“The coach entered the modest house and took away the 42-year-old woman,” read the front-page headline of the newspaper Jornal do Comercio de Manaus, in January 1904.
Don’t consider yourself upset, dear reader, this was the average life expectancy in Manaus at the beginning of the 20th century.
Since then, that number has almost doubled in Brazil: last year it reached 76.6 years, according to IBGE. For men, 73.9 years; For women, 79.9 years. Despite this disparity, few realize that if there is a weaker sex, it is us, not them.
The primary reason for this numerical jump was economic development: we were a very poor country, plagued by rural epidemics, with high mortality rates among infants, recently freed from slavery, that left the “freed” black population to their fate.
The establishment of a unified health system and advances in medicine were crucial: vaccines, antibiotics, milk pasteurization, basic sanitation (limited to this day) and home-made serum.
The World Health Organization and the medical journal The Lancet considered the introduction of home-made serum to be the procedure that saved the largest number of lives in the world during the twentieth century. Also here: The organization Pastoral da Criança, led by Dr. Zelda Arens and Dom Geraldo Añello, played a decisive role in implementing the program to popularize the home-made serum, which had a significant impact on reducing infant mortality.
When I was born in the 1940s, the infant mortality rate was approximately 150 out of every 1,000 births. Last year, this index decreased to 12.3. However, we are far from the rate of 2.4 in Sweden and 4.1 in France.
In recent years, we have ceased to be a country of children, teenagers and young adults. Today, the fastest growing age group is those over 60 years of age. There are over 32 million of us.
The problem is that we age poorly. According to the Brazilian Society of Cardiology, 60% to 65% of women and men reach the age of 60 and suffer from high blood pressure. According to the Brazilian Society of Endocrinology, there are at least 16 million people suffering from diabetes, most of them in this age group.
These two conditions are the main causes of myocardial infarction, strokes and other cardiovascular diseases, chronic kidney failure, blindness and amputations, among other diseases that cause suffering, shorten lives and increase health care costs.
It is true that everyone wants to live long, but not at any cost. No one wants to spend their final years lying in bed, wearing diapers, with a tube in their stomach, giving away work to family members they no longer know. The Ministry of Health estimates that at least 8.5% of people who reach the age of 60 suffer from some degree of dementia, which is certainly an underestimate of the total.
No country is prepared to support so many people who are cognitively deficient, frail, and unable to perform basic tasks. Not Japan, the wealthy country, where life expectancy is around 85 years.
A person with dementia needs constant care to face a range of complications: mental confusion, insomnia, aggressive phases, personality disorders, inappropriate behavior, confusion, progressive difficulty in motor coordination, and others.
Under these circumstances, there is a constant demand for professionals from various fields: physiotherapy, speech therapy, occupational therapy, psychology and psychiatry, doctors, nurses and caregivers. Neither SUS nor health plans are designed to serve these patients.
Without relying on the health system’s help, families can only face the problem on their own. In general, the responsibility falls on the woman, whether a wife or daughter, who gives up her personal life to meet the needs of others.
Over time, the companion becomes exhausted and experiences psychological disturbances ranging from generalized anxiety to severe depression, a condition some call “caregiver syndrome.” When this happens, we have two sick people in the same house.
It is indeed difficult to find a family that does not have relatives with some degree of dementia. It is urgent to develop public health policies to care for them. Even if we are lucky enough not to die early, the risk of becoming one of them will be increasingly high.