Mirella Valles, mamá de Jessica. Está contenta porque su hija no tendrá más hijos, más bebes, más gastos. Cuando me enteré de las citas en el hospital de Tumeremo, le dije que corriera, que no perdiera la oportunidad y cuando se quite ese, que se ponga otro. ---- Mirella Valles, Jessica's mother. She is happy because her daughter will not have more children, more babies, more expenses. “When I found out about the consultations at the Tumeremo hospital, I told her to run, not to miss the opportunity and when she takes that one [contraceptive device] out, she will put another one in.” © Jesus Vargas

Venezuela: Supporting women to take control over their sexual health in Bolívar state


Jessica had her first child at the age of 14. The second at 15. The third at 18, and then she had four more children before she turned 25. In total she has seven children. She lives in Tumeremo, a mining area in the state of Bolivar, in southeastern Venezuela.

“My husband works in the mines, far from here, and spends up to a month there,” says Jessica, while her children run around the house, listening to their mother’s instruction to behave well.

“He sends us money, supplies or whatever he can back to us via some friends,” says Jessica. “In the meantime, here I fix nails and do cleaning work. I couldn’t continue studying, I have to stay at home to take care of the children.”

Brigitte, a 27 year old mother of 5, also lives in the rural area of Tumeremorural. She sits in front of her house built with tin cans that she lives in with her entire family.

“I’m at home all the time taking care of the children. My husband works in the mines and I spend all day talking care of the children so they don’t go to the street; it is very hard,” says Brigitte. “He spends up two months in the mine. I have gone and worked doing whatever I can: cleaning, cooking, even washing soil to get gold.”

“The children do not study, I do not have an identity card and I have not been able to enrol them in school,” Brigitte continues. “I studied up to the first year of high school, after then I had my first child and I couldn’t continue.” 

They are just some of the hundreds of women who live in Tumeremo town; their stories are repeated house by house, block by block. Many of them hope to be able to move forward, but in the midst of so much need, they have no time to think about the future. They struggle in adverse conditions to get even the most basics things for their children.

MSF provides free contraception in an area where it’s scarce and expensive

One of the main economic activities in Tumeremo is mining related to the extraction and commercialisation of gold. Many of the women living in the area are left alone at home, while their partners go to work in the mines, and are exposed to various challenges. Access to healthcare is limited, and this is compounded by the high cost and sometimes scarcity of contraceptive methods to prevent unwanted pregnancies or sexually transmitted diseases.

Since November 2021 at the José Gregorio Hernández Hospital in Tumeremo, a team from Doctors Without Borders/Médecins Sans Frontières (MSF) has been working with local authorities and staff from the Public Health Institute to provide medical care in sexual and reproductive health.

In the six months until May 2022, teams have assisted more than 1,000 women in the community through comprehensive, free and confidential family planning consultations. Almost 90 per cent of women have received some form of contraception, and more than 70 per cent of them have received a long-acting contraceptive method, such as a subdermal implant or an intrauterine device.

In the waiting room of the consultation area at the José Gregorio Hernández Hospital, women from Tumeremo in the state of Bolívar in southeastern Venezuela, wait to be seen. They go for contraception, to treat a symptom or for information.Jesus Vargas


Health promotion raises awareness in the community

In a joint effort with the hospital authorities and with medicines and medical supplies donated by MSF, teams see about 20 patients twice a week for sexual and reproductive health consultations. In addition, an average of 10 women each day are screened for sexually transmitted diseases such as syphilis, HIV and hepatitis B, and condoms are provided. The health promotion team also works in the hospital and in the community, providing information about the services, and raising awareness among people about the prevention and control of pregnancy and sexually transmitted diseases.

Armando accompanied his wife to the José Gregorio Hernández Hospital very early in the morning after they received information from MSF health promotion staff about sexual and reproductive health services.

“My wife wanted to get an intrauterine device and when we arrived, we found almost 500 people waiting, all of them had appointments,” says Armando. “A month later, my wife had her copper T device implanted, and in 20 minutes she was ready. That day we met young people from the area, friends and neighbours. There is a great need.”

The community feel in the village is present when you hear everyone say, “my aunt told me”; “my mother told me not to miss the opportunity, to run to get the appointment”; “all the neighbours already know that they can help us”; “many women on my block already have the implant and others have the appointment”.

Jusluis Rodríguez, MSF obstetrician/gynaecologist, says that the impact of the family planning consultation at the hospital has been very positive for the community.

“Knowing that we can help so many women at the clinic motivates me to continue every day and do my best,” says Rodríguez.