The article analyzes the relationship between hygienist policies in effect in Belém in the late nineteenth century and the expansion of activities of the Santa Casa de Misericórdia do Pará. Considered one of the first hospital institutions in the former Grão-Pará Province, in addition to its own hospital, the Brotherhood administered several other health facilities in the capital, and the study of its physical displacement made it possible to "map" three health centers in Belém: Pioneer, Expansion and the Santa Casa, which reinforce the growth vectors of the city. The expansion of its activities is configured as the expansion of the Santa Casa de Misericórdia to serve the underprivileged and sick, preceding the establishment of a public health system in Pará.
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