At 8am, my host mom knocks on my door. She smiles warmly through the pain. I have a doctor's appointment at 9am. I'll leave in 20 minutes, but breakfast is on the table. Leave everything when you are done -- you don't have to clean up. She says with a look that conveys that we've been over this before.
I take a minute to process her lengthy instructions and respond in a clumsy Potuñol. Spanish is my first language, and with the high lexical similarity between it and Portuguese, they can be mutually intelligible. In theory. On my second day in country, I was mentally celebrating a complex conversation in Portuguese with a hotel staff member, only to realize that halfway through we had transitioned to Spanish. I was not, in fact, suddenly fluent in Portuguese, despite my months of cursory Duolingo practice.
My host mom had suffered a fall a year ago that left her with a hurt knee. Her doctor was able to provide a treatment to quell the pain, but the aches emerged again in December, leaving her with limited mobility. Unfortunately, the holidays interfered with her usual speedy treatment. Today, January 9, she will be able to receive a cortisone injection to reduce the inflammation and numb the injury.
The public healthcare here is very good, but there are long lines. So I have private insurance that lets me get seen sooner. And within a few weeks, she is receiving care. It would have been sooner had her doctor not been away for Christmas.
In late 2021, my for-real mom fell down and fractured a bone near her knee back home in LA. I took her to urgent care. What followed was a myriad of calls: to her primary care doctor, her insurance, different specialists, her primary care doctor again. She was initially referred to a gastroenterologist. But her leg is broken. More calls to insurance, primary care. When we finally got a referral to an orthopedic surgeon, they didn't have availability for over a month. But her leg is broken now. My mom was lucky to have a privileged daughter that was born in the United States, speaks English, can take time off work to sit on hold. I was able to get her an appointment with a specialist a week later. It may have taken her months to get her much-needed treatment sorted out had I not been available to advocate for her. She may not have gotten treatment at all if she was among the 27 million uninsured individuals in the United States.
Brazil offers universal healthcare for all. Despite this, access to care is still impacted by a long, cruel history of enslavement of Africans and Afro-Brazilians and systemic racism. Our morning class on HIV in Brazil further highlights this unjust reality. While the country has made great strides to reduce the spread of HIV, destigmatize diagnosis, and minimize inequities, Black women are still disproportionately impacted by the disease. As one interviewed patient put it: Being a Black woman with HIV means facing three forms of violence: gender, race, and serology.
My host mom spends the afternoon recovering in bed. Her neighbor, Mama Ruth (Janelle and Madam Ola’s host mom), adopts me for the day. With a flurry of energetic and steady steps we are caught in her whirlwind; she ushers me off to a vegetarian restaurant, carts us to the salon, hauls us to market, totes us on a leisurely (but in a hurry!) stroll around the neighborhood, before plopping me at home for a couple of hours. My lofty plans of exploring Salvador are overcome but a sudden realization in a rare moment of stillness: I need a siesta.
Pronto! Mama Ruth announces, her presence electric. We are whisked away to a bar for a night of live music. Luciano, the professor for the University of Kansas group, is the guitarist for the band DendêSoul. He shows us to the venue, where we are the first to arrive. We choose the best seats in the house. By 8:00pm, a few more students have trickled in and we await the start of the show. 8:15pm. 8:30. More people pile in, more tables and chairs appear out of thin air and settle in front of our best seats. Mama Ruth feigns offense. By 9:12pm the tables are packed, sparking the music to begin.
The Afro-Brazilian Baian beats flow through our bodies as we sway in rhythmic unison. Mama Ruth summons us to the dance floor. At 72, she is out-dancing us all, making new friends (and picking up phone numbers) along the way. Despite the current systemic racism pervasive in Brazilian society, connecting to culture and identity is a form of resistance and medicine. This music is evidence of the strength of the Afro-Brazilian community, their influence on mainstream Brazilian culture, and the continued fight for equity, representation, and dignity.
Patricia Ferrero
MPH Maternal and Child Health with Global Perspectives
CSPH Anschutz