A Shift in Paradigm

Harvard’s Trailblazing Course in the Brazilian Amazon

Former Harvard President Claudine Gay had all it would take to be a tremendous leader of the institution. Her vision, bold humility and intellectual vibrancy were deeply appreciated by the community of university affiliates, as shown by the mobilization of more than 700 Harvard faculty in support of her presidency. One of the most compelling lessons from her term is the quest to turn an ivory tower into a civic-oriented institution with a commitment to partnering with local, underprivileged communities around the world. She resigned from the presidency having shared the vision of a history-defiant Harvard committed to advancing the prospects of humankind beyond the borders that have traditionally defined who benefits from Harvard’s spaces and works.

In January, I found a ray of hope for the future of the institution amidst the inconformity brought by the resignation letter. For the first time in history, Harvard offered an in-person course in the Brazilian Amazon focused on listening to local voices, including riverine and Indigenous communities, and amplifying the findings of Amazonian researchers. An initiative led by Marcia Castro, the first woman Brazilian professor tenured at Harvard, the Harvard-Brazil Public Health Collaborative Field Course has been led by the Chan School for 16 years, hosted by universities in various Brazilian cities. It is worth noting the crucial role played by the Brazil Office of the David Rockefeller Center for Latin American Studies (DRCLAS) whose staff not only supported us in preparing for the course but guided us through every step of the in-person journey.

Group of students and faculty from Harvard and Brazilian universities during a site visit at the Foundation for Amazon Sustainability, an NGO founded by a former Harvard Ph.D. student Virgílio Viana.

With Manaus, a city in the heart of the Brazilian Amazon, as the destination, the course shed light on the challenges and successes of the country’s universal health system to provide coverage to remote communities that can often only be reached by days of boat ride. Sixteen Harvard students joined fourteen students from Brazilian universities for the immersion, which consisted of a combination of lectures, site visits and conversations with local experts and practitioners. The organization of the course was threatened, however, by an unprecedented challenge posed by climate change to the Brazilian Amazon: over the past few months, the rainforest which largely relies on the health of its rivers experienced its most severe drought in 121 years (CNN, October 2023). The effects were unfortunately drastic as food security, transportation and biodiversity of Amazonian communities were severely affected. With a rampant increase in rain and water levels in late December, the course faced trying conditions.

Showcasing the university’s potential to incorporate local, underprivileged communities in its teaching strategies, programming included visiting and learning from the leaders of Brazil’s largest Indigenous neighborhood in an urban area—inhabited by 35 different Indigenous groups with 16 different languages. Instead of allowing Harvard students to come up with solutions from their preconceived perceptions, the team of Harvard and Brazilian-university faculty course leaders assigned local researchers and professionals as mentors of the student research groups. Members of the class had to complete five papers with suggested innovations for the provision of equal access to universal health care in the Amazon in topics related to five areas of public health – health systems, nutrition, tuberculosis, malaria and HIV/AIDS.

Playing soccer with kids and teenagers at the riverine community named Santa Helena do Inglês

As a Brazilian junior at Harvard College—the only undergraduate to participate— I felt fulfilled to witness a demonstration of the university’s commitment to valuing my culture and especially the culture of those who reside in the Amazon. A fascinating moment during the course was to sleep over in a riverine community where the NGO Foundation for Amazon Sustainability built a model eco-village as an example of how a responsible and sustainable use of natural resources can be associated with a better livelihood by riverine communities. We aimed to collect information about the food security of children and adolescents, asking them questions that ranged from the quality of school meals to the effects of river pollution on their food sources. One of the intriguing findings was the overconsumption of ultra-processed foods by some riverine and Indigenous communities given a lacking sustainable food system that allows for nutrient-diverse products to reach their communities.

Despite the immense challenges for the government to provide health care in regions accessible only by boat, there are scientific innovations created in the Amazon that are way beyond the developments of elite academic institutions around the world. First, the public health care system designed fluvial basic health units, through which remote communities can have free access to primary care, rapid tests and multidisciplinary health teams in the middle of the river. Second, public research agencies based in the Amazon—such as the Fiocruz—are at the forefront of complex scientific experiments like metagenomics, anticipating the surveillance of undiscovered viruses. Finally, local researchers have been working tirelessly on the edge of confronting climate change—whether through informing public policy on combating deforestation, developing innovative ways to sequester carbon or emphasizing the need to combine sustainability with improving the livelihood of poor Amazonian communities.

Site visit at Fiocruz Amazônia, a public agency in Brazil for the development of research in Biological Sciences, where we witnessed the top-notch studies and experiments conducted by local Amazonian researchers.

What Harvard’s public health course in the Brazilian Amazon has proved is that our institution can do so much more in how well “we work together to help others thrive,” as emphasized by Gay at her inauguration. Although her resignation showed us that pushing through obsolete traditions and practices can lead to strong backlash, we shall never forget that the privilege of being at Harvard impels us the duty of expanding inclusivity in our research practices, collaborating with local communities to learn from their perspectives and hopefully contributing to their challenges through collectively thought-out solutions.

Photo with Professor Márcia Castro, the Andelot Professor of Demography, chair of the Department of Global Health and Population, and director of the Brazil Studies Program of the David Rockefeller Center for Latin American Studies.