February 2024
In the remote community of Tekohá Y' Apo, in the Department of Canindeyú, some 280 kilometers from Paraguay's capital, stands the Avá Guaraní ethnic group health post, a small pink wooden house with a tin roof. For years, medical care in the area was limited, but recently, thanks to an initiative led by the (PAHO) and financed by the U.S. Government, 31 health facilities, including hospitals, family health units, and dispensaries, have undergone a transformation.
"Before, we had nothing and had to transfer the patient out of the community for any basic care," says Natalia Saucedo, the nurse at the Tekohá Y' Apo community health post. "Now I have the equipment I need to do everything, including blood pressure checks and wound care,” she adds.
Since November 2022, the 31 facilities in the area, along with the professionals that work in them, have received training and donations of medical devices, computer equipment and furniture. This has significantly improved their capacity to address and resolve common health issues.
Canindeyú has a population of almost 250,000 people, 38% of whom live in poverty and 7.7% in extreme poverty. It is also the department with the third largest indigenous population in the country. Guaraní is one of the most widely spoken languages in the area, along with Spanish and Portuguese, due to its proximity to Brazil. Canindeyú was selected for this project by PAHO and Paraguay's Ministry of Public Health and Social Welfare as part of an effort to address the needs of this vulnerable population.
Dr. Tatiana Fleitas, PAHO national consultant on health systems and services, notes that the main objective was to strengthen the capacity of family health teams to provide care, especially after the COVID-19 pandemic.
Natalia Saucedo provides medical care and makes home visits
125 kilometers from the health post where Natalia Saucedo works, the Regional Hospital of Salto del Guairá, the capital of the department, was strengthened with furniture and medical devices, such as refrigerators for storing and transporting vaccines, scales for weighing babies, incubators for newborns, as well as adult and pediatric crash carts.
For its medical director, Nicolás Ocampo, these donations were crucial, especially to refurbish the hospital's second operating room, which has improved the quality of surgery, reduced procedure times and increased the capacity of the teams to attend more patients.
A two-and-a-half-hour drive away is the Curuguaty District Hospital, the other medical center in the department. In 2021, in response to COVID-19, the hospital received a medical oxygen plant from PAHO, which helped ensure oxygen for patients both in health centers and at home during the pandemic.
"The technical cooperation marked a before and after in services," says Dr. Angie Duarte, director of the hospital. This change, she says, was especially noticeable in areas such as neonatology and in the operating room, which was refurbished from scratch after having been closed for six years.
The operating room, which was blackened by a previous fire, now looks radiant and contains everything necessary to perform surgeries, from an operating table, lights and surgical instruments to vital sign monitors and an anesthesia device. "Having new and modern equipment makes it possible for us to provide quality care to patients," Duarte emphasizes.
New neonatology equipment has also improved care for premature babies and allows Dr. Jennifer Heyn and her team to detect vision problems, monitor airways and maintain the newborns' body temperature. This gives them greater decision-making capacity, as well as safety and peace of mind, as they previously had to be more vigilant, she says.
Dr. Jennifer Heyn next to a newborn who sleeps peacefully in one of the servocribs donated by PAHO to the Curuguaty District Hospital.
The Maracana 2do Encuadre family health unit was another beneficiary. Reaching the unit involves traveling 80 kilometers from Curuguaty, including via a red dirt road through the Mennonite community of Nueva Durango. Dr. Joel Franco arrived at 2do Encuadre eleven years ago when the unit was very basic. With time and the help of the community, it has been improved. Now, PAHO has donated equipment, including an electrocardiogram and a crash cart, which have made it possible to stabilize patients who suffer a heart attack locally before their transport to the Curuguaty district hospital, reducing the risk of death en route.
The Regional Health Directorate then hired more doctors, and the 2nd Encuadre health center began to operate 24 hours a day, including weekends, which increased the number of consultations from 400 to 1,500 per month, Franco says.
Twenty kilometers from the health unit of 2do Encuadre, Noemí González, a licensed nurse, attends patients at the Virgen de los Milagros Health Post, located in front of a school. "Previously, we had nothing, we couldn't even check blood pressure," she says. But thanks to donations, she now has chairs, shelves, a pediatric scale, a refrigerator, a blood pressure monitor and a minor surgery kit. This allows her to perform small wound dressings and sutures without the need to transfer patients to 2nd Encuadre.
Dr. Joel Franco performs an electrocardiogram with the equipment donated by PAHO.
"During the first stage of the project, we strengthened health services so that the population can have access to better-equipped health units with a greater response capacity. This allows personnel to provide adequate care to the population, avoiding travel to large urban centers, which can be costly and difficult," PAHO Representative in Paraguay Marcelo Korc says.
The second phase of PAHO's technical cooperation, which began in 2023, seeks to expand the quality of services, train personnel and improve networking. The PAHO Representative hopes that this project will pave the way for a more resilient health system throughout the department of Canindeyú.
With strengthened teams and care in Canindeyú, many health problems now find solutions locally in the community, close to the people, following PAHO's vision of leaving no one behind.
