating."
While this may be commonplace in the city, the Kawamin live in a world where it is not.
Staff member Jillson explains to the children how to prevent parasites. She tells them that it is dangerous to drink water from wells, springs, or rivers as is, so they should tell their parents to sterilize the water with hypochlorite before drinking it.
This place is only seven kilometers away from the center, but the lifestyle is the same as that of other remote communities. A road to the center was recently built, but there are no cars. It takes an hour and twenty minutes to walk there one way. Since it is close to the center, the teacher commutes there by boat every day.
According to the principal, electricity cables were laid from Centro in 2004, and "until then we lived by lamps and didn't even have television."
Electric wires stretch along the dirt road, just wide enough for one person to pass, like an umbilical cord to civilization. Wooden stilt houses stand about every 50 meters, and the sound of televisions can be heard.
Emerson Borges, a HANDS staff member who gave us a tour, said with a serious expression, "The television signals are clear in the houses at the front, but the electricity gets weaker the further you go, and at the very back, even the electric fans won't work."
About ten meters away from every house, there is a thatched hut. It is a toilet. According to Mr. Emerson, until recently, it was normal for people to relieve themselves in the grass nearby, but now they have been instructed to build toilets to prevent infectious diseases.
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We ate lunch prepared by the cook while standing on the boat, then headed to the next community, Santa Litta, about an hour away in the opposite direction from Centro. There was also a four-piece set centered around a church.
About fifty children gather, sitting in chairs in an auditorium, and hear the same health and hygiene talk.
Antonio Prado Alfaia (64), a local health worker, praised the work of HANDS, saying, "When they explain things like this, the residents' attitudes change. Parasites used to be severe here, but the situation has improved considerably." He added, "There are also quite a few leprosy patients here, so I would like them to investigate those as well."
On the way back, everyone gathered on the boat for a debriefing session. The fact that there was a group of people who were so dedicated and serious about their work was surprising.
HANDS conducts this kind of boat tour, visiting two community schools a day, for about ten days to two weeks each month. If they go downstream this month, they will go upstream the next month. It is hard work, even though it is helpful to everyone.
In response to requests from remote communities without telephones who wanted to be able to consult with doctors and specialists when people fell ill, HANDS distributed radio sets to 29 communities last year. Local health workers set aside one hour in the morning and one hour in the evening to communicate over the radio for health consultations and other purposes.
However, the hospital where ManiColle is based does not respond to radio calls. "I think they don't want to add to their already complicated work," says Jillson. "But we do respond to consultations. In cases of serious illness, we call a doctor and have them talk to us directly."
Although everyone agrees that stronger cooperation between community health workers and medical institutions is necessary, it will take time to change people's mindsets.
*This article was originally published in the Nikkei Shimbun on November 28, 2008 and is reprinted with permission.
*The Nikkei Shimbun ( www.nikkeyshimbun.com.br ) is a Japanese language newspaper published in Sao Paulo City, Sao Paulo State, Brazil, for immigrants, Japanese descendants, and expatriates.
© 2008 Nikkey Shimbun
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