Sao Paulo hospital, a haven for slum mothers, to close

It's a cry that wakes the most human of instincts - Celina Mendes dos Santos's tiny baby boy is only minutes old and he is making his presence in the world known to all around him. To his adoring and exhausted mother he is unique, but he is also one of hundreds of babies born at Amparo Maternal Hospital in the run-up to Christmas.

The biggest public maternity hospital in Sao Paulo, it is the only one in Brazil to operate a policy of never refusing anyone, and is a lifeline to the country's poorest and most vulnerable women who often fail to find vacancies at overcrowded public hospitals for hundreds of miles around. Some women who give birth here have been turned away many times elsewhere.

In a country where millions live on little more than £1 a day, for the majority of Brazilians private medical plans are inconceivable - many of the women here are young, single, homeless or live in the city's many sprawling favelas.

But Sao Paulo's Amparo Maternal - where around 40 babies are born every day - is threatened with closure unless it can raise nearly £2m to clear its outstanding debts, which creditors are no longer willing to sustain.

The Amparo, literally meaning to "hold" or "support", was founded in 1939 by a Catholic group led by the Archbishop of Sao Paulo, concerned by the growing number of homeless pregnant women they saw on the city's streets, and is funded by the governmental health agency and donations. Though run according to Catholic principles, it aims to help all in need regardless of race or religion. For some women that simply means providing a free maternity bed.

But as more than three quarters of the women attending the hospital are single, according to last year's figures, staff also provide trained volunteers who will stay with the often young and frightened mothers-to-be - 35 per cent are between 16 and 20 - to provide emotional support and reassurance. It is the social wing of the hospital that provides 100 refuge beds for homeless expectant mothers - those abandoned, fleeing domestic violence, or escaping life on the streets - that makes the Amparo different. Some women stay in the dorms for up to a year, while they work out a new life for themselves and their babies. In return for help in the hospital kitchens the women receive food and clothing, complete medical care, access to psychologists, help with addiction problems, and courses in domestic skills, literacy and IT. It is an expensive ideal.

"The debts have accumulated over the years allowing us to continue to operate but there exists a limit," explained Sister Enir Loubet, vice-president of the hospital. "We need to be able to pay back 7m reais (£1.7m) to our debtors. If we can't raise that money we will work on as long as we can but there is a real danger that we will need to close." The hospital has already overcome many barriers. In 2003 staff who failed to receive their monthly salary threatened a walkout, though the crisis was averted.

Later that year, the electricity was nearly cut off due to unpaid bills, putting hundreds of lives, including those of premature babies, at risk. The hospital has launched a major campaign to allow it to pay off its debtors and avoid closure.

A main focus of the initiative is an adoption scheme of the social hospital beds, at the cost of just over £10,000 each. The current archbishop of Sao Paulo will be the first to sign the "adoption" papers and talks are currently ongoing with potential benefactors.

"We are now living in a moment of hope that we will raise this money and we will keep hoping," added Sister Loubet.

According to Marlene Beatriz Nascimento Novaes, co-ordinator of the social wing, without the hospital these women would be on the streets.

"Everyone here has very different stories. But they are all very vulnerable women," she said.

Tereza Aline, 33, is one of hundreds of thousands that the hospital has helped in the past 66 years. Brought up in an orphanage, she became homeless at 17 years old and developed a crack addiction while working as a prostitute. Her first son was born prematurely on the streets of Sao Paulo. The reason he is no longer with her is not clear. When she became pregnant for the second time, most suggested that her best option might be to seek an illegal abortion, but Aline was certain that she wanted to keep her baby. A church group put her in touch with the Amparo, where she gave birth to her son, Tiago, two months ago. Both are staying in the refuge while Aline makes plans.

"Without the Amparo I don't know what would have happened," she said. "What this has meant to me is that I have been able to start a new life."