UBS in São Paulo City vs. UBS in Prado, Bahia: What Healthcare for the Poor Really Feels Like
Brazil’s public health system — the Sistema Único de Saúde (SUS) — is often praised as universal and accessible.
And it is.
But using a Unidade Básica de Saúde (UBS) as a low-income family in two very different places — Sapopemba in São Paulo and Prado — reveals something important:
Access to healthcare exists.
Dignity inside the experience is inconsistent.
UBS in Sapopemba, São Paulo — Better Funded, Faster Pathways
In Sapopemba, the UBS experience showed the advantages of being in a major city.
- Faster referrals to specialists when needed
- Better stocked facilities
- More staff on hand
- Quicker access to follow-up care
If something required more advanced care, São Paulo’s network could handle it.
But even here, we noticed familiar problems.
Supplies Running Out
Orthodontology services would regularly run out of basic supplies.
Appointments were postponed, not because of patient issues, but because materials weren’t available.
Lack of Discretion
Medical staff often discussed personal matters in open areas.
Privacy was minimal. Conversations could be overheard.
You were treated, but not always with dignity.
Long, Uncomfortable Waits
Even in a better funded UBS, waiting long periods with children was normal.
Seats were limited.
As a family of five, we often occupied most of the available seating, leaving others standing — which made the experience uncomfortable for everyone.
UBS 03 in Prado, Bahia — Heat, Waiting, and Endurance
At UBS 03 in Prado, the differences were stark.
- Long waits in intense heat
- No fan
- No air conditioning
- Very limited seating
Prado gets extremely hot.
Waiting for hours in that heat with children becomes physically draining.
You are already unwell. Now you are exhausted too.
The care is there — but the environment makes receiving it harder than it should be.
The Same Problems in Both Places
Despite funding differences, both locations shared the same issues:
- Long waiting times
- Limited seating
- Staff lacking discretion with patient matters
- Orthodontology and other departments running out of supplies
This is not about doctors.
This is about infrastructure for dignity.
Healthcare Treats Symptoms — Environment Recreates Them
In both Sapopemba and Prado, we noticed the same pattern:
Families returned to the UBS repeatedly for:
- Coughs
- Skin issues
- Fatigue
- Recurring minor illnesses
And we began to see the connection:
These were linked to:
- Nutrition gaps
- Living conditions
- Stress
- Heat
- Overcrowding
The UBS treats you.
But you return to the same environment that made you sick.
What This Experience Revealed
Brazil’s healthcare system works.
But for the poor, using it often feels like endurance rather than care.
Not because of the doctors.
Because of:
- Waiting conditions
- Heat
- Seating
- Lack of privacy
- Supply shortages
Healthcare exists.
Comfort, dignity, and ease often do not.
FAQ
Is healthcare better in São Paulo than in rural Bahia?
Yes, São Paulo offers faster access to specialized care, but both share issues of long waits and supply shortages.
What was hardest about UBS visits in Prado?
Waiting in extreme heat with no ventilation and very limited seating.
What problem existed in both places?
Lack of patient comfort, privacy, and consistent medical supplies.
and then