In Venezuela, after decades of class polarisation, neglect of the needs of the majority, corruption on a massive scale and unbridled bureaucracy, the magnitude of problems that Venezuela's Bolivarian revolution led by socialist president Hugo Chavez is attempting to tackle is enormous.
A study of the problems of health in Venezuelan society published by Angel Miguel Rengifo in 2005 found that in 1995 (three years before Chavez's election), some 40% of Venezuelans below 17 years of age suffered from malnutrition, out of a total population of 25 million. This translated into 4 million children and adolescents, including 1.2 million between the age of seven and 14 years with acute nutritional deficiency.
According to information from the Venezuelan government office of statistics and information, in 1994, 27% of the Venezuelan population lacked basic necessities and 21.6% were in a situation of extreme poverty (unable to feed or clothe themselves adequately). Half of the latter group were homeless.
According to the Economic Commission for Latin America and the Caribbean (ECLAC), poverty affects women more than men, and the majority of the homeless are women who are single heads of families. Another group of people who are at risk of severe poverty are young, single, pregnant women, writes Rengifo. In Venezuela, there are 60,000 births a year to women under 15 years of age. Birth complications multiply at this young age and if these young women come from poor families, often they are malnourished. Many turn to prostitution as the only available means of income.
According to the Pan American Health Organization, there are another 40,000 births a year to adolescent women over the age of 15 years. In the pre-Chavez era, one in 10 would have had no prenatal birth care. Some 71% of these young mothers were poor, and one in five had left school before the age of 15.
Maria Leon, president of Venezuela's main women's rights organisation Inamujer (the National Institute of Women), spoke to Green Left Weekly last year about efforts to overcome some of these problems. "We have been struggling all our lives in Venezuela for the rights of women. And one of those is the fundamental right to have the number of children we want, when we want and when we can look after them properly. This right is established in the Venezuelan constitution [which was adopted by popular vote in 1999].
"The constitution says that a couple have the right to decide on the number of children they can properly take care of. The state will guarantee to do whatever is necessary to make this effective. The minister of health has introduced a law on sexual health and reproduction.
"The government is developing a program to tackle all aspects of sexual and reproductive health, to prevent the high rate of pregnancy among adolescents, which results in the problem of 'backyard abortions'. Thousands of women currently die as a consequence of these unsafe abortions. Now, the state is finally beginning to implement this law, which was passed a few years ago. It is not easy changing a system of health which was only used to help a small number of people, who were seriously ill in hospital."
Leon explained that "right now we are reconstructing the Venezuelan health system" with the assistance of thousands of Cuban doctors, through the popular health program Mision Barrio Adentro, which provides free medical care in poor communities across Venezuela.
"We hope to be able to observe the full effect of this policy when we are able to properly measure the results through the National Institute of Statistics (NIS). Inamujer is seeking an agreement with the NIS to differentiate between men and women in collection of health statistics. We know there are improvements in health overall, but at present changes in women's health are not registered specifically.
"We are confident we will find an improvement, not only in a lower number of pregnancies among students in the schools and universities, and among young women in general, but also in the problems of sexual diseases and sexual health overall. President Chavez has signed a document which has decreed that the national budget include a gender perspective. From 2007 onwards, the government will have to dedicate funds to prevent adolescent pregnancy and AIDS, for other sexual problems, for the problem of abortion, etc.
"We are working very hard to bring the gender question into national focus, so that each suburb, each municipality, each state, will know how much of the budget they need to dedicate to solve these health problems."
Venezuela is traditionally a very strong Catholic country and there is yet to be an extensive education campaign to win broad support for women's right to access abortion. Free, legalised abortion is one of Inamujer's demands. "The constitution, in practice, legalised the right to abortion. To charge anyone for undergoing an abortion is unconstitutional, because Article 76 says that one has the right to have the number of sons and daughters that you can maintain, and the state is supposed to provide you with the conditions to practice this right. The law says 'the couple', so that when there is a couple, the decision is taken by both, but when the woman is alone, the decision is taken solely by her. The implementation of this law is surely going to reduce the problem of adolescent births."