"The living conditions in the slum are precarious and access to social and health care is very limited," explained Susana De Deus, head of mission in Brazil. "It is a violent environment with many narcotics and arms dealers."

MSF is opening a clinic in the Marcilio Dias slum, north of Rio de Janeira, Brazil, to improve access to primary health care and psychosocial support for the local community. The program, targeting children, adolescents and women, includes preventative and curative consultations, improved access to medicines and the launch of prevention and health education activities. "

The living conditions in the slum are precarious and access to social and health care is very limited," explained Susana De Deus, head of mission in Brazil. "It is a violent environment with many narcotics and arms dealers.

The population is very young - almost half is under 19 years old - and poorly educated; 70% of the families have a monthly income that is below US$100 and the rate of unemployment is extremely high." The Marcilio Dias slum consists of the areas of Marcilio Dias itself, Kelson and Mandacaru and has a population of around 10,000 people.

Insecurity is high, due to the violent narco-trafficking context, which leaves the community isolated from the outside world. Due to poverty and a lack of public transport, public health facilities are extremely difficult to reach for the slum population. "Our objective is to provide medical and psychosocial consultations for the population through an MSF health unit in Marcilio Dias," said Susana De Deus. "Our team provides treatment free of charge and is developing preventative health measures such as vaccinations.

This will involve the training of community health workers. "Through in-depth study of the psychosocial needs of the community, we are aiming to define particular approaches that can be linked to issues such as violence within the family, adolescent maternity and other problematics that are typical of an excluded urban community living in these kind of harsh and violent circumstances."

MSF will promote focal group discussions with community leaders, the target population, churches and other relevant community social actors. They can help in identifying and defining psycho-social problems in the slum community and their consequences. The project is in close collaboration with the local health authorities who will gradually take over its running during the next three years.