The Sanitation of Brazil


Book Description

Celebrated as a major work since its original publication, The Sanitation of Brazil traces how rural health and sanitation policies influenced the formation of Brazil's national public health system. Gilberto Hochman's pioneering study examines the ideological, social and political forces that approached questions of health and government action. The era from 1910 to 1930 offered unique opportunities for public health reform, and Hochman examines its successes and failures. He looks at how health became a state concern, tying the emergence of public health policies to a nationalistic movement and to a convergence of the elites' social consciousness with their political and material interests. Politicians weighed the costs and benefits of state-run public health versus the burdens imposed by disease. Physicians and intellectuals, meanwhile, swayed them with warnings that endemic disease and official neglect might affect everyone--rich and poor, rural and urban, interior and coastal--if left unchecked. The book shows how disease and health were and are associated with nation-state building in Brazil.




Engineers and Communities


Book Description

Access to water and sanitation service in industrialized countries is nearly taken for granted, but in many developing countries less than half of the population has access to such services. Decades of effort on a global scale have been invested to solve this problem. One such effort--Brazil's participatory approach to water and sanitation--is Nance's subject in Engineers and Communities. In the early 1980s, Brazilian engineers created participatory sanitation (known locally as condominial sewerage) to make basic sanitation service more inclusive. Fiercely contested at first, the technology's success hinged on the formation of strong and stable coalitions of diverse actors and on the promotion of both real participation and a participation narrative. The innovations described in the book contributed to the now indispensable concepts of community participation and locally appropriate technology. Today the technology has spread across Brazil- it has been legally incorporated into sewer design norms and codes, it is counted in the national census, and the model is being transferred to other countries by The World Bank and others who are trying to make basic urban services more inclusive of the poor. Engineers and Communities sheds light on what is essential in the broader discourse of international development.










Sub-sector Report


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Sanitation and Health


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Access to Water, Sanitation, and Public Health Services Among Urban Poor in Maceio, Brazil


Book Description

Access to water, sanitation, and public health services is a key indicator of quality of life, and these resources are greatly limited for the urban poor in Maceio, Brazil. Maceio, the capital of Alagoas state, is an environment rich in natural resources and culture. A sharp rise in population, new construction, and globalized business have made a marked impact on the city, since its founding in 1815. Despite development, the urban poor struggle to advance, unable to afford the new standards of modern living, including finding the means of accumulating income, the challenges of retaining good health, and seeking quality access to basic needs. Never designed for its current population, Maceio's original infrastructure is limited, and its ability to provide services to the entire community is severely strained. This field study, based on field research in 2008 and 2009, examines the type of access impoverished citizens have to resources in urban areas of Maceio looking at three critical resources: water, sanitation and healthcare. The thesis investigates whether lack of access to clean water, sanitation, and efficient health care led to population vulnerabilities to, in particular, waterborne and hygiene-related diseases, and what level of care was available to those affected by disease Using data gathering, primarily through interviews and participant observation, I was able to determine the proximal access to resources and services to the poor, and through these indicators, make connections between that access and the occurrence of disease in the population. Although the study is meant to be anthropological rather than epidemiological, this observation of the "diseases of poverty" interprets various diseases as both widespread in the studied population, and a product of social inequality. The imbalance of access uncovered during my fieldwork illuminates the growing concern in public health that unnecessary suffering and premature death, typically among the poor, still exists in modern Brazil. Inequality among those who greatly need services is rampant, yet the developing nation concentrates its expenditures on alternate priorities.