Hello from Brazil: Arriving in San Jose Rio Preto

Children’s very own Patsy Stinchfield, recent recipient of the prestigious Pediatric Nurse Practitioner of the Year Award, is in San Jose Rio Preto, Brazil to help the Hospital de Base better control their post-operative infection rates. The following is Patsy’s first report from Brazil.



I have finished my first day in the Hospital de Base in a small town called San Jose Rio Preto.  It is a city of 400,000 people and is surrounded by beautiful farmland.  We are staying at a hotel called none other than, The Saint Paul Hotel!

I am consulting in the public hospital here called Hospital de Base, an 800 bed hospital with a full pediatric cardiovascular surgery ICU.  They are having trouble with post-operative infections and are seeking help for Infection Control considerations from me and my great traveling companion, Dr. Steven Kurachek, a Harvard trained pulmonologist who is consulting on intensive care management.

It was a marvelous day, filled with observations of wonderful care by smart, compassionate people (pediatric cardiologists, surgeon, anesthesiologists, nurses, nurse technicians and respiratory therapists).  They are a warm and open group, eager to continually take the best care possible of their very vulnerable patients some of whom were so malnourished it was heart-breaking.

We made rounds on their 4 patients in the cardiovascular ICU and 3 patients in their step-down area.  We observed their care, listened, asked questions, engaged the team in dialogue about how they prevent pneumonia in ventilated patients and tried to play CSI with where their systems are breaking down to cause their patients to have more infections than most other hospitals. It was “Magnifico!”  We found some problem areas, but also found some practices better than we do in the US.  As usual, the teachers will come back having learned more than they taught.

One unexpected surprise was to tour a beautiful manufacturing facility near the hospital called Braile Biomedica which makes 450 different products mostly for heart surgery. (Think Brazilian Medtronic).  We met with Dr. Domingo Marcolino Braile, the “retired” cardiologist who founded this company with brilliant engineers and his experience doing cardiovascular surgery by knowing there is always a better way to do things.  We watched the staff trim bovine tricuspid valves and hand sew them in preparation for patients needing a valve replacement.  Simply amazing work.

In the evening, our hosts, Dr. Ulisses Croti (pediatric cardiology surgeon) and his wife, Dr. Lilian Beani (a neonatologist) are intent on showing us a good time in Brazil.  Tonight we went with 4 of the cardiology team staff to a traditional Brazilian beef house (think Fogo de Chao X 10) where they bring the hot meats and carve individual slices at the table.  (After a day in the cardiac ICU we all passed on the BBQ chicken hearts…).

They speak Portugese, which has a little similarity to Spanish but is very fast with different accents.  Instead of HOla it is hoLA for hello.  We have 3 medical interpreters who are amazing because they know all the medical technical language and do simultaneous (they prefer we just talk, not pause for them) English to Portugese conversation (we all wear little ear pieces).

After just one day, we have a list of suggestions as well as recognitions for work well done.  We also have a list of things we want to improve back at Children’s based on what we see here and know we can improve at home.  We all deal with the same pathogens and people problems no matter where in the world we work.  It is fascinating!

I will try to write a bit everyday.


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