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Paraguay: Bringing health care to the slums

by Ruud Tinga

The majority of the 350,000 people who live in the Villa Laurelty area of Asuncion, the capital of Paraguay, have nothing at all. Their simple, self-built houses could not be called a property. Sometimes they have only a piece of plastic draped over a rope.

Beneath many of these meagre shelters are women looking after their children. The fathers have left them and never returned. These mothers are among those who can get medical care and education at the Tekokatu Clinic of The Salvation ArmyMark and Maria Rosa Kent are in charge of the clinic, which offers direct medical care and education. Local people can learn about family planning, hygiene and nutrition as well as how to deal with domestic violence. The name of the clinic means ‘well-being’ or ‘good health’ in Guarani, the official language of Paraguay. When the centre, with its attached meeting hall, was officially opened in March 1999 there were only 1,100 medical files. Now there are more than 5,500.

every morning people line up to be seen

Mark’s involvement with the people of Paraguay began in 1990. As a member of The Salvation Army in Nottingham, England, Mark wanted to put his faith into action. He felt that he could do more for people in a developing country and did not like the idea of spending the rest of his life behind a desk.

During a meeting at The Salvation Army’s International Headquarters in London he was asked if he was prepared to learn Spanish. ‘They needed a volunteer for a children’s home in Paraguay,’ Mark recalls. ‘In February 1991 I left for Asuncion, where I worked for over a year at the El Redil (the Sheepfold) Children’s Home as the handyman. I paid for the airfare and other expenses. For the work I did I received a small salary.’

Back in England in March 1994, Mark was asked unexpectedly to return to his old job again in the children’s home. ‘I did not have to think long about it. For a while I was unemployed and not long after I worked again in El Redil as “jack of all trades”. I was the driver, fetched the food on the market, did some fund-raising, was the administrator, the mechanic – you name it, I did it.’

During this time in Paraguay he met Maria Rosa Machin, a Salvationist from Uruguay, who went back to her native country in 1997 to take charge of an eventide home. When she returned a year later to be the leader of the evangelical work of The Salvation Army in the San Lorenzo District and to explore what activities the Army could do, the couple realised they were more than just good friends. They married in 1998.

Mark Kent speaks with a woman in the slums

Tekokatu Clinic, which they are now responsible for, was built on the recommendations in Maria Rosa’s report.

During her research she found that the people in the San Lorenzo District, women and children in particular, needed primary health care.

In Paraguay, women between 15 and 44 have an average of four children. If they have had less than three years school education, they often have six or more children. Twenty per cent of the children suffer from malnutrition. For the 92 per cent of people who do not have health insurance there is no medical care available. Poverty forces the people from the country into the cities, where they end up in slums like Villa Laurelty. They are often called ‘the farmers without land’.

In the clinic every morning from 7.30 to 11.30 a doctor can be consulted. Twice a week a dentist calls and once a week a gynaecologist is available. Every afternoon there is an educational meeting.

Several times per week Mark and Maria Rosa, assisted by the four other workers, go into the slums to point out to the women their rights. ‘In Paraguay there is still a macho culture and women have little or no self-respect,’ explains Maria Rosa. ‘At the family planning meetings we want to tell them that they have the right to say no to sex. What we also mean is that they do not have to have more children against their own will.’

Maria Rosa Kent welcomes a woman to the clinic

Child death is very high as a result of the poor hygiene and because of the fact that the mother is assisted at the birth by someone who is not a midwife. Nobody wants to go to the hospital, for the care is very bad and the patients themselves have to supply the medical instruments and medication. There is a great need for a maternity clinic. ‘It is our dream to have a five-bed labour ward. We now help them during pregnancy, but when the baby is born we have to send them away.’

Sex education at the schools, also given by the workers of the Tekokatu Clinic, discourages the children from having babies. During one of their visits to the slums they push aside a blanket which is used as a door to a wooden shed. A mother lives there with seven children and her 12-year-old daughter has a six-month-old son. ‘More than 150 women come to our educational meeting about family planning on a regular basis,’ says Graciele, one of the nurses and educational workers. ‘It is our aim to get in contact with the grandmothers as they have an enormous influence on their daughters and granddaughters, so what they say is often law.’

As an answer to the increasing domestic violence and the physical abuse of women and children, the clinic has, working in cooperation with an organisation which specialises in this field, launched a special programme. The victims now can ask for and receive help and advice. Until last year the Kents were also responsible for The Salvation Army’s evangelistic work at the centre. Almost a year ago an officer was appointed to be in charge of the corps work. The time they spent on that part of the work is now invested in creating little gardens next to the slums. Sixty families and two schools have joined the horticultural programme they have set up. The people learn how to grow vegetables and fruit. The Army provides the seeds. In this way they want to fight malnutrition among young people. The Kents feel that they are called by God to serve the poor in Paraguay. ‘We know we can earn more money in the rich and developed countries in the West, but we know that we have to answer God’s call. As Christians we want to fulfil the task God has given to us.’

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