News 6 of 12

A Tribute to Brazilian Researcher, Fernando Branches

Dr Fernando Branches (IDRC Photo: J. Lebel)

2003-03-07

Dr Fernando Branches passed away on November 23, 2002. He was a Brazilian cardiologist who taught me many unforgettable lessons about doing research in the South — lessons that have stayed with me in my work as a program officer and team leader for the International Development Research Centre (IDRC). I’m normally not one for writing obituaries, but I wanted to pay tribute to Dr Branches in any way I could. The following are my impressions of the man who was referred to by all who knew him as “the good doctor”.

I met Fernando Branches in 1993, when I was just three months into my PhD studies. I was looking for a starting point for researching human exposure to methylmercury (by means of the consumption of contaminated fish) and the corresponding impact on human health. The staff of Universidade Federal do Para in Belem, Brazil told me that if I wanted to discuss mercury and its impact on people, Branches was the one to see. So I traveled to Santarem to meet him. His depth of knowledge was immediately apparent as he spoke about the subtle way mercury and methylmercury poisoning reveals itself. He was particularly concerned that no studies had examined the effects of long-term, low-level exposure — the kind of exposure he believed was taking place in Brazilian communities. During the numerous conversations that we had, and over a few drinks, he was also quite clear about one thing. He had problems with ‘gringos’ coming to the field and hunting for data, writing their papers, building up their careers, and never returning to the communities. Branches strongly believed that without trust, it was not really possible to create change that would improve people’s quality of life. And he knew that trust could only be built over the long term.

During the time when he was a prosperous cardiologist in Santarem, Branches began receiving patients who were all showing unusual clinical symptoms — and who were all involved in mining. He decided to investigate. He traveled up river on the Tapajos to learn more about the mining activities that were turning the once clear water of the Tapajos into a muddy stream. On his way, he stopped at the village of Brasilia Legal, a daily stop of the boat liners serving the region. I don’t know how, but he ended up becoming the ‘resident’ doctor of this forgotten place. Perhaps rural roots motivated him to take this on. He undertook his work as a field doctor over the weekends — and on his own time.

Testing our resolve

However, Branches did not bring me to Brasilia Legal while I was there in 1993. I think he first wanted to see if I would return to the area. And in 1994, I came back to the area with my thesis advisors, Donna Mergler and Marc Lucotte, along with the recently formed Canadian-Brazilian research team, to do an initial pilot study. We tested a sample of 20 villagers to assess their exposure to mercury. And in fact, we ended up finding early signs of mercury poisoning. Branches’ schedule did not permit him to join us, but I wanted to tell him of our results. So, Mergler and I met with him in Santarem to brief him. Mergler did a great job of presenting the research and the two hit it off right away — to the extent that I became a tiny bit jealous of their easy rapport! Let us say that in the Spring of 1994, Branches and I began to pursue a mutual quest for knowledge of each other.

In November 1994, Mergler and I decided to go back to Brasilia Legal with our Brazilian colleagues in order to disclose the first results to the villagers — despite the fact that we had no resources to actually fund this trip. So we cut back on other expenses in order to fund the trip. I made it clear at that time to my thesis supervisors that we should not take any samples while we were in the field. Instead, we should just take the time to show the population that we were serious with our efforts and committed to their situation. In a certain sense, this was doing the unthinkable: going to the field while you are in a PhD program — and then not collecting data! To this day, I do not know how I managed to convince the research team to do this. But the day he saw us arriving on his doorstep, Branches lost any scepticism he might have had and decided we were serious.

Branches’ support of my research

In May 95, we pursued the full study on the source of methylmercury contamination and its impact on human health. Branches joined us after we had been in the community for five days. At that point, I had fewer than 20 people who agreed to participate in the testing to assess exposure and the related impact on the nervous system. In other words, my field work was not proving to be a success. However, Branches went to work as soon as he arrived at 5:00 in the evening (and the power was on only between 6:00 and 9:00 p.m., by the way.) He brought me to every house in this village, one at a time. He introduced me, told villagers that we were trustworthy, that we would come back with our results, and that we were working to try and improve the well being of the community. And he also said he thought it would be a good idea for people to participate.

The next morning there was a line up at the health post. It took us several days to test everyone.

Learning from Branches’ approach

In fact, when it came to community participation in research, Branches was my mentor. For example, he advised me not to refuse the special meal offered to me by the villagers. It was turtle — an endangered species. The local environmental nongovernmental organization (NGO) that was participating in the project wanted to kill me for this! Some of my other colleagues were not too thrilled about it either. But from Branches I understood that this meal was an offering of appreciation that I should accept in the spirit in which it was given. Branches also pointed out all the local bakeries. He told me that when we buy baked goods, we should make sure that we rotate which bakeries we go to so that there would be a balance in revenue generation. In short, he told me many things that are not in a book.

He then showed Mergler and I a new technique he had developed for evaluating the neurological health of patients coming to the health post — in addition to the classical methods of assessment. He had observed that some people had subtle deficits with their ability to cross one arm over the other while tapping their thighs. Mergler helped to systematize this practice and we introduced it into the battery of tests during the field work. This test has since turned out to be useful for assessment of the impact of other neurotoxins. We named the test after the good doctor. It is now known as the Branches Alternate Movement Task, the BAMT.

Branches truly had a keen sense of observation and a curious, investigative nature. Moreover, he was always grounded in reality — he understood the reality of the field and of the people. It was these qualities combined with his training that made him so exceptional. He actually received his formal training with detecting methylmercury poisoning from Japanese researchers who brought him to Minamata, a place where an accident with methylmercury occured at the end of the 1950s.

Continuing collaboration

Branches continued to collaborate with researchers from the Université du Québec à Montréal (UQÀM), Universidade Federal do Rio de Janerio (UFRJ), and Universidade Federal do Para (UFPA). I was very moved when he called after my PhD dissertation in December 1996 to congratulate me and thank me for the work done.

In 1998, I learned that Branches had cancer but that the treatments were effective. My last meeting with him was in January 1999. I believe he was quite happy to learn that a new generation of young researchers, including many Brazilians, were getting involved in research on mercury in the Amazon (through a project supported by IDRC). He thought building the capacity of up-and-coming researchers was the best way to make sure that solutions would be found over the long term.

A lasting influence

I was hoping to bring a team member from the Ecosystem Approaches to Human Health (Ecohealth) program initiative to Brazil to introduce him to issues related to mercury in the Amazon — and, more specifically to introduce him to Branches. It saddens me greatly to know that there will be no more meetings with this compassionate and intelligent man: the good doctor. But I know that his spirit and influence will remain in all the work we support regarding mercury in the Amazon, and on those that worked with Fernando Branches.

So long Fernando, thanks for the good times and for having challenged me to come back to Brazil! Nights in Santarem will never be the same for me.

Jean

Dr Jean Lebel is the team leader of Ecohealth — an IDRC program initiative.

Editors note: This text was first distributed via email in December 2002.

Top of Page

News 6 of 12