Part of the history of health in Santa Catarina is told by the HST (Santa Teresa Hospital), built in 1940 in San Pedro de Alcantara. It does not have corridors, but streets: there are houses, a church in the center, a city hall, a theater, its own treatment plant and even a prison.

It was planned to be a small town, but it was subject to mandatory lifelong hospitalization for leprosy, the standard form of treatment for the disease until 1962. It is one of 40 facilities across Brazil built with patient segregation.

It currently provides specialized services in psychiatry and general practice, but its main activity is in skin diseases, as it is the reference center for dermatology in the State of Santa Catarina. HST is among 6 hospitals in Greater Florianopolis in “critical condition” according to the Health Emergency Decree issued by the SES (Secretary of State for Health) on March 28th. The NDI (ND Group Data and Research Center) team went to the hospital to access and learn exclusively about the patient’s current situation.

Santa Teresa Hospital works with a structure compromised by time and lack of maintenance – Photo: Jonata Machado/NDTV Reproduction

There are more than 100 services daily, 1800 per month.

Anyone who sees it from the outside comes across an old and well-preserved structure. But the renovation, carried out on a whim, actually reveals a lack of investment in the structure of the Santa Teresa Hospital, an 83-year-old “elder” that is still active and has much of the original facilities.

It is on the list of 6 hospitals in a “critical” situation in Greater Florianopolis, which was issued a state government order in March of this year. In a report released by the SES, roofs and walls, the power grid and wastewater treatment were listed as emergency points.

Roofs in several houses are in danger of collapsing – Jonatha Machado/NDTV reproduction

Peeling walls also depict a scenario of neglect – Jonatha Machado / NDTV reproduction.

The inside walls are also out of service – Jonatha Machado / NDTV reproduction.

Roofs are crumbling and floors and walls are worn out in houses scattered across Santa Teresa – Jonata Machado / NDTV reproduction

There are cases of cracks in the interior walls of buildings – Jonatha Machado/NDTV reproduction

Without investment and maintenance, the Santa Teresa Hospital is turning into an abandoned city.

The electrical section of the Santa Teresa Hospital has the same images as on the day it opened, and the sewage treatment plant was in operation until almost 2008 – a complex project for a 1940 context, but one that is demolished today.

Roofs are collapsing, including in homes that house long-term care facilities. Eight of the prisoners are permanent residents, the last people isolated due to leprosy who, even cured, could not return to their families due to society’s prejudice against the disease.

Key parts of the structure are original, like a living museum. However, this not only poses a risk to patients and staff, but also hinders equipment upgrades.

If, on the one hand, the team strives to make thoughtful repairs, then, on the other hand, the chronic lack of investment in updating the electrical wiring and drainage system forces to slow down progress. A structure that has stopped in time.

“Our type of need is different from others. Because here you have to manage the city,” sums up José Augusto da Silva Velho, director of HST.

The Santa Teresa Hospital has managed to keep most of its structure, but the renewal of some materials becomes an exaggeration 83 years later.

‘On the way to the century’: renovation of the electrical panel is one of the emergency situations

One of the decisive moments hindering the further development of the hospital is the electrical distribution system: the poles are of old and rotten wood, and the power shields are original parts, even insulating cables made of varnished fabric.

The hospital is open 24 hours a day and accepts emergency admissions through the polyclinic, as well as patients from other hospitals.

Energy is distributed in such a way that everything continues to function, with special attention to the emergency sector.

High and medium voltage installations wear out and there is a risk of possible electric shock to patients and employees.

Almost a century old, the HST force shield has original parts, from the foundation of the building – Jonatha Machado / NDTV reproduction

The situation causes work restrictions and risks for specialists and patients – Jonata Machado/NDTV Reproduction

Then there is the evil that HST faces on a daily basis: the limitations of an electrical system that, despite repairs here and there, will soon be a hundred years old.

“Part of the chain dates back to the 1940s. This is a requirement that we must immediately meet. What we do to not take too many risks: we advise not to turn on the air conditioner, especially during hospitalization, outpatient treatment. So far it has worked. Among all our priorities the electrical grid comes first, even though everything we want will depend on the electrical structure, it’s no use chasing other things without solving this,” says José Augusto.

The backlog of the system directly affects the services provided, as it hinders significant technological advances in the diagnosis and treatment of diseases.

Without the necessary energy, it is impossible to maintain more modern, more accurate and faster equipment that could guarantee better treatment results and even save lives.

Structure suffers from lack of maintenance

With more than 30 houses scattered throughout the “village”, there are also serious problems with roofs, walls and streets due to lack of repair.

“People come, they look, they say that they will do this and that, but nothing comes of it. In some houses that we have already begun to build, 15 years ago there was some kind of reform in these houses, some were made, and some were not. This is something that requires constant maintenance,” says Anselmo Stahelin, the hospital’s secretary, who complains about the “slowness” of the bureaucratic process to speed up reforms.

He explains that the hospital does not have a maintenance company and all claims are made through internal administration or requests to the Health folder. There is no ongoing development.

“There is only maintenance of the hospital, as they say, putting out the fire. It’s a tricky thing because it’s government policy, not government policy. The government comes in, the government goes out and everything changes.”

One of the premises in need of major repairs is the Community Center.

The site, which offered a variety of recreational activities for patients, was banned after severe damage caused by the storm. Today it is dangerous to enter a building with pieces of wood falling from the ceiling.

Open sewerage and floods: in the “small town” poor sanitation

Isolated within the municipality of San Pedro de Alcántara, the “village” of Santa Teresa Hospital also faces problems common to most towns in Santa Catarina: basic sanitation.

Sections of the drainage and sewer network have already reached levels that pose a serious danger to the patients living there, as well as to the entire surrounding population.

The hospital is surrounded by the Imarui River, which flows into the coast of Palos. The structure was built 83 years ago, with its own sewer network, an advanced system for that time.

The Santa Teresa hospital sewage emerges into the open sky; the medical network stopped working 15 years ago – Photo: Jonata Machado/NDTV Reproduction

However, it has never been updated. The station became overcrowded in 2008 and the hospital has been running without treatment ever since. During a visit to Santa Teresa, the ND team witnessed open sewage in an area close to the clinics and the river.

“This is part of the obstruction of the storm network and sewerage. The time has come when they mixed up and became one,” says Anselmo Stahelin.

He indicates that the project, which will be sent to service providers, includes a completely new sewer system.

“83 years ago, someone thought about wastewater treatment. Even 15 years ago, the system was being treated here. Now it’s not. There is no cure.”

Lack of wastewater collection and treatment is a major problem in many cities across the state, which is also reflected in the “little village” of Santa Teresa.

“It’s obvious: domestic sewage, faecal coliforms, waterborne diseases… this whole vicious cycle of pollution that our mission is to prevent and eliminate. Infectious material from a hospital usually has its own collection before entering the network, so the situation is similar to household sewage, neither “worse” nor “better”. Wastewater is bad in any situation where it is exposed to and in contact with the public,” explains plumbing engineer Vinicius Ragianti.

In addition to the sewer network, drainage is also a big problem. The village has a history of floods and landslides.

This site still has traces of the last one in March 2023, which caused erosion of some parts of the upland and banks.

Water that naturally descends from hills, puddles. The water intake system from the streets is improvised, and even the existing manholes have lost their protective grids and throughput.