Brazil - Staying Safe and Healthy

Expat Briefing Editorial Team, 16 June, 2014

It’s the land of Pele and samba football (of the association variety). Indeed, if England is regarded as the “mother country” of the beautiful game, then Brazil is widely recognised as its spiritual home. The perfect place then, to hold the 20th World Cup. Yet the build-up to the competition has been anything but serene. Chaotic and controversial would be more apt descriptions. Barely completed new stadiums still resemble building sites, riot police are out in force on an almost daily basis, strikes are paralysing the transport systems in the largest cities, and international focus has turned to Brazil’s societal problems in a country where extremes of wealth and poverty rub shoulders uncomfortably.

For football fans all over the world, the prospect of attending a World Cup in Brazil is a seductive one. But given all of the aforementioned problems, it is also a daunting one. This is especially the case for expats on assignment living and working in Brazil on a long-term basis.


Brazil “Safe” for Foreigners

With its reputation for drugs and violent crime, a foreigner could therefore be forgiven for looking forward to a trip to Brazil with a mixture of excitement and trepidation. However, the Government is insisting that travellers have little to fear, and last month Brazil's Justice Minister, Jose Eduardo Cardozo, reiterated that the country is safe for foreigners.

His comments followed clashes between indigenous Indians and police near Brasilia's new Mané Garrincha football stadium – a venue for the World Cup. Cardozo was quoted by the G1 news website as saying that police had sought to allow freedom of expression, but that the force is also responsible for enforcing the rule of law and preventing abuses.

Attorney General Rodrigo Janot said that street demonstrations occur all over the world, and that foreigners should not lose confidence that Brazil is friendly and safe. He also explained that the Ministry of Justice would create a special "crisis cabinet" to deal with demonstrations in World Cup cities swiftly. His attempt to reassure visitors are hardly confidence-inspiring, however!

One police officer was wounded in the leg by an arrow during the protest. The Indigenous Missionary Council said that the protest had been peaceful until the police attacked protesters with rubber bullets and tear gas, which it said had prompted some to react in "self-defense."

The Indians and their supporters are protesting over Government spending on the World Cup, rather than on other social projects, and the Government's failure to recognize indigenous land rights.


But Brazil Issues Safety Warning

A tourist or expat in Brazil would be foolish to think that they can travel the country in complete safety, especially in a city like Rio where, affluent areas bump into the favelas, the shanty-town-like neighbourhoods clinging to the hills surrounding the city. Indeed, in December, Sports Minister Aldo Rebelo conceded that violence with social origins is a "horrible fact" of Brazil.

To increase awareness of these issues, the police service in Brazil is producing leaflets that advise World Cup fans on how to stay safe during their time in the country, amid concerns of high crime rates in Rio.

Mário Leite, who is in charge of security for the event, told Estadão de Sao Paulo that police are being made ready to tackle the problem of armed robbery, but said that visitors from Europe and North America may not be used to encountering this type of crime. In particular, visitors are being advised not to challenge robbers, and to be particularly vigilant, to keep valuable objects hidden, and be careful when out at night.

Leite explained that the leaflets are being published in English, Spanish, French, and Portuguese, and will be distributed abroad by Brazilian embassies and consulates. Similar advice has also been issued by Japan's Ministry of Foreign Affairs for Japanese citizens traveling to the event.

The UK Foreign and Commonwealth Office gives the following safety advice for travellers to Brazil:

It is also worth knowing that foreigners need to present their passports when exchanging money at banks, and that most banks impose a BRL1,000 (GBP300) limit on cash withdrawals from foreign credit/debit cards.

The FCO recommends that visitors to Brazil carry just enough cash to get through the day, that they are aware of who is standing around them when using cashpoints, and that they their inform their bank that they intend to use their debit or credit card abroad. Additionally, it advises visitors to let someone know their travel plans, and that they travel in pairs or groups if attending large events or out and about at night.


Stay Healthy - Get The Necessary Jabs

Health awareness campaigns in several of the countries taking part in the World Cup are reminding football fans planning to travel to Brazil that certain vaccinations are essential. And ideally, these health risks should have been discussed with a travel doctor at least six to eight weeks ahead of departure.

Yellow Fever remains widespread in Brazil, including in areas where World Cup games are scheduled to take place. The disease kills one in six of those infected, and carriers may spread it further. There is no cure, and the illness can cause kidney and liver failure.

Australia’s awareness campaign is headed by Dr Deborah Mills, a spokesperson for the Travel Medicine Alliance. To spread the word, Mills is partnering with the Docceros, the Australian medical football team, who will be participating in a tournament in Brazil coinciding with the World Cup.

Mills warns: "The number of reported deaths from yellow fever among travellers during the past decade has increased, and this figure may increase without yellow fever vaccination."

Vaccinated individuals are given an internationally recognized certificate for inspection by immigration officials, effective ten days after vaccination and valid for ten years. Those who, for medical reasons, cannot receive the vaccine may apply for an exemption certificate.

Travellers to Brazil are also advised to ensure they are up-to-date with vaccinations for Measles, Mumps, Rubella (MMR), as well as for hepatitis A and B, typhoid, and rabies.

Another risk is Dengue fever, which remains relatively common, especially in the more rural areas of Brazil. Indeed, an outbreak of Dengue fever in 2002 affected 800,000 in the Rio area. And private healthcare in Brazil, although generally of a good quality, can be expensive to access. So adequate travel and health insurance cover are essential for anyone considering a trip to Brazil.

Malaria for example can often require an emergency evacuation, especially if contracted in a rural environment. The disease is particularly prevalent in the north western city of Manaus in the Amazonian region, which is holding four World Cup matches, including England’s opener against Italy.

Debbie Purser managing director of Medicare International points out that: "Malaria is the biggest parasitic disease killer that there is in the world and there is currently no vaccine, so having fast and effective access to the right medical facilities to ensure diagnosis and treatment is essential. In particular, where an individual is living in a remote part of Brazil, it is likely that evacuation to a nearby, more comprehensive international medical facility will be needed.”

Purser adds that the company has recently arranged and paid for the evacuation of two clients in similar circumstances, where the costs exceeded USD9,000 in each case.

“At MediCare International, the offer of emergency evacuation is a core part of our package for working expatriates of any nationality, but it is particularly important where difficult diseases are prevalent,” she continues. “Whilst the costs of the drugs required to treat malaria is relatively modest, emergency evacuation is not, but all such costs could be met under our policies, both on an individual or group scheme basis."

The healthcare system in Brazil has improved after years of investment, and the Brazilian constitution guarantees that everyone has access to basic medical care in Brazil. This service can be obtained from the public national health system, from private providers subsidised by the federal government via the Social Security budget, or from the private sector via private insurance or employers. Medical care is available to anyone who is legally living in Brazil including foreign residents.

For the highest quality of health care in Brazil, the private system is generally better than the public system, with shorter waits and better care. The more affluent Brazilians generally use this system, which covers about 20% of the Brazilian population.

Purser adds: “Expatriates of any nationality holding a private international healthcare policy who may be thinking of travelling to see the football should find they are covered for international healthcare costs in Brazil whilst on holiday there. Whereas short-term travel insurance policies can be limiting in terms of the cover they offer, a good quality international health insurance plan will offer a very broad range of support for those in Brazil temporarily, matching the care quality levels even a footballer might expect.”


Getting Around

Brazil is a big country - seven times the size of South Africa, the competition’s last host country. It is essential therefore that journeys between cities are planned carefully as they may be spread far apart; a flight between Rio de Janeiro and Manaus is about four hours. Planning will be made all the more challenging given industrial action by bus drivers, metro workers and airport staff in various Brazilian cities.

The FCO gives the following advice for travel and accommodation Brazil:


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