Essential care for vulnerable communities in Anzoátegui State

Verónica is one of the many teenagers who regularly visit the Amigos para la Salud health centre, operated by the medical humanitarian organisation Médecins Sans Frontières (MSF)/Doctors Without Borders, in Anzoátegui State, northern Venezuela.

This has resulted in limited access to healthcare for the population. Like in many other parts of the country, medical needs in El Vidoño are not being met.
Claire Damar, MSF’s project coordinator in Anzoátegui State

During the first months of her pregnancy, before she found out about the health centre, Verónica didn’t go to the doctor. “I was afraid at the thought of having a check-up or an ultrasound and besides, my family didn't have money,” she explains.

“But one day my sister heard about a clinic that had opened nearby where I could be treated for free. By then, I was already five months pregnant. I went there and had my first prenatal visit, had all the tests I needed and started going there regularly.” 

MSF opened the Amigos para la Salud health centre in collaboration with an organisation called Fe y Alegría (which runs a neighbouring school) and the national health authorities in November 2018.

“The political and economic crisis in Venezuela has deeply affected the health system,” says Claire Damar, MSF’s project coordinator in Anzoátegui State, “this has resulted in limited access to healthcare for the population. Like in many other parts of the country, medical needs in El Vidoño are not being met.”

Particular attention to teenage mothers

“Venezuela has a very high rate of teenage pregnancy and it has only increased in recent years because many people have difficulty accessing or paying for contraceptives,” explains Magali Gutieres, MSF’s medical responsible in the health centre Amigos para la Salud.

“The crisis in Venezuela has considerably increased people’s vulnerability. But we believe that adolescents and children are even more at risk and often struggle to reach the type of services we offer here. That's one of the reasons why our services in the health centre are so focused on them.”

Nearly 40 percent of the people that MSF treats in this health centre are children aged under five and almost a third of the pregnant women who come to the clinic are teenagers. 

Verónica looks at Alexander, her four-month-old son, and smiles. “I kept going to the clinic after his birth. I go there when my child is sick or when he needs to be vaccinated. Today, for example, I'm here to vaccinate him against polio. When I became a mother, the nurses and health promoters gave me a leaflet explaining all the vaccinations my son had to get and when. I put the leaflet on the refrigerator, so I wouldn't forget the appointments.”

Seventeen-year-old Juznedi is also at the centre waiting for her eight-month-old daughter Juli Angel to be vaccinated. For her, the MSF clinic also has made a big difference. “Whenever I need to, I come here. For example, two weeks after giving birth my daughter had a problem with her eyes, and they took care of her. They also helped me with family planning services. Now I'm taking birth control and I feel more in control of things,” she says. Like Verónica, Juznedi uses most of the services provided at the health centre: family planning, prenatal and postnatal care, and paediatrics for her daughter.

The two teenagers have also used the mental health services offered at the outpatient health centre. Juznedi speaks enthusiastically of her sessions with the psychologist: “She helped me a lot. During our sessions, I was able to talk about the father of my baby who left me when I became pregnant and I was also able to share my fears about my daughter's future”.

When they share their experience, Verónica and Juznedi insist that mental healthcare is something they could never have afforded, if it had not been provided for free at the Amigos para la Salud health centre.

Facilitating access to essential medical services in times of crisis

In the Amigos para la Salud health centre, MSF provides primary care, pre- and post-natal care, medical and psychological care for cases of sexual violence, family planning, nutrition programmes, immunisation services, malaria diagnosis and treatment, and health promotion activities.

In Anzoátegui State, MSF also supports Guanire health centre and El Rincón and San Diego health posts in the Sotillo municipality, where staff provide primary care, vaccinations, sexual and reproductive health, family planning, community activities to distribute mosquito nets, deworming and water treatment. In addition, teams carry out a house-to-house malaria detection and treatment programme in rural areas. “Our aim is to bring health as close as possible to the population and to facilitate essential medical care and services,” Damar notes.

Many activities have been adapted because of the COVID-19 pandemic. MSF’s priority has been to ensure the continuity of services while guaranteeing the safety of patients and health staff. Special triage circuits inside clinics have been established for people who arrive with symptoms related to the coronavirus, as well as the provision of protective and cleaning supplies, training for medical and non-medical staff and extensive health promotion campaigns to prevent the spread of the disease.

In the first half of 2020 alone, MSF's work throughout Anzoátegui State has reached 24,718 patients. Dozens of patients arrive from early in the morning at the Amigos para la Salud health centre every day, many suffering from respiratory infections, diarrhoea and skin diseases. Here, it is clear to see how the economic and political crisis has affected the population, and free medical care is desperately needed.

“We live a difficult life: everything is expensive, we lack basic goods and we don't always have as much to eat as we would like. It really helps to know that there’s free medical assistance close by if we need it,” explains Juznedi.

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