Billions Invested, Little Gain Seen : Brazil’s Poor Untouched by Trickle-Down Theory

Dr. Albert Sabin, who won a Nobel Prize for his oral polio vaccine, was pleased to learn recently that a public vaccination campaign here in impoverished Cearastate in Brazil’s Northeast region had reached 2.5 million children and virtually eradicated the paralyzing disease.

But Sabin was shaken, during a visit to the children’s hospital that bears his name, by evidence that 70% of the patients admitted to the 170-bed hospital are victims of another disease for which there is no vaccine--hunger.

“Most of the cases we treat here originate in malnutrition. Until we overcome the absolute hunger of children and their mothers, there is little we will accomplish with money spent on medical programs,” said Federico de Lima e Silva, medical director of the children’s hospital.

Children Show Neglect

The hospital, which has a teaching staff and 16 resident physicians, is filled with children being treated for diseases related to malnutrition, poor hygiene and neglect. There are children with bellies swollen to grotesque size by schistosomiasis, a parasitic liver disease transmitted by snails in untreated drinking water. Others arrive temporarily blind for lack of Vitamin A.

Many of the children seem stunned, unable to hear, except when offered food. Mothers arriving from the interior on buses at the nearby terminal stay for weeks beside the cribs of the patients, hoping for some food for themselves, too. They have no money and no relatives in the city.

“We have the unwelcome privilege of seeing cases of nutritional deficiencies and their consequences that most Western physicians never see. But we know that the hospital receives only a fraction of the cases. Many die and are buried without records in their rural areas,” said Dr. Ana Maria Cavalcanti, who is organizing a national conference of pediatricians here in October.

Poor Benefited Little

For the past 20 years, Brazil’s military regime and its technocrats have invested billions of dollars in programs that have tripled the production of goods and services. But these spectacular increases in the gross national product have not produced income redistribution and the benefits for Brazil’s poorest people that were supposed to be a necessary consequence.

And the expansion of industry and agriculture has not kept pace with the burgeoning population, which has grown from 78 million in 1964, when the military took power, to 132 million now.

Despite a 50% increase in lands sown in crops, the number of Brazilians who don’t get enough to eat by medical standards has increased both in the cities and in the countryside.

Foods produced for export, such as soybeans and orange juice, have shown spectacular gains. Sugar cane production for alcohol plants that provide fuel for automobiles, in place of gasoline, has been subsidized generously. But production of basic foods, such as beans, rice and mandioc root, has declined on a per capita basis.

The decline of nutritional levels, and inadequacies of the education and public health system for an increasing population, are the main elements of what is called the “social debt” being left for Brazil’s new democratic government of President-elect Tancredo Neves.

“The military thought big about the economy, but they thought small about the population,” said a commentator in the weekly magazine O Senhoir.

One consequence of past neglect is that there are two Brazils--one, largely based in the industrial central-southern states, with Sao Paulo at the center, that has living standards which match those in southern European countries, and the other, an archipelago of poverty that includes the Northeast and the nation’s urban slums, which resembles the Third World.

“Since I was born, I have heard that Brazil was ‘the land of the future.’ If you had asked me 10 years ago what Brazil would be in 1985, I would have said a great country. But we are on the rocks. Something has to be done,” said Carlos Eduardo Salem, 43, a Sao Paulo financier instrumental in organizing a community self-help group called “Brazil Action.”

Hunger and deprivation are most heavily concentrated in Brazil’s Northeast, a nine-state area subject to chronic drought that is home to 40 million people who practice subsistence agriculture. But similar social problems are common among the 35 million people who live in the urban shantytowns known as favelas.

Slum Home to 200,000

Rocinha, the largest favela in Rio de Janeiro, is home to 200,000 people who live in shacks and brick houses on a plunging hillside that overlooks the high-rise apartments of San Conrado, one of the wealthiest sections of the city.

At a chapel in Rocinha, children attending a Roman Catholic Mass chanted a song, to a samba rhythm, that said “Humble the powerful, elevate the poor, give bread to those who are hungry.”

Nearby, at the only public school in the community, 1,500 grade-school students--out of an estimated 20,000 of school age--studied in three-hour shifts. More than 400 victims of mud slides that killed 12 people and wiped out 60 homes during recent rainstorms awaited a hot meal at the school.

Illiteracy is growing both in poor rural areas--more than half the adults in the Northeast cannot read--and in the urban slums. School officials say illiteracy will persist if grade-school attendance fails to keep pace with population growth.

And with hunger and illiteracy come other social problems. “If the school authorities are not capable of listening to those of us who have grown up here, and have practical solutions for the favela problems, the children abandoned to drift in the streets will be tomorrow’s criminals,” said Maria Helena Pereira da Silva, 25, a grass-roots teacher in a system of kindergartens and president of the Rochina Neighborhood Improvement Assn.

The gravity of the country’s social problems was discovered late in the game by the military authorities when they began to review the results of the annual conscription of 18-year-olds for military service.

In 1983, out of 770,000 youths who were given physical examinations for the draft by the army, navy and air force, only 390,000 qualified. That was a rejection rate of 47%.

In the state of Ceara, 83% of the potential draftees were rejected for physical reasons.

“How can this nation reach its goals if half of its youths, both men and women, are physically incapacitated?” said Gen. Waldir Vasconcelos, an air force officer heading the joint chiefs of staff.

Supports Birth Control

Vasconcelos said publicly supported birth control should be legalized. Private family planning services exist in Brazil, but they are strongly opposed by the Roman Catholic Church hierarchy. They are tolerated by the federal health authorities, but Congress has never voted explicit funding for birth control.

Special feeding programs, including maternal health care through the Ministry of Health and school lunch programs in some states, have been set up, but budgets have been cut back severely by the Ministry of Planning to meet austerity requirements demanded by the International Monetary Fund to reduce public deficits.

With virtually all political, social, religious and military groups in agreement on the gravity of the situation, there is nevertheless a lack of agreement on what to do about it. Proposals to deal with the causes, and not just the effects, of poverty in Brazil, tend to emphasize land reform and a new national urban strategy.

Land Is the Key

“There is no solution to the problem of rural hunger without making land available to landless rural laborers,” said Archbishop Aloisio Lorscheider of Fortaleza. He is a former president of the National Conference of Bishops and a social progressive.

Large landowners in Brazil, particularly in the Northeast, strongly oppose expropriation of land by the state. But they demand major public investment in transportation and irrigation that increases the value of their land.

“It is going to take a change in the way politicians see their interests. In a democratic situation, the poor can organize and generate pressure on the political system in a way that was not possible under authoritarian rule,” Lorscheider said in an interview.

A federal land statute, adopted in 1965, permits land expropriation by the National Agrarian Reform Institute with payment in long-term bonds. But it has been so little used that in the last 20 years only 2,450 families received farms under the last distribution program in Ceara. The amount of land distributed represents 3.6% of the large properties and benefits fewer than 1% of 280,533 sharecroppers who own no land.

Title Not Important

Lorscheider said the peasants do not want a land title as much as they want access to land with water where they can produce food crops for their families and for local sale. He suggested a program that would stop short of expropriation but would allow the state to put idle lands to use and regulate contracts between landlords and sharecroppers.

The problem of rural poverty spills over into the cities, through massive migration to the wealthier southern states from depressed rural areas. An estimated 500,000 landless, migratory workers live in Sao Paulo state, where sugar plantations, orange groves and coffee farms need seasonal labor.

These rural workers have organized unions, and they staged a major strike last year before the citrus harvest. For the first time, the owners were forced to sign a labor contract and to recognize the union.

Jaime Lerner, former mayor of Curitiba, capital of the wealthy southern state of Parana, has proposed that 15,000 “rurban” communities be placed strategically along major highways, providing farm workers with urban amenities, including schools, public health services and entertainment.

100-Family Communities

Each community would have 100 families, with lots of 5 acres, served by basic water services, and would provide food and a building site. With an average of six family members, this would settle 10 million people in areas where they would have seasonal work.

“The migrations that have flooded the metropolitan areas with persons literally expelled from the countryside for lack of land can only be stemmed by improved living conditions in rural areas,” said Lerner, an architect and urban planner who studied at New York’s Columbia University.

Many other proposals have been put forward, including a complete study of land reform in the Northeast prepared by a team led by Ronaldo Costa Couto, former secretary of planning of Minas Gerais state, where the new president was governor.

Many such proposals have been made before, however. Proponents of social reform say the basic question is whether the new Neves administration will have the political will and the necessary support in Congress to re-allocate resources toward the lower two-thirds of Brazil’s population after two decades that favored the wealthier upper third.

Private Efforts Started

In the meantime, some private efforts are under way. Local organizations, such as Brazil Action, are moving to counter community problems and improve living standards at the grass roots.

At Matao, a rural township in the citrus region of northwest Sao Paulo state, schools have been inundated with the sick and often hungry children of migrant orange pickers. The town set up a community garden system and a processing plant that makes flavored soybean milk. The program provides 10,000 school lunches and 7,500 bags of soya-milk to meet the nutritional needs of migrant children.

“We discovered that the federal government spent 1.2 trillion cruzeiros (about $300 million) on school lunch programs last year, but only 6% of that money was spent on food,” said Salem. “The rest went to support an administrative apparatus that you don’t need when the community organized itself.”