2015 AEA International Holdings Pte. Ltd. For permission to reprint contact International SOS.

Transcription

1 2015 AEA International Holdings Pte. Ltd. For permission to reprint contact International SOS.

2 Brazil: Lessons Learned and a Look Ahead (MCCNO) Speakers: Professor Robert L. Quigley, MD, D.Phil, Regional Medical Director and Senior Vice President of Medical Assistance, Americas Region, International SOS Michael Reedy, Regional Security Manager, Americas, International SOS and Control Risks 2015 AEA International Holdings Pte. Ltd. For permission to reprint contact International SOS.

3 Learning Objectives At the end of this session, you will: Analyze the security and health risks in Brazil for special events as well as everyday business travel. Anticipate how you would effectively respond to an event as a risk professional. Discuss how to communicate this information to your travelers AEA International Holdings Pte. Ltd. For permission to reprint contact International SOS.

4 Brazil in the News

5 Fast Facts: Brazil World s fifth largest country 3.3 million square miles World s fifth most populous country 201 million people About 85% live in urban areas

6 Brazil: Key Facts One of the world s largest petroleum reserves; Self-sufficient in oil production; Third largest aircraft manufacturer and top producer of models up to 120 seats; Growing consumer market over 30 million have risen to middle class in recent years; Economic woes will have an effect over security; World Cup was not an economic boom.

7 Medical Risks: Travelers and Expatriates Different regions, different risks Routine vaccination up to date Dengue everywhere Malaria mostly in the Amazon region Yellow fever more generalized Rabies

8 Infectious Diseases in Brazil: Malaria, Dengue, Yellow Fever Rio, Belo Horizonte, Brasilia, Manaus, Salvador and Sao Paulo are six cities selected to host soccer matches.

9 Infectious Diseases in Brazil Malaria Dusk Dawn Chemoprophylaxis Dengue Dawn Dusk No Chemoprophylaxis

10 Infectious Diseases in Brazil: Malaria (Chlorquine-resistant P. falciparum) Rx: Malarone, Lariam,? Doxycycline NOT available in country for chemoprophylaxis only for treatment Travelers bring personal supply, labeled bottle, and MD s Rx Malaria Dusk Dawn Chemoprophylaxis

11 Infectious Diseases in Brazil: Rabies

12 The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been corrupted. Restart your computer, and then open the file again. If the red x still appears, you may have to delete the image and then insert it again. Before You Go Routine Medical Care: Obtain routine medical and dental care before you leave. In addition, see a travel health practitioner 6 to 8 weeks before departure. Some vaccinations require a series of doses spaced weeks apart. Some malaria medications should be taken a week or more before arriving in the malarial country. Arrange a copy of your personal health record to carry with you when you travel. Pack an ample supply of prescription and routine medications in their original packaging. Place them in your carry-on luggage, with copies of your prescription. Consider carrying a doctor s note explaining your need for legal, non-prescription drugs you have packed in English and the language of your destination(s). Routine Vaccinations: All routine vaccinations should be current; these include: Measles-Mumps- Rubella, Polio, Tetanus-Diptheria-Pertussis, and Varicella (? Yellow Fever? Rabies).

13 Healthcare System Physicians All major specialties, ER new Excellent specialists in major centers English-speaking in many of the major cities Unions Nurses (RN) and nurse technicians (LVN) No nurse practitioners No paramedics The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been corrupted. Restart your computer, and then open the file again. If the red x still appears, you may have to delete the image and then insert it again.

14 Healthcare System Public System Universal Coverage: Free for all including travelers (ER) Demand greater than supply, particularly hospital beds Overcrowding, lack of adequate equipment and trained staff Physician shortage in rural areas Specialist shortage in smaller cities especially north/northeast Private System: Top medical care in most major cities comparable to US and western Europe Several hospitals with international accreditation JCI Excellent care by well-qualified physicians and nurses Many physicians trained in US and Europe

15 Healthcare System in Brazil Public System Standard of care varies quite dramatically across locations Some good hospitals especially major cities Free vaccination program polio practically eradicated Low cost and free medicines through dedicated pharmacies Many private non-profit facilities in the system EMS not always reliable

16 Private Care Very well-equipped facilities VIP suites at major hospitals International patient centers Medical Tourism destination Cost increasing many procedures comparable to western Europe and some close to US Delays obtaining appointments

17 Key Medical Takeaways Travelers Expatriates Employers Preparation according to destination Vaccinations Increasing healthcare costs Delays for routine visits unless paying out of pocket Very regulated OHS Unions Labor & welfare protection

18 Risk Rating Tool

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20 Media vs. Real Facts Petty crime Traffic accidents and gridlocks

21 Social Media

22 Brazil Key Travel Security Risks Crime: Opportunistic but criminals are young/dangerous Traffic safety: accidents are still the top cause of death in the country. Socio-economic landscape of major Brazilian cities is unique Favelas Economically depressed areas of the cities and extreme population density and lack of basic services.

23 Crime Main gangs PCC (Sao Paulo), CV (Rio), AA: Leaders control crime from inside prison Riots in Parana Prison in August 14 Significant fire-power: shooting down helicopters, RPGs Robbery: Highways outside cities / remote areas / banditry In traffic on motorcycle Restaurants including upscale traveler frequented Homes whole apartments complexes Beaches arrastoes / mass robbery

24 Security Kidnap for ransom mostly wealthy locals but rising incidence in middle class; Drink spiking / prostitution / sex tourism; Extortion Phone based and protection rackets; Express kidnapping Vehicle and ATMs. Has affected travelers; Police corruption and brutality (incl. militias) contribute to sense of lawlessness; Travelers should avoid favela tours even if pacified ; Self driving discouraged.

25 Boa Noite Cinderella

26 Social Unrest Protests during Confederations Cup 2013, FIFA World Cup 2014; 1.5 million took to the street to protest in equality, corruption, event over-spending; Concerns over radical Black-Blocks overblown; Social media catalyst (coordination); Foreign personnel unlikely to be singled out, incidental violence can pose risks; Traffic is likely to be disrupted and severely exacerbated by protests.

27 Brazil Security Outlook Recession will hit poor, increasing violence UPP Pacification Units brought mixed results: Targets moved to un-pacified favelas Internal displacement Staying power in question Ready for 2016 Olympics? Prison over-population will likely set-off further incidents Needs for travelers/expats: Policies Plans Preparation / Training Information / Assistance

28 Past Events It is against this backdrop that Brazil took the world s public stage as the nation hosted two high-profile international sporting events: Confederations Cup 13 and World Cup 14. What did we learn?

29 FIGURES TOTAL COST STADIUM 21 Billion 12 STADIUMS The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been INDIRECT COST 22 Billion HOLIDAYS REVENUE CITIES 30 Billion LOST 13 Billion FIFA REVENUE 4 Billion NET: 3 Billion NUMBER PEOPLE TV WATCHING MATCHES TOURIST TOURIST IMPRESSIONS FLIGHTS DELAY NUMBER OF TV NETWORKS NUMBER OF TV TRANSMISSIONS (HOURS) INTERNET CONNECTIONS MOBILE SOCIAL MEDIA ACCESS 60 % WORLD POPULATION 1.4 Million 95% SATISF./RATE 7.5% MORE THAN M 1 Billion 4.2 Billion PEOPLE 1 Million RIO SOUTH AMERICA - USA W.RECORD W.RECORD W.RECORD W.RECORD

30 32 Countries participated in the 2014 World Cup >65 Countries will participate in the 2016 Olympics

31 Service Delivery Model IHC Response Center PHL Assistance Center

32 Help! Member First Call Brazil-LATAM Assistance Team One Team; Two Locations RIO BR. Network MGR NewCase RIO BR. OPS. MGR PHL BR. OPS. MGR Dedicated Opera9ons and Medical Team

33 C LI N I C Medical Staffing First Call Brazilian MD INTL.SOS MD Brazil-LATAM Assistance Team One Team; Two Locations RIO BR. Network MGR NewCase RIO BR. OPS. MGR PHL BR. OPS. MGR Dedicated Opera9ons and Medical Team

34 Emergency Response Plans for All Sites Rio, Belo Horizonte, Brasilia, Manaus, Salvador and Sao Paulo are the six cities selected to host soccer matches.

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36 Medical Cases Including Match days and non- Match Salvador Days Fortaleza 8% Total: cases - Venues 9% Rio Janeiro 21% Recife 8% Natal 5% Manaus 5% Cuiaba 5% Brasilia 7% B.Horizonte 8% Curitiba P.Alegre 2% 6% Sao Paulo 16%

37 Spectators: Total Cases: Average: 48.7 Cases/ Match

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39 Your Travel Risk Mitigation Program Automated pre-travel advice; real-time travel tracking, on-demand and insightful reports and communication with globally-mobile employees. Organizations can plan and act immediately in the event of a crisis or simply arm employees and international assignees with information that will keep them healthy, safe and secure. Real-time ability to track and assess risks to travelers and to your company. Uses location services to show real-time positions. Obtain travelers flight, hotel, car rental, and current position in once snapshot; receive notifications about global medical and security events along with an impact assessment to understand risk exposure.

40 Prior to Departure Suits occasional and frequent travelers Trip-related timeframe Compliance link Actionable information

41 Prior to Departure Links to your own resources mobile friendly dynamic content, as seen from a general traveler's point of view comprehensive presenta=on of des=na=on country

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43 Questions? Professor Robert L. Quigley, MD, D.Phil., Regional Medical Director and Senior Vice President of Medical Assistance, Americas Region, International SOS Michael Reedy, Regional Security Manager, Americas International SOS and Control Risks - michael.reedy@intlsos-cr.com