A Lesson From Venezuela: Empowering Women in 4 Steps

What started as a student adventure in a tropical mountain fruit farm in Venezuela became a lifelong mission of empowering rural women! Read the fascinating life story of Steven Bloomstein, co-founder of Turimiquire Foundation, an organization that has helped 70,000 women with family planning and reached over 80,000 people with workshops about reproductive health.

Before we touch on what Turimiquire does, I’d love you to share your life story. Can you tell us about how you settled down in Venezuela and what was the turning point that made you focus on family planning and education?

When I was studying college, I had a roommate who was North American but was raised in Venezuela. He proposed almost as an adventure that we go back to Venezuela after college. So we shifted there with some of his family members and my girlfriend. Eventually we selected an absolutely paradisical river valley where we bought a farm and started fruit farming. The nearest road was three hours walking from  the farm. We became close with local people who taught us farming and soon they started sharing their life stories and troubles. Many women told us they wanted to get tubal sterilizations because they had up to four or more children. But from the time they wanted to be sterilized until it actually happened in the public health system, they could have several more children.

How were you able to provide this medical procedure to women when you were growing fruit?

(laughter) That’s a very good question. I knew an Argentinian doctor in Cumaná (the central town in Sucré) who worked for the Ministry of Health and we began directing our patients to him at a small hospital in another remote rural town. We were paying for it out of our pockets. We didn’t have very much money but we could at least help a few people. But the demand kept growing by word-of-mouth and so we set up the Turimiquire Foundation.

It’s been more than 50 years that you’ve lived in Venezuela. How have the needs of the rural marginalized communities in Sucré evolved over this period?

The overriding reality of poverty continues to be the case. Most people live hand-to-mouth. They do not even have bank accounts. In fact, it was a status symbol for many years to be able to acquire a bank account. My wife is from another small rural valley and one of her  proudest achievements in life was to acquire a bank book with a small amount of disposable income. She’s a seamstress, she raised three children as a single mother and nonetheless managed to acquire a bank book. It gives you an idea of the hand-to-mouth existence that most of these people have.

Has the reproductive health of women improved?

Yes, it has changed quite a bit for the better. When we started it was not at all uncommon for a thirteen or fourteen year old girl to have her first baby and then sequentially have babies one after another. Some women would go seven years without a period during sequential pregnancies. At the age of 30, women could have eight or more children, plus lost  pregnancies or infants, and they were often pregnant yet again. Now, most women whom we perform tubal ligations on are in their late 20‘s, early 30‘s with between two to four children. We still do come across women in remote areas in their early 30‘s with seven or eight children but they are outliers. And most women don’t give birth in their early teens anymore.

Sounds like a great achievement! Unfortunately, Venezuela is facing a deep socioeconomic crisis, due to which it has a collapsing public healthcare. How is it even possible to provide family planning services in this medical emergency?

The public sector has collapsed but will respond minimally if you can come up with medical supplies. There is one public hospital in the city of Cumaná and it’s ringed all around by small street vendors who are selling what the doctors need in order to treat the patient. The private sector works better but is simply not affordable for most low-income Venezuelans. We work with doctors in private clinics who perform tubal sterilizations at a very low cost. We have promoters who organize everything from bringing people in from remote rural areas, accompanying them through the procedure, and making sure they get home safely. Rural nurses do follow-up and we do it all at a very low cost. Many women chip in 5 or 10 dollars if they can for a service that would cost them a thousand dollars in the private sector or for which they might have to wait years in the public sector if at all.

Is tubal litigation so popular in Venezuela?

Yes, it’ is by far the most popular method for rural women. They usually have a series of pregnancies and then they want to be sterilized. It’s a practical solution for them because they don’t have to make periodic long trips to town to buy the pill and they don’t have to think about it ever again. Tubal sterilizations are very effective and with good recovery you don’t have secondary effects. Hormonal contraceptions can carry secondary effects.

Do you offer other methods?

Yes. We offer long-acting reversible contraception (LARC), which are implants and IUDs, and then also short-term methods, which are pills and injections. Younger women may opt for pills, injections, implants and IUDS to space their children first. We work in the public sector where we distribute a lot of these for free and in the private sector through social marketing so we reach as wide a range of people as we can. The demand for birth control is enormous. You don’t have to convince anyone of anything, but we also offer workshops in reproductive health and family planning. We usually have a back-up list in any given activity.

That’s great! Speaking of public health, I noticed that on your website you frequently refer to a “Recipe for a Thriving Community”. Can you describe in a nutshell how you work with communities?

Our Recipe for a Thriving Community has four steps. The first step is family planning, which is always the first thing women consistently ask for. The second thing families ask for once they control their fertility is the opportunity to educate their children and perhaps even themselves since many  rural folk are semi-literate or completely illiterate. The third is better employment and community support because most rural people have hard lives and work as  subsistance farmers. And finally our fourth component is humanitarian aid, which began to play a bigger role in our work as Venezuela entered into this humanitarian crisis.That’s when we added selected primary and secondary healthcare so that families who had other problems besides their need for family planning could receive at least some kind of assistance. 

What communities do you work with?  

One typical community would be a small remote river valley with no roads where families live in rudimentary housing scattered along the river. Another typical community would be the barrios – sprawling shantytowns that extend for miles around major cities and where most people are low-income and live hand-to-mouth. We also work with urban, lower-middle-class working communities. These are people who may live hand-to-mouth but maybe have a bank account and a motorcycle or old car. It all depends on where you come from. What we call lower-middle-class here in Venezuela would be considered serious poverty in the United States or Czech Republic.

I think that one of the most important things for these people is to get out of poverty. Do you have any ideas how?

The biggest single step you can take to help people get out of poverty is family planning because you cannot get ahead in your life if you are having one child after another and your husband can barely afford to feed you all. As soon as women receive family planning they have control of their fertility and they can begin to branch out and do other things – work in the informal sector, maybe improve their own education.

That makes sense.

Being educated here even on a rudimentary level is not necessarily going to guarantee you a well-paying job but it’s a step forward. It’s empowering to feel that you can defend yourself, you can sign your name, you can read something. I think it’s really important to understand that every little step empowers people in a big way. Poverty is not just about money. It’s about feeling you can participate in the society, feeling that maybe in some small way you can spread your wings and fly.

Can you share an example of someone whom Turimiquire helped to fly?

We have one young woman now who is studying nursing (she is one of a number of nursing graduates we have seen through) and she wants to lift her family out of poverty. Her father died unexpectedly young, her mother was left with eight children, she’s the oldest daughter. One of the personally most meaningful things for me has been watching young women feel empowered, spread their wings and fly out of what was previously such a limited horizon for them. They have a completely intuitive understanding that this is what it’s supposed to be, that this is their right and that this is their time. I believe that the global movement that is empowering women the world over is one of the most significant if not the most significant social dynamic going on globally. And we are honored to be able to be part of this.

I couldn’t agree more! It’s important to empower women and give them the hope that they can live better lives even if they live in harsh conditions, poverty, or humanitarian crisis.

Yes, I see this reality in my daily life. My wife Teresa is one of twelve siblings, which was a typical family size for rural people. Teresa spent much of her youth taking care of her younger siblings. As soon as she got to be six, she had a younger baby on her hip. She never got to go to high school. And now her daughter is a refugee in El Salvador where her granddaughter is entering college. She is the first to access college in her family.

That’s a huge success! Congratulations.

Thank you.

In your own words, what has Turimiquire achieved over the last 25 years?

I’m proudest of our numbers because each number is a person whose life has been changed for the better. We’ve helped over 70 thousand women and their families with family planning, reached over 80 thousand young people with workshops about reproductive health. By now, we have provided over 20 thousand medical consultations and 15 thousand medical interventions. What allowed that to happen is our incredible medical and administrative staff and outreach people. And the wonderful support of all of our donors, who make this possible.

That’s impressive, especially nowadays, when so many nonprofits focused on reproductive rights have to cut their budgets and downscale their work. Do you have any final tips for readers in case they’d like to help empower women in marginalized communities and save nature?

First, think globally and act locally. I feel like so much can be done on a local level. There are so many small grassroots foundations that are living the realities of the people, working on a small budget and are very effective. I’d encourage funders to take a look at these small organizations.

Secondly, focus on where there is demand that can have a positive impact. There is not a demand especially in poor countries to consume less petrochemicals or drive less. People are struggling to have what they need in order to get ahead. But the demand for family planning is enormous. Women want control of their fertility. It’s their human right.

I believe that the big issue is to curtail involuntary fertility. People should have the children they want, that’s not the problem. The problem is that people are having children they don’t want to have because they can’t control their fertility.

Part of the problem is that in Europe and in the US, people don’t experience these problems. They don’t understand what it’s like for a 14-year old girl to be pregnant and be pregnant again in two years and have no choice in that matter. This is a very solvable problem through family planning.

Steven, thanks a lot for this interview and for being there for communities who are so often overlooked and who need as much attention, love and care as each of us.

Thank you for listening and sharing!