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Brazil
MSF has worked with Rio's street population in an effort to improve their living conditions, increase their access to health care and social services and promote their inclusion in society. Photo © Fabrizia Granatieri
Today one-third of Rio de Janeiro's inhabitants live in extreme poverty within slums, where there are few or no health care services available. To help remedy this problem, MSF runs a basic health center in Marclio Dias, a slum area located in the northern part of the metropolis.Marcílio Dias is generally regarded as one of the slums with the highest levels of social exclusion and violence. Many residents come into daily contact with violence whether between police and drug traffickers or within families, and women and children are particularly vulnerable. Residents also face high rates of drug and alcohol use and teenage pregnancy. The MSF team provides medical and psychosocial consultations and medicines, and carries out educational activities to help prevent health problems. Each month, approximately 1,500 people consult the clinic's staff. The team is composed of medical doctors, nurses, a psychologist, a social assistant, and an educator, as well as community health workers who live in the neighborhood and regularly visit families to spot problems and perform health-prevention and promotion activities. A women's community group provides psychosocial activities including group discussions with local women and youth that address such topics as domestic violence, teenage pregnancy and drug abuse. Dance, sports and handicraft activities led by community volunteers in the health unit have mobilized people to join discussion groups. MSF also supports the realization of citizenship and civil-rights workshops, community social events and the growth of a local newspaper by area youth. MSF will continue its work at the health center until the end of 2005. Afterward, the municipal health secretary will include Marcílo Dias in the city's family health program expansion plan. At that point, it will be handed over to local authorities and community organizations. MSF's project that provided social, medical and psychological assistance to homeless people in the city's downtown district was closed in December 2004. Although exclusion remains, and the street population has not diminished, MSF has observed an increase in public services for street people. A permanent monitoring commission, co-founded by MSF and composed of local organizations, street people's delegates and public institutions linked with this population, now acts as a consultant for municipal and state authorities in designing special policies toward the street population. MSF has worked in Brazil since 1991.
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