International staff: 6
National staff: 29
The broader challenges facing native American and rural communities throughout Latin America are omnipresent in Bolivia. Over 50% of the population is indigenous, but people of European or mixed European-native American origin hold political and economic power. Nine out of ten rural households are poor.
Caring for a rural population
"Rural communities, especially indigenous, live in extreme poverty and have little or no access to health care and water and sanitation services," explains Reyes Otero, general coordinator of the MSF program in Bolivia. "Indigenous people have little access to modern medicine."
The municipality of Chimoré, in the department of Cochabamba in west-central Bolivia, is home to about 15,000 people, including 3,000 Yuki and Yuracaré native Americans. Outsiders who were lured there in the early 1980s by profitable coca crops pushed the indigenous population to inaccessible spots near the Chapare and Ichilo rivers. MSF has been working to improve health care in the area since April 1999.
In addition to providing drugs, medical and cold chain material and radios, MSF runs a basic health care program in collaboration with the Chimoré health center. Educational outreach covers basics such as hygiene, water, nutrition, mother and child health care and sexual education. The team recently built a new clinic in Chimoré and another in the area where the Yuracaré live. New toilets are slated for the schools, and water systems for communities that have none.
In neighboring Mizque, also in Cochabamba, MSF helped organize and manage a health care district for some 35,000 Quichua. The project was handed over to the Ministry of Health in July 2000.
Mother and child care amid urban population pressure
A new mother and child health care program will begin in fall 2000 in the municipality of El Alto, in the department of La Paz. Population pressure in the area is tremendous. The growth rate is higher than in any other Andean city. Around 70% of the district's half a million people - mostly Aymará, Quichua and GuaranÃ? - live in poverty.
The result is a permanent social emergency. People suffer from cultural and economic exclusion. Urban planning is nonexistent, and health and education infrastructure is inadequate. Women and children are the most vulnerable: Domestic violence, high abortion and maternal mortality rates, poor pre- and postnatal medical care, malnutrition and acute diarrhea and respiratory infections abound.
The MSF program emphasizes mother and child health care, sexual and reproductive health and counseling for victims of violence. MSF also plans to create a woman's clinic to help reduce maternal morbidity-mortality rates.
MSF has been working in Bolivia since 1986.