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Opinion – Marcia Castro: Knowing how to listen to face challenges in public health


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From the 3rd to the 19th of January, I coordinated a Collaborative Public Health Course in São Paulo, in partnership with the USP Medical School, the Getúlio Vargas Foundation, and the Brazil Office of the Center for Latin American Studies at Harvard University.

The course brought together local and Harvard professors and 36 participants (18 from Harvard, of various nationalities, and 18 from different Brazilian states). In its 16th edition, this course has already trained around 480 people (half from Brazil and half from Harvard). The host city alternates. The course has already been held in São Paulo (with activities in Sorocaba, Espírito Santo do Pinhal and Diadema), Rio de Janeiro, Salvador (with activities in Jiquiriçá) and Fortaleza (with activities in Sobral).

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The professional and academic trajectory of the participants after the course includes doctorates in national and international universities, exchanges in Brazil and abroad, and collaboration projects, among others.

It was a great honor to see Dr. Luciana Servo, a student of this course in 2016, will be appointed president of Ipea (Institute for Applied Economic Research).

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What makes this course special? The format.

The first week there are morning classes—45 minutes of lecture, 50 minutes of discussion. We reflect on the SUS (Sistema Único de Saúde), the family health strategy, the history of disease burden and control in Brazil, the current pattern of disease burden, and specific topics that address health challenges in the host city of the course . This year we focus on HIV/AIDS, tuberculosis, child development, Covid-19 and the health system.

The rest of the time is devoted to field visits and collaborative problem-solving work. We visited the Department of Health and the SUS network, including the Basic Health Unit, specialized service, street clinic, Caps (Center for Psychosocial Care), in addition to other services and social and shelter projects aimed at vulnerable populations.

Collaborative work takes place in groups that address selected topics. Each group includes three participants from Harvard and three from Brazil, who work with managers, community leaders and SUS professionals in the search for solutions to local challenges.

The partnership between academia and the health service is transformative. Course participants learn that the greatest quality for working in public health is knowing how to listen (listening without judging), exercising empathy and respect for culture and others, leaving aside “formulas” and certainties about how to solve problems. There is no solution without understanding the context. And you only understand the context by listening.

During the presentation of final projects, the transformative power of this collaborative course is illuminated. Harvard participants emphasize the importance of SUS and its format, something totally different from what they knew. Participants from Brazil often discover a reality and history that they ignored, despite being Brazilian. Professionals and the community feel valued for having had a space for sincere and respectful dialogue. We all learn life lessons.

This is the essence of the course. The academy, walking arm in arm with the service and the community, teaching and learning, sharing experiences, seeking solutions in a collaborative way, listening, understanding, without judgment.

Not everyone who studies public health in Brazil and the United States has the chance to live an experience like this. At a time when empathy and a sense of community are lacking in society, it is important to rethink how we train future generations.

The academy plays a crucial role in the “union and reconstruction” journey. The time is now.

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