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STORY: BRAZIL / CHILD MORTALITY HEALTH PROGRAMME
TRT: 3.31
SOURCE: UNICEF
RESTRICTIONS: NONE
LANGUAGE: PORTUGUESE
DATELINE: 23 AUGUST 2013, FORTALEZA, CEARÁ STATE BRAZIL
1. Wide shot, Community Health Agent Maria das Graças walking to gate
2. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“My name is Maria das Graças Silva.”
3. Med shot, Community Health Agent Maria das Graças as seen through opposite side of gate then greeted by woman
4. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“I love my profession. Without a doubt, I like it very much.”
5. Med shot, Community Health Agent Maria das Graças walking away with woman who greeted her
6. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“When I started this job in 1991…”
7. Close up, Community Health Agent Maria das Graças
8. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“…many children were dying of dehydration and pneumonia.”
9. Med shot, child
10. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“And later malnutrition became a problem. Today the work of health agents is very different.”
11. Med shot, two adolescent girls, one holding a younger girl
12. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“Infant mortality has been reduced and so has malnutrition.”
13. Close up, girl’s feet as she removes her sandals and steps on a scale
14. Wide shot, Community Health Agent Maria das Graças with family, recording data from examinations
15. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“1 year and 5 months old and she weighs 10 kilos. Of the 40 children that I weigh, none are malnourished.”
16. Close up, girl’s feet as she steps of scale and places feet in sandals
17. Close up, adolescent girl and two younger children
18. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“When I started this job with 75 children, 15 of them were malnourished.”
19. Wide shot, Community Health Agent Maria das Graças interacting with family
20. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“Heloisa, did you receive this kind of care when you had your children? Was it better then or is it better now?”
21. Close up, Heloisa and a woman breastfeeding beside her
22. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“We didn’t used to have health agents. Many children died from infections and diarrhoea. We didn’t have doctors to help. It’s much better now, because fewer children are dying.”
23. Close up, Community Health Agent Maria das Graças
24. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“When I started, it was difficult for women to get prenatal care.”
25. Close up, Community Health Agent Maria das Graças interacting with family
26. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“Today it’s much better, we start meeting with a woman in the first month of her pregnancy.”
27. Med shot, Community Health Agent Maria das Graças interacting with family then speaking to expectant mother
28. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“How’s your baby doing, good?”
29. SOUNDBITE (Portuguese) Expectant Mother:
“Yes.”
30. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“Have you been going to prenatal visits?”
31. SOUNDBITE (Portuguese) Expectant Mother:
“Yes.”
32. Close up, expectant mother
33. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“Adolescents always listen to me.”
34. Med shot, children in courtyard
35. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent: “Because at first they don’t tell their parents that they are pregnant.
36. Med shot, Community Health Agent Maria das Graças talking to expectant mother
37. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“So they tell us everything.”
38. SOUNDBITE (Portuguese) Expectant Mother:
“You’re like a mother. You give us advice. It’s really nice.”
39. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“I am here when you need me. You can talk to me about anything.”
40. Close up of Community Health Agent Maria das Graças seated in courtyard
41. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“I’ve been doing this for many years.”
42. Med shot, Community Health Agent Maria das Graças playing with children
43. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
“I love the families as though they were my family. When they have any problem like family disputes they come to my home.”
44. Close up, Community Health Agent Maria das Graças seated in courtyard
45. SOUNDBITE (Portuguese) Maria das Graças, Community Health Agent:
46. “I am a health agent, a lawyer. I am everything here. If a child is sick during the night, they come to my home so I can pray. It makes me very very happy.”
At 56, and after 23 years of visits to families across her impoverished community outside Fortaleza, Graça Campos is on the front line of reducing child mortality in Brazil. And, in spite of Brazil’s impressive progress so far on that front, she shows no sign of slowing down.
Maria loves her profession.
“Without a doubt, I like it very much.
When I started this job in 1991, many children were dying of dehydration and pneumonia. And later malnutrition became a problem.
Today the work of health agents is very different. Infant mortality has been reduced, and so has malnutrition.
Of the 40 children that I weigh, none are malnourished. When I started this job with 75 children, 15 of them were malnourished.”
Heloisa, a mother, says things have clearly improved.
“We didn’t used to have health agents. Many children died from infections and diarrhoea. We didn’t have doctors to help. It’s much better now, because fewer children are dying.”
Maria agrees.
“When I started, it was difficult for women to get prenatal care. Today it’s much better, we start meeting with a woman in the first month of her pregnancy.
Adolescents always listen to me. Because at first they don’t tell their parents that they are pregnant. So they tell us everything. “
A young expectant mother is grateful for Maria’s help.
“You’re like a mother. You give us advice. It’s really nice.”
And Maria is happy to help.
“I’ve been doing this for many years. I love the families as though they were my family. When they have any problem like family disputes they come to my home. I am a health agent, a lawyer. I am everything here. If a child is sick during the night, they come to my home so I can pray.
It makes me very, very happy.”
In 2012, Brazil reached Millennium Development Goal 4 – reducing the under-5 mortality rate by two thirds. Disparities across Brazil mean that work remains to be done, particularly in some impoverished communities and among marginalized groups, including Afro-Brazilians and indigenous people.
Since the 1990s, Brazil’s highly effective Community Health Agent programme – which started in Ceará State in 1988 – has been one of the most important factors in reducing under-5 child mortality across the country. By visiting families and teaching them about the importance of breastfeeding, hygiene and vaccinations, health agents like Graça have been critical in reducing child deaths caused by pneumonia, diarrhoea, malnutrition, measles and other preventable diseases.
UNICEF’s 2013 Progress Report on Committing to Child Survival: A Promise Renewed, which examines trends in child mortality since 1990, analyses the main causes of under-5 deaths and highlights national and global efforts to save children’s lives.
