Working with the street children of Brazil

Liz Searle shares her experience

I spent a month in the summer of 2000 at the Quixote (pronounced "keyshotsch") Project working with street children in São Paulo, Brazil. This is a day programme run by the department of psychiatry at the Paulista Medical School and the Federal University of São Paulo. The philosophy of the project is to offer an alternative social network and activities for children to replace their existing lives on the street or their dependence on drugs or both, while dealing with any underlying emotional issues, and providing some hope of a brighter future. I found that the Brazilians had a natural warmth and affection, which was extended to the children, creating a supportive and accepting environment.

My day to day work at the project involved taking part in various workshops. Activities are relevant to the culture of the children and adolescents, including graffiti, breakdancing, drumming and "capoeira" (Brazilian fighting dance), as well as vocational workshops, such as for hairdressing and computing. The children also have access to the services of clinical staff--for example, psychiatrists, psychologists, and paediatricians-- and other professionals. In addition, a school has been set up specifically for the children who attend the project to allow them to go through an accelerated education process as many have missed vital school years. I was impressed by the professionalism and creativity of the service. Joining in with the workshops was fun, and the children were friendly and affectionate and interested to learn about life in another country.

Language was a problem
My major problem was language, or lack of it. I had done a basic Brazilian Portuguese course, but this was insufficient for the kind of specialised language required. My first few days at the project were quite a shock, with only a couple of people speaking any English. So this meant that I could do little more than observe at first. It was also isolating and tiring to have to concentrate so hard on what was being said. Nevertheless, everyone at the project was friendly and helpful. My Portuguese quickly improved, and I was able to understand and communicate much more by the end of the month. Being immersed in a foreign language like this is probably the best way of learning. However, I would recommend a more thorough knowledge of Brazilian Portuguese to get the most from the project.

The true picture
Working at the project challenged my preconceptions about the lives of Brazilian street children. These children were not stereotypical street urchins, gangs of orphans roaming the streets, committing crimes, as often depicted in media images of Brazil. Of course, the situation is much more complex. Most children live at home with their families, but have serious social problems, not least poverty, many coming from the notorious "favelas" (shanty towns). Some live in hostels or squat houses. Many have problems at home, such as violence, abuse, difficult family relations, or problems with drugs and alcohol. Their faces revealed such vulnerability but showed wisdom way beyond their years. Some become involved in drug misuse and dealing themselves, notably cannabis and cocaine. The streets can be attractive to many of these children. Here they make new friendships, can escape from their suffering, and find a sense of freedom.

Life on the streets has its own culture and set of rules, which may involve drugs, crime, and violence. Some children are fleeing violence at home, but the cycle of abuse continues. I learnt that it is common for children to be sexually assaulted on the street. Many of the girls dress like boys as a means of self protection. There are also cases of physical violence and murders of such children. However, projects such as Quixote undoubtedly have a huge positive impact on the lives of individual children.

How you can get involved
The Quixote Project in São Paulo is affiliated to the International Federation of Medical Students (IFMSA) and placements are coordinated by local medical students. They can be contacted at scoph_epm@hotmail.com. A contribution of $200 is required to cover administration costs, and lunch is provided in the (much maligned) medical school canteen. I was lucky to stay with another medical student and her family, who were very hospitable. Otherwise, accommodation can be arranged nearby for around £10 a night. There are several projects in Brazil, including specific medical projects suitable for electives. Further information and application forms can be obtained from the national coordinator, Caio Shwafaty, at caioshwafaty@yahoo.com

For anyone interested in psychiatry, paediatrics, drugs, or social or international issues, a placement at the Quixote Project is a wonderful opportunity, and you just cannot help falling in love with Brazil.

Liz Searle, second year clinical student, Royal Free and University College Medical School
Email: e.searle@ucl.ac.uk

I would like to thank UCL Expeditions and Travel Committee and Friends of UCL for their support.

studentBMJ 2001;09:305-356 September ISSN 0966-6494