Cuidados biomédicos de saúde em Angola e na Companhia de Diamantes de Angola, c. 1910-1970 / Biomedical health care in Angola and in the Companhia de Diamantes de Angola, circa 1910-1970

Pretende-se caracterizar a prestação de cuidados biomédicos em Angola durante a atividade da Companhia de Diamantes de Angola. Uma análise comparativa de políticas e práticas de saúde pública de vários atores coloniais, como os serviços de saúde da Companhia, sua congénere do Estado e outras empresas coloniais, revelará diferenças de investimento na saúde, isto é, instalações e pessoal de saúde, e tratamentos. Este escrutínio bem como as condições de vida iluminarão o carácter idiossincrático e central dos serviços de saúde da Companhia em termos de morbimortalidade em Angola, e a centralidade destes para as representações de um império cuidador.

The scope of this paper is to analyze the provision of biomedical care in Angola during the activities of the Companhia de Diamantes de Angola. A comparative analysis of public health policies and practices of various colonial actors, such as the health services of the Company, its state counterpart and other colonial companies, will reveal differences in investment in health, namely in health facilities, personnel and treatment. This survey as well as the living conditions highlight the idiosyncratic and central nature of the health services of the Company in terms of morbidity and mortality in Angola, and the importance of these representations for a caregiving empire.

[Monitoring antibiotic consumption in the surgery and orthopaedics]. / Monitorização do consumo de antibióticos: nos serviços de cirurgia e de ortopedia de seis hospitais SA.

Monitoring antibiotic consumption is a valuable tool which has been increasingly used in the last years due to the current concern with the emergence of resistant microbial strains. The present study aimed at monitoring antibiotic consumption, evaluating the economic impact of hospital antibiotic prescription and assessing the relationship between the prescribed antibiotics and the indications for either prophylactic or therapeutic use. This was a longitudinal pilot-study for which data were collected in six privately managed public hospital units during the month of May 2004, with a resulting sample of 1,122 admitted patients. We observed a prescription incidence rate of 76.9%, corresponding to a total of 1,154 dispensed antimicrobials, with a mean 71.2% of these antimicrobials being dispensed for the prophylaxis of surgical site infection (SSI). The mean cost of antibiotic courses was higher in cases of "suspected infection" (9.09 euro) or "confirmed infection" (8.74 euro) and lower in cases of "prophylaxis" (5.67 euro), a finding which is explained by the shorter mean duration of the later. There was a considerable variation among the different hospital units regarding the type of antibiotic compound that was used for SSI prophylaxis, with a mean duration of antibiotic use of 2.61 days for this indication and about half of the prophylactic regimens lasting longer than 24 hours, a fact that suggests an insufficient observation of the current recommendations for antibiotic use in SSI prophylaxis. This finding indicates the need for an investigation on the actual existence of local recommendations for SSI prophylaxis in individual hospital units and also for the evaluation of the compliance of practicing surgeons with eventually existing recommendations.

A saúde e a Companhia de Diamantes de Angola / Health and Angola's Companhia de Diamantes

O uso da medicina em contextos coloniais é um tópico cada vez mais estudado e ilustra formas mais sutis de disseminação de poder por parte do Estado colonial. A Diamang contraria os estudos de empresas mineiras coloniais realizados até agora, trazendo algo de novo para as relações coloniais. Neste caso houve um cuidado extremo com a saúde dos trabalhadores e das populações da região. No entanto essa vigilância sanitária encontrava-se intimamente ligada com idéias de produtividade e constante melhoria na gestão dos recursos humanos disponíveis.