The data on people undergoing drug treatment was available for three years
The federal government unduly revealed the personal data of more than 30,000 chemical dependents who are hospitalized in therapeutic communities, including that of about 1,300 children and adolescents. These nonprofit institutions offer treatments based primarily on abstinence from drug use, spirituality, and isolation.
From this information, BBC News Brazil rebuilt in detail the trajectory of José (fictitious name), an adolescent who was in a therapeutic community between 2013 and 2016. The young man is in prison today.
The treatment aiming at stopping him from using marijuana and cocaine began in January, 2014, when he was 15. That same year, he was convicted of theft alongside three other teenagers. José would spend 22 of the next 26 months in a therapeutic community in the interior of São Paulo. The community receives public funds.
The boy's care cost the Union R$18,000 per year, in nominal terms, almost triple of what the country spent, for example, with a high school student in 2015 (R$ 6,637).
José had dropped out of school, and his mother was searching for alternatives to keep him away from drug use and to get him back to school.
Since the Judiciary also does not fully protect the data of minors, it is easy to find in an Official Gazette available on the internet that the boy's mother sought treatment for her child in 2013 and even reached an agreement with the City Hall to treat him without internment.
The following year, the Justice would determine the forced hospitalization of the youth at his own request, after a medical evaluation.
Four years after the beginning of the treatment, José was arrested by the Civil Police in a low-traffic street with about ten grams of cocaine and marijuana and indicted on suspicion of drug trafficking.
In the trial, he said he was a user, having been hospitalized four times in adolescence because of the consumption of narcotics. He also accused the police officers who arrested him of forging the possession of more drugs in order to frame him as a trafficker and thus extort him. He said he denied the offer since he was not a drug dealer and had a young daughter.
At the sentencing, the judge said that the version of the police could only be disproved unless the accused presented evidence of his innocence. He also stated that there was no evidence to prove José's long history as a drug user. In 2018, he was eventually sentenced to five years in prison.
Much of the details about José's life were among the data published in 2016, still under Dilma Rousseff (PT) government, in the Open Data portal of the Federal Government. The full name, date of birth, fiscal number, job, type of drug that led to the treatment and even hospitalization costs of all the people who were hospitalized between May 2013 and April 2016 and whose internment was funded by the government were unduly disclosed.
RIGHT TO PRIVACY
In addition, it also shows data on audits, bank accounts of therapeutic communities and the names, telephones and CPFs of those responsible for these entities.
The information was only removed from the portal after BBC News Brazil questioned the ministries of Justice and Citizenship about breaching the privacy of patients. The Open Data portal is a tool aimed at democratizing access to public information.
However, Brazilian legislation determines the absolute secrecy of health data, since there is a high risk of social stigmatization. The Child and Youth Statute (CYS) mentions the right of respect, which "consists in the inviolability of the child and youth's physical, psychological and moral integrity, encompassing image and identity preservation."
In a note, the Ministry of Justice and Public Security stated that "approximately one hundred files related to the Therapeutic Communities Management System that were available on the Open Data portal are part of an extraction performed in 2016 of the entire system, which on a preliminary analysis did not consider issues related to the restriction of personal data. This extraction was not known to the current management of this board."
According to the file, "In agreement with the Ministry of Citizenship, the Ministry of Justice and Public Security requested those responsible for the management of this matter, to take measures so that access to these files is made unavailable."
According to Miriam Ventura, a lawyer and professor at the Institute of Collective Health Studies at UFRJ (Federal University of Rio de Janeiro), the disclosure of sensitive personal data increases the possibility of stigmatizing these individuals, who may find it even more difficult to obtain employment in the future, for example. "The secrecy of patient information is a basic requirement of medical ethics and professional ethics."
Lígia Prado da Rocha, a federal public defender, argues that patient medical data is confidential and does not fit the guidelines of the Access to Information Act - a rule that regulates the disclosure of data produced by government agencies.
That is, public authorities can disclose quantitative data, such as the number of people in a given service and the amount spent on vacancies in therapeutic communities, but not the names of the patients or sensitive information such as the type of chemical dependency or medication used individually.
"Individual rights establish that medical treatments need to be kept in a private and intimate sphere. This information is restricted. Only the patient and the hospital, or the health facilities that provides public care, as in the case of therapeutic communities, have the right to access it," explains Rocha, who is part of the Office of Human Rights Defenders Of the Union.
"When the State publishes this information, even more because it is stigmatizing, a right to reimbursement for undue exposure arises," says the defender.
Attorney Alessandra Gonsales, a partner at WFaria Advogados and a compliance specialist, says that all 30,000 people who have had personal data disclosed by the federal government can seek compensation through the courts. "The Prosecution Office has opened investigations to collect compensations for the victims, in addition to fines, in cases of large groups of people whose private data was breached. And the longer the information was available, the greater the damage," he explains.
For Gonsales, the data leak on minors is "even worse." "We all have the right to inviolability of intimacy, but in relation to children and adolescents, this subject is much more sensitive, so there is a specific legislation for this age group, the ECA," he says.
PROFILE OF THE PATIENTS
Therapeutic communities are one of several models focused on the dependent that are offered by the public health system. The beds, offered free of charge, are financed by the federal government and each costs R$1,172 per month, currently.
The participation of these equipments in the National Policy on Drugs, to combat crack addiction, began during Dilma's administration and has been gaining strength in the public policy focused on drug addition under the Jair Bolsonaro administration.
According to Federal Government data, approximately R$ 234 million were transferred to 384 entities of this type from 2015 to 2018, in nominal amounts. In March, the current minister of Citizenship, Osmar Terra, increased by 78% the number of contracted entities (from 280 to 497). This year, R $ 149 million will be transferred to cover 10.8 thousand vacancies, without bidding.
It is possible, based on the analysis of data improperly exposed by the Brazilian government, to draw a profile of the thousands of patients in therapeutic communities between 2013 and 2016. The age range varies from 12 to 86 years, with average around 35 years. In general, they spend four months at the facilities.
The time they remain in the facilities is determined according to the law, by an individual plan drawn up in common agreement between the therapeutic community and the person who presented itself voluntarily. In general, this period varies between 6 and 12 months and people can leave the place when they want.
Resolution 01/2015 of Conad (National Council on Drug Policy), which regulates therapeutic communities, states that "reception can not exceed the limit of 12 months in the period of 24 months." But, according to data presented by the government, more than one hundred people took a vacancy in a therapeutic community for a period between 18 and 26 months.
FORCED INTERNMENT OF TEENS
According to experts, one of the main problems related to the forced hospitalization of minors is related to the small number of therapeutic communities destined to receive exclusively adolescents.
Data from the 2018 federal government, released through the Law on Access to Information indicate the contracting of 236 spots for adolescent males and 65 for females in therapeutic communities - 6% and 2% of the 4,207 financed at the time, respectively. Of the 312 entities that received public money, 53 gave shelter to minors, but only five were exclusive to this age group.
According to a mapping by Ipea (a research institute linked to the Ministry of Economy) published in 2017, one in five therapeutic communities in the country said it housed young people between 12 and 17 years old. There are around 2 thousand entities of this type operating in Brazil. Reading the Bible is a daily activity in 89% of them, and participation in religious services and ceremonies is compulsory in 55%.
"The presence of adolescents in therapeutic communities goes against the right to family coexistence, complicates school development and can create a forced demand, under the pretext of protecting adolescents," said promoter Márcio Rogério de Oliveira, of the Public Ministry of Minas Gerais, in the Legislative Assembly of Minas Gerais in 2017.
THERE ARE OTHER RISKS
In 2018, a therapeutic clinic in the mining city of Conceição do Pará - which had already been denounced three years earlier due to health irregularities - started to allow the coexistence between adult and underage patients. Shortly afterwards, a patient was arrested on charges of sexual abuse of the adolescents interned there.
A report produced by the Federal Public Ministry and the Federal Counsel of Psychology in 2018 points out that parents, courts, prefectures and even tutelary councils have sent adolescents to these places. The document cites cases where minors won't attend school during the treatment period.
The forced hospitalization of a minor for treatment of chemical dependence follows a rite established by law.
According to Daniel Palotti Secco, a lawyer at the Center for Children and Youth of the Public Defender of São Paulo, juvenile detention in these communities is irregular, even when decided by the courts. He also argues that methods, even when adopted in hospitals or public health units, are "exceptions" if other possibilities of treatment have been inefficient.
"The new drug law, passed by the Senate, says communities are tools of voluntary shelter. They are not a form of medical treatment. So the law does not allow a minor to voluntarily enter these places, he does not have the power to decide that," he explains. "The Justice can only admit an adolescent into a public health facility when it is demonstrated in reports that all other possibilities of treatment have been exhausted."
The lawyer Mariana Chies Santos, coordinator of childhood and youth of the Brazilian Institute of Criminal Sciences, criticizes the way in which hospitalizations has been authorized by the Justice. "It's a way of arresting these people in those institutions that work in a very similar way to asylums, which are forbidden by law."