The Bus That Brings Reproductive Care to Homeless Women

Why this story matters: This is a story about the power of a single idea and the community that rallied behind it. It serves as a powerful testament to the fact that we are never truly powerless to improve the world around us.

Quick summary: This story highlights recent developments related to reproductive health, showing how constructive action can lead to meaningful results.

For the homeless women who board the Panarosa bus on the streets of Caracas, their first point of contact might be Mariannys Quintero. Quintero, a nursing assistant, welcomes them to the bus, where they will receive gynecological care. She explains what they can expect and emphasizes that they are not alone. There’s hardly a better person for this role: She was in their place less than one year ago.

Quintero was one of the almost eight million Venezuelans who left the country — but, after struggling in Colombia, she decided to return to Venezuela with her 10-year-old daughter while pregnant with twins. Back in Caracas, she couldn’t figure out her living situation and ended up on the streets. A doctor at a public health maternity hospital told her about the Panarosa, where she sought medical attention for her high-risk pregnancy. The staff supported her through the difficult time that followed: Quintero received necessary medical and psychological care both during the pregnancy and after she lost the babies. A social worker helped her find a place to live with her daughter — and start working for the organization.

“He was like that walking stick, that support, at a moment when I was saying, wow, I’m never getting out of this, you know?” said Quintero. “There came a point where I felt — I imagine it’s the same thing those women feel, the ones who are mothers or who are pregnant, when we say we have no one to help us. But there’s always that person who offers you support, who listens to you, who understands you, who doesn’t judge you.”

Aid on wheels

The idea behind Panabus — a modified bus; “pana” is Venezuelan slang for friend — is that homeless people are nomadic, therefore services to help them should be, too. Panabus was launched in 2016 by the nonprofit Fundación Santa en las Calles as a mobile clinic offering complete care to the homeless population, including psychosocial interviews, hygiene kits, clean clothes, medical evaluations, basic dental care and treatments for common conditions like infections and colds. The social workers on staff scout the city for places where there might be a homeless encampment and, once they find one, they park the bus there for the day.

Since its launch, the program has carried out more than 6,000 care visits.

Then, in November of last year, the team realized that while the number of women in need of attention kept growing, Panabus was seeing mostly men. That’s how Panarosa came to life, Panabus’ sibling — “or its boyfriend, we haven’t decided yet what the relationship is,” jokes María Angélica ‘Maru’ Rodríguez. Rodríguez is the general manager of Santa en las Calles, which runs the two programs.

The programs work similarly, but for Panarosa, a specialist in gynecology and obstetrics provides the same level of care available in a private health center. That includes physical exams, Pap smears, family planning and ultrasounds when needed.

Alejandra Ceballos, the program’s medical coordinator, explains that currently they have three staff doctors, plus the specialist who joins the Panarosa route. Panabus can treat seven patients a day, while Panarosa has a capacity of five. “We return to the same areas as many times as necessary until we’ve reached 100 percent of the people there,” says Rodríguez.

During Panarosa’s first route, the team was cautiously optimistic: Gynecological care carries a lot of taboos for women. Rodríguez explains that they told themselves they should be proud of their work, even if they only treated one woman, because they were doing it, and that “little by little, we’ll build on it.”

But the experience banished their doubts: They saw five women during that first day and, so far, they have treated 100.

The patient number is limited mostly due to the water tank reserves the bus can hold, but Ceballos adds that it also allows for better care. “You can have a real doctor-patient relationship with each person, connect with their story, and in some ways help them even more than you would in a hospital. Because in the hospital, the patient load is very high and time is very limited.”

Beyond the bus

Now working for Santa en las Calles, Quintero is the most visible case of reintegration success, but far from the only one. If, during the psychological evaluation, a patient expresses a desire to stop living on the streets, and the organization has the right tools to help, the team begins its reintegration program.

For both Panabus and Panarosa, this includes restoring the individual’s health, family bonds and sense of identity. But Rodríguez explains that in Panarosa it is more common to see complete family units. “In those cases, the reintegration program activates for the entire family, not just the mother, but the children, too. We also add school enrollment and academic catch-up for the children.”

According to Rodríguez, the effective reintegration rate sits between two and three percent. While that figure may seem small, it is considered high-impact given that each individual represents the rescue of an entire family. For Panabus, the number of people successfully reintegrated so far is 200.

When asked about the future, Rodríguez says that they will continue working on their main goal: restoring the dignity of people living on the street. “It’s extremely important to us that every single visit we provide meets that standard and represents the best care these people could possibly have access to.”

But she also adds the bigger goal of continuing to work to destigmatize people experiencing homelessness, while “raising awareness among civil society that everyone can do their small part and make a difference in the life of someone living on the street or in a situation of vulnerability in our country.”

Ceballos is full of gratitude for how Santa en las Calles has changed her life — and career. “I must give thanks for what I have been given,” she says. “My dream was to become a doctor — it was something I asked God for — and I think that, in some way, being part of the foundation allows me to be an instrument for helping all these people.”

---

BluAZ.com curates positive and solution-focused stories from trusted sources around the world.