Take medical care. The majority of the people here are uninsured, which means they must go to public health care for medical needs - "Postos de Saude," or "Health Posts" are literally every few blocks. Steve and I joke that all they know how to do is give shots. Headache? Here's a shot. Bladder infection? Shot. Husband beating you? Oh, this injection will clear up the problem in no time.
The public hospitals are much the same. We've been to a couple in emergencies, and they were experiences we're not anxious to repeat. (Anecdote: I almost passed out one time ... after a shot, of course. They neglected to ask about or take my blood pressure, and the medicine they gave me lowers it considerably - I, who already have abnormally low blood pressure. Bytheway, I went in with strep throat.)
We did find a clinic that is near-ish for emergencies,
but for all vaccines, child well visits, and ObGyn appointments, we drive to Sao Paulo. We are currently praying that child #3 doesn't decide to be born during rush hour.
Today, the traffic was pretty good - I made it in just over an hour. There are days, however, that it takes almost three. Not to mention the pollution and overall stress of being in this 26-million-people-strong city, with slums ("favelas") and crime everywhere you look. ("No, Nathan, we HAVE to roll up the window when we're driving in Sao Paulo.")
And the river stinks, too.