At the end of the 1980s, as a doctor, working at Hospital da Lagoa, in Rio de Janeiro, I clearly perceived the relationship between the diseases that affected children hospitalized there and the situation of risk and social vulnerability to which they and their families were subjected. A few years later, I founded, with a group of hospital employees, Institudo Dara, at the time called Associação Saúde Criança Renascer. We developed the Plano de Ação Familiar (PAF – Family Action Plan), an innovative social technology, which plans actions and goals in five areas – health care and nutrition, citizenship, housing, education and income generation – according to the needs of each family.
It was through the implementation of this plan that, over the years, we were able to remove more than 75 thousand people out of misery, improving their living conditions and supporting them to become protagonists of their own destiny.
With the arrival of Covid-19, we had to learn to work remotely, but without compromising the integrality of our actions. Based on the knowledge of almost three decades of work in combating poverty, I believe that as poverty is a multidimensional problem, the integrated way thet we work is crucial to promote social inclusion.
Most of the more than 1,300 people/month supported today by Instituto Dara live in communities spread across the State of Rio de Janeiro. More than 40% of families are in the Baixada Fluminense region and have an average per capita income of BRL 380 per month. This was the situation in the pre-Covid-19 era. Many lost their main source of income when we were quarantined. Our first concern is that these families will not go hungry. Those who are hungry are in a hurry, said my friend Herbert de Sousa.
In this time of crisis, people and social organizations are mobilized. It is noticeable to see the potential of civil society to help others. At Dara, we work with the periodic recharging of a food stamp that each family has so that they can buy food and cleaning supplies near their homes, thus fostering local markets. This is the fastest way to help those who need it, while maintaining the precautions of social distance. We recharge online, in addition to guiding each family on the precautions they must adopt when making their purchases. Once the basic needs are guaranteed, we are able to maintain a comprehensive view of families.
It is precisely this different look at each member of the family, the DNA of our social technology, which has brought us significant positive and transforming impacts. Last week I was moved by the testimony of one of our doctors, when she revealed the relief that a mother of a premature child felt when talking to her on the phone and being properly guided. I smiled when I saw the video of a mother making a banana omelet that our nutritionist taught. I was moved by a father who sent us a video thanking us for the campaign’s contribution. I was happy to see a child studying at home according to the guidelines of our pedagogue. Our psychology team maintains permanent contact with families providing services through cell phones. The medical team continues to guide families, especially those who use long-term control medication, and pay local pharmacies where families go to get the medication they need.
Nutritionists continue to provide individual guidance to all patients, especially those with comorbidities, prescribing adequate food. The same is true for the legal advice sector, providing guidance remotely and advising those who suffer in this period of pandemic with domestic violence, in addition to informing about their rights with the government. The institution’s pedagogy service continues to provide remote assistance, guiding mothers and other caregivers to deal with their children’s studies and recreational activities in this difficult time for all families with young children and teenagers at home. The only area that for obvious reasons we are unable to work on during the pandemic is housing improvement.
The systemic impact that we have promoted over the years on our target audience is enormous, and the rupture in the intergenerational cycle of poverty is evident. According to research carried out by Georgetown University, among families who were discharged 3 to 5 years after participating in our program, their income practically doubled and hospital readmissions fell by 86%, just to highlight some of the long-term impacts found in our work.
Amartya Sen, Nobel Prize in Economics in 1998, tells us that the best way to end misery is to end the cause of misery – the real needs that affect human life. In this long trajectory of the Institution, we did exactly what the famous economist advocates for many years.
Poverty has a solution, and we know how to act even in times of pandemic.
