What are Your Dreams for this Family?

When hospital patients are well enough to be released, ideally they head home to an environment where they will get even stronger and healthier and make a full recovery.

But what happens when those patients -- young patients in particular -- are released into home environments that make recovery impossible? What if their families cannot afford the crucial follow up care? What if they are struggling just to provide basic nutrition and a safe or sanitary home?

Working as a pediatrician at Lagoa Hospital, a public facility serving Rio de Janeiro’s poorest citizens, Vera Cordeiro knew all too well. “Children we’d treated kept coming back with preventable diseases like pneumonia, tuberculosis and dysentery,” she says. “Worse, the weaker ones with low immunity levels sometimes succumbed to even minor infections.”

Cordeiro and her beleaguered colleagues knew that sometimes “sending these kids home was akin to passing a death sentence on them.”

In 1991, Cordeiro and a handful of those colleagues started a program to try and change the odds for these patients.  What they created was Saude-Crianca Renascer, a consortium of hospital staff, social workers and volunteers that reaches beyond the hospital walls to the most overburdened families.  By meeting these families where they are and evaluating their circumstances in a sensitive but realistic light, they are able to make dramatic interventions.

Cristiane de Luna’s family was among the beneficiaries. Her 6- month-old son Luiz had been in the hospital since birth.  When Renascer’s team of social workers met her in the pediatric ward, she was neatly dressed and well groomed. “She didn’t seem that bad off,” one of them recalls.  After winning her trust, they made a visit to her home, which they discovered was a shack of wood scraps with a dirt floor covered in rugs that were damp from periodic flooding. 

She lacked running water, refrigeration and even a working stove.  De Luna explained that with no money for propane, she had been unable to make a hot meal in over a month. 

“A sick child simply could not come back to an environment like this. He would only get worse,“ says Renascer worker Marcia Barros.
The family’s needs were numerous – and problems usually addressed by a handful of different social services. But Renascer’s multi-pronged approach was what de Luna needed to make her home a healthy environment for her sick son. And de Luna had a head start of her own: self-esteem, says Barros.  

After securing some emergency aid -- a water filter, a tank of propane and some extra transportation vouchers to the hospital, they invited de Luna to join their program where the real work would begin.

Renascer works with about 250 families at a time, most of them headed by single mothers.  With each, the first question they ask is “what are your dreams for this family?” Then they sit down and come up with a comprehensive Family Action Plan.  Over the next 18 months, Renascer helps each mother to get her family on its feet.  

She learns about her sick child’s needs and how to meet them, she learns a craft that can earn some income, and she gets some help with home improvements and repairs. Lastly, she makes connections with the staff and other mothers in similar circumstances that can lend her meaningful support.

So far, over 2,400 families have become more self-sufficient, and as many as 8,000 children have been given a healthier home.   As word has spread about the dramatically reduced hospital re-admission rate at Lagoa (63%) along with the attendant financial savings, programs like Cordeiro’s are sprouting up in different parts of Brazil.  Cordeiro makes her methodology and success strategies available to everyone.

“Our goal isn’t to make poor families rich,” Cordeiro says. “We’re taking families who are living in misery and providing them tools and support networks to take care of their future health and well-being.”