Four months ago, while at home, José Prado fell and hit his ankle. In pain and worried about the swelling, he went from one public health centre to another but could not get an x-ray. He was forced to go to a private clinic, where he had to pay USD$40 for an x-ray and a further $40 for a doctor to examine him, diagnose a fractured ankle and treat it. José had to borrow money from several people to cover the total cost of $80. His monthly salary as an administrator is equivalent to less than a dollar, so he also does minor home repairs and sells food to cover his family’s expenses.
Insufficient economic resources to access healthcare
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Today, he has recovered from his fractured ankle, but he is still paying off his treatment debt.
José lives in a rural area of Anzoátegui state, Venezuela, with his wife and two children, and has serious concerns about access to healthcare for himself and his family.
"Before, you would go to any clinic or any health centre and you could at least get a pill for pain, but now you go there and there is nothing, no syringes, no alcohol, nothing,” he says.
There are many other Venezuelans like José who live in vulnerable situations and do not have sufficient economic resources to access healthcare services.
Provision of free healthcare through 'health fairs'
In November 2018, medical humanitarian organisation Médecins Sans Frontières/Doctors Without Borders (MSF) began working in Anzoátegui, together with local authorities, to strengthen the state's health system.
"The most frequent conditions we see among people in Anzoátegui are diarrhoeal diseases due to difficulties in accessing drinking water; skin diseases due to the impossibility of buying cleaning products; and respiratory infections caused by burning garbage or wood-burning stoves," explains Lucia Brum, MSF´s medical advisor in Anzoátegui.
Each week, multidisciplinary teams from MSF and state health authorities run ‘health fairs’ in semi-rural areas of Anzoátegui to provide people with free medical consultations, vaccinations, nutrition screenings, family planning, water purification, malaria diagnosis and treatment, mosquito net distributions, mosquito fumigation and health promotion activities.
José is one of the people in the community who has benefited from these health fairs.
His sons Jorge and Fernando, 7 and 8 years old respectively, received treatment for worm infections, and their house was fumigated and supplied with mosquito nets to help prevent malaria.
They also received water purification supplies and instructions to ensure the water they use at home is drinkable, and information on how to prevent waterborne diseases.
Family planning consultations
Early in the morning of each fair, MSF staff, state medical teams and members of the local community assess the most important needs of the people in the area.
They go from house to house to make assessments and inform the residents about the health services that will be available that day.
This is how Georgina Muñoz, 19 years old, learned about the possibility of taking her one-month-old child for a comprehensive medical evaluation.
While at the consultation Georgina also signed up for a family planning consultation.
She had had to make the choice between contraception and buying food for herself and her family
She wanted contraception but had been unable to afford to buy it from other providers: she had had to make the choice between contraception and buying food for herself and her family.
After a medical check-up, the medical team offered Georgina a contraceptive implant that is placed under the skin of the arm and is effective for five years.
Georgina looked in the other direction while staff performed the implant insertion, to avoid seeing the procedure.
At the same time, her young son Isaac received his medical evaluation and her nephews received pentavalent, trivalent, tetanus and polio vaccinations.
Maximizing opportunities to provide healthcare to many
"We work in full cooperation with the Ministry of Health, the National Malaria Program, all local health authorities and community leaders, and with broad community participation,” says Brum.
We do our best not to miss the opportunity to give people access to healthcare
Lucia Brum, MSF´s medical advisor in Anzoátegui
“If we see a mother for a medical consultation, we take advantage of the opportunity to offer to vaccinate her children."
In the second half of 2020, the Anzoátegui health fairs run by MSF and local authorities reached 28 communities and provided care for more than 20,000 people.
After a half-hour procedure, Giorgina’s contraceptive implant was fitted, and she was given information from the health promotion team about her sexual and reproductive health, breastfeeding and caring for a newborn child.
She returned home with a new perspective on how to take care of herself and her family.
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