In the last three years, around 10 thousand health professionals have been trained to work in the 2014 FIFA World Cup. They are ANVISA (National Health Surveillance Agency) and SUS (Unified Health System, equivalent to the country’s National Health System) staff from states and municipalities, in addition to volunteers from the SUS National Force.
The 12 host cities have been equipped with 531 SAMU (ambulance service) mobile units, 66 medical emergency units (UPAs) and 67 hospitals, which will work in an integrated manner, providing healthcare services to the local population, as well as Brazilian and foreign tourists.
Moreover, a Ministry of Health webpage is available online aimed at travellers (www.saude.gov.br/viajante), where it is possible to find out more important health prevention information in Portuguese, English, Spanish and French. Posters and a pocket book with the same information will be put up in locations where there is a great flow of people.
Find out which are the reference public hospitals in the 12 World Cup cities (PDF files)
Standardisation and integration
The Ministry of Health has been working to improve infrastructure and how services are organised, making the most of the World Cup to ensure better quality services as a legacy for Brazilians. In 2011, the National Health Technical Chamber was set up, bringing together professionals from several areas from the Ministry of Health, the 12 host cities and their respective states. The intention was for them to work in a standardised and integrated manner, structuring management processes, mapping risks and organising health surveillance and assistance interventions at the federal, state and municipal levels.
“The expectation and need for services of those coming to the World Cup, who are going to watch the matches is rather low. All the improvements made to SUS is a legacy that will be left behind for our population, cities and will also have an impact in the metropolitan regions where they are located. The structure is already available and will mean better daily services for the population", emphasised the minister.
Demand and preparation
Based on the history of World Cups held in other countries and the Brazilian experience with the 2013 Confederations Cup, the expectation is that only 1 to 2% of fans will need medical services at match venues. From this percentage, over 99% of the demand tends to be serviced and solved on site. And between 0.2% and 0.5% need to be referred to high complexity hospitals. Usually, people who attend this type of event tend to be young, from 25 to 49 and generally healthy, which means they do not need special healthcare.
In addition to the structure that has been put together to provide services to the Brazilian population in a continuous way – also providing services to foreigners in the case of emergencies -, the Ministry of Health has developed contingency plans for accidents with multiple victims. Plans were also designed for chemical, biological, radiological and nuclear accidents.
The state and municipal secretariats of health are going to set up advanced medical posts, which work as emergency units (UPAs). If necessary, the SUS National Force is able to add another nine units to the structure, which would be set up when host cities are presented with situations that go beyond their response capacity.
Joint Operations Centres
To monitor risky situations, the demand for health services and surveillance, providing coordinated responses, the Ministry of Health set up the Joint Health Operations Centre (CIOCS) in 2011. The centre will coordinate health actions with the secretariats. The headquarters are in Brasilia and there is a regional centre at each host city. They will be activated at least 20 days before the beginning of the World Cup and will remain in operations for some weeks after, to monitor the return home of delegations and tourists. Approximately 1.5 thousand health professionals will work in field and monitoring activities.
Thanks to the CIOCS, it was possible to provide figures to the services rendered during the Confederations Cup. Health services were rendered to 1.598 fans from the 796 thousand who came to the tournament. No serious cases were recorded. Around 98% of the cases were solved on site.
In stadiums and their surrounding areas (up to 2 kilometres away from the grounds), FIFA is responsible for emergency services. Nevertheless, there will be a CIOCS professional in each stadium monitoring any problems, in addition to other health surveillance and assistance staff to carry out risk assessments and ensure the rendering of services. Whenever necessary, the SUS structure may be called upon to lend a hand.
CIOCS is part of a larger structure, which includes the other bodies involved in organising the event. They work in a coordinated manner at the National Command and Control Centre (CICCN), set up in 2001. The centre develops coordinated monitoring actions, sharing information as the need arises. In addition to the Ministry of Health, the Brazilian Intelligence Agency (ABIN), the Ministry of Defence, the Ministry of Justice, the Ministry of Sport, the Federal Police, the Civil Defence Office, among others, are part of the centre. There is a regional centre at each host city.
SAMU will work in integration with private health plan operators in cities where agreements have been made with the National Health Agency (ANS). These agreements will enable SUS ambulances to take patients with private health insurance to private hospitals.
As a result of coordinated action by ANVISA, local health surveillance bodies have intensified their overseeing activities in hotels, bars, restaurant and hospitals. In coordination with FIFA, the agency is also following the recruitment and training of health and food service renderers for the stadiums. Health surveillance professionals are being trained for big events, to assess capabilities, identify points that require more uniform and specific technical support, testing tools and engaging in the exchange of successful practices. In ports and airports, ANVISA will increase the number of staff working in detecting and responding to events of interest for public health.
The Ministry of Health has conducted a campaign aimed at tourism professionals (taxi drivers, hotel staff) to encourage them to vaccinate against measles – common disease in European countries -.
Because of climate conditions, the period when the World Cup is held is not one when there are a lot of dengue fever cases. At this time of the year there is a reduction of almost 74% in dengue fever cases in the country. Despite this, the federal government has been allocating resources for prevention campaigns, particularly in host cities. In 2013, an additional allocation of R$ 363 million was made for dengue fever prevention plans in Brazilian municipalities, R$ 53.6 million of which was earmarked for Confederations Cup host cities. Inspections will be carried out at stadiums and other locations with high people flow to avoid breeding sites of the mosquito. If necessary, insecticides will be used.
App for fans
The Ministry of Health is using cutting-edge technology to develop an app aimed at fans. The app will provide useful health related information, like the location of hospitals and pharmacies. The app also monitors health related information in social networks and maps out epidemiological trends. In addition, it maps the flow of travellers coming to Brazil and the risk situation in their countries of origin, by detecting diseases digitally. Based on the results, measures will be taken to inform and protect the population. Users will have access to the app through their mobile phones.
Eleven for health (Onze pela Saúde)
The Ministry of Health supported FIFA in designing project 11 for Health (11 pela Saúde), which has the aim of disseminating messages about health and football among public school students at the World Cup host cities. The messages are disseminated in 11 videos recorded by big football names (Neymar, Lionel Messi, Marta, among others). The schools and students taking part in the programme, selected by the Municipal Health Secretariats, are part of the More Education (Mais Educação) programme of the Ministry of Education and the Health at School (Saúde na Escola) programme of the Ministry of Health. Teachers, who will replicate the messages in the schools, went through a training course. The project will be shown to students starting 24 February and will last 13 weeks.
In partnership with UNAIDS, the Ministry of Health has also launched the campaign Protect the Goal (Proteja o Gol), which shall distribute 1.8 million condoms and provide 10 thousand rapid tests, in addition to counselling through mobile units available at the 12 host cities.