Public Service Fellow in São Paulo, Brazil

SMU senior Carol Sale is volunteering at Associação Saúde Criança in São Paulo, Brazil this summer, but she is not just another volunteer. In addition to her work at this innovative health organization, Sale is also performing an SMU staff-facilitated anthropological study of the moral distress of doctors, psychologists, social workers and lawyers who work closely with many of the severely disabled clients of the NGO.

Saúde Criança is well equipped to work with these clients through a multidisciplinary methodology that acknowledges extreme poverty as the root cause of many of the diseases treated in public hospitals. Consequently, it seeks to eliminate what the organization calls the “vicious cycle” of “poverty, disease, admission into the hospital, discharge, re-admission and death” (www.saudecrianca.org). Called the Family Action Plan (FAP), the methodology identifies the five areas of Health, Education, Citizenship, Housing and Income as crucially interconnected, and seeks to help families become more stable and capable of caring for their children not only during hospitalization but afterwards as well.

While the staff and professional volunteers at the organization are well-equipped for this multi-disciplinary work with families and children, such work can be exhausting. The overwhelming task of caring for sick/disabled children and their impoverished families often leads to what Sale identifies as “moral distress,” or “the feeling that comes about when individuals have done everything within their power, but know that it is still not enough.” Sale expects that this feeling is particularly pronounced among public health workers and volunteers in Brazil, a country which, like the United States, is suffering from a lack of access to affordable health care coupled with increasing economic inequality. Sale hopes that her study will help illuminate both the changes that need to be made to these systems and the ways that Saúde Criança is already succeeding against these odds.

Sale, who is pursuing a triple major in Human Rights, Health and Society, and Biology with a minor in Spanish is performing her research this summer under the direction of SMU Anthropology professor Carolyn Smith-Morris. Her funding comes from the Cary M. Maguire Center for Ethics and Public Responsibility through the 2019 Maguire Public Service Fellowship.

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