Global Health Project Wins MU International Poster Prize

This year's 2020 Marquette International Research Poster Session Winner is Dr. Alexandre Martins!

 

A poster created by Dr. Alexandre Martins, a professor in the Theology department, won our international research poster prize. Dr. Martins’ project focused on human agency and healthcare issues in his native country of Brazil. His project was entitled Community Participation in Public Health Decision-Making and Human Rights: Neoliberal Policies and Universal Health Care Coverage in Brazil.  According to the abstract:

“This project addresses the relationship between human rights, democracy, health care, health policies, and community participation in Brazil. The Brazilian public health system was created after the 1988 Constitution stated the right to health. Recent political decisions and policies have favored the private health sector and the commodification of health. This project examines the impact of these policies on low income families. Using participatory action research combined with insights from liberation theology, semi-structured interviews were

performed to understand people’s experiences with healthcare services in two communities in Sao Paulo. The material collected from these interviews will be analyzed during the fellowship at the Kellogg Institute. The aim is to measure from people’s narratives whether or not the

new health-related policies promote more access to healthcare services and participatory democracy. The findings will provide education for the communities and resources for public health strategies.”

We interviewed Dr. Martins to find out more.

How did you come to be interested in healthcare ethics?

When I was 14 years old, I moved to the city of São Paulo, the largest in Brazil, and I got involved with a youth group with socio-political activism for better public health care and social justice. This awoke in me a passion for health care and its relationship with social justice. At the same time, I was a curious person, who had existential questions that led me to study philosophy and then theology. I found in the discipline of ethics a way to seek answers to my existential questions, connecting them to my social activism for healthcare as a human right. Naturally, healthcare ethics became a path in which I could seek ways to address existential and social questions that impact people’s lives in the context of healthcare and their well-being. 

What are the main findings of your research?

My research is still a work in progress. It is not complete yet, but we have some preliminary results. This research is a three-phase project about the impact of the last five years of health-related policies on the Brazilian public health-system and the services that low-income families received from this system. The Brazilian health-system, known as SUS (Portuguese acronym for Unified Health System) is based on the Brazilian Constitution that states the right to health. It is a public universal coverage system. In the first phase of the research, we examined the last five years of health-related policies in Brazil and their impact on the SUS. We found that these policies have favored the private health-sector in Brazil and worked to dismantle the SUS, that is, the public system that serves the entire population and not only the top richest 20% who may choose to pay for private services. This creates a conflict with the constitutional mandate for the State to provide health care as a right. In the second phase, we involved two low-income communities in São Paulo. Using a method of participatory-action-research combined with the liberation theology method of see-judge-act, we engaged with these communities and their struggle for accessing healthcare. These communities have strong levels of socio-political activism, organized in grassroots groups in their Catholic churches, inspired by the Catholic Social Teaching. Acting with them, we also collected data from semi-structured interviews from community members who have used the public health system in the last five years. The goal is to measure whether the healthcare services that they receive have changed (in quality and accessibility) during the time that these new health-related policies were implemented. This is the stage we are in right now in the research. It has been slowed down because of the pandemic, which has prevented us from in-person activities. Then final phase of the project will be the analysis of the material collected from these communities.

Why is it important for the wider Marquette community to take notice of this work?

First of all, because it shows the Catholic, Jesuit mission of caring for the poor and working for social justice of Marquette being embodied in global health. It also presents an example of international research collaboration that includes partners from two academic institutions, and members of low-income communities. This work is not only research led by scholars, but it is a work in which community-members have a role and a voice. This work is inspired by Pope Francis’ call for us to listen to the poor and learn from them. Presenting this work to the MU community is an opportunity to hear the voices of marginalized people, who have been voiceless because of their social status. In addition, this work shows that the poor and the marginalized have something to contribute to our mission to promote population-health and build justice. Finally, the results of this study will offer a different view of health care, revealing the impact of health-related policies that favor a neo-liberal health-market on people’s lives. As this liberal perspective is dominant in the USA, I think it is important for people here to be exposed to the impact of a neo-liberal health-market being imposed on another country to dismantle its public health system based on a human-rights perspective. 

Where do you see the project going in the future?

I see this project creating resources for the communities where we are working, for the global-health debate, community that advocates for healthcare as a human right, and for policy-makers who are seriously thinking about health-policies that contribute to creating health-equity. Moreover, this project will offer a concrete example of interdisciplinary work for the field of global health and healthcare ethics, expanding this field to include more agents in the endeavor of understanding why health injustices and disparities exist, and how to address them with the help of those who are the victims of this injustice.