CHAPTER II

Hospitals in the Interior

Art. 33. For the purpose of reducing the distances and the time of the journey for the inhabitants of the interior in the valley of the Amazon, who must find a centre of supplies where they can be treated when sick, or provide excellent medicines for their domestic ills; of proportioning to all who may desire means of immuning themselves against contagious diseases, and of creating a propaganda service of the hygienic habits and practices necessary for everyone who must live and work in the Amazon regions, there shall be built a hospital surrounded by a small agricultural colony in Boa Vista do Rio Branco; S. Gabriel do Rio Negro; Teffé or Fonte Boa on the River Solimões; S. Felippe, on the River Juruá; Bocca do Acre, on the River Purús; at the confluence of the Rivers Arinos and Juruéna; on the Alto Tapajóz; Conceição on the River Araguaya and Montenegro on the Amapá.

Art. 34. The hospitals shall be built in places that have the following requisites:

1. To have a plain of low elevation, conveniently ventilated for the construction of the hospital buildings so-called and its dependencies, and houses of residence for the personnel.

2. Existence around or close to the plain of dry lands, provided with good and abundant water, which serve for agriculture and cattle raising and of sufficient area for the founding of an agricultural community of at least 100 families.

3. Facility for the establishment of rapid communication with a fluvial port, or one that must serve them.

Art. 35. Each hospital shall have a capacity for 100 sick persons.

Art. 36. Each hospital shall possess the following installations:

(a) Five separate pavilions, each for 20 sick, each sick person having 5 cubic metres and an area of 12 square metres.

One of the pavilions should be installed with the necessary requisites for the isolation of infectious diseases; for this purpose it should be divided into rooms for isolation, independent and easily disinfected, with the proper sanitary apparatus.

All the hospital buildings should have the windows protected by wire screening whose openings should never exceed 1½ millimeter and the doors provided with:

(b) A disinfectory provided with an apparatus to disinfect in boiling lye and a stove for sterilization by the combined action of heat, vacuum and formal. Annexed to the disinfectory shall be the laundry.

(c) A laboratory for the diagnostic clinics and microbiology.

(d) Surgical operating room.

(e) Clinic consulting room.

(f) Room for autopsies.

(g) Pharmacy.

(h) Sanitary installation, in which should terminate all the drainage pipes of the hospital, destined for the bacteriological treatment of the water used, which not until after this operation must be allowed to flow into the natural river courses.

(i) Dependencies for the administration and quarters of the personnel.

Art. 37. In each hospital there shall be made in the respective pharmaceutical laboratory a preliminary study of all the remedies used by the people of that region to determine which are prejudicial and which inoffensive. The respective Director shall show the people in printed circulars, frequently and profusely distributed that their use is improper. Those which are found efficacious and susceptible of improvement, shall be sent for more complete studies in the chemical laboratories and federal pharmacies, letting the people know the results obtained.

Art. 38. When the installation of each hospital is complete, a contract shall be made, by public bidding, or independent of it, as the Government may think best, with some professional of recognized ability, the direction and maintenance of the respective services, the contract including the following obligations:

1. The reservation of one hour daily in the medical consultation room, where the sick known to be without means may freely receive examination and be furnished with the necessary medicines.

2. The maintenance of a bureau for vaccination against smallpox and other contagious diseases by means considered efficacious, and to attend gratuitously to all who may wish it.

3. To submit for the approval of the Government the regimen internal of the establishment and a table of prices for the treatment of the sick, which should be revised every 3 years.

4. To expose for sale in the pharmacy only medicines of the best quality, especially sulphate of quinine and such other preparations, under penalty of having destroyed all drugs known to be impure in addition to the fine to suit the case that may be fixed in the contract.

5. To give a bond in money, or policies of the public federal debt that will guarantee the good conservation of the establishment during the time of the contract.

6. To distribute abundantly every six months leaflets containing advice about hygiene prevention of the sicknesses of that region, showing in clear language, within the reach of all, those that are improper and the danger in the use of alcoholic drinks, and teaching what measures to take and the common remedies which should be applied in different cases when there is no physician to be had.

7. To be subject to the inspection of the Government which should be very minute and severe as to the condition of cleanliness and conservation of the establishment, the quality of the medicines employed and sold to the public and the care with which the sick are treated.

Art. 39. The hospitals and all their dependencies and sections are not subject to any duties to the state or municipality, being the property of the Union and doing a federal public service.

Art. 40. To each hospital there shall be given an annual pecuniary subvention, proportioned to the services to which it will have to attend, until the income of the establishment and all its dependencies derive a profit of 10 per cent, during 3 consecutive years on the respective capital invested, which amount shall be acknowledged and previously approved by the Government.