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Field hospitals are preventing a healthcare collapse in Brazil

. May 04, 2020
Field hospitals are preventing a healthcare collapse in Brazil Maracanã field hospital, in Rio de Janeiro. Photo: A. Paes/Shutterstock

In at least five Brazilian states — Amazonas, Ceará, Pará, Pernambuco, and Rio de Janeiro — over 85 percent of intensive care units are currently filled. In Greater São Paulo — home to nearly one-third of the country’s cases — the occupation rate reached 89 percent, with at least 12 cities running out of intensive care units altogether. The city of Rio de Janeiro reportedly had only three vacant ICU beds as of Monday morning.

Meanwhile, the federal government promised to expand the capacity of the national healthcare system but has delivered only 17.5 percent of the 2,000 new intensive care units it had originally pledged.

</p> <p>With the healthcare system collapsing nationwide, local governments have taken it upon themselves to organize their Covid-19 responses, with around 40 field hospitals in at least ten states being set up to accommodate the overflow of state and municipal health systems. At least 4,000 temporary hospital beds have been installed throughout the country, a number that is expected to double within the next two months.</p> <p>Despite being a quick response to a rapidly-evolving problem, field hospitals have encountered many problems in a country that struggles with bureaucracy and a scarcity of resources.</p> <div class="flourish-embed flourish-map" data-src="visualisation/2242350" data-url="https://flo.uri.sh/visualisation/2242350/embed"><script src="https://public.flourish.studio/resources/embed.js"></script></div> <h2>Putting empty facilities to good use</h2> <p>From convention centers to schools and universities, every empty space has the potential to become a mobile care unit in such times of crisis.</p> <p>With sporting events around the world suspended due to social isolation rules, stadiums and training facilities have been used as a weapon to fight Covid-19. In the Peruvian capital of Lima, the oldest bullfighting ring in Latin America was turned into a <a href="https://news.yahoo.com/historic-peruvian-bull-ring-converted-virus-homeless-shelter-171325808.html">homeless shelter</a> during the crisis. In Spain, Real Madrid&#8217;s Santiago Bernabeu stadium is being used to store medical supplies.&nbsp;</p> <p>In Brazil, these temples of football are being used as field hospitals. The <a href="https://brazilian.report/sports/2020/03/23/stoppage-to-plunge-brazilian-football-teams-into-dire-crisis/">Pacaembu stadium</a> in São Paulo is now home to <a href="https://brazilian.report/coronavirus-brazil-live-blog/2020/04/07/sao-paulo-to-build-field-hospital-coronavirus-ibirapuera-park/">200 improvised hospital beds</a>, while Rio de Janeiro&#8217;s Maracanã stadium is being prepared to treat <a href="https://brasil.elpais.com/esportes/2020-03-31/do-pacaembu-ao-maracana-templos-do-futebol-se-transformam-para-combater-coronavirus.html">up to 400 sick Brazilians</a> at a time. In the Northeast, Bahia&#8217;s old Fazendão training center is being used to treat non-Covid-19 patients, to free up space in local hospitals and allow those who test positive for the coronavirus to receive care.</p> <figure class="wp-block-image"><img src="https://brazilian.report/wp-content/uploads/2020/05/frrf-1-1024x576.jpg" alt="Field hospitals are preventing a healthcare collapse in Brazil" class="wp-image-38117" srcset="https://brazilian.report/wp-content/uploads/2020/05/frrf-1-1024x576.jpg 1024w, https://brazilian.report/wp-content/uploads/2020/05/frrf-1-300x169.jpg 300w, https://brazilian.report/wp-content/uploads/2020/05/frrf-1-768x432.jpg 768w, https://brazilian.report/wp-content/uploads/2020/05/frrf-1-610x343.jpg 610w, https://brazilian.report/wp-content/uploads/2020/05/frrf-1.jpg 1200w" sizes="(max-width: 1024px) 100vw, 1024px" /><figcaption>Field Hospital outside of Rio&#8217;s Maracanã Stadium. Photo: GOVERJ</figcaption></figure> <h2>Bureaucratic barriers</h2> <p>With resources scarce during the crisis, planning where to install these mobile units is key to avoid overwhelming the health system in a continental-sized country such as Brazil. From its part, the federal government has so far announced the construction of two field hospitals: one near the capital Brasilia and another in <a href="https://brazilian.report/coronavirus-brazil-live-blog/2020/04/11/mandetta-government-build-field-hospital-amazonas/">Manaus</a>, where the local healthcare system collapsed weeks ago. Bureaucratic obstacles, however, have stopped the former from <a href="https://www1.folha.uol.com.br/colunas/painel/2020/05/propagandeado-por-bolsonaro-hospital-de-campanha-de-goias-esta-fechado-por-burocracia-do-governo-federal.shtml">being inaugurated</a>, despite construction being completed many weeks ago.&nbsp;</p> <p>Meanwhile, states that have completed their field hospitals still struggle with a lack of medical equipment and health care professionals. In Rio de Janeiro — which has over 10,000 confirmed cases — only one of the nine planned mobile hospitals has been inaugurated so far. According to Rio de Janeiro Health Secretary Edmar Santos, the state government expects to open five more field hospitals within the next two weeks. However, as things stand, only <a href="https://oglobo.globo.com/rio/atrasados-hospitais-de-campanha-aguardam-equipamentos-profissionais-de-saude-para-serem-inaugurados-24403201">30 of the 3,400 promised hospital beds</a> are available for use.</p> <p>Midway through March, an investigation by news website <em>G1</em> found that the construction of field hospitals in Rio de Janeiro and Minas Gerais was <a href="https://g1.globo.com/rj/rio-de-janeiro/noticia/2020/04/17/aquisicao-de-hospitais-de-campanha-tem-proposta-plagiada-e-concorrente-fantasma-no-rj.ghtml">plagued with fraud</a>, with Rio&#8217;s Deputy Health Secretary placed under compulsory leave until the matter is cleared up.</p> <h2>The history of field hospitals</h2> <p>Though the use of field hospitals originated as part of military medicine, they have long been used in pandemics. From the Spanish Flu in the 1910s to the Ebola epidemic of the last decade, these mobile hospitals have served as a prompt response to rapidly-evolving problems.</p> <p>The goal of these hospitals is not to treat patients in critical conditions, specialists say, but to avoid the possibility of mild or moderate cases also needing intensive care. But as the Covid-19 numbers continue to climb in Brazil, field hospitals serve as an opportunity for the country’s health care system to catch its breath before <a href="https://brazilian.report/society/2020/04/19/more-brazilian-states-facing-collapse-under-covid-19-pressure/">a potential collapse</a>.</p> <p>New field hospitals are being inaugurated in the country every day. It is expected that the current number of mobile hospital beds will double within the next two weeks, surpassing 8,000 units.

 
Augusta Saraiva

Augusta is a Brazilian journalism student at Northwestern University

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