JOSé AMéRICO SILVA FONTES

Brazil,

Dr. Jose Americo Silva Fontes is a pediatrician specializing in neonatal care from the northeastern city of Salvador. He has invented numerous medical devices that are lifesaving, simple, and affordable. He is now launching a foundation to put the equipment and know how that he has developed to use throughout Brazil and other poor countries.

This profile below was prepared when José Américo Silva Fontes was elected to the Ashoka Fellowship in 1992.

INTRODUCTION

Dr. Jose Americo Silva Fontes is a pediatrician specializing in neonatal care from the northeastern city of Salvador. He has invented numerous medical devices that are lifesaving, simple, and affordable. He is now launching a foundation to put the equipment and know how that he has developed to use throughout Brazil and other poor countries.




THE NEW IDEA

Jose is a neonatal specialist by profession and an inventor out of necessity. He turns ordinary, inexpensive household and hospital items into lifesaving medical equipment that he hopes will benefit not only Brazil but the entire world. Using Tupperware containers and glass water bottles, he has made oxygen hoods for babies in his care. From track lighting, cotton netting, and dimmer switches, he has made phototherapy units for jaundiced babies. Hospitals, clinics, and even families are thus able to have the benefits normally thought possible only from equipment (usually imported) that costs many times more.

For infants with clogged nasal passages that are unable to breathe from their noses, Jose designed a special pacifier with an eyedropper inside that allows the baby to draw in air while sucking on the pacifier. He has even made a type of caressing machine with feathers and a recording of the mother's voice to cuddle and rock the child when the mother or nurse is not available. Even the affection of a mechanical surrogate mother can help quicken the recovery of a newborn.

Jose has three principal words to describe his innovations: humanizing, simplifying, and preventative. At the hospital, he works with nurses and mothers to train them to apply these principles to the care of the children. Of his inventions, which number more than 100, he once told a journalist, "All of sudden, the ideas just pop out."




THE PROBLEM

In Brazil, up to ninety percent of the public hospitals do not have adequate neonatal intensive care units or other equipment necessary to help sick newborns, according to Jose. The problem is compounded by the fact that at least half of all Brazilian mothers do not receive any type of prenatal care.

Under such conditions, in 1992, Brazil's infant mortality rate was roughly sixty deaths per 1,000 live births (as compared with thirty seven per 1,000 in Mexico and fourteen per 1,000 in the United States). Hospitals need to find innovative ways to provide the best care possible for babies even with their limited resources. Jose has proven that with a bit of ingenuity, overcoming the odds is possible.




THE STRATEGY

Jose has now created a foundation to continue developing and distributing new low cost equipment across Brazil and internationally. A growing number of Brazilian hospitals are using his innovations. Jose is currently working with the state secretary of health in the northern state of Ceara in order to produce his devices for use in hospitals statewide.

The foundation will also seek out other centers that are developing alternative medical technologies and stimulate the exchange of ideas and encourage collaborations between these centers. It will highlight and help developing countries meet the need for appropriate and affordable medical equipment that can deal with difficult infant care problems.




THE PERSON

When a child, Jose dreamed that his late Uncle Francisco warned him that his infant brother, also Francisco, would die and that nobody could save him. The dream was prophetic, and his brother died. This event caused Jose to change his course of study from law (which was his father's influence) to pediatric medicine.

Now, at the age of fifty six, Jose, has more than thirty years of experience in neonatal practice and is head of the neonatal medicine at Sacred Family Hospital in Salvador. Furthermore, he has written nine books, has published material in numerous medical journals, and has even designed a manual on newborns for midwives and community health agents. He describes himself as a religious person who is grateful for what he has received in life. "I feel privileged in a country where the majority have nothing, and I feel I have a debt to pay," Jose said. "Everything I have given so far is very little in comparison to what I have received. I still owe a lot."

Jose was elected an associate member. Since his election he has brought his creativity to bear in collaboration with other members of the fellowship. For example, working with Suely Carvalho, he has developed a set of simple, easily maintained devices midwives can carry on their bicycles.