Featured Country: Brazil

For more information on trade relations between the United States and Brazil:

• The Brazil-U.S. Business Council
• 2011: US trade with Brazil on the Census Bureau’s Website
• The US-Brazil Economic Relationship on the White House Website
• A Brookings Institution report on US-Brazil trade relations

To assist you in your business in Brazil:

• The Brazilian-American Chamber of Commerce
• The US Commercial Service in Brazil
• The Embassy of the United States in São Paulo
• ACEB – Brazilian Business Trade Association
• Trends of Doing Business in Brazil in 2011 – (Pocket Guide 2010/2011) on the South African Department of Communication and Information System’s Website
• SEBRAE – A Brazilian government agency that supports business development for small and “mirco” enterprises

Trade shows in Brazil:

• Hospitalar, leading medical trade fair in Latin America – Sao Paulo – 05/22/2012 – 05/25/2012
• 28th Fispal, Latin America’s largest trade show dedicated to the food service industry – Sao Paulo – 06/25/2012 – 06/28/2012
• Rio Oil & Gas, leading industry exhibition and key entry point into the Latin American market – Rio de Janeiro – 09/17/2012 – 09/20/2012

Department of State Consular Information Sheet for Brazil – Medical care is generally good, but it varies in quality, particularly in remote areas, and it may not meet U.S. standards outside the major cities. Expatriates in Brazil regularly use the Albert Einstein Hospital in Sao Paulo. It is inspected and certified by the Joint Commission International and offers international service assistance. The hospital phone is (55-11) 3747-1233. Prescription and over the counter medicines are widely available. Emergency services are responsive. Travelers may call a private ambulance company or call 193 and request an ambulance for a public hospital. Callers must stay on the line to provide the location as there is no automatic tracking of phone calls.

Adam Bates from Insurance Services of America recommends reviewing your current health insurance policy to ensure it covers local medical expenses in Brazil and more importantly, your policy should cover emergency medical evacuation insurance which provides medical transportation when local care is not adequate. If your current insurance policy does not cover medical expenses while you are traveling, then your can purchase travel medical insurance from the friendly people at Insurance Services of America. Call them for a quote at (800) 647-4589 or 01 (480) 821-9052.

Many insect borne-illnesses are present, including Yellow Fever, Malaria, Dengue, and Leishmaniasis. Insect precautions are encouraged in all areas of Brazil. Schistosomiasis is present in many areas. Travelers should avoid freshwater exposure.

The CDC recommends Yellow Fever vaccination for persons over 9 months of age for travel to all rural areas of all states, including Iguaçu Falls tourist resorts, and for travel to Brasilia and Belo Horizonte. Cities in jungle areas are considered rural, not urban, in nature. Yellow fever is not a currently thought to be a risk for travel to major coastal cities from Fortaleza to the Uruguay border, including the major tourist/business destinations of Sao Paulo, Salvador, Rio, Recife, and Fortaleza. However, there has been a recent increase in yellow fever cases, including deaths, in Brazil. This has involved some areas in Brazil not previously at risk, such as the southern state of Rio Grande do Sul. Travelers are advised to consult with their medical provider or travel clinic for up to date advice on the risks versus the benefits of yellow fever vaccination.

Dengue fever is an infection transmitted by the mosquito aedes aegypti and is an affliction seen in many parts of Brazil. The typical “season” for dengue is from December to June, but it is possible to be infected at any time of the year. An increase in dengue fever cases in early 2008 led to a number of deaths, mainly around Rio. In early 2009, an outbreak occurred in Belo Horizonte. In late 2009, tests in Fortaleza found larvae of the aedes aegypti mosquito present in 95% of the city’s neighborhoods.

Malaria is present throughout the year in forested areas of the Amazon region. There is also some risk on the periphery of cities and towns in the Amazon region. There is little to no risk of malaria in all other areas of Brazil. Tuberculosis is an increasingly serious health concern in Brazil.

Plastic and other elective/cosmetic surgery is a major medical industry in Brazil. While Brazil has many plastic surgery facilities that are on par with those found in the United States, the quality of care varies widely. Make sure when arranging plastic surgery that emergency medical facilities are available, as some “boutique” plastic surgery operations offer luxurious facilities, but are not hospitals and are therefore unable to deal with unforeseen emergencies.

Several U.S. citizens have died while visiting non-traditional healers outside of urban areas. While this is not surprising given that this type of treatment often attracts the terminally ill, U.S. citizens are advised to ensure they have access to proper medical care when visiting such sites.

In the unfortunate event of a death, relatives or friends of any deceased U.S. citizen are advised to immediately contact the U.S. Embassy in Brasilia or the U.S. Consulate in Sao Paulo, Rio de Janeiro, or Recife, and not to contract with local mortuary services before seeking embassy assistance.

Sao Paulo is the largest city in Brazil and the seventh largest metropolitan area in the world, with a population of more than 19.8 million people. As the biggest financial center in the country, the city is the 10th richest city in the world and expected to become the 6th richest by 2025. Sao Paulo’s economy was originally based on a strong industrial sector, but has become increasingly dependent on the tertiary sector, focusing on commercial services for Brazil. It is home to a large number of foreign corporations as well as the Sao Paulo Stock Exchange and many landmarks, including the Paulista Museum, the neo-gothic Metropolitan Cathedral, and the Octavio Frias de Oliveria Bridge.

While Sao Paulo remains one of the region’s most dangerous cities, according to Altegrity Risk there has been a marked improvement in the security environment. Since 1999, when the city recorded 35 homicides for every 100,000 residents, there has been a 70.3% decline in the homicide rate; police statistics in February 2011 report a rate of 10.47 homicides per 100,000 inhabitants. Armed robbery, carjacking, kidnapping, and extortion are all reported on a daily basis in the city. Foreign nationals are not explicitly targeted by criminals in the majority of incidents; however, during the annual Carnival each February, there are typically a rash of robberies and muggings of foreign nationals. In February 2010, five men armed with machetes and handguns assaulted nine tourists at a beach house and locked the victims in the bathroom before pillaging through household valuables.

There is a high risk of robbery in Sao Paulo, including commercial and residential burglary, mugging, carjacking, and vehicle theft. In early 2010, authorities reported that fatal muggings in Sao Paulo had increased by 45% in 2009, with 100 people killed in such crimes. Meanwhile, all robberies, excluding bank assaults and vehicle thefts, had jumped 13% the same year, with 123,482 incidents reported. Police in June 2011 arrested nearly 30 people in connection with a series of ATM heists that left some parts of Sao Paulo with limited access to cash. Five current or former police officers were arrested in the operations, and investigators suspect that another two dozen police may be involved. Around 60 banking machines have been blown up, torched, or otherwise broken into in the metropolitan area. Weapons are easily obtained in Brazil and criminals in Sao Paulo are typically armed and willing to use violence. In November 2010, a professional soccer player was shot dead by gunmen as he arrived at his Sao Paulo home during a robbery attempt. Separately, a popular Brazilian cartoonist and his son were killed during a burglary on his residence in Sao Paulo’s Osasco suburb in March 2010. Unidentified gunmen reportedly shot the victims after forcing their way into their home.

Transportation-related crimes are frequently reported in Sao Paulo as well. Foreign nationals are advised to always park vehicles in safe areas, preferably secured garages or guarded parking lots. Carjackings typically involve extreme violence and victims are often left injured or dead. In November 2010, a British race car driver narrowly escaped a carjacking attempt in the city when five or six armed men approached his armored car in a traffic jam. However, the foreign national’s driver, an undercover police agent, made a quick escape through the traffic jam. Local reports suggested that several of the race car driver’s teammates had been targeted the same day in similar carjacking attempts. Foreign nationals are advised to use armored cars if possible and whenever stopped at a traffic light or in a traffic jam, always leave enough room between vehicles to make a quick escape.

There is a high risk of kidnapping in Sao Paulo, where authorities reported that the crime had doubled in 2009, when there were 23 reported incidents. Kidnapping throughout Brazil is significantly underreported due to fears that kidnappers may harm the victims if the crime is reported to police, therefore, the number of incidents in Sao Paulo is believed to be significantly higher. In August 2010, police dismantled a kidnapping ring that used social networking sites to identify wealthy targets. The gang allegedly used profile information to track victims to their jobs or favorite bars. The gang was first uncovered after police rescued a 19-year-old being held hostage by the gang. Four months earlier, a 13-year-old boy was released by kidnappers in Ferraz de Vasconcelos one month after he was snatched. One person was arrested after he attempted to contact the family for a ransom payment.

Adam Bates from Insurance Services of America advises if you are traveling on businesss or with a high profile organiztion, then consider purchasing a standalone Kidnap and Ransom policy which provides ransom, negotiations and will orchestrate extractions in the event of a kidnapping.

Express kidnappings are the most frequent type of kidnapping reported in Sao Paulo. In the majority of express kidnappings, a victim is snatched, often at random, from the street or from a vehicle and forced to empty their bank account before being released. Such incidents are typically shorter and involve a smaller ransom payment than a traditional kidnapping, but occur more frequently and target a wider variety of victims. In April 2010, a pharmaceutical executive was killed during an express kidnapping in Sao Paulo’s Jabaquara neighborhood. Police reportedly saw the kidnapping unfold and began chasing the kidnappers, but failed to keep up with the suspects and the victim was found shortly later after being shot in the neck. Four months earlier, kidnappers stormed the home of a businessman on the outskirts of the city and abducted him after tying up his family. The victim was forced to withdraw an undisclosed amount of cash from an ATM before being released.

Gang violence has become a major concern in Sao Paulo following a series of attacks by the First Capital Command (PCC) group in 2006. The massive criminal organization is largely run by imprisoned gang leaders who communicate with their followers via smuggled cell phones. The gang first struck during the May 2006 Mother’s Day holiday, and staged a series of coordinated prison riots and attacks directed at security forces. In the space of a week, gang members launched 293 attacks against targets ranging from police residences to buses and banks, which left 41 police officers, 107 suspected gang members, and four civilians dead. The attack left the city paralyzed, with residents terrified to travel after dark. While PCC has not successfully launched similar large-scale attacks since 2006, they continue to operate in Sao Paulo. In August 2010, PPC members attacked the headquarters of the police’s special operations. Ensuing clashes between police and PPC members left at least one gunman dead and several others arrested. In response, the gang set fire to at least 10 vehicles throughout the city.

Civil unrest is frequently reported in Sao Paulo, although the majority of protests, strikes, demonstrations, and rallies remain peaceful. Nonetheless, a number of protests do turn violent. In May 2011, Brazilian riot police fired tear gas to break up a protest in support of the legalization of marijuana in the city’s financial district. A court ruled the march was illegal and six people were detained. Meanwhile, the majority of protests are likely to cause transportation problems for residents and visitors to the city. In June 2011, two Sao Paulo public transportation unions launched a work stoppage that affected hundreds of thousands of commuters. The strikes hit a number of subway lines as workers demanded wage increases.

There has been growing tension between residents of Sao Paulo’s favelas, or slums, and police, often leading to clashes. In September 2009, rioting erupted in the Heliopolis favela after police killed a 17-year-old during a police chase. Police used tear gas and rubber bullets to disperse rioters who set fire to buses and cars and blocked roadways. Separately, residents in the Itaim Paulista neighborhood launched a protest against recent flooding that destroyed dozens of homes. Protesters filled roadways with furniture and set objects on fire, hampering traffic. The demonstration lasted for five hours until police intervened and fired tear gas into the crowds.

Foreign nationals should avoid soccer games if possible, as clashes, protests, and violent incidents are common in and around stadiums. In February 2010, one person was killed and 20 others injured following a game as rival fans clashed on six separate occasions during the evening. In a separate incident, one person was killed and 130 others detained when rival soccer fans launched riots in the city in June 2009. Fans of one of the teams reportedly attacked rival fans, sparking clashes that spread throughout the city.

While the risk of terrorist attacks in Sao Paulo is low, reports in December 2010 indicated that the city is home to at least one terror cell. According to the report, which was released by a controversial whistle-blowing website, the Brazilian government is closely monitoring about 20 people with alleged links to militant groups Hezbollah and Islamic Jihad. The case was reportedly investigated by the Federal Police and the Brazilian Intelligence Agency, which were alerted by their U.S. counterparts. The individuals were all of Brazilian nationality, converted to Islam, and lived in Sao Paulo and Rio de Janeiro. The CIA allegedly believed that “they were recruited to learn how to establish political or armed cells.” The report also suggested that the Brazilian government was purposely downplaying the risk of terrorism in Brazil in order to preserve its reputation, despite the presence of such groups. While terrorists are unlikely to plot attacks against interests in Sao Paulo, the city may be used as an operations base to plot attacks in other cities in the region.

Sao Paulo is often affected by natural disasters, with heavy rains, flooding, and landslides frequently reported. In January 2011, numerous cities were inundated with heavy rains causing landslides which claimed hundreds of lives. While the worst affected area was Rio de Janeiro state, heavy rains led to more than one dozen being killed in Sao Paulo. Main roads in the city were cut off by mudslides and the city government estimated that 100,000 people were displaced.

Military and civil police are well-trained; however, widespread corruption in these units that often inhibits emergency response. Police have been linked to a number of bribery and extortion attempts. In April 2010, two police officers were arrested for bribing a businessman in the city and demanding 50,000 reais (US$28,000) for not arresting him on purportedly false charges. Meanwhile, police have also been affiliated with death squads, often leading such gangs. In June 2010, 17 police officers in the state were arrested for their involvement in a death squad that had killed 23 people in late April.

Most Dangerous Areas

Crimes against foreign travelers tend to be most often reported in areas surrounding hotels, discotheques, bars, nightclubs, and other establishments that cater to visitors, especially during the evening hours. Stoplights are also dangerous, as the city has a high rate of armed robbery targeting idle motorists and pedestrians.

The entire metropolitan area of Sao Paulo is considered dangerous for both walking and driving, particularly after dark. Car thefts and break-ins are common in Sao Bernardo do Campo’s commercial district. Neighborhoods popular with foreigners are especially vulnerable to crime, including Itaim-Bibi, along Avenida Paulista, and the Italian quarter of Bixiga. The suburban area of Santo Amaro is also a target of thieves. Avoid known trouble areas such as the Praca da Sao Rua Augusta north of Avenida Paulista, the Estacao de Luz metro area, and the Praca da Republica (downtown area), especially after dark. All travel to the city’s poorer neighborhoods (favelas), including Parque Selecta and Jardim Aracati, should be avoided.