Association of Community Health Educators Family Health Clinic Program

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Brazil is the largest country in South America and is best known for its contrasts. Along with the splendor of the well-known beaches and Carnival of Rio de Janeiro, lie the favelas (shantytowns) and high levels of poverty for a large proportion of the population. 

Many Brazilian shantytown women have been trained as grassroots health educators over the years by leaders (including retired Global Ministries missionary Barbara de Souza) of the programs leading up to the current Association of Community Health Educators and the Family Health Clinic in Rio de Janeiro. These grassroots health educators from the shantytowns have worked with neighboring families in their communities on matters of preventive health care and public health issues. The health educators also facilitate networking and advocacy in order to call local authorities to their responsibility in providing adequate conditions for positive community health. 

In 1996, the first Shantytown Health Clinic was established, bringing a new phase to the work of training grassroots health educators. The network of grassroots health educators acquired non-profit status as the Association of Community Health Educators (AECS). The Clinic began with four volunteer doctors for a few hours each week as well as student interns. In June 1999, the addition of the Family Health Program was instituted, prioritizing preventative health care instead of just curative health care.

Year 2013 began with the continuation of the four Courses for the Training of Community Health Educators and there were three classes graduating with a total of 44 students. There are now four teachers, two of whom are former students. Nine new teachers were prepared to take over their own groups in early 2014. There has been a growing increase in the number of persons wanting to take this Course since 2011 because of the many jobs for Community Health Agents being offered by the State Family Health Program. These new health professionals become part of the staff in Basic Health Programs being financed by the Municipal Secretary of Health in Rio de Janeiro. There are many former students working as community health agents already. The Association of Community Health Educators is proud of the fact that in the 16 years of their existence, so many of the former students in this program have changed the lives of so many, principally women, who had never been able to continue their studies because of children and family, the customary role for women. The main objective of this Course has always been not only to empower but to encourage further studies, thereby increasing professional opportunities for women. Many women, after graduating from the Course, have gone on to further studies, achieving training as medical technicians, nursing assistants, nurses, and teachers. Some of these women had not completed grammar or high school when they took the Course. The Shantytown Health Clinic is very gratified to have had a part in the empowerment and professional growth of these women.

In 2014, some changes in the duration of the Course are being made, shortening it to 12 months because most of students are seeking jobs in the city health system, and 18 months was too long to wait. In 2014 they will begin two new groups, a total of 70 new students, in two areas where the Course had never been taught before.   

The Physical Therapy Program continues in place, with an average of 100 patients per month. Because there is no other such program for lower income patients, there is currently a waiting list of 30 persons to access these services. 

The city of Rio de Janeiro currently is preparing for the World Cup in 2014 and the Olympics in 2016. In the midst of all these preparations, the children in the shantytowns participating in the Family Health Clinic Program are doing art work, playing and eating, laughing and singing in a safe place. These children are painting towels, making hand prints, decorating soap boxes, and other crafts. They are enthusiastic and full of joy and their lives are enriched. Some of these children have known so much violence at home and on the streets, but are at the Shantytown Health Clinic making beautiful things. 

Other programs with children include computer training using Word, Windows and Excel; improving reading skills; composition and creative writing; planting and caring for a vegetable garden in the local community; nutritional workshops related to the vegetable garden; play writing and theater; and sports. 

Because of the levels of poverty in the area where these children live and the shortened school days, children do not have access to a sports program. The Clinic is aware of the need for this, not just for recreation, but for physical and mental health as well as a relief of normal stress. Good sports-person-ship is a skill that the participants will use through their lives, especially since sports an important part of Brazilian culture. 

One of the participants of the sports programs shares his story: I want everyone to know about the activities for kids at the Clinic. These activities have been very important for me and my friends, principally because of the new friendships I made. All that we learn in the different activities, we can use in our everyday life. One of the best examples is our community garden where besides learning to plant and cultivate, we pick and consume what we plant. All of our plants are cultivated with organic fertilizer that is prepared in our own garden workshop. Because of these reasons, this project is so important for me and my friends. Thank you, all of you who help us!

Recreational activities include: creative art including theater, educational games, creating and illustrating stories with special themes, cartoons, sports, and special trips outside of the shantytown. The children also participate in festive celebrations of holidays, birthdays, and special events. A light lunch is supplied. For many children, it is the only meal they will get since leaving home early in the morning. 

Teachers and sometimes parents who are not working help with the children’s programs, as well as some students and teachers from the University, Faculdade Internacional Signorelli.  This University has a partnership with the Association. It is hoped that this partnership can be an example of how other schools and universities can cooperate with Shantytown Health Clinic. The program is growing, and there is much more can help increase the number of children that the Clinic can serve. In order to do this, they have identified a goal to obtain a larger space to work to allow the program to expand. They believe they not only keeping children off the streets, but they are changing lives.