Douglas Ciríaco, a general practitioner in Brazil and a member of the Brazilian public health system (SUS), is melting hearts with his selfless behavior. The 26-year-old general practitioner is the sole doctor serving 10 rural communities in Ouro Branco, Alagoas. This municipality in northeastern Brazil has severely limited access to healthcare. Douglas Ciríacor works through the Mais Médicos program, a government initiative that addresses chronic shortages of doctors in underserved regions. While never expecting anything in return, the young doctor sometimes receives gifts such as eggs, live chickens, pumpkins, and scerola cherries, in exchange for his care.
Originally from Arapiraca, Alagoas, Ciríaco says he has never worked in a private clinic. Ciríaco said he joined the public health system because he believes healthcare should be accessible regardless of a patient’s ability to pay for care. “I am a doctor for the SUS (Brazilian public health system),” he explained in an interview in August 2025. “I have never charged for a consultation.”
Ciríaco regularly receives gifts from patients, though he does not consider them payment. “Eggs, chickens, corn, acerola cherries, pineapples, pumpkins… this is a way of showing gratitude from the people in the rural area,” he said. Among his patients are 2 elderly sisters, Ms. Cícera and Ms. Antônia, who visit him for various health concerns. They brought him a basket of eggs as a form of gratitude for his services.
A Photo That Went Viral
Dr. Douglas Ciríaco kneels beside elderly patients Ms. Cícera and Ms. Antônia, demonstrating the respect and humility he extends to rural residents who express gratitude through simple gifts of eggs, produce, and handmade items from their farms. Credit: Instagram.com/@dr.douglasciriaco
On his Instagram account, @dr.douglasciriaco, Ciríaco posted a photo of himself kneeling beside the 2 elderly sisters with the caption, reading: “Ms. Cicera and Ms. Antônia, it’s always a pleasure to receive this simple gift from you! Some things have their price, others have their value. While they speak ill of SUS on the Internet, here in the rural area, it’s still going strong!”
By November 2025, the post had gone viral, spreading across social media platforms and reaching millions of users worldwide who praised Ciríaco for his charitable approach to medical care. Ciríaco continued to share photos of gifts throughout 2025, including live chickens, vegetables, and religious figurines.
The doctor said the patients who bring him gifts are demonstrating appreciation for healthcare that would otherwise be inaccessible. Ms. Cícera and Ms. Antônia, who reside within the Basic Health Unit’s coverage area where Ciríaco is employed, are among the patients. According to the doctor, the gifts these patients offer show gratitude for healthcare services that they would otherwise be unable to access. “They come to me for everything: pain, stress, a little bit of everything,” he said. “I’m so happy, it’s great to know that my work is being well-appreciated.”
The Only Doctor for 10 Communities
Ouro Branco is a rural municipality with a population of approximately 11,446 residents, according to 2022 census data. The region is plagued with significant poverty, with Alagoas state reporting 11.8% of its population living in extreme poverty in 2020. The municipality’s healthcare infrastructure struggles to meet demand, particularly in rural areas where residents must travel long distances to access medical services.
Ciríaco’s healthcare services cover more than 10 farms and rural settlements. “My rural area has more than 10 farms, and I’m the only doctor,” he said. On Thursdays, he makes home visits to patients with mobility challenges, including elderly residents and those managing chronic conditions like hypertension and diabetes. “I go to their homes so they can access the consultation, because the situation is quite complicated in rural areas,” he explained.
Because of frequent shortages of medications and supplies, the doctor likened his practice to “war medicine.” He expressed a sense of fulfillment, stating, “We offer the best care with what is available at the moment, and that’s what makes me feel fulfilled, knowing that I was able to contribute to someone’s life in the best way possible.”
Mais Médicos: Addressing Rural Doctor Shortages
Ciríaco works through the Mais Médicos program, which was launched in July 2013 by the Brazilian government to reduce regional healthcare disparities. The initiative offers 3-year contracts to doctors willing to work in primary healthcare facilities located in inland, rural, and remote municipalities. Doctors receive a monthly stipend of R$10,000 from the Ministry of Health, while municipalities provide housing, food, and transportation.
In its first public call in July 2013, 3,511 municipalities requested a total of 15,460 doctors. By July 2014, the program had deployed 14,462 doctors to 3,785 municipalities, filling 93.5% of requested positions. The North region, which includes the Amazon, saw more than 80% of its municipalities receive doctors through the program. The Northeast, where Alagoas is located, saw 73% of municipalities receive doctors.
The program prioritized areas with high percentages of residents living in extreme poverty, indigenous reserves, and regions with limited access to healthcare services. According to a 2016 study published in Rural and Remote Health, the program achieved a 75% reduction in the number of municipalities with fewer than 0.1 doctors per 1,000 inhabitants.
Ciríaco is a year into his 4-year contract with the Brazilian public health service. The young doctor said he joined because he wanted to work where he was most needed. “Thank God my patients like me,” he said.
Brazil’s Healthcare System and Rural Access
The Brazilian population, particularly those with lower incomes, largely relies on the Unified Health System (SUS – Sistema Único de Saúde), which covers about 75.5% of residents. This system offers comprehensive, free healthcare, including primary, emergency, and specialist services (the latter requiring referrals). Despite these provisions, significant disparities in access to care remain across different regions of the country.
In 2020, Brazil had an average of 1.99 doctors per 1,000 residents nationally. Maranhão, the poorest state, had only 0.84 doctors per 1,000 residents, while Rio de Janeiro had 3.75. A 2019 study found that 53.5% of the rural low-income population in Northeast Brazil lives farther than 5 kilometers from the nearest healthcare facility.
The shortage of doctors is particularly acute in Family and Community Medicine, the specialty focused on primary care. In 2020, Brazil had only 7,149 Family and Community Medicine physicians, representing 2.4% of all medical specialists in the country. Many rural regions continue to face challenges in recruiting and retaining doctors despite government initiatives.
The Family Health Strategy, Brazil’s primary care model, expanded coverage from 7.8% of the population in 2000 to 58.5% in 2016. However, only 65% of Brazilians are covered by family health teams, leaving gaps in access to continuous, community-based care.
Gratitude Over Payment
Ciríaco emphasized that the gifts he receives are not payment for his services. “When patients give me these gifts, I don’t see it as payment, but as a gesture of affection,” he said. “It’s the purest recognition for my work.”
The doctor said he has received a variety of items in addition to eggs and produce. Patients have brought him live chickens, doves, corn, string beans, avocados, and even small religious images. Each gift represents what patients can offer from their own resources, often from their farms or gardens.
Social media users who saw Ciríaco’s posts praised both the doctor’s dedication and the patients’ generosity. One commenter on Facebook noted that the doctor knelt in the photo to be at the same height as the elderly women, interpreting the gesture as a sign of respect. “He knelt down to be at their height, how beautiful! May God continue to bless this doctor more and more each day,” the user wrote.
Ciríaco said he appreciates even the simplest gifts. “It’s always a pleasure to receive this simple gift from you! Some things have their price, others have their value,” he wrote in his Instagram post with Ms. Cícera and Ms. Antônia. The doctor said he approaches his work with humility and faith. “I ask God to give me wisdom,” he said.
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Defending SUS in Rural Areas
Ciríaco has used his social media platform to defend Brazil’s public healthcare system. In his viral Instagram post, he contrasted the criticism SUS receives online with the reality he sees in rural Ouro Branco. “While people criticize the SUS (Brazilian public healthcare system) online, here in rural areas it remains strong!” he wrote.
The doctor’s statement highlights a tension in Brazilian healthcare discourse. While critics point to long wait times, resource shortages, and infrastructure challenges in the public system, rural residents often have no alternative. For communities like those Ciríaco serves, SUS represents their only access to medical care.
A 2023 study on healthcare access in Brazil found that low-income individuals have greater walking access to primary healthcare facilities than high-income individuals, largely because primary care units are intentionally distributed to reduce inequalities. However, access to high-complexity healthcare remains concentrated in urban centers, leaving rural populations at a disadvantage for specialized care.
The gifts Ciríaco receives demonstrate that rural patients value SUS care. The elderly sisters who brought eggs, the patients who brought live chickens, and those who offered produce from their gardens are expressing gratitude for a doctor who shows up consistently in a region where medical professionals are scarce. Ciríaco said patient recognition motivates him to continue working in challenging conditions. “Thank God my patients like me,” he said.
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