Paper short abstract:

Through an ethnography of a private São Paulo hospital’s philanthropic healthcare project, this paper explores ideas among wealthy Brazilian elites on social responsibility, the relationship between philanthropic and state provision of healthcare and the ‘right’ of the poor to health philanthropy.

Paper long abstract:

What role should local philanthropy play in the provision of health services in Brazil, a country characterised by extreme socio-economic inequality and a critically underfunded national health service? This question will be addressed through an ethnographic study of a philanthropic healthcare project, run by São Paulo's most prestigious private hospital, which provides healthcare services, medicines and vaccination to 10,000 children in the hospital's neighbouring shanty town. Rooted in the religious and cultural-political traditions of philanthropy among Brazil's financial elite, this project has evolved in line with changing ideas about the role of the third sector and (corporate and family) philanthropy after the fall of the military dictatorship in the mid-1980s. The advent of neoliberal politics and the drawing back of the state at this time saw increased state outsourcing of social services, and encouraged the growth of philanthropy and CSR. This paper will explore how the question of responsibility for the provision of healthcare to the poor within this context is viewed by different actors, drawing on ethnographic fieldwork among the project's leaders, elite volunteers and shanty town beneficiaries, and analysis of the institutional discourse of the private hospital which funds it. Do private hospitals and wealthy volunteers have a social responsibility to practice philanthropy in Brazil? Does such philanthropy replace state provision of healthcare services, and if so, what are the implications for beneficiaries? And finally, if philanthropy is a responsibility of the rich in countries of great socio-economic inequality, is it also a right of the poor?