Pequeno Príncipe Hospital: in 100 years, a revolution in the healthcare of children and adolescents

From reducing child mortality rates to building a new rights-based form of care, the institution innovates to support and protect childhood

The seed of Pequeno Príncipe, Brazil's largest pediatric hospital, was planted when a group of women who were a part of the Violets' Guilt brought Red Cross to Curitiba. Through this organization, the Children's Hygiene and Childcare Institute was created in 1919 and it offered free medical service to families that couldn't afford this kind of service.

Due to alarming child mortality rates, paying attention to children's health in the beginning of the 20th century was urgent. In the first week of January in 1917, the year that Paraná's Red Cross was founded, 37 babies were born in Curitiba and 39 people passed away. Of those, 30 were children. In the following month, 22 babies were born and 23 people passed away; of those, 19 were children. "Almost one hundred years after the inauguration of what was our start, Curitiba registered one of the lowest child mortality rates in Brazil in 2017: 8.3 deaths for every thousand births. In Paraná, the rate was 8.9, placing the state among the three best results in the country. With modesty and a lot of certainty, we can state that we have contributed significantly to building this new reality," says Ety Cristina Forte Carneiro, Pequeno Príncipe's executive director.

By consolidating outpatient treatment to children, Violets' Guild and the Red Cross soon realized that they would have to advance to hospital treatment. After a series of fundraising campaigns, in December of 1922 the building for Children's Hospital was launched, and then inaugurated in 1930.

In the beginning of the 20th century, offering porridge, soup and unsterilized cow's milk in place of breast milk contributed to the development of gastrointestinal infections in children, which was the main cause of child mortality at the time. Today, the situation is very different. "Specialists are unanimous in saying that, under one digit, the child mortality rate needs hospital assistance to continue to decrease. Our children no longer die of diarrhea. They face problems such as cardiac malformations, rare diseases and neoplasms, situations in which early diagnosis and highly specialized treatment are key to have a positive outcome," explains Ety.

Two decades after the Hospital's inauguration, the institution already has a posture of attention and whole care towards its patients. In the report for 1940-1949, the director at the time, Haroldo Beltrão, wrote: "The Children's Hospital's hasn't been glad with just delivering their patients a sterile environment, adequate utensils or proper equipment for scientific investigation. What we have strived to have as a characteristic is the clinical organization that guarantees ample, ready and effective protection for any disease that could threaten a child's life or health."

If at the beginning, we faced lots of limitations – ranging from financial and structural restrictions, to the limits regarding medical and scientific knowledge – today, Pequeno Príncipe has immense support from society to overcome its challenges. "The Hospital's greatest wealth is concentrating, in the same place, more than 30 health specialties with professionals with different expertise. We are a reference in rare and complex diseases and we have an extremely relevant role in the public and private health field. This aspect is recognized by society and explains the support we receive," points out Donizetti Dimer Giamberardino Filho, Pequeno Príncipe's technical director.

In the 2000's, Pequeno Príncipe College and Pelé Pequeno Príncipe Research Institute were created to consolidate the institution's systemic perspective and calling for education and research, furthering the continuous strive for innovation.

Pioneering institution

The understanding that children deserve healthcare services customized to their development phases and mobilizing society to guarantee that care made Pequeno Príncipe a pioneering institution in the fight for children’s rights. Just a decade after the inauguration of the Children’s Hospital, child protection became a public policy for the first time in the country, with the Law nº 2.024, that created the National Department for Children. Only in 1947, the State of Paraná’s Department for Children was created by the governor at the time, Moysés Lupion.

Pioneering has always followed the Hospital in its journey. In the 1980’s, Pequeno Príncipe brought families into the Hospital, guaranteeing children the right to be accompanied during the entire period of hospitalization. In Brazil, this right was guaranteed by law in 1990 by the Children and Adolescent’s Statute.

The same thing happened regarding access to education. Since 1987, the institution has a school program for hospitalized children, allowing them to have school follow-up during the entire treatment. “We were born to support the development of a healthy childhood. Over the years, we understood that health and other rights walk side by side. Food, education, culture, family interaction, respect and love are part of an unbreakable unit to guarantee a healthy childhood. This is what we have worked for in these 100 years and we are committed to continue striving towards this for the 100 to come,” defines Ety.