Word: curitiba
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There is an expression in Brazil--dar um jeito--that, loosely translated, means no problem is unsolvable and no barrier too great to cross. Dr. Randas Jose Vilela Batista adopted this attitude in dealing with the patients in his tiny rural hospital outside Curitiba, in the south of Brazil. Many of them were dying of congestive heart failure, which caused their hearts to weaken and enlarge. Because he lacked the resources necessary for the standard American treatments for the disease--drug therapy and heart transplant--Batista needed to come up with a different solution. The one he finally adopted appears...
...conditions under which Batista, 50, operates when he is in Brazil are spartan at best. There is little modern monitoring equipment at his Curitiba hospital. Instead, his technicians are instructed to look for three things: the patient's feet should be pink, to demonstrate adequate blood pressure; there should be urine output, to indicate that the patient has not lost kidney function; and the surgical drain should be clear, to show no internal bleeding. Surgeons depend on large windows in the operating room to provide adequate light for operations...
Working in his subpar facilities in Curitiba, Batista becomes discouraged by the U.S. medical system's reluctance to help the sickest patients. "In America," he says, "if a doctor doesn't do anything and the patient dies, it's called a natural death. But if the doctor tries to do something to save that person and he dies, the doctor gets blamed for the death. That's backward thinking." The sickest patients excite Batista most because, he says, "they are the ones I can help the most...
...easy to understand why Brazilians would migrate to Curitiba, but why do people keep streaming into a Kinshasa or a Karachi, Pakistan? What is the irresistible lure of the megacity? To the outsider, a neatly swept native village in Africa, Asia or Latin America may look more inviting than a squalid urban squatter settlement. But until recently even the most wretched city slums have offered better access to paying jobs, more varied diets, better education and better health care than what was available in rural communities...
Ultimately, the responsibility for making cities livable rests with their governments and their people. Too often those governments, whether in New York City or Kinshasa, become corrupt systems for dispensing benefits to agencies, employees and political supporters. If, as in Curitiba, governments can learn again how to serve the public, they can regain a mighty power -- the power that comes from harnessing the combined imaginations and enterprise of millions of human beings...