Mary Weng, 2013 GHLI Fellow
With a population of more than 11 million, São Paulo city could be classified as a small country. Working with public health on such a large scale is certainly daunting, but I am reminded that while there are great challenges, the potential benefits and gains are also great.
When I first started work on a strategy for early child development (ECD), I strived to seek out the perfect plan that would address the issue. My experience this summer has taught me that there is no “silver bullet” to address ECD in Brazil. During various site visits, I witnessed extremes in the range of quality and delivery of care. I visited the Dante Pazzanese Cardiology Institute, one of the premier pediatric cardiology centers in Latin America, and in contrast, then visited an Unidade Básica de Saúde (primary care unit) in a under resourced area of the city, where doctors sometimes see up to four patients an hour.
In a city as large as São Paulo, the vulnerabilities that children face are diverse. No single program or plan can address all of the issues; a set of strategies would be more adequate. At the same time, I have learned that the implementation process is just as important as the plan itself, and that the people working with the children must be equipped with the ability to handle the vulnerabilities they encounter.
I’ve met with NGO activists, child psychiatrists, nurses pioneering parenting programs, public health officials from the city of Sao Paulo – and I am inspired by the way everyone I have met does his or her job with such passion. The children of São Paulo have some great advocates on their side! As a result of my meetings thus far, I have been able to better map existing ECD programs and policies, and identify possible gaps that need to be addressed. With just a few weeks left in the country, I am picking up the pace to make sure I observe and contribute as much as I can before I leave.