Saúde portátil
Andréa Azambuja, Coordenadora da Rede em Rio de Janeiro
Rio de Janeiro 4 janeiro 2016
Segundo o Ministério da Saúde, as doenças crônicas não transmissíveis (DCNTs), como diabetes e hipertensão, causam 72% das mortes no Brasil. Este índice representa especialmente as camadas mais pobres da população, que comumente moram em favelas (16 milhões de pessoas) e têm acesso restrito a serviços de saúde: o tempo médio de espera para atendimento primário na rede pública é de quatro meses – caso seja necessário algum exame, são mais três meses para realizá-lo e, depois, mais quatro para apresentá-lo ao médico –, e hospitais costumam ser muito distantes.
No Rio de Janeiro, onde mais de dois milhões de pessoas vivem em assentamentos informais – se unificados, formariam a 7ª maior cidade do país – o problema se agrava: por urgências médicas, muitos moradores têm que apelar para a ajuda de líderes do tráfico e acabam devendo favores e, então, vinculando-se ao crime, mesmo contra vontade. Esta prática, no entanto, deve diminuir, graças à Plataforma Saúde, projeto que oferece serviços de saúde utilizando tecnologias móveis.
A proposta da Plataforma Saúde é atuar de forma preventiva, com foco na população carente em áreas de difícil acesso. Para isso, leva serviços de qualidade, integrados e sustentáveis, que identificam problemas antes dos sintomas aparecerem e antecipam as DCNTs, a zonas quase esquecidas. Seu principal produto, o Saúde Agora, consiste numa avaliação geral do paciente – incluindo testes de glicemia, colesterol e aferição de pressão arterial – e de seu estilo de vida, com atenção especial para os fatores de risco, como o tabagismo, o consumo nocivo de álcool e o sedentarismo.
O resultado dos exames é entregue no final do processo, que dura apenas 20 minutos, impresso em um sistema de cores de trânsito, uma linguagem universal que facilita o entendimento por pessoas analfabetas. O usuário recebe, ainda, login e senha, para ter acesso online aos dados sempre que precisar – tudo fica armazenados na "nuvem" –, e são desenvolvidas ações pontuais de conscientização e acompanhamento, como o envio de alertas via SMS.
Este serviço não é gratuito, mas acessível: custa de R$5,00 a R$ 25,00 no total. Além do baixo valor e da mobilidade, chama atenção o atendimento: os profissionais interagem de forma mais acolhedora e horizontal com os usuários, nos locais onde eles moram (evitando que tenham que despender horas em locomoção ou filas), com linguagem acessível e apresentam resultados instantaneamente, o que aumenta a influência de suas palavras. A inteligência de dados do sistema facilita ainda mais o entendimento, favorecendo a autogestão dos doentes crônicos e permitindo que cada um tenha controle sobre o seu histórico clínico – informações acessíveis a todos os enfermeiros, para que sempre possam monitorar progressos individuais.
A ideia da Plataforma Saúde surgiu em 2014, no Startup Weekend Rio Favela, o primeiro evento de empreendedorismo do mundo realizado numa favela. A partir de demandas vindas diretamente da comunidade, dois jovens empresários procuraram médicos, gestores e especialistas, conceberam o formato, executaram o protótipo e, em tempo recorde, começaram a resolver um dos problemas nacionais mais complexos – o que os governos tentam, mas não conseguem fazer.
Se a iniciativa não supre a necessidade da construção de hospitais e postos de atendimento completos, atua no problema da saúde pública de forma eficiente, ágil, econômica, digna, democrática, sustentável. Uma abordagem inovadora, que pode servir de modelo no mundo todo (mais da metade das mortes globais se devem às DCNTs) – e que foi reconhecida com inúmeros prêmios, como o de Empresa Mais Criativa das Américas pelo BID EUA, o "Play to Win Award" – Prêmio 3M de Empreendedorismo e o Prêmio de Inovação Social TIC Américas Panamá, além de ter sido reconhecida pela ONU em relatório recente de mercados inclusivos. Close.
Foto: Tales Gomes, criador do Plataforma Saúde. Crédito: Espaço Nave.
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Saving lives with portable health
Andréa Azambuja, Rio de Janeiro Community Manager
Rio de Janeiro, 4 January 2016
According to the Ministry of Health, chronic non-communicable diseases (DCNTs), such as diabetes and hypertension cause 72% of deaths in Brazil. That index especially represents the poorest sections of the population who often live in slums (16 million people) and have restricted access to health services. The average waiting time for primary care in the public system is four months. If any examination is necessary, it takes another three months to do it, and then four more months to introduce it to the doctor – and hospitals are very far away.
In Rio de Janeiro, where more than two million people live in informal settlements – if unified, they would form the 7th largest city in the country – the problem is magnified. Because of medical emergencies, many residents have to call on the help of drug trafficking leaders and end up owing them favors, and, at the end, linking themselves to the crime. This practice, however, should decrease thanks to Plataforma Saúde, a project that provides health services using mobile technologies.
Plataforma Saúde aims to act in a preventive manner, focusing on the poor in areas of difficult access. To accomplish that, it takes quality, integrated and sustainable health services that are able to identify problems before symptoms occur and anticipate the DCNTs to almost-forgotten areas. Its flagship product is a general assessment of the patient, including blood glucose tests, cholesterol and blood pressure measurement, and lifestyle choices, with special attention to risk factors such as smoking, harmful use of alcohol, and physical inactivity.
The test results are delivered at the end of the process, which lasts only 20 minutes, and then printed in a traffic color system, a universal language that facilitates understanding by illiterate people. The user also receives login and password information to have online access to data whenever they need it (everything is stored in the "cloud"), and specific actions of awareness and monitoring are developed, such as sending alerts via SMS.
The service is not free, but cheap: it costs from R$5 to R$25 (up to US $5) in total. Besides the low price and mobility, the professional´s care is worth noting: they interact more warmly with users, where users live and present results instantly. The system data intelligence also facilitates understanding, promoting the self-management of the chronically ill and allowing each patient to have control over their medical history.
Plataforma Saúde was created in 2014 at the Startup Weekend Rio Favela, the world's first entrepreneurship event held in a slum. From demands directly from the community, two young entrepreneurs sought doctors and specialists, conceived the format, prototyped the project and, in record time, began to solve the most complex of national problems - what governments try, but usually are not able to do.
The initiative does not displace the need for construction of new hospitals and full service centers, but it does show a solution that operates an efficient, agile, economic, dignified, democratic, sustainable system. There’s great promise year for this innovative approach – one that has been honored with many international awards – to have resonance worldwide to help stop the large numbers of global deaths due to DCNTs. Close.
Photo: Tales Gomes, Plataforma Saúde creator. Credits: Espaço Nave.
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January 2016 — This year, 2016, is not like every other for the urban debate. In October, leaders from across the globe will convene in Quito, Ecuador, for one of the most significant global conferences on the future of our cities. The United Nations Conference on Housing and Sustainable Urban Development – known simply as Habitat III – will set out a roadmap for a more sustainable urban agenda. Cities from across the world will be showcasing their most promising projects. With this in mind, this month, URB.im's Community Managers will share what they believe to be the big ideas for 2016 from their respective cities. These are ideas that "integrate equity into the development agenda" – from tackling homelessness in Curtiba to making Jakarta into a Smart City. Every day we'll publish a new idea from a different city. Join us in this lively discussion.
Equidad por medio del ser expuesto
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Eko Atlantic City: the emergence of Africa’s new financial haven
Sobre el proyecto emblemático de Medellín, "Parques del río"
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Grassroots solutions to ease accessibility in Bangalore’s underbelly
The politics of ecological and sustainable development
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Whereas the urban—albeit depoliticized—sensibility of such emergent projects in Johannesburg give some hope for new beginnings, a new mega-project in Cape Town, known as the 
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ويعقد المرالهدف الرئيسي للمشروع هو تطوير رؤية للقاهرة حتى 2050 باستخدام نهج تشاركي عملي، كما تهدف لإعداد خطط للمشاريع ذات الأولوية الوطنية مثل التنمية الحضرية وتطوير قطاع شمال مدينة الجيزة في إطار نهج جديد للشراكة بين القطاعين العام والخاص لتحسين العشوائيات ومنع نمو المزيد من الأحياء الفقيرة. وعلاوة على ذلك، يسعى المشروع إلى إنشاء وحدة الرصد الحضري المحلي لإقليم القاهرة الكبرى كآلية لرصد التنمية الحضرية ودعم تطوير السياسات الحضرية المستقبلية بالإضافة إلى تعزيز قدرات الفاعلين المحليين في النهج التشاركي والتخطيط الاستراتيجي والإدارة والتنفيذ.
Comments
Promoting cycling where gas is dirt cheap
Hi Marcela,
Great article! It's wonderful how EcoDelivery is taking the lead on sustainable delivery services! What do you think the best way to incentivize the government to investing in sustainable transport is? Could they reduce bus fares with such low gas prices?
Ashali
Servicios en el proyecto del Río
Lou, muy interesante el proyecto sobre el Río de Medellin; en México existen estrategias similares para el rescate de espacios públicos como estrategia para eliminar actividades delictivas o de vicio social. El proyecto del río suena más ambiciosa en cuanto a los años de implementación y alcances, me parece buena idea en el sentido de la creación de nuevas viviendas de interés social. ¿En estas viviendas se reubicarían a las personas que se encuentran actualmente en situación de calle en el río? y por otro lado ¿También se desarrollarían servicios junto con el proyecto? Si bien un reto de las ciudades es que en los nuevos desarrollos se contemple el acercamiento a los servicios para que las personas tengan acceso a las necesidades básicas y sin generar problemas de movilidad y transporte.
Building the Resiliency of the Urban Poor
Hi Sumaiya,
It's great that through the URP and UBSP, infrastructure is being upgraded to reduce vulnerability to disaster. Are there any training programs for citizens to teach them how to react in case of an earthquake or fire, or is it solely and infrastructure upgrading project?
Re: Building the resiliency of the urban poor
Hi Sumaiya,
I really enjoyed your article on the resiliency of the urban poor. The one question I had is with regard to the more 'soft,' aspect of this initiative - specifically, with regard to organizational structure and training, are the relevant organizations and staff adequately trained to handle search and rescue and emergency management? For me this is always the other side of the equation when providing 'hard' interventions, namely when new equipment is provided, the organizational structure and skills of the relevant personnel must also be reviewed to ensure that they can use the equipment properly. Is this happening in this project?
Sáude portátil
Andréa, great article. It seems that beyond making the system easier, it made health care cheaper for the beneficiaries, so I was wondering, how is it financed? Does it get subsidies?
Participatory Approaches
Hilary, it is very interesting the strategie in order to promote quality of life for slum dwellers in Nairobi. Definetely buttom-up approaches help to detect local needs of inhabitants and includes them in order to make sustainable projects due the complaince of their expectatives.
House on the path of Freedom
Dear Andréa,
Great piece on psycho-social support for the homeless. Just wondering, the surge in homelessness in Curitiba, are they all poverty-induced? You also mentioned the admission requirement which must be based on previous records like hostels and Centros Pop, do they admit those without any record of staying in temporary shelters (new homeless). Also, do they subject new intake to some medical examination to guide against disease outbreak. Thanks
Saúde Portátil
Hi Lo,
Thanks for asking! I do not think the founders of Plataforma Saúde get any subsidies from the government or from any company. They invested their own money, but did get a lot of awards that helped them to put the project together and functioning.
The project was first presented in an event called Startup Weekend Rio Favela, when they were awarded with products by Microsoft and got invites to participate in different events of project acceleration. They were also selected by Endeavor's acceleration program, an organization focused on corporate business, and NAVE, an university program, what represented a major technical and also monetary assistance.
Besides the machines, Plataforma Saúde's design is not very expensive, as they do not have to pay rent, and the services they offer are limited (consequently, the costs are easily controlled). In addition to that, the services offered are not free of charge, but very cheap – anyways, by the volume of calls, I think they expect to recover the amount invested very soon. At the same time, they have talked with the government and I'm sure they would like to do some partnership – maybe in the future! :)
EAC- Lagos
Dear Peter,
Great article. Despite being in Africa, Egypt, but I never heard about EAC, so thanks for sharing. The project seems effective, economic-oriented and sustainable for business, however, while I am reading I had really strong concerns on the aquatic life, as the government as you said will seize large parts of the ocean and its surrounding. Also, the environment will drastically change I believe given this transformation in the ecological and geographical aspects of the life in the area. You stated that briefly in the article, however, I wonder what are the roles of Environment NGOs as Greepeace for instance in understanding its responsibility for awareness toward this massive project, also how the government will mitigate such environmental changes which will affect the locals eventually? Thanks for sharing this!
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