Bolivian immigrants' access to public health services in the city of São Paulo

Abstract

The current increase in international migrations calls into question states' responsibility to ensure basic social rights to immigrant populations, including access to health. This paper seeks to contribute to the understanding of Brazil in this new international scenario through a qualitative study on recent immigrants' access to health in São Paulo. Twenty-three in-depth interviews with Bolivian immigrants were conducted, using a semi-structured script. It was surprising to find that the immigrants valued Brazilian health services, unlike those in Bolivia, especially considering Brazilian citizens' intermittent dissatisfaction with the care available in the country's Unified Health System (SUS). This positive assessment, as we shall show, can only be understood if we analyze their status as first-generation immigrants. It was essential to understand a comparative view of Brazil and Bolivia, which was used by respondents to evaluate access to health care in Sao Paulo. To contextualize the data collected, we feined the principal institutional components of the two countries' health systems and presented a systematic portrait of comparative macro-social data for Bolivia and Brazil. In conclusion, we discuss to what extent the reported experiences reaffirm or do not reaffirm the main theses presented in the literature on immigration and health, in light of the research findings. The role played by workshop owners and community health agents in facilitating access is noteworthy, as are networks of family members and co-nationals.