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People of Baltic & Brazilian Heritage 1
People of Baltic & Brazilian Heritage
Elsa Sosa
Florida National University
People of Baltic & Brazilian Heritage 2
The Balts or Baltic people are an Indo-European ethno-linguistic group who speak the
Baltic languages, a branch of Indo-European language family, which was originally
spoken by tribes living in the area east of Jutland peninsula in the west and in the
Moscow, Oka and Volga rivers basins in the east. One of the features of Baltic
languages is the number of conservative or archaic features retained. On the other
hand we have the culture of Brazil, it is primarily Western, but presents a very diverse
nature showing that an ethnic and cultural mixing occurred in the colonial period
involving mostly Indigenous peoples of the coastal and most accessible riverine areas,
Portuguese people and African people.
People of Baltic & Brazilian Heritage 3
People of Baltic & Brazilian Heritage
Baltic tribes arrived in what is now Latvia from the Pripet marshes around 1000
B.C.E. These included the Lettgalians, and the term latvju derives from the peoples and
province of Latgale. The most important minority group was the Baltic Germans, who
settled there in the thirteenth century. Jews arrived in the seventeenth century. A
sizable Russian community moved to the cities, particularly Riga. The polarization of
cultural identification in terms of Latvian and Russian is primarily a rural-urban divide.
Urbanization, war, and the Soviet occupation have been the major sources of
demographic change. Until the Soviet occupation Latvia was a predominantly rural
society. WWII and the Soviet occupation brought about massive changes. The German
occupation resulted in the extermination of the Jewish population as well as thousands
of Latvians. The Soviet occupation led to the loss of 250,000 Latvians through exile and
death. At present ethnic Latvians account for 56% of the population.
The Christianization of Latvia occurred through contact with Germans and
Russians. The Orthodox Church arrived before the twelfth century, and the Catholic
religion was brought by the knights of the Teutonic order. The Moravians who arrived in
Riga in 1729 and founded a seminary in Valmiera quickly attracted a following. This
movement evoked ecstatic responses and acquired a strong nationalistic streak.
Baptists who arrived in the mid-nineteenth century also succeeded in awakening the
interest of the indigenous population. The Lutheran and Catholic religions were
identified with the oppressive Baltic German presence. Traces of traditional earlier
beliefs have been assimilated within the local understanding of Christianity, and
influence everyday attitudes and conversation. The continued celebration of the
People of Baltic & Brazilian Heritage 4
midsummer solstice Jani is a reminder of the power of earlier beliefs and practices and
has come to symbolize national identity. Religious activity was repressed during the
period of Soviet occupation, and many ministers were imprisoned. However, funerals
and commemorative days of the dead were highly elaborate affairs and came to provide
an indirect vehicle for the expression of national sentiment. The post-Soviet era has
witnessed a revival of religious practice and the introduction of a large number of new
religious movements.
Soviet Latvia was well provided for in terms of medical and psychiatric care.
However, there was an absence of family practitioners, and this led to an extensive use
of emergency ambulance services. Post-Soviet attempts to privatize health care have
met with resistance. Latvia has a strong tradition of folk remedies and treatments which
is undergoing a revival.
Moving on to Brazil; because of its size and diversity, Brazil is one of the nation’s
most deserving of the name “land of contrasts.” The country is often divided into five
regions: Norte (North), Nordeste (Northeast), Centro-Oeste (Central West), Sudeste
(Southeast), and Sul (South). These divisions are used for administrative purposes such
as the national Brazilian census and they roughly correspond to geographic,
demographic, economic, and cultural variation within this sprawling nation. The
Northeast has the greatest proportion of people of African descent; the South and
Southeast are home to the bulk of Brazilians of European and Japanese ancestry, while
indigenous peoples live largely in the North and Central-West. Still, regional migration
and extensive miscegenation has made Brazil one of the most racially diverse nations
on earth. Aside from the official fivefold regional division of Brazil, a simpler economic
People of Baltic & Brazilian Heritage 5
distinction is made between the poor, underdeveloped North and the wealthier, more
industrialized South. This distinction is sometimes referred to as the “two Brazils” or
“Belinda,” with the wealthy South being compared to Belgium and the poor North to
India. At times these contrasts are translated into negative stereotypes as when
inhabitants of Sao Paulo, the huge metropolis in the southeastern Brazil, blame their
city’s poverty and high crime rate on migrants from the North.
Brazil is the largest Catholic country in the world even though the percentage of
Brazilians who belong to the Catholic Church has declined in recent years, down from
95% in the 1950s. Today about 73% of Brazilians identify themselves as Catholic but an
unknown number are Catholics by tradition, not faith. Although church and state are
separate in Brazil and, by law, there is freedom of religious belief and expression, a
close relationship exists between the Catholic Church and the state. Major Catholic
holidays are public holidays and a priest always presides at the inauguration of public
buildings. Also, church-based welfare and educational institutions, such as religious
seminaries, receive financial support from the federal government. At various times in
Brazilian history the Catholic Church has either strongly endorsed the state or
vigorously challenged the status quo, as in the case of liberation theology, a latetwentieth century movement that provided religious justification for questioning the
yawning gap between haves and have-nots in Brazil.
Brazil has long had a public health system, but like other social programs that
primarily serve poor, it is vastly underfunded. In the early 1990s, per capita spending on
health care was only about $50 annually, a paltry sum for a system on which over 60%
of the Brazilian population depends. Many of the poor either self-medicated or get
People of Baltic & Brazilian Heritage 6
whatever remedies they can from local pharmacists who are the only health care
providers in some rural areas. For those who can afford it at the other end of the social
spectrum, Brazil has world class health care in modern medical centers, particularly in
the prosperous Southeast and South.
People of Baltic & Brazilian Heritage 7

Baltic Culture. (n.d.). Retrieved July 18, 2018, from

Brazil. (n.d.). Retrieved July 18, 2018, from

Burns, E. B., & Martins, L. (2018, July 09). Brazil. Retrieved July 18, 2018, from

Latvia. (n.d.). Retrieved July 18, 2018, from
People of Baltic Heritage and People of Brazilian Heritage
Roxana Tejera
Florida National University
Nursing Department
BSN Program
NUR 4636
Prof. Cassandre Milien, MSN
People of Baltic Heritage and People of Brazilian Heritage
Baltic Countries
The term Baltic countries refer to the nations found along the Baltic sea. These include
Estonia, Latvia, and Lithuania (Purnell, 2012). They were formally part of the Soviet Union
but have since changed their healthcare systems orientation towards the western ways of
managing healthcare and governance, since the collapse of the Soviet Union (Hakansosson,
Jurgutis, Ovhed and Kalda, 2016).
The View of The Baltic Nations of Evidence-Based Healthcare and Health and Diseases.
Culture and healthcare delivery in the Baltic nations has changed significantly since the
fall of the Soviet Union because the Baltic nations began to adopt western systems and cultures
(Hakansosson, Jurgutis, Ovhed and Kalda, 2016; Purnell, 2012). Subsequently, there have been
shifts in the perception of people in the Baltic nations about the use of evidence-based
healthcare delivery and beliefs related to health and diseases as well.
For example, Hakansosson, Jurgutis, Ovhed and Kalda (2016) opined that there
occurred in the Baltic nations a change from soviet polyclinic-based health care system to a
western system based on primary health care. This new system introduced narrow
specialization and education of healthcare workers in the Baltic countries (Hakansosson,
Jurgutis, Ovhed and Kalda, 2016). This is the first evidence of a positive view at the regional,
national and community levels of evidence-based healthcare delivery.
Before, there was a reliance on home-based specialists who did not lay emphasis on
formal training hence it can be argued that evidence-based healthcare delivery was perceived
as important. However, the situation now is that the three Baltic nations have developed
emphasis and a positive attitude towards the education of healthcare givers, who are then able
to provide evidence-based care to the Baltic population. Even when there is a need for health
care delivery at home.
Tilk et al (2017) state that the patients still seek the services of educated nurses who
then treat them from home. This is a further indication that evidence-based health care services
offered by educated caregivers are viewed as more effective and satisfactory. Evidence-based
health care in Baltic nations is supported by their involvement in primary care research
(Hakansosson, Jurgutis, Ovhed and Kalda, 2016). The act of committing resources (both time,
financial and human resources) into primary care research in order to find evidence on which
practice is grounded indicates that the Baltic nations view evidence-based health care provision
positively as a means by which positive patient outcomes may be achieved.
At the family and individual levels in Baltic nations, support for the evidence-based
practice is shown by the fact that people opt for primary care provided by specialists and adhere
to the prescription given in the clinics. According to Purnell (2012), families in Baltic nations
assist their sick member to seek medication in hospitals and they also willingly adhere to
prescribed medical regimes.
This is an indication that people have faith in modern medical services which are more
evidence-based compared to those initially provided by untrained caregivers. The attitude of
Baltic nations, from national to individual levels, thus support evidence-based health care
provision and subsequently promoting the health situation of Baltic people. There are other
aspects of culture in this region that also impact on health care in different ways.
The Baltic people value a healthy lifestyle, a culture that then supports the overall health
of the community. For example, the Baltic people believe in eating fruits, grains, and
vegetables (Purnell, 2012) which are known to supply the body with vitamins and nutrients,
that make the human immune system stronger. On a daily basis, 40% of the male population
and 50% of the female population in Baltic nations consume vegetables and fruits (Tilk et al,
Exercise is also valued among people of all ages in the Baltic nations (Purnell, 2012),
which is also associated with a lower level of obesity and improved health. However, the Baltic
culture that believes in continuous work without rest may limit efforts to achieve positive health
outcomes in the region. For example, Purnell (2012) states that since people believe in work in
this region, they will tend to work even when rest is recommended for medical reasons, thus
limiting efforts by caregivers to improve health for individuals.
People in the Baltic region also stigmatize mental and physical illness thus they may
endure pain for a long time without disclosing because they believe it’s a shame or curse
(Purnell, 2012). This could also limit the ability of the primary health care professional to help
the community achieve desirable healthcare outcomes. In general, therefore, it can be argued
that Baltic culture largely supports healthcare and especially evidence-based care, even though
some elements of the culture such as attitude towards work and mental illness may be limiting
Give an Overview of Brazilian Heritage
Brazil has a rich heritage that supports healthcare system and disease prevention. For
example, they believe in specialized healers and spiritual healers who pray for the sick and
exorcize evil spirits (Purnell, 2012). These healers do not replace trained caregivers but
complement their efforts in order to improve health outcomes. The Brazilians also have beliefs
related to food that improve human health. For example, Brazilians believe that certain foods
are not supposed to be consumed by pregnant women if they are to maintain good health
(Purnell, 2012). Vegetables and grains are the traditional food, and meat is only consumed
sparingly (Purnell, 2012).
This value attached to vegetables supports health care because vegetables supply
essential nutrients and cause fewer side effects compared to animal products. Health is valued
in Brazil over work and thus positively viewed. However, Martins-Melo et al (2018) argued
that Brazilians have retarded healthcare-seeking behaviour. This raises the question of whether
Brazilians view of health is changing to the negative with time. Self-reporting of chronic
diseases among Brazilians is less than 50% (Rzewuska et al, 2017), a quantity that further
reinforces the idea that health is not viewed as a priority by the Brazilians in the contemporary
Research by Rzewuska et al (2017) revealed that Brazilians take some diseases more
seriously as compared to others. For example, men tend to report cases of stroke but mostly
ignore cases of malignancy (Rzewuska et al, 2017). The government also tends to ignore the
Neglected Tropical Diseases (NTDs) in its strategies to improve population health in Brazil
(Martins-Melo et al, 2018). It can, therefore, be argued that health is currently negatively
impacted in Brazil and some diseases such as NTDs are seen as being neglected even though
they contribute to mortality.
There are a few similarities between Brazil and the Baltic nations regarding beliefs and
the view of health. For example, in both cases, there is belief in the consumption of plant
products as a major community food as opposed to animal products. This belief contributes to
the general good health of the communities in these regions. In both cases, spiritual healers are
interveners in case of illness, where they complement the efforts of the formal healthcare
providers in hospitals. There is also evidence in literature that evidence-based healthcare is
valued in both Brazil and Baltic nations. For example, in both cases, people including pregnant
women seek services in primary care clinics or purchase prescribed medicine from qualified
chemists, where evidence is the basis for practice, (Purnell, 2012).
Hakansosson, A., Jurgutis, A., Ovhed, I., and Kalda, R. (2016). Family Medicine in the Baltic
Countries. Scandinavian Journal of Primary Health care, 26, 67-69.
Purnell, L. D. (2012). Transcultural Healthcare: A culturally competent approach. Davis
Company; 4th Edition.
Martins-Melo, F. R., Carneiro, M., Ramos, A. N., Heukalbach, J., Ribeiro A.L., Werneck,
G.L. (2018). The burden of Neglected Tropical Diseases in Brazil, 1990-2016: A
substantial analysis from the global Burden of Disease Study 2016. PLoS Neg Dis,
Rzewuska, M., Azevedo-Marques, J.M., Coxon, D., Zanetti M.L, Franco, J.L et al. (2017).
Epidemiology of Multimobidity within the Brazilian adult generation population:
Evidence from 2013 health national survey. PLoS ONE, 12(2), 1-13. DOI:
Tilk et al, (2017). Heath in Baltic Countries 2015. Tallinn: National Institute for Health

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