| Most of the censuses taken in recent years in Latin American countries indicate that in 11 of the 18 countries studied, more than 50% of the population live in rural areas. It may therefore be construed that most of the population is scattered, since it lives small, isolated villages. The problem of providing the population with medical care is overwhelming not only because of its constantly increasing numbers but also because of the irregular geographical distribution of physicians. Venezuela has been greatly concerned over the fate of its scattered rural population, especially in view of the fact that, in 1965, 46.6% of the country's physicians were practicing in Caracas, which comprises only 14.6% of the total population. The II Venezuelan Congress of Public Health (1961), the Venezuelan Society of Public Health (1962), and the Medical Federation of Venezuela (1961 and 1962)studied the extent of this problem and estimated that only one-third of the 3.5 million persons affected had access to medical services. The three bodies, therefore, attempted to implement some type of medical care that would be in keeping with scattered populations. To that end, they proposed a programme of health penetration, consisting of a reddirection of the activities or rural dispensaries, so that certain minimum, well-defined preventive and curative services would be offered to precede the rural medical officer. It was known as the programme of "simplified medicine." It was proposed that the programme should be incorporated into the health organization of Venezuela, and should adhere to its standards (single command, regionalization, districts, integrated services, constant supervision, periodic evaluation, and personnel training). The plan was favourably received by the Medical Federation of Venezuela, and by late 1966 the programme of simplified medicine was being applied in seven areas of Venezuela. As part of the project, training was given to 269 nursing auxiliaries, 196 of whom were already in their posts by late 1966. Among the activities of the dispensaries were recording of births, first aid, various kinds of vaccination, home visits, educational talks, and the taking of samples for tests. By now the programme is technically and administratively consolidated in the areas where it was applied and is receiving the vivid interest of participating personnel at all levels and the cooperation of voluntary personnel. Thus it is well on the way to reaching the objectives for which it was established. (Revised journal abstract.) |