An October 27 fire at a hospital in Brazil’s state of Rio de Janeiro resulted in the deaths of eight people, at least three of them COVID-19 patients. All had suffered some kind of complications after a rushed transfer to escape a blaze on the underground floor that spread dense smoke through several sections of the hospital.
Disoriented by the lack of any emergency plan, nurses, doctors and other workers were forced to improvise, even using a nearby tire store to temporarily relocate some of the patients. One of those who lost their lives was Núbia Rodrigues, 42. She was a radiologist and had been hospitalized a few days before, after having already passed through two other public health care units. She was carried out on a sheet by her colleagues and taken to another facility, but died on the way inside an ambulance. Of the 44 patients who were transferred on the day of the fire, 21 are still hospitalized.
The fact that a fire occurred at the Federal Hospital of Bonsucesso (HFB), the largest hospital complex in the state of Rio’s public health network, is the criminal outcome of the precarious conditions plaguing the whole of Brazil’s public health care system.
At the beginning of the pandemic, this same hospital was considered as a possible center for the treatment of COVID-19 patients. The facility, which has on average 1,300 hospitalizations per month, was to be adapted with about 200 new beds for COVID-19 cases, but the plan was not realized due to a lack of equipment and health care professionals.
The then Minister of Health, Nelson Teich—one of the three who has held the position this year alone—made a visit to the hospital and found that the facility was underutilized due to a lack of basic supplies and respirators. At the time, the workers staged a protest demanding the purchase of PPE (personal protective equipment) and decent working conditions. After this visit, the hospital was discarded as a COVID-19 center and was forced to face increasingly precarious conditions.
According to a survey by the Open Accounts Association, the hospital’s budget has been cut by almost 40 percent since 2010, from 218 million reais (about US$38 million) to 131 million reais (about US$23 million) per year. The deterioration of the hospital, therefore, was predictable. A survey conducted in 2019 pointed to serious flaws in the fire prevention system and “high risk of explosion” due to the overheating of two transformers.
The failure to act on this warning, as well as the rejection of the demands made by the workers, is part of a deliberate policy of capitalist governments on both the national and a state level. This is already the fourth hospital fire in Rio de Janeiro since September of last year. And although Rio’s cases are particularly serious because of the deaths, the same problems are present in all of Brazil’s states. Since the beginning of 2020, the Sprinkler Brazil Institute has counted 45 fires in public and private health facilities throughout the country, an increase of 96 percent compared to the same period last year. And it is estimated that the real number is higher, as quickly controlled fires are often not reported.
The precarious infrastructure of the public health care system, upon which 70 percent of the population depends, has an even more tragic effect due to the coronavirus pandemic. The “fight” against the pandemic was marked by the installation of provisional and precarious sites for the treatment of COVID-19 cases, which served to systematically divert public resources, while already existing hospitals remained virtually abandoned.
Under these conditions and under the herd immunity policy promoted by President Jair Bolsonaro and the ruling class as a whole, Brazil has already recorded more than 160,000 COVID-19 deaths and over 5.5 million cases. The rate of coronavirus transmission in Brazil has risen again, according to monitoring by Imperial College (United Kingdom). Its report, released last Monday shows that the index increased to 1.01 (in August, it had fallen for the first time to below 1).
Even in view of the high number of cases and the increase in the transmission rate, the already insufficient hospital infrastructure is being dismantled. In the state of Para, some 300 workers were laid off last month after the closure of the Castanhal Regional Hospital. The workers responded with a protest on October 15, and again on October 28, after not even receiving their overdue salaries and severance pay.
In addition, most of the temporary beds in different states, including in the field hospitals that had been set up in soccer stadiums, have been deactivated, overloading other health facilities.
After the fire at the Bonsucesso Federal Hospital, the administration announced that the hospital would be completely closed and that all of its employees would be placed on vacation. The hospital workers responded with a protest, arguing that at least the wings not affected by the fire should continue to function. After that, the administration reversed itself, deciding to partially reopen the hospital.
Each of these cases demonstrates that the defense of basic health care and the fight against the deactivation of beds, the cutting off of resources and a state of deterioration in which Brazilian public hospitals are literally burning can only be guaranteed by the independent action of the working class. The mass infections and deaths in the COVID-19 pandemic have laid bare the preexisting condition of the complete incompatibility of capitalism with the essential social needs of the working class, including free quality health care.