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Surgical treatment in the Amazon

Surgical treatment in the Amazon. Md phd Fabio Tozzi. SUS. universality equity Whole/Completeness. Amazon / Indigenous Health. Context - summary. Low population density Great distances - scarce transport routes

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Surgical treatment in the Amazon

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  1. Surgical treatment in the Amazon Md phd Fabio Tozzi

  2. SUS • universality • equity • Whole/Completeness Amazon / Indigenous Health

  3. Context - summary • Low population density • Great distances - scarce transport routes • Difficulty of internalization - medical staff - low physician / inhabitant ratio • Small investment in health ($/ inhab.) • Small supplemental coverage (private health insurance) • low currency circulation • health services ill-equipped • Injuries resulting from lack of access to health services and infrastructure / sanitation • Microregion - aggravated indices

  4. Framework of Social Exclusion and Lack of Policies • Live by hunting, fishing, collection of forest, and regional crops, being very low currency circulation; • No longer able to secure their livelihood due to deforestation; • minor illnesses become serious lack of effective intervention, with high rates of malnutrition and infant mortality; low coverage in basic health • Only 7.5% with access to high school education; • 47.5% of the population is under 15.

  5. Roads in North region-Logic of by the river health

  6. different laws and rules for territories

  7. Percentage of municipalities in terms of number inhabitants. v IBGE-senso 2010

  8. doctor / population ratio Distribuição de médicos (coorte 1990 a 1999), segundo local de domicílio ou trabalho – Brasil, 2013 inside of Pará, there is a higher average ratio of the country (1/4466 inhab.), performance results from the fact that 73.3% of the active state doctors are concentrated in the capital Belém, which meets only 20.4% of the state population Fonte: CFM; Pesquisa Demografia Médica no Brasil, 2013.

  9. HDI (Human Development Index)

  10. Government spending on health

  11. Health supplemental coverage (private health insurance)

  12. Santarém City- case report 240 doctors/300.000hab/1.200.00 Low complexity ultra low investment low coverage 30% 30 Family health teams   300.000hab / 1.5 M.R$/ month per capita Investment $ 14 +Doctors-3provab only 1 medical consultation/year/inhab HAS/Diabetes/parasitose / mal nutricion Water born diseases medium complexity low investment High Number users 900admissions/250surg/month                  800.000hab 300,000 + / 3.5M.R$/month   per capita  investment $$ Trauma/Emergency/Diabetic foot High complexity high investment low coverage few beds (130) Only400admissions/350 surg. / Month Difficulty of access 1.200.000hab / $ 9M.R$/month percapta investment $$$$$$ Cancer surgery / neurosurgery general Trauma orthopedic complex surgery 1US=2.25Real

  13. Surgery Suppressed Demand Media-STM Rural areas = NO ACESS Orthopedic surgeries Cholecystectomies / Hernias / Varices -vascular Ophthalmic surgery 5.000

  14. How to solve this problem?? Strategies knowledge Technology Research public health policies 1-Abaré 2-Use of technology for special areas 3-Surgery journey/Task force 4-New therapies

  15. The Abare in Primary Health Care for People of the Forest PUBLIC POLICY 2010 - ministerial decree 2191- ESF Fluvial 2014 Ministry of Health resources transformation into a Teaching Hospital

  16. DEFINED TERRITORIALITY • Region of Western Pará •   3 Municipalities • 150 Communities • 30,000 beneficiaries MOBILE HEALTH UNITS ABARÉ: since 2006 / Tapajós New boat: 2009-10 / Arapiuns

  17. ABARÉ – Fluvial Family Health Team Results Fonte: Brasil, Norte, Pará – DATASUS (2007) Abaré – Sosniski, Cristina (2008), Pesquisa Socioeconômica e de Saúde, e Relatórios do Abaré

  18. ZOÉ laparoscopic colecistectomy one day 6 surg. We We need preserve and help them!

  19. 4

  20. Pilot study to evaluate the treatment of varicose vein with polidocanol treatment of choice for inland areas: Task force/Journey to eradicate varicose vein in Municipio de Juriti -Pará (April 9 Hospital and City Hospital Juriti) Fabio L. Tozzi FL, Campos W jr , AzevedoER,Pedrosa A. Ana Marcia . ONE DAY 130pacientes 5US$/each one

  21. video

  22. ! 240Medical students 10 courses of medical residency Obrigado! Thanks

  23. The important thing is not to give the fish but teach to fish!

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