Home>Service> Global Love of Lives Award> 16th Fervent Global Love of Lives Award> Vera Cordeiro, Brazil—The Angel in White
 [Reform and Resurrect]  
 
Doctor Vera Cordeiro, a pediatrician at Hospital da Lagoa who has devoted to reforming healthcare in Brazil, founded Associação Saúde Criança (known as Brazil Child Health in English) in 1991, providing comprehensive post-hospitalization care and the items required to keep them healthy outside of the hospital, such as food, clothing, and financial support.
 
 
Tens of millions of Brazilian city dwellers live in favelas, where millions of children are malnourished and no proper housing, clean water and toilets are accessible. As a physician, Vera recognized that illnesses were not simply matters of biology but were rooted in socioeconomic factors that aggravated and perpetuated the disease. She saw many of her patients fall into a cycle of hospitalization, treatment, discharge, re-infection, and re-hospitalization. “Treatments given at the hospital were ineffective if her patients simply returned to the environments that made them sick in the first place” Vera commented.
 
Dr. Cordeiro’s programs have extended to fourteen public hospitals in Rio de Janeiro, São Paulo and Recife, providing over ninety thousand children with medical and socioeconomic care. She plans to further expand the organization to every public hospital in Brazil.
 
Other than premium medical remedies, Dr. Vera Cordeiro lays emphasis on the wellbeing of all patients. Known as one of the 100 most respected doctors in Brazil, Vera heals those with pneumonia, tuberculosis, rheumatism, anemia and malformation. Many of her patients are also infected with Canine Leptospirosis via drinking or showering with water contaminated by rat’s urine, all caused by acute and chronic medical and health conditions. “I can’t stand to see these terribly and terminally ill children obtain treatment only to be released to such poverty that they could not recover!” Vera cried.
 
For Vera, patients are like family, for whom she provides her expertise and kindness that prevent them from their early demise by founding the first non-profit organization in Brazil, Associação Saúde Criança. Together with many volunteers, living standards have been improved, and healthcare in Brazil has been reformed.

The Day of Foundation
One day, a one-year-old boy was sent to Hospital da Lagoa for an amputation surgery, the seriousness of which necessitated Vera to counsel the patient in person. She tried to explain that it was imperative to remove the limb to Petrina, the mother of the boy, who had just lost her job as a maid and had no idea where to live and what to eat. To Petrina, purchasing a prosthetic limb for her son was unthinkable. After the conversation, Vera sat in her living room thinking about Petrina over and over again during the evening, and the next morning, Vera started a fundraising campaign for Petrina.
 
The next day, Vera was assigned to counsel a mother of ten, whose 7-year-old son was diagnosed with kidney cancer. “Will you keep my boy warm at night?” the mother asked, “I have nothing to cover him at night, but if he catches a cold, his chemotherapy will have to be terminated. So can you please provide me with a blanket or a sweater?” After listening to her plead, it came to Vera that chemotherapy would be pointless if the patient did not have a warm blanket, and she found herself in a mental paradox in which her life and career were stuck.
 
A few years ago, a friend of Vera’s gave her the Book of Changes, from which she started to seek answers. One day, she cast three coins and gained a result known as “obstruction in the heavens and the earth”, which was further explained by the Book that hope should rise after demise and one should innovate to surmount the obstruction.
 
On the 25th of October, 1991, Dr. Vera Cordeiro invited fifty of her colleagues to her apartment, where she announced the commencement of her project at 7pm and raised funds with prize drawing, from which she gathered 100 U.S. Dollars to found Associação Saúde Criança, looking after patients beyond the capacity and capability of hospitals.

Healing Flesh and Souls
Vera Cordeiro was born in 1950 in Bangu, to a father who was an engineer at a local textile factory and a mother who was a psychologist. With housemaids, chefs, a chauffeur and a guard, her family was comparatively affluent, which was perceived by Vera as a child. When Vera was six years of age, she was once reprimanded for giving away her toys to the poor.
 
Under the influence of one of her uncles, Vera embarked on the path to become a physician. However, Vera regarded the courses at the medical school as too narrow and unable to meet her interests. It was not that she disliked anatomy, but that she was more eager to learn the mental effects on illnesses, which were not included in all medical subjects.
 
After graduation in 1975, Vera started her career at Hospital da Lagoa, where she examined 20 patients every morning. In the beginning, Vera was overwhelmed by the workload, but gradually she started to find time to chat with patients, who were mostly poor women. As the relation between illnesses and stress became Vera’s main focus, she founded psychosomatic medicine department after 2 years of lobbying, before which no Brazilian public hospital had established any such units. Vera introduced psychosociological therapies, including art therapy and group psychotherapy to help asthmatic and cardiovascular patients alleviate pain.
 
In 1988, Dr. Vera Cordeiro requested to transfer to the Pediatric department, turning to a new page of her career. “I have always hoped to treat children.” Vera said, “It is somehow mentally painful when treating these kids. I had never thought of setting up a nonprofit organization when I treated adults, but when I became a pediatrician, I realized there were only two choices: give up, or find another way to help children.”

Helping One at a Time
At the time Associação Saúde Criança was founded, the faculty of ten included Dr. Vera Cordeiro, her mother, a handful of psychologists and nurses, and a few friends. They set up an office in Hospital da Lagoa, where they made phone calls to ask for donations such as milk, food and medicine and to exchange ideas such as purchasing lab equipment and holding fund-raising activities.
 
The main focus were mothers, who were taught to prevent re-infection and potential health risks. Dr. Cordeiro also acquired names of children who were about to be discharged from doctors and social workers at Hospital da Lagoa. To place mothers in a proactive position, Associação Saúde Criança provided free dietary supplements and medications for six months in return for bimonthly revisits.
 
In the first interview, mothers were asked for information including household income, social status and dietary conditions. After the assessment, volunteers would visit the household in person to inspect whether there were running water, sturdy roofs and ceilings, beds and clothes. When conditions were confirmed, Associação Saúde Criança would start a customized program in the following six months designed by doctors, social workers and nutritionists. All procedures were planned chronologically, including repairing roofs, boiling water, arranging beds, improving diet, and applying for government aids.
 
“The key is that these mothers should know where to seek support.” Cordeiro explained, “And then they reach their goals with our stepwise programs.”
 
“Associação Saúde Criança explicates that the organization improves their living conditions, but such support is only temporary, which is what these mothers should understand in the first place.“ Cordeiro added.
 
These mothers discuss with volunteers over their treatment plans while claiming medications at the office. They might consult with a psychologist, nutritionist or social worker if necessary. The organization records details from these mothers, such as changes in children’s health conditions that require immediate responses, which include contacting medical authorities, acquiring water filtration and enrolling mothers in barber training courses.
 
Volunteers at Associação Saúde Criança are truly devoted to their mission. Not every discussion between mothers and volunteers is pleasant, and sometimes being unable to keep their promises frustrates these volunteers as well as mothers. “I had fought for over six months to have this woman prepare all the paperwork for the government.” A volunteer said, “but nothing was done.”
 
Despite the disappointment, such frustration never turned into anger. Volunteers never say, “this does not concern us”, nor do they say “fill out this form, and come back three weeks later.” but instead, they only face the challenges with a positive attitude.

More Than Just Medicine
It is reported in 1999 that Associação Saúde Criança had reduced the number of re-hospitalized children at Hospital da Lagoa by 60% from 1991 to 1997, which was considered an amazing achievement. “Before Associação Saúde Criança was founded, we had only spent much money and effort treating these young patients, even though they would only return to and die in their families where there were insufficient recourses.” a doctor at Hospital da Lagoa recalled, “But now we can rest assured when these kids are discharged, and we know what we do is worth the endeavor.”
 
Vera Cordeiro discovered that it used to take eight months, or even more than twelve months, for an organization to solve the problems. But Cordeiro reminds herself that Associação Saúde Criança was not founded to deal with every problem in Brazil, but to ensure that all children stay healthy after they receive premium medical care the organization provides. Although Associação Saúde Criança is not omnipotent, its goals are measurable and time-framed. With clear policies and systematic methods, the organization has popularized medical treatments within a planned period of time.

Charisma
Cordeiro has long recognized her own charisma that enticed people to fight for her cause. “When Vera started the program, many of us were appealed,” commented by the former Coordenadora do Programa Profissão (Professional Training Coordinator), “She would tell us to work with her, or she needed us. The energy she emitted was beyond description.”
 
Regina Milanez, the former councilor in Conselho Fiscal (Audit Committee), also recalled, “I had seen Dr. Cordeiro on a magazine cover before I called her. When she heard that I had worked for IBM as a financial analyst, she asked for my help. And then I went to her office twice a week to reconfirm all the financial statements. I found I had all the know-how and I was glad that I did everything I could. I also designed a series of models to assess operating costs that help us figure out ways to help those families.”
 
Cordeiro spends most of her time pondering about the need. She seems to be able to understand people’s lives by looking into their eyes. For instance, Vera instinctively speaks in first person when she describes a patient. Instead of “This woman does not know what to do” she would say, “This woman told me ‘Please help me, doctor. I do not know what to do’.”
 
Vera emphasizes the importance of each and every volunteer. When she introduces volunteers to visitors, she would tell her guests that they are all the most important members of Associação Saúde Criança. And when Dr. Vera Cordeiro introduced Mr. Luis Carlos Teixeira, who has been the President of Conselho Consultivo (Advisory Board), she said, “This is our King Solomon, the most important person ever in Associação Saúde Criança!”

Social Workers Disgruntled
From the very beginning, Cordeiro has always kept in mind that only with volunteers could she possibly bring hope to the multitude of children. She trains and motivates people by building up passion and granting them the freedom to choose their own solutions to problems.  Vera discovered that the majority of volunteers are middle class women who are respectable and aware of themselves. People with insolence never bear to stay in the organization for long.
However, Associação Saúde Criança was criticized by social workers at Hospital da Lagoa for supporting children with volunteers. They protested to Dr. Vera Cordeiro that non-professional practitioners should not support women in poverty, and the methods adopted by her organization was irresponsible. In response to this protest, Vera contended that professionals were for special cases, whereas it was proper for non-professionals to deal with general ones. “The biggest contribution is self devotion” Vera said, “Discharging children back to favelas and oblivion is irresponsible.”
 
When applying to Ashoka: Innovators for the Public, a nonprofit organization based in the United States, candidates are usually asked who their friends and foes are. Bill Drayton, the founder and Chair of Ashoka, suggested that concepts change methods and interpersonal relations. “You are changing their position of power. You are a threat that tells them their knowledge, which is their capital, is obsolete. People might not embrace these changes. Therefore, social entrepreneurs should be fully prepared for such responses.” Drayton remarked.
 
At Hospital da Lagoa, social workers were the first “foes” against Associação Saúde Criança, and the reason was that the organization clearly pointed out things that should be done and yet to be done. When tension rose, a group of social workers filed complaints to several hospital managers, who later on held a discussion, during which social workers demanded the termination of Associação Saúde Criança in front of Dr. Cordeiro and other high executives.
 
Upon listening to the objection, a manager inquired a member of the organization for his opinion. “When I saw these children coming in and out of the hospital, I saw a major problem. But this problem is solved, all thanks to Associação Saúde Criança, without which I would demand for another organization to play its role.” He answered.
 
The answer rendered all social workers attending the meeting speechless. The executives eventually decided not to terminate the organization, but stipulated that Associação Saúde Criança must move its office away from the hospital. Cordeiro knew that the new location should be close to the hospital, but the rent would be unaffordable. It occurred to her that she could use the abandoned stable in Parque Lage, where she used to play around as a child. The walls of the stable were wobbly, and there were holes in the roof, but above all, it was not far away from Hospital da Lagoa.

Medical System Reforms
In 1992, Bill Drayton attended a meeting in Brazil, where he was intrigued by a speech delivered by Dr. Vera Cordeiro. Drayton then spoke to Vera, hoping that she would share every detail regarding the operation of Associação Saúde Criança, including how they decided when to discharge patients, how they empower mothers, how they promoted their ideology, and how they dealt with the government. When Vera Cordeiro attempted to expand operations to other hospitals, she carefully analyzed all the predicaments all on her own.
 
When Dr. Vera Cordeiro wrote the mission statement, she realized that in a corrupted and apathetic society, the only access for the poor to health care was public hospitals. Any disease that a child suffers from may cast huge impact on the family, and it would be cruel to not provide post-hospitalization services for young patients, which was a new concept that the medical system had not yet been ready to accept, and had to be founded by citizens themselves. Associação Saúde Criança, with a substantial number of volunteers, was able to achieve what was thought to be extraordinary in a country where people enjoyed little freedom. The organization liberated the spirit of Brazilians and bridged between the privileged and commoners. “A person who earns less than the minimum wage may be able to change the life of an elite, because the poor are not just short of money, but also of the meaning of life.” Cordeiro said, “Associação Saúde Criança brings reforms to societies, not just in Brazil, but throughout the world.”
 
In October 1992, Dr. Cordeiro became an Ashoka Social Entrepreneur one year after she moved the operation to Parque Lage, where Vera had worked in the shaky stable. At that moment, an international organization recognized that her mission would change the medical system in Brazil. As a member at Ashoka, Vera would receive subsidies from the national social department at the amount of 9000 U.S. Dollars in three years. Although it was not a fortune, it came when Associação Saúde Criança needed it the most, doubling the total budget of the organization.
 
Ashoka not only supported Associação Saúde Criança financially, but also mentally.  Ashoka also brought funds as well as connections between members of both sides who shared the same cause. “I still remember I was in blue trousers and a T-shirt on that day,” Vera recalled, “And in the afternoon, when Ashoka informed me of my acceptance, I burst into tears. I had feared that the failure to become one part of Ashoka would have made our efforts a long walk into the night, and when someone else recognized our mission and significance, it meant a lot to me.”
 
In the early 1990s, when scandals filled the media every day, social movements were rare. President Mello, who embezzled over one billion dollars and exiled after deposition, was as corrupted as the warlords before him. “How could I guarantee that I would be clean?” Cordeiro had asked.
 
Valdemar de Neto, another Ashoka Social Entrepreneur, recommended having an audit firm inspect their financial records for the organization, which had not come into Vera’s mind before. Dr. Cordeiro turned to Arthur Andersen, which would later involve in the Enron scandal, and convinced the firm to offer free accounting services. From the day on, transparent financial operations has become part of the culture of Associação Saúde Criança, which includes a presentation of accounts in the organization’s publication that is sent to thousands of volunteers and donors every season.

The Ideal Passed Down
At home, Vera Cordeiro gathers her family and talks about Associação Saúde Criança, until Laura or Marina freaks out, “Mom, are you insane? Stop talking about Associação Saúde Criança!” Paulo, Vera’s husband, also said, “Vera’s work has invaded our family from 7 a.m. to meia noite.”
 
“There is no food in the storage,” Vera said, “The house is a mess, but I don’t have time to clean it. I am not interested, either.”
 
In 1991, Laura, who was 10 years old, started to hold grudge against Associação Saúde Criança. “Suddenly, it was as if we had a baby brother, and my sister and I were very angry.” She complained.
 
Marina and Laura were intermittent volunteers at the organization who joined, left and then rejoined. Despite the grudge, the sisters were attracted by the relationship between the families they had helped as well as the unique experiences. Laura now practices law, and wishes to contribute to her ideals. Marina, who is also interested in law, said, “I hope I could build a more tolerant society with my know skills.”
 
In 1994, Associação Saúde Criança had recruited 508 members, who paid 4000 U.S. Dollars a month. Cordeiro also received other private donations from various foundations as she expanded the organization. Transit authorities provided Vera with discounted bus vouchers, which would be distributed to mothers by Associação Saúde Criança. Vera, discovering that the duration of assistance needed by most families were over six months, launched a plan that connected these families with the middle class, extending medical and dietary supplies to six month. Another program was initiated to train these full-time homemakers to make handicrafts in order to derive additional income for mothers. In light of the fact that most mothers had no clue about the prevention of AIDS and cancer, and the methods of breastfeeding and contraception, health-training programs were held for mothers in many favelas.

Awards
A television producer heard about Associação Saúde Criança when he received medical treatment at Hospital da Lagoa. The producer then invited Vera Cordeiro to attend Fantastico, a very popular talk show in Brazil. Vera’s appearance in the show attracted much media coverage that doubled the number of members of the organization.
 
Meanwhile, Cordeiro invited people to visit their office at Associação Saúde Criança wherever she went, and soon after, their phone lines became very busy. “I heard that your organization helps people. May I pay you a visit?” people would ask from the other side of the phone.
 
Many other related organization sprung out. Relive was established in 1993, and then Reappear and React were founded soon after, and finally, Redo was set up in 1995. Vera Cordeiro demanded that these four organizations meet four requirements: stable cooperation with their hospital, experiences with helping patients in poverty, compliance with Associação Saúde Criança’s regulations and standards, and the aspiration to promote charity.
 
For example, Albenita Barros Correia, the founder of Reappear, is a passionate woman who works for a children’s hospital in Rio de Janeiro as a psychiatrist and a manager. Like Cordeiro, Correia could not bear to see children suffer from diseases that could have been prevented and controlled, the solution to which was cooperation with the mothers of the patients.
 
The methodology of Associação Saúde Criança attracted much attention. In 1996 Vera Cordeiro was awarded Servico Social do Comercio Medal and Servico Social da Industria, Medalha de Décimo Quinto Aniversário, two of the major social service awards in Brazil. In the following year, when Vera’s methodology extended to three more hospitals, she was presented five more awards: the Tiradentes Medal, Beija-Flor Trophy, Bem Eficiente Award, Rio de Janeiro Government Award and the International American Foundation Award. Since 1997, nine other hospitals have adopted Vera’s methods.
 
Before the expansion, Associação Saúde Criança had to stabilize its structure and set up management procedures for professional practitioners. Fortunately, Cordeiro received a phone call from Anamaria Schindler, who was head of Ashoka Social Entrepreneur Center in São Paulo at the time. Schindler had launched a joint venture between Ashoka and McKinsey & Company in Brazil, and she asked Vera Cordeiro whether Associação Saúde Criança needed free services provided by advisors at McKinsey. Cordeiro, thrilled by the offer, immediately started planning for an expansion plan that would consume fifty thousand dollars. The plan was later submitted to BNDES (Banco Nacional de Desenvolvimento Social).

Ties with McKinsey & Company
Before Schindler further strengthen the relation between Associação Saúde Criança and McKinsey & Company, Drayton had developed connections with McKinsey, where Schindler had served for nine years. “Many changes are unexpected, but this is one of the most significant changes in the world that forecasts opportunities for rapid development over the coming decades.” Drayton commented, “If McKinsey knows how to bridge corporations and societies, it brings advantages to everyone. McKinsey would also understand more about new perspectives than others, including economic, societal, moral and commercial perspectives. Its advisors would understand more about the future on the whole, and their social clients would benefit from their commercial and societal knowledge.”
 
Under the cooperation between Associação Saúde Criança and McKinsey & Company, advisors from the latter would visit their clients and discuss for weeks about their missions, values, opportunities and challenges. “Advisors at McKinsey take their jobs very seriously.” Drayton added, “They wear suits and ties everyday, but I love them, because they are so smart, that they’ve figured out everything.”
 
“People would love Associação Saúde Criança.” Commented Frederico Oliveira, an advisor at McKinsey & Company who cooperated with the organization and later on became one of the supporters of Associação Saúde Criança. “This organization is not only modest and frank, but also it emphasizes morals and directions. In fact, you’ve got to hold it, because when Vera Cordeiro comes up with an idea, she would lose her mind, which excites many of us. We’d love to discuss, and we’d love to transform her ideas into reality.”
 
The advisors comprehended how Associação Saúde Criança managed its volunteers and how it decided when to discharge young patients by analyzing the way the organization selected and tracked their subjects. They divided the services of the organization into core and non-core services, sorting out different key capabilities and weaknesses. They also recommended improvements needed for Associação Saúde Criança to expand 30% in the next two years.
 
Thanks to the advisors, Dr. Cordeiro raised the budget for her proposal from fifty thousand to 250 thousand dollars, and convinced BNDES to provide the fund. She also decided to set up a new position with the equivalent authority to Chief Operating Officer to relieve her with the managing responsibilities. The advisors also suggested establishing three units: marketing, executive and fundraising departments, along with clear administrative procedures between other sectors. “McKinsey truly enlightened me with structures.” Vera said.

The McKinsey Revolution
Associação Saúde Criança had 15 thousand family records, but the way these records were stored rendered it impossible for immediate analysis. From the admission of children, advisors established a database that would track all subjects for a year after these patients were discharged. Associação Saúde Criança also built a new file system for other related organizations to make standard procedures of their own. BNDES also supported one of the organization’s researches on conditions after discharge.
 
Meanwhile, Associação Saúde Criança assessed the health and employment conditions of these families. The standardized assessment sorted these families into three colors. Green stood for acute syndromes that require eight months of treatment and health care, accounting for 40% of the total number of families. Yellow stood for chronic diseases that require fourteen months of support, accounting for 50% of all families in need. White stood for terminal diseases that require twenty-four months of support, accounting for the final 10%.
 
Associação Saúde Criança also regulated that only when the family had a net income exceeding 180 Real (63 U.S. Dollars) per month after intervention, the patient can be discharged. If the family consisted of five members or more, the threshold would be 250 Real (87.5 Dollars). Families with children with terminal disease or disabilities were subjected to all possible government aids that provided concrete houses with two rooms, one bathroom, one sink, one shower and a flush toilet, and the health condition of these children must be assessed either as “fair” or “good”. All children over 4 years old were sent to daycare centers or subjected to special care, and those from 5 to 16 years of age were mandated to receive formal education. All children under 10 must be vaccinated, and all family members should go through several government procedures. Finally, all mothers must learn contraception.
“What McKinsey has done is a revolution.” Vera commented.
 
But this revolution had it’s own challenges, with one of which being applying business models to social movements and reforms. It was not an easy task to strike a balance between finance and human resources, and between professionalism and approachability. It was also challenging to be flexible and standard at the same time.
 
Philip Reade once asked Vera, “If there were only ten volunteers but twenty families needed our assistance, what would you choose to do?”
 
Vera answered, “We’d had no money from the beginning, and we started in a wobbly, wet little stable. It is our mission to help all twenty families, and when things happen, it is our chance to grow.”

Boldness
In 2001, Dr. Vera Cordeiro was recognized as one of the ten most outstanding women and one of the twenty greatest social leaders in Brazil. In early 2003, Associação Saúde Criança was awarded the Most Innovative Development Project Award.
 
In 2008, Associação Saúde Criança had helped 35200 children and 7400 of their relatives from 17400 families, while other related organizations aided ten thousand people. One particular research in 2008 revealed that percentage of children living with “high risk” had dropped from 42% to 10%, and the monthly income of these families had increased by 58%
 
Currently, the head quarter of Associação Saúde Criança is located in a beautiful park just 5 minutes away from Hospital da Lagoa on foot. From a wobbly little stable, to a pink building that looks like a middle-sized, efficient organization, Associação Saúde Criança has truly gone through many challenges. Their office is now filled with psychologists, social workers, nutritionists and volunteers, as well as young patients and their mothers. There is also a storage room where food and medication are kept, and there is a bulletin board right next to the front gate with all the demands posted, such as electric fans, candles, food grinders, filters, clothes, wheelchairs, nebulizers, a child suffering from hydrocephalus who needs a baby carriage, and many more.
 
On the walls of the hallway, one can see many photographs of Dr. Vera Cordeiro being awarded. Beside the pictures, there is a quote from Johann Wolfgang von Goethe, “Boldness has genius, power and magic. Begin it now!”