Elaine Smith

‘The dream of Projeto Saude e Alegria is to become needless’. That’s how Caetano Scannavino Filho, general coordinator of Projeto Saude e Alegria (PSA), started his presentation to a group of people that had just spent five days in a boat navigating through Rio Arapiuns in the north of Brazil. The ‘very urban group’ came mostly from Sao Paulo – the city with the largest population, industrial complex and economic production in South America. It is the third year that a group has been organized by Instituto Geracao and Nucleo Oikos to go to this region to experience a learning journey. I think I can speak on behalf of the other passengers of the boat: we are all very grateful.

My idea of the Amazon region was simplified to the rain forest needing to survive to benefit the entire world. What I found was that there are a number of regions within the Amazon (and I only saw one of them). I found a number of people living in a part of the Amazon characterized by several rivers. I’ve learned there are beaches and white sand in the region during the dry season. I saw the biodiversity, the weather and the rich culture of forest people living far from the cities. The struggle for survival extends beyond the forest and nature. This is a learning journey that all of us should experience. Caetano Scannavino Filho says: ‘the eco-tourism that your group experienced is managed by the communities you visited. It is an economic alternative to generate income for those families. It has no impact to the environment, highlights the local culture, and maximizes other activities of the local region.’

Davide Pompermaier from PSA was the coordinator of our trip. He highlights the importance to meet with the local population to see how they live and they keep their culture alive, how they relate with nature and the natural resources of the region.

Projeto Saude e Alegria has worked in the Amazon region since 1987, helping to boost the developing of communities in a sustainable way, supporting public policies in improving the quality of life and human rights. The region they oversee has about 30,000 families in 129 municipalities, most of them depending on local agriculture in rural zones, combined with fishing and hunting. They are exposed to social exclusion given the distance from city centres – up to 20 hours by boat. Social work in an urban area involves waking up early, taking several public transportations, working in the community and then finding your way back home; in rural locations, one has to spend up to 10 days in the field, because of the distances they have to travel. The PSA team that was in the boat I was in, for instance, had a six-day trip away from their homes and families, including a weekend to accommodate the group needs.

The story of PSA started with a doctor called Eugenio Scannavino Netto in 1983 (also featured in the movie Quem se Importa or Who Cares). In the early 80s he worked in the city of Santarem as a doctor for families living the rural areas by the river, several hours from a city. With the support of the Brazilian Developing Bank (BNDES) and art educator Marcia Gama, he created the NGO PSA to increase knowledge about health and prevention of diseases. The use of chlorine to treat the water, food supplement production from plants in the region and basic sanitation were the main items in the early stage of their intervention in communities. Later they included the prevention of sexually transmitted diseases and support for pregnant women.

For better results and to get the positive attention of the community, their team had clowns that created songs and sketches teaching simple rules to prevent diseases. Their boat (Abare, which means ‘friend that cures’ in the local Indian language Tupi) was bringing not only health but also joy to the local people.

Their work continued to develop, now with the enthusiastic work of Eugenio’s brother Caetano, realizing that the prevention was not enough. Low family income, poor education and lack of environmental conscience could also be blamed for high mortality rates in the region.

Almost three decades later, the NGO splits its focus into four main areas: health and basic sanitation (consultations, medical tests, medicine and follow-up visits), communication (education, culture, environment and digital inclusion), social organization (including human rights, citizenship values and empowerment of women) and sustainable economic alternatives or income generation for the communities (mostly artisan products and eco-tourism). The communities are learning how to use their culture to create income.

Art, playful clowns, theatre and sketches are some of the vehicles the group uses to communicate and to mobilize the local population. But the content and background of this team astonished even the most pragmatic banker in my group. They do very serious public work for a population that is far away from politicians and the government eye.

I also had the chance to talk with Dr Fabio Lambertini Tozzi (general coordinator of Santarem Municipal Hospital and also coordinator of the health department of PSA) who told me that public policies such as Bolsa Familia, monthly support from the federal government that goes to over 13 million families (Brazilian current population is getting close to 200 million people) are helping the poor population to decrease hypertension (salt is used to store food and local development decreases the use of salt). It also helps to diminish the speed of deforestation because people increased plantations of manioc. The Bolsa Familia also provided access to more industrialized products. Unfortunately, some of these products are poor-nutrition carbohydrates (such as cookies), spirits and processed food (salted snacks), and these products increase the amount of garbage created in the community. It is also important to say that families spend R$18 each way to receive this R$140 in the city.

The health boat named Abare was financed by the Dutch Terre dos Hommes in 2006. It became public policy in 2010 and is now run by the municipalities. The government is now looking finance 32 smaller Abares. Locals hope the quality of the service to the population remains intact from PSA history.

In part 2, next week, I will write more about the details of the trip.

Elaine Smith is development manager at Instituto Geração.