Bahia Adventist Clinic

The Clínica Adventista da Bahia (Bahia Adventist Clinic) (CAB) is a medical missionary institution of the Seventh-day Adventist Church, which is part of the Adventist Health International Network. It is located in the territory of the East Brazil Union Mission (ULB) and operates on the Faculdade Adventista da Bahia (Bahia Adventist College) (FADBA) campus, on BR-101, km 197, Zip Code 44300-000, Capoeiruçu neighborhood, in the city of Cachoeira, state of Bahia, Brazil.

The medical institution “offers the services of several specialized professionals and is also a place where research and extension projects are developed, in addition to serving as an internship point for nursing, physiotherapy, dentistry, pedagogy, and psychology students.”¹ The clinic has served the community with health activities in the areas of Nursing Services: preventive, prenatal, wound care, vaccination, pressure check, capillary blood glucose, and Body Mass Index (BMI); Physiotherapy Services: orthopedic clinic, neurofunctional clinic, and cardiological clinic; Dental Services: dental surgery, pediatric dentistry, and dental clinic; Psychology Services: psychodiagnosis, child therapy, family therapy, and adult therapy.²

Developments That Led to the Establishment of the Institution

It has been reported that the first Adventist baptism in the state of Bahia took place on October 2, 1907, and from then on the gospel has developed, and more people were reached. Along with the church, educational institutions have being established, and higher education received a strong boost in the late 1970s.³ At that time the Capoeiruçu farm was purchased, in the city of Cachoeira, where Bahia Adventist Clinic is currently located.⁴ With the purchase of this farm, the Instituto Adventista de Ensino do Nordeste (Northeast Brazil College) (IAENE, present Bahia Adventist College) was founded and courses in the health area could be established later. Through this educational institution, evangelization work in the region grew exponentially.

After FADBA started offering courses in the health area, such as nursing and physiotherapy, the need arose to open a clinic in order to improve students' learning and contribute to the development of courses.⁵ The physiotherapy course of FADBA is one of the oldest of the institution, which began on February 1, 1999. The course started very well and as a result, in the following year (2000), it was featured in the magazine of the Federal Council of Physiotherapy (COFFITO).⁶ This recognition further encouraged the institution's administrators and employees. After all, having a clinic close to the college would make FADBA’s health courses more relevant.

At the end of 2000, Professor Cláudia Bahia, coordinator of a health project for more than 600 families in the city of Capoeiruçu, was already warning of the importance of having a health clinic on site. With the clinic in operation, there would be more professionals to serve the residents of the region, and it would be possible to better prepare health professionals graduated from FADBA to serve both the church and society.⁷

Among those who dreamed and actively contributed to the establishment of the clinic were: Cláudia Bahia herself, who became the clinic's first director; the deputy director, Prof. Silvio Bernardes; the IAENE director at the time, Pastor Clovis Bunsen Ferreira Junior; together with the financial director, Pastor Joel Gonsioroski Silva; and pastors Helder Roger Cavalcanti Silva, Ivo de Azevedo Vasconcelos, Jorge Luiz de Oliveira Sousa, and Carlos Alberto Rosa de Oliveira.⁸

The Institution Foundation

Building a well-structured clinic to provide good health services to the population is not an easy task due to the complexity and regulatory requirements. This project required a lot of hard work, planning, and investments. In 2001 the Northeast Brazil Union Mission (UNeB) and Bahia Conference (AB) encouraged and invested the necessary resources for the viability of this project. At the time, these administrative units led Adventist work in that region.⁹ Through this support the implementation works began in mid-November of that year.¹⁰

The clinic's inauguration ceremony was held on April 25, 2002. The constructed area was of 1,445.65 m². The event started at the institution's temple, and the participants went to the clinic to continue the program. On the occasion, about a thousand people were present, including ecclesiastical and political leaders, students, professionals from different areas, and community representatives. After the speech by the representative of the Health Department of the state of Bahia, the inaugural ribbon was cut, and the participants and guests were able to visit the clinic's facilities. At the time, the institution was considered “one of the most modern health parks in the country.”¹¹ At its inauguration its leaders wanted it to be a “benchmark in the region, in terms of quality, good service, and even provision of social service.”¹²

Although it has been commonly identified since its establishment as Physiotherapy Clinic or School-Clinic, its official name is Bahia Adventist Clinic.¹³ The institution was founded with the mission of contributing to the development of the practical skills of FADBA students, providing a multidisciplinary vision in promoting physical, mental, social, and spiritual health. Furthermore, it also seeks to encourage the professional and personal growth of its professors and employees so that they can contribute to improving the quality of life, longevity and education of every citizen who has contact with the clinic.¹⁴ Throughout its journey the institution remains firm in this preestablished purpose.

At the beginning of its operation, physiotherapeutic rehabilitation services were offered in the areas of orthopedics and neurology for adults. In the following year (2003), the amount of health courses increased, and the clinic started offering these same services to children, in addition to cardiac care for adults. In the same year chaplaincy services were added in partnership with the faculty of theology, operating on the same university campus.¹⁵ Due to the clinic's location and the focus of its employees' work, certain groups were served more often. The elderly, obese people, pregnant women, hypertensive, and adolescents undergoing dental treatment were part of that group.¹⁶

The Institution History

Over the years, through a diversified assistance planning, the clinic has been characterized by the continuous progress of its activities, which can be noticed in the improvement of both its structure and services. A substantial contribution to this came from two very significant research and extension projects. The first is the “Reabilitação Cardiovascular” (Cardiovascular Rehabilitation) project, which started in 2004 and lasted until 2015. It provided recovery therapies for cardiac and hypertensive patients and those with metabolic diseases. This initiative enabled the clinic to become the basis for conducting research and publication.¹⁷ The second is the “Um sorriso para você” (A smile for you) project, which is a multidisciplinary care program for children with special needs and their mothers. It started with the participation of professors and students from the courses in physiotherapy, pedagogy, and theology. Subsequently, women from AFAM-SALT joined the project,¹⁸ who collaborate with handicraft courses.

As of 2005 the physiotherapy sector was strengthened, providing 80 daily appointments. Furthermore, another extension and research project entitled “Rede Cegonha” (Stork Network) was initiated. This program of the physiotherapy course was intended to help pregnant women in the community and operated until 2017. Other services started to be offered in the same period, such as Medical Clinic, Orthopedics and Family Therapy. During 2008 about three thousand appointments were carried out by the Clinical Psychology sector alone. Among the patients there were students and people from the community. Supervised by their professors, trainees from the Psychology course were (and still are) able to offer service in nine different approaches that adapt to the needs of each patient.¹⁹

In 2010, the “Disfunções Temporomandibulares” (Temporomandibular Dysfunctions) project started to operate, with the aim of offering specific physiotherapeutic and dental care for the various diagnoses, seeking the well-being of the patient when fighting orofacial pain.²⁰ In parallel to this, the Faculty of Nursing was inaugurated in 2010, and thus the project received a reinforcement, as the participants also began to be served by professors and students of that course. The nursing course also started to provide nursing evaluation and wound-care services. Then the project team started to receive support from professors of the administration course, who offered home finance courses for mothers. The opening of the Faculty of Psychology also made it possible for professors and students of the course to participate in the program. However, even with the support of several courses, the “Disfunções Temporomandibulares” (Temporomandibular Dysfunctions) project was ended in 2013 and subsequently reestablished in 2018.²¹

From 2011 psychopedagogy services for college students started. The project also received international aid. Institutions such as the Department of Dentistry of Loma Linda University and the Maryland and Burnt Mills SDA churches, in the United States, contributed and still contribute to its development. Aid comes in the form of financial support and advice. The physiotherapy sector also benefits from these contributions.²² Support has also been given by students from other Adventist institutions, who come to Brazil to dedicate themselves to volunteer work. In this type of action, students work on the several FADBA missionary fronts, including chaplaincy, School of Missions, and the project “Um sorriso para você” (A smile for you).²³

In addition to efforts made by the clinic's administration to establish partnerships with Adventist institutions, other accords have been sought with a view to also making it possible to maintain projects and implement new initiatives. In this context an agreement signed with the City Hall of Cachoeira enabled the 14th Family Health Unit of the city to be inaugurated on September 25, 2014. The unit was built on the premises of the School-Clinic, adding medical appointments, dentistry, preventive medicine, and vaccination services to the population living in its surroundings. With this partnership, the clinic came to be called Unidade de Saúde da Família Esmeraldo Damasceno (USF) (Esmeraldo Damasceno Family Health Unit),²⁴ the second Unit in the village of Capoeiruçu. The college students, community residents, SDA members, the then general director of FADBA and other directors of the institution, the city's health secretary, and some political representatives attended the inauguration. This important partnership showed that one of the Clinic's goals was being achieved. With the development of the institution, in 2014, the Psychology Clinic was also inaugurated in a joint effort with the new sector of management and coordination of internships for each course at FADBA. As a result the institution's area increased by 727 m², reaching a total of 2,172.65 m².²⁵

Still in search for the well-being of the community, in 2014 and 2015 the multidisciplinary extension project “Dor Crônica” (Chronic Pain) took action, whose goal is to offer rehabilitation for patients with low back pain and fibromyalgia, based on the School of Posture model,²⁶ and with the participation of physiotherapy and psychology students. In 2016, sickle cell disease was the research topic at FADBA. In partnership with the health secretariat of the city, students led by professors from the institution planned to carry out a mapping of this type of disease in Quilombola communities, where there are high incidence rates. In the city of Cachoeira there are at least five Quilombola communities, which received special attention.²⁷ As envisaged, “the importance of this work is the future development of a health reference center in the college's clinic where, in the future, people diagnosed with sickle cell disease can be treated.”²⁸

Through these and other actions, the Bahia Clinic expanded its operations beyond the borders of the city of Cachoeira, allowing people from other locations to benefit from its activities. For this purpose, partnerships were made with the city halls of the region, thus making it possible to provide medical services to more patients from neighboring cities who go to the clinic in order to be treated.²⁹ As a result of the increase in demand for the clinic's services, its facilities were expanded, and more people were employed.

From 2015 the clinic started providing dental care for children and teenagers, under the guidance of professors in this area. Two years later (2017), during a series of inaugurations that took place at FADBA, the dentistry section was also inaugurated. This 737 m² sector was incorporated to the clinic's complex, and thus its total built area increased to 2,909.65 m². Although the clinic had been offering dental care since 2015, it was only from 2018 that students of the course were also able to provide services to the public, which started to contribute to their training, in addition to representing an important increase in the service to the local population.³⁰

In fulfilling its medical missionary mission, the clinic has helped many people to have their lives transformed by the gospel. One of them is a lady who received medical and psychological assistance after going through difficult situations that led her to think about taking her own life. After receiving Bible studies and attending the daily worship services that were held at the institution, in mid-2017, she decided to be baptized. The baptism took place in the clinic's pool and was attended by about fifty people. Stories like this are evidence that CAB, in addition to treating the physical health of patients, presents the Word of God to them. Through this work many people have been reached by the gospel, having their lives completely transformed.³¹ Another patient whose life was transformed was a federal prosecutor who participated in one of the health projects promoted by the clinic. After his participation and involvement, he also accepted the message of salvation and joined the SDA organization.³²

In 2018 another extension project called “Qualidade de vida para o trabalhador” (Quality of Life for the Worker) was started, which aims to offer multidisciplinary care to FADBA employees. This was an important milestone for the institution, since from then onwards its employees have endeavored to offer assistance to the campus employees, counting on the participation of physiotherapy, psychology, nursing, and dentistry students.³³ Another achievement in 2018 took place when the Pênfigo Adventist Hospital donated some sterilization devices to the clinic. Soon a room where this equipment could be used to perform hundreds of procedures was built.³⁴

Nowadays the reach and importance of the work provided by the clinic's team is notorious, as shown by the number of appointments in each sector of the institution. The monthly average of procedures is 1,152 in physiotherapy, 280 in dentistry, 415 in psychology, and 216 in nursing. Altogether, there are about two thousand sixty-three monthly procedures in those four areas. Among the actions performed, it is worth mentioning the appointments, exams, physical and psychological recovery therapies, dental care, health and vaccination campaigns, prevention work, and monitoring of pregnant women.³⁵

The Institution’s Historical Role

The chaplaincy of the clinic, in partnership with SALT (Latin-American Adventist Theological Seminary), has developed a work of permanent spiritual assistance to the professional team, students, and the population served. Two worship services are offered daily, in the morning and evening hours. Visits to patients are also carried out, with an average of five weekly meetings. Furthermore, this sector offers six Bible studies in this same period. Theology students take patients from the clinic to churches near their homes in order to continue missionary activities. On average, there are 40 churches in the region. As a result of this work, 10 patients have already been baptized. Thus, the clinic has also been an instrument that helps the growth of the churches in its surroundings. In 2017 the first evangelistic meeting was held in its facilities. Currently, the clinic has adopted a group of 20 teenagers in the Alecrim neighborhood, in the city of Cachoeira, where every Sabbath it offers Bible courses for these young people and their families.³⁶

Observing its history and the activities carried out during its institutional journey, it is possible to notice the impact of the clinic on the place where it is established. At the beginning of its operation, its employees needed to go out into the village of Capoeiruçu, inviting residents to visit the institution. Many were cautious about seeking assistance at a privately owned clinic, fearing that treatment costs would be unfeasible to the needy population that predominates in the region. This notion gradually changed, and as the residents of the region realized the accessibility of services, they began to seek treatments and receive medical care provided through the institution's own projects and through the SUS (Unified Health System) Family Health Unit that operates there. Besides, as a result of continuous expansion, it was possible to assist even some municipal health clinics and other neighboring cities.³⁷

Outlook

Although throughout its history the clinic has advanced in carrying out its mission, there is still a great challenge to be faced. It needs to raise more financial resources so that it can meet its demand for care. With a greater financial support, it will be able, in addition to improving its services, to advance in more research in the health area, through access to more advanced technologies. Overcoming this challenge will bring a greater benefit to the clinic, to FADBA, and consequently, to the population around it. However, while these and other improvements are not possible yet, the clinic and everyone who contributes to it already receive daily expressions of gratitude from the patients and residents of the Capoeiruçu village who recognize the effort and commitment dedicated to them.³⁸

The administration of FADBA and the entire technical and administrative team of the clinic plan a further development for the medical institution to operate as a day hospital in the future, in addition to seeking to make more agreements and expand the range of services provided.³⁹ Furthermore, the administration proposed to work for the clinic to become a benchmark center in dentistry, being a point of support for all dentists in the region, both in carrying out complementary exams and in training through continued education. In addition, efforts will continue to be made so that the clinic increases the offer of natural therapies, focusing on the complete program of treatments through the eight natural remedies, in accordance with the Adventist philosophy of integral health.⁴⁰Thus, Bahia Adventist Clinic will keep striving for excellence in the medical services it provides in a way its missionary work can continue to contribute so that people served may receive more physical, mental, social, and spiritual development.

List of Directors

Claudia Bahia (2002-2004); Lilian Becerra de Oliveira (2005, 2006); Menilde Araújo Bião (2006, 2007); Fabiano Lechzering Silva (2007, 2008); Karina Grace Ferreira (2008, 2009); Lilian Becerra de Oliveira (2009-2011); Rogério Spagnolo (2011-2017); Lilian Becerra de Oliveira (2018-Present).⁴¹

Sources

Almeida, Wagner. “Estudante argentina fala da paixão pelo voluntariado” [Argentine student talks about the passion for volunteering]. Notícias Adventistas [Adventist News] (Online), June 8, 2012.

ANS - Agência Nacional de Saúde Suplementar [ANS - National Supplementary Health Agency]. http://www.ans.gov.br/.

Becerra, Lilian. (Bahia Adventist Clinic manager). Interviewed by Adilson da S. Vieira (ESDA writing assistant), June 17, 2018.

Bérgamo, Fábio. “Faculdade Adventista da Bahia cresce em ritmo acelerado” [Bahia Adventist College grows at a fast pace]. Revista Adventista [Adventist Review], no. 6, year 98, June 2003.

Carneiro, Heitor and Vanessa Arba. “Doenças falciformes são tema de pesquisa na Faculdade Adventista da Bahia” [Sickle cell disease is the research topic at Bahia Adventist College]. Notícias Adventistas [Adventist News] (Online), April 8, 2016.

Clínica Adventista da Bahia [Bahia Adventist Clinic]. http://www.adventista.edu.br/clinica-escola.

“Clínica de Fisioterapia no IAENE irá atender comunidade carente” [Physiotherapy Clinic at IAENE will serve the needy community]. Revista Adventista [Adventist Review], no. 6, year 98, June 2002.

“Clínica de Odontologia Atende Comunidade Local” [Dentistry Clinic Serves Local Community]. Comunica [Communicate], semiannual edition, 1st semester of 2018.

Da Redação [By the Editors]. “IAENE: uma escola inovadora” [IAENE: an innovative school]. Revista Adventista [Adventist Review], no. 3, year 97 (March 2001).

Facebook. https://www.facebook.com/.

Faculdade Adventista da Bahia [Bahia Adventist College]. http://www.adventista.edu.br/.

INCRA, “Território de comunidades quilombolas na Bahia é reconhecido pelo INCRA” [Territory of quilombola communities in Bahia is recognized by INCRA]. Notícias [News] (Online), May 25, 2018.

Minute of Bahia Sergipe Mission, no. 219, October 21, 1977, vote no. 77-297.

Minute of Bahia Sergipe Mission, no. 231, February 23, 1978, votes no. 78/049 and no. 079/50.

Portal da Educação [Education Website]. http://portal.mec.gov.br/.

Portugal, Norma S. Information provided by Bahia Adventist Clinic secretary, July 2018.

“Profissionais Destacados Abrilhantam II Jornada Inter Profissional de Saúde” [Outstanding professionals brighten II Inter Professional Health Conference]. Comunica [Communicate], March-April 2017.

Seventh-day Adventist Church (Brazil) Website. http://www.adventistas.org/pt/.

Santiago, Gilson (FADBA construction director). Interviewed by Nesias Joaquim dos Santos, June 24, 2017.

Santos, Nesias J. and Natan F. Silva. Contando Nossa História: 110 anos da Igreja Adventista do Sétimo Dia no Estado da Bahia [Telling Our History: 110 years of the Seventh-day Adventist Church in the State of Bahia]. Salvador, BA: EGBA Publisher, 2016.

Notes

1. Clínica Adventista da Bahia [Bahia Adventist Clinic], “Quem Somos” [About Us], accessed on June 30, 2020, https://bit.ly/3ik7DhZ.↩

2. Clínica Adventista da Bahia [Bahia Adventist Clinic], “Nossos Serviços” [Our Services], accessed on June 30, 2020, https://bit.ly/2NLyqWK.↩

3. Nesias J. Santos and Natan F. Silva, Contando Nossa História: 110 anos da Igreja Adventista do Sétimo Dia no Estado da Bahia [Telling Our History: 110 years of the Seventh-day Adventist Church in the state of Bahia], Salvador, BA: EGBA Publisher, 2016, 62.↩

4. Minute of Bahia Sergipe Mission, no. 219, October 21, 1977, vote no. 77-297.↩

5. Minute of Bahia Sergipe Mission, no. 231, February 23, 1978, votes no. 78/049 and no. 079/50.↩

6. Faculdade Adventista da Bahia [Bahia Adventist College], “História da FADBA” [FADBA History], accessed on May 4, 2020, https://bit.ly/3fmQSS2.↩

7. Da Redação [By the Editors], “IAENE: uma escola inovadora” [IAENE: an innovative school], Revista Adventista [Adventist Review], no. 3, year 97 (March 2001): 33.↩

8. Gilson Santiago (FADBA construction director), interviewed by Nesias Joaquim dos Santos, June 24, 2017.↩

9. Ibid.↩

10. Lilian Becerra (Bahia Adventist Clinic manager), interviewed by Adilson da S. Vieira (ESDA writing assistant), June 17, 2019.↩

11. “Clínica de Fisioterapia no IAENE irá atender comunidade carente” [Physiotherapy Clinic at IAENE will serve the needy community], Revista Adventista [Adventist Review], no. 6, year 98, June 2002, 32; Norma S. Portugal, information provided by Bahia Adventist Clinic secretary, July 2018.↩

12. “Clínica de Fisioterapia no IAENE irá atender comunidade carente” [Physiotherapy Clinic at IAENE will serve the needy community], Revista Adventista [Adventist Review], no. 6, year 98, June 2002, 32; Fábio Bérgamo, “Faculdade Adventista da Bahia cresce em ritmo acelerado” [Bahia Adventist College grows at a fast pace], Revista Adventista [Adventist Review], no. 6, year 98 (June 2003): 33.↩

13. Lilian Becerra (Bahia Adventist Clinic manager), interviewed by Adilson da S. Vieira (ESDA writing assistant), June 17, 2018.↩

14. Norma S. Portugal, information provided by Bahia Adventist Clinic secretary, July 2018.↩

15. Ibid.↩

16. Lilian Becerra (Bahia Adventist Clinic manager), interviewed by Nesias Joaquim dos Santos, June 2018.↩

17. Ibid.↩

18. The Women's Area of the Ministerial Association is “part of the Ministerial Association, serving the wives and families of church workers, engaged in professional ministry.” Seventh-Day Adventist Church (Brazil) Website, “AFAM e departamento dos ministérios da mulher” [AFAM and women's ministries department], accessed on April 17, 2019, https://bit.ly/34VFuqz.↩

19. Lilian Becerra (Bahia Adventist Clinic manager), interviewed by Adilson da S. Vieira (ESDA writing assistant), June 17, 2018.↩

20. “Clínica de Odontologia Atende Comunidade Local” [Dentistry Clinic Serves Local Community], Comunica [Communicate], semiannual edition, 1st semester of 2018, 2.↩

21. Lilian Becerra (Bahia Adventist Clinic manager), interviewed by Adilson da S. Vieira (ESDA writing assistant), June 17, 2018.↩

22. Ibid.↩

23. Wagner Almeida, “Estudante argentina fala da paixão pelo voluntariado” [Argentine student talks about the passion for volunteering], Notícias Adventistas [Adventist News], June 8, 2012, accessed on June 11, 2019, https://bit.ly/31Z5W20.↩

24. The name is a tribute to the first joiner at IAENE, who was especially relevant in the evangelization of the local community.↩

25. “Prefeito inaugura a 14ª Unidade de Saúde da Família do município” [Mayor inaugurates the 14th Family Health Unit in the city], PMC 2013/2016, Facebook post, September 25, 2014 (10:36 p.m.), accessed on June 11, 2019,” https://bit.ly/2V14zOV.↩

26. One of the goals of the School of Posture is to “promote the population's awareness to change the focus from chemical treatment to treatment through physical resources, aiming at decreasing medication costs and reducing harm to users caused by the excessive use of these drugs,” showing, in this way, “the possible causes of back pain and teaching how we can avoid (posture tips) and/or treat this in the best possible way.” Portal da Educação [Education Website], “Escola de Postura” [School of Posture], accessed on June 17, 2019, https://bit.ly/2WMjJoq.↩

27. INCRA, “Território de comunidades quilombolas na Bahia é reconhecido pelo INCRA” [Territory of quilombola communities in Bahia is recognized by INCRA], Notícias [News], May 25, 2018, accessed on June 12, 2019, https://bit.ly/37xeHS2.↩

28. Heitor Carneiro and Vanessa Arba, “Doenças falciformes são tema de pesquisa na Faculdade Adventista da Bahia” [Sickle cell disease is the research topic at Bahia Adventist College], Notícias Adventistas [Adventist News], April 8, 2016, accessed on June 11, 2019, https://bit.ly/2vrWYy6.↩

29. Lilian Becerra (Bahia Adventist Clinic manager), interviewed by Adilson da S. Vieira (ESDA writing assistant), June 17, 2018.↩

30. Faculdade Adventista da Bahia [Bahia Adventist College], “FADBA comemora 38 anos de existência com inauguração de estruturas e desfile cívico” [FADBA celebrates its 38th anniversary with inauguration of structures and civic parade], accessed on June 13, 2019, https://bit.ly/2Illftu; Lilian Becerra (Bahia Adventist Clinic manager), interviewed by Adilson da S. Vieira (ESDA writing assistant), June 17, 2018.↩

31. Faculdade Adventista da Bahia [Bahia Adventist College], “O milagre da Clínica Adventista da Bahia” [The miracle of Bahia Adventist Clinic], accessed on June 17, 2019, https://bit.ly/2MT9sqO.↩

32. Lilian Becerra (Bahia Adventist Clinic manager), interviewed by Adilson da S. Vieira (ESDA writing assistant), June 17, 2018.↩

33. “Profissionais Destacados Abrilhantam II Jornada Inter Profissional de Saúde” [Outstanding professionals brighten II Inter Professional Health Conference], Comunica [Communicate], March-April 2017, 2.↩

34. Faculdade Adventista da Bahia [Bahia Adventist College], “Sala de esterilização e novos quartos são inaugurados” [Sterilization room and new rooms are inaugurated], accessed on February 15, 2020, https://bit.ly/2RiT7dr.↩

35. Lilian Becerra (Bahia Adventist Clinic manager), interviewed by Adilson da S. Vieira (ESDA writing assistant), June 17, 2018.↩

36. Ibid.↩

37. Ibid.↩

38. Ibid.↩

39. “The Day Hospital (HD) is an intermediate assistance system between hospitalization and outpatient care. For clinical, surgical, diagnostic and therapeutic procedures, the Day Hospital is indicated when the patient's stay in the unit is required for a maximum period of 12 hours.” ANS - Agência Nacional de Saúde Suplementar [ANS - National Supplementary Health Agency], “O que é Hospital-dia?” [What is a Day Hospital?], accessed on June 30, 2020, https://bit.ly/3dQ0uTg.↩

40. “Eight general principles on how to develop and maintain a better physical, emotional and spiritual life. For Adventists, according to Romans 12:1 and 2, quality of life should not be sought only for longevity or momentary well-being, but because of a successful relationship between the creature and the Creator and Originator of life.” They are: “Healthy eating, Regular water intake, Breathing fresh air, Exposure to sunlight, Physical exercise, Rest, Temperance and Trust in God.” Seventh-Day Adventist Church (Brazil) Website, “Saúde” [Health], accessed on June 30, 2020, https://bit.ly/2WBF06e.↩

41. For more information about Bahia Adventist Clinic, access the website http://www.adventista.edu.br/clinica-escola/.↩