A REVIEW OF ADULT EDUCATIONAL HEALTH NEEDS IN VENEZUELA ANDTHE POSSIBLE USE OF INSTRUCTIONAL RADIO, TELEVISION, MDLTI-MEDIA AND METHODS TO HELP, ‘ , MEET THE DEFINED NEEDS Thesis for the Degree of Ph. D. MICHIGAN STATE UNIVERSITY JOSE FONTAN-PUEYO 1970 ’J‘M“ nu:- -'.v “A... *4. mg...- 1 1: 12?}? I 5.: 1:1, I E IIIIIIIIIIIIII IIIIIIIIIIIIIIII I “38:3; This is to certify that the thesis entitled A Review of Adult Educational Health Needs in Venezuela and the Possible Use of Instruc- tional Radio, Television, Multi—Media and Methods to Help Meet the Defined Needs. presented by Jose Fontan- Pueyo has been accepted towards fulfillment of the requirements for Ph. D. deg-33in Education ili’fl/(z / I L‘ .- o-nas i ABSTRACT A REVIEW OF ADULT EDUCATIONAL HEALTH NEEDS IN VENEZUELA AND THE POSSIBLE USE OF INSTRUCTIONAL RADIO, TELEVISION, MULTI-MEDIA AND METHODS TO HELP MEET THE DEFINED NEEDS BY Jose Fontan-Pueyo The study focuses on the application of radio and television and other media to help solve the needs of Venezuelan adult population, and selects population ex- plosion as an example to show how the systems proposed will work with other available resources to help solve those needs. The study presents the job of mass media in helping solve this particular problem of population explosion, as a vehicle to spread information and a sense of social rightness about the practice of birth control in order to gain social support of the community for the Family Plan- ning Program. In terms of media to be used, the study prOposes for the first year, the use of audiovisual materials such as charts, filmstrips, slides, and recordings covering vital health program information; for the second year, the Jose Fontan-Pueyo use of audiovisual materials and radio; and for the third year, the use of radio, audiovisual materials, and tele- vision. Different types of mass media forums are presented: radio, television, and "radiOphonic" (radio) schools of Latin America and their effectiveness in diffusing knowl- edge and changing attitudes. The present situation of the Venezuelan Broadcasting Systems, and the actual regulations for the establishment of educational radio and television stations, their maxi- mum and minimum possible power and frequencies are in- cluded. The study presents a program designed to be used by the preposed radio and television systems as a part of the total communication program on family planning. The program consists of a filmstrip, radio, and television scripts for the first unit to be presented with follow-up materials and related methods for other units of the pro- gram. These are the most relevant recommendations of the study: 1. To establish a pilot project for the use of media in a restricted basis for the first three years. 2. To use existing facilities and services, and/or establish an audiovisual center to provide educational materials related to birth control instruction. Jose Fontan-Pueyo 3. To establish radio broadcasting stations cover- ing the population of the Family Planning Centers of the pilot project area. The use of radio is recommended in two broad areas: General information and instructional education. Instructional radio lessons will be broadcast to: a. "RadiOphonic" schools b. Home-based audiences 4. To establish television stations covering the p0pulation of the Family Planning Centers of the pilot project area. The use of television for general informa- tion and education. Educational television lessons will be directed to: a. Television schools b. Home-based audiences 5. Extension of the television and radio systems to other parts of the country, after their second year of operations, and if the results of the evaluation research indicates the need of doing so. Television should be used mainly in urban areas where electricity and television sets are available, and radio in rural areas of the country where electrical power is less available and transitor radio receivers are much more common than television sets. A REVIEW OF ADULT EDUCATIONAL HEALTH NEEDS IN VENEZUELA AND THE POSSIBLE USE OF INSTRUCTIONAL RADIO, TELEVISION, MULTI-MEDIA AND METHODS TO HELP MEET THE DEFINED NEEDS BY Jose Fontan-Pueyo A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY College of Education 1970 ACKNOWLE DGMENT S The writer wishes to express his indebtedness to Dr. James L. Page, his doctoral committee chairman, for his personal interest, guidance and individual assistance in the conduct of this study. Sincere appreciation is also extended to other members of his guidance committee: Dr. Elwood E. Miller, Dr. Thomas F. Baldwin, and Dr. Charles A. Blackman for their continuous guidance through his doctoral program. Furthermore, the writer wishes to express his grati- tude to the Pan American Union for its help, and to offi- cials of the Venezuelan Government for making available documents pertinent to this study. Finally, the writer is very grateful to Dr. and Mrs. Manuel G. Diaz and all his friends for their moral support, and to his family for an understanding that knows no bounds. ii TABLE OF CONTENTS Page ACKNOWLEDGMENTS. . . . . . . . . . . . . ii LIST OF TABLES O O O O O O O O O O 0 O 0 v LIST OF FIGURES. . . . . . . . . . . . . Viii LIST OF APPENDICES. . . . . . . . . . . . ix Chapter I. INTRODUCTION . . . . . . . . . . . 1 Purpose of the Study . . . . . . . 8 Objectives. . . . . . . . . . . 8 II. POPULATION EXPLOSION, HEALTH NEEDS, AND AVAILABLE RESOURCES TO SOLVE THEM . . . . 12 Population Explosion . . . . . . . 13 Summary. . . . . . . . . . . 28 Population Explosion and Family Planning. 29 Demographic Aspect . . . . . . . 30 Health and Medico-Social Aspect. . . 31 Health Resources. . . . . . . . . 37 Health Needs Priorities . . . . . 47 Preliminary Considerations . . . . 52 Operational Relationships Between the Systems Proposed and the Family Plan- ning Programs. . . . . . . . . 57 First Year. . . . . . . . . . 58 Second Year . . . . . . . . . 60 Third Year. . . . . . . . . . 67 Summary. . . . . . . . . . . . 69 III. FAMILY PLANNING PROGRAM . . . . . . . 71 Proposed Units for an Educational Family Planning Program in Venezuela . . . 73 I. Filmstrip . . . . . . . . 75 II. Radio . . . . . . . . . 86 III. Television. . . . . . . . 97 Summary. . . . . . . . . . . . 110 iii Chapter Page IV. COMMUNICATION CHANNELS. . . . . . . . 111 Types of Mass Media Forums . . . . . 114 Radio Forums . . . . . . . . . 114 Radiophonic Schools in Latin America . 116 Television Forums . . . . . . . 123 Chinese Communist Study Groups . . . 125 Effects of Media Forums . . . . . 125 Venezuelan Broadcasting Regulations . . 126 Educational Broadcasting Stations . . 127 Radiophonic Schools of venezuela . . . 129 Summary. . . . . . . . . . . . 135 V. REVIEW AND RECOMMENDATIONS . . . . . . 136 Recommendations . . . . . . . . . 141 BIBLIOGRAPHY. O O O O O O O O O O O O O 151 APPENDICES . . . . . . . . . . . . . . 158 iv Table l. 10. ll. 12. 13. 14. 15. LIST OF TABLES Projection of the urban and rural population for 1961, 1965, 1970, 1975. . . . . . . Centers and rural population, 1961 . . . . Centers and urban population, 1961 . . . . Migration from rural to urban areas. . . . Typical city expansions, 1950—1961; and estimated in 1970 (in thousands). . . . . Population distribution by age and sex in 1961 and estimated June 30, 1970. . . . . Marriages and divorces by age, 1966. . . . Marital status, 1961. . . . . . . . . Number of born alive and rate per 1,000 popu- lation, 1961, 1964, 1965, 1966, 1967 . . . Number of births alive by the age of the mother, 1965, 1966 . . . . . . . . . Late foetal deaths and rate per 1,000 alive births, (28 weeks of gestation at least) 1963-67 0 O O O O O O O O O O C 0 Principal indexes of fecundity in Venezuela, 1963 O O O O O O O O O O C O O 0 Federal States per capita income 1958, and raw rate of births 1963. . . . . . . . Average of legitimate children per family by occupation of the father, 1963 . . . . . Percentage of legitimate and illegitimate live births, 1962, 1963. . . . . . . . Page 14 16 16 17 18 19 20 20 21 22 22 23 24 24 25 Table 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. Interviews in relation to the number of fathers in each of the 136 group of fami- lies by age of women. . . . . . . . . Deaths and death rates per 1,000 population, 1965-1969 a o o o o o o o o o o 0 Mortality rate per age in Venezuela and in the United States, 1965. . . . . . . . Life expectancy by age, 1961 . . . . . . Life expectancy for different periods . . . Fecundity survey of Caracas metropolitan area, 1963 . . . . . . . . . . . . Average of pregnancies of women according to their grade of instruction, Venezuela 1963 . Use of anticonceptive methods among Catholic women according to their reception of com- munion, 1963 . . . . . . . . . . . Methods of birth control in family planning centers of Venezuela, 1966-1969 . . . . . Number of hospitals in Venezuela, 1969. . . Number of medical doctors and population per M.D. in federal dependencies, Venezuela, 1969 . . . . . . . . . . . . . . Classification of Educational Broadcasting Stations by power and frequencies . . . . Radiophonic schools of Venezuela: Students and schools by states . . . . . . . The five first causes of death and death rates per 100,000 population, 1968, 1969 . . Rates of death by five diseases in Venezuela and the United States, 1965, 1966 . . . Number and rate of maternal mortality per 1,000 children born alive as compared with that of the United States vi Page 25 26 27 28 28 30 33 36 40 41 128 133 160 161 162 Table 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 47. 48. 49. 50. 51. Mortality per infectious diseases, 1969, 1968 . . . . . . . . . . . . . . Tuberculosis; deaths and rate per 100,000 population 1964-1969. . . . . . . . . Program for the control of R. Prolixus, 1969. Area of eradicated malaria in Venezuela, 1968 O O O O O C O O O O O C O 0 Synthesis of the plan for eradication of the AEdeS Aegypti, 1967-1968 0 o o o o o 0 Mortality caused by some diseases due in part to poor environmental sanitation in rural and urban areas, 1961 . . . . . . Activities to fight Ankylostomiasis in 1968 . Water supply for rural pOpulation, 1966 . Reports on deficiency diseases, 1965 . . . Minimum intensity power needed to cover primary zone . . . . . . . . . . . Minimum height of antennas on radiating posts for transmission on long wave bands. . . . Radio stations on amplitude modulation (AM) . Frequency gamut in megacycles for TV channels. . . . . . . . . . . . . Minimum broadcasting power needed to cover population areas . . . . . . . . . . TV Station: YVVA—TV Radio Caracas tele- vision . . . . . . . . . . . . . TV Station: YVXA—TV Venevision . . . . . TV Station: YVUA-TV color television (CVTV). TV Station: Televisora Nacional. . . . . TV Station: Ondas del Lago Television. . . TV Station: YVOX-TV Teletrece (Radio Valencia TV) . . . . . . . . vii Page 163 164 166 167 168 171 173 175 179 194 196 200 202 203 206 206 207 207 207 208 LIST OF FIGURES Figure Page 1. Urban and Rural Population Distribution of Venezuela . . . . . . . . . . . . 15 viii Appendix A. LIST OF APPENDICES Health Needs of the Venezuelan Adult Population . . . . . . . . . . . Venezuelan Broadcasting System Regulations. Distribution Map of the Radio and Televi- sion Stations and Schools of the Proposed Pilot Project in Venezuela . . . . . . ix Page 160 184 210 CHAPTER I INTRODUCTION The underdeveloped countries of Latin America are faced with many social problems. These major social prob- lems are in such areas as health, agriculture, community development aspects, better distribution and use of water, housing, nutrition, and education. In the area of education, illiteracy is becoming in- creasingly grave. About 50 million people in Latin America, 15 years old and over, are illiterate, and taking into ac- count that the average adult population is of third grade education, the whole picture shows that Latin America is an uneducated society. The illiteracy index has drOpped for the Latin Ameri- can region by 2 percent from 1950, that is, from 20 per- cent to 18 percent, but the number of absolute illiterates has increased by 10 percent, or five million additional illiterates. Out of the total Latin American population of 48 million pupils between 7 and 14 years old, only about 33 million are registered in elementary schools. And yet, according to statistics, only about 20 percent of these will complete their elementary school education. Considering that the present annual growth is 3 per- cent, the Latin American population will be doubled in 25 years. Thus the illiteracy problem will become increas- ingly depressing. On the other hand, of the 200 million people, only 0.8 percent of the adult population, that is, 1,607,102 were registered in elementary adult education in 1962. In Venezuela alone, the percentage of illiteracy was 17 percent for those 14 years old and over, and only 9 per- cent in the total population of 8,722,212 million in 1962. Thus, the whole picture seems to indicate that with the present actual system of education, it will be difficult to eradicate illiteracy in the region during the present century.1 The heads of the American States during their meet- ing at Punta del Este, Uruguay, in 1967, recognized that education should be in a high priority in the policy of development of Latin American countries. Although they were aware that there has been improvement in education during the last 10 years in their countries, they also admitted that they need to increase the efficiency of national efforts for education, and that their national systems of education should fit the economic, social, and lFelix Adam, Educacion de Adultos (Caracas, Vene- zuela: Oficina‘de Educacion de Adultos, Ministerio de Educacion, n.d.). cultural needs of their countrymen. In accordance with those beliefs, they issued a resolution urging the improve- ment of the planning and administration of educational sys- tems in order to increase the level of education, and to give priorities to those activities related to the eco- nomic, social, and cultural development. So, they agreed to orient and restructure their educational systems in order to achieve, among other things, the security and en- largement of the programs of adult education.2 The heads of the American States also recognized in the same meeting that the improvement of health conditions among their peOple is basic for the social and economic de- velopment of Latin America. And for primary objectives they have the following: to eradicate disease among their population; to supply water and sanitary services to urban and rural areas of population of low income; to improve nutrition in poor areas, to increase programs of children's care and family orientation methods. There is need for another kind of education in addi- tion to the effort to eliminate illiteracy in Venezuela, according to George W. Hill. This education should be in every practical aspect of agriculture, in the improvement and care of the peasant's home. It should be focused on 2Union Panamericana, Reunion de Jefes de Estado Americanos, Punta del Este, Uruguay, 1967 (Washington, D.C.: Secretaria General de la Organizacion de los Estados Ameri— canos, 1967). the improvement of their standard of living. There is a need to teach Venezuelan peasants pediatric care aimed at reducing the infant mortality rate; cardiac care and tumor detection, to combat the country's first and second largest cause of death; dental care; nutrition; infectious dis- eases, and malaria eradication campaigns to prevent fresh outbreaks in parts disinfected; environmental sanitation, better housing and sanitary facilities, and better distri- bution of water; saving and buying goods; community de- ve10pment aspects; and organization of cooperatives in rural and urban areas.3 The Inter American Committee on the Alliance for Progress (CIAP), Subcommittee on Venezuela, in its study report recommended that in order to alleviate the social problems of the country it should propose a series of goals and policies to be pursued by the public sector and to be included in the National Plan for 1965-68.4 In the health section, the Plan aims to set up pro- grams to achieve a series of specific targets, all of them 3George W. Hill, et al., "La Vida Rural en Venezuela, Revista Venezolana de Sanidad y Asistencia Social, 24 (January-February, 1959), No. l and 2. 4Inter American Committee on the Alliance for Pro- gress (CIAP), Subcommittee on Venezuela, Domestic Efforts and Needs, External Financing for the Development of Venezuela (WaShington, D.C.: Pan American Union, 1967). aimed to 5 improve the living conditions of the population. The Plan sets the following goals: 1. In the field of environmental sanitation, con- struction of aqueducts, sewerage, and sanitary services, and the elimination of environmental factors that cause diseases. In housing, programs for meeting needs in urban and rural areas by both the public and private sectors. In nutrition, creation of nutritional programs, especially pre-school, and dental and pediatric care programs. Provide for the construction of hospitals and medical buildings, and medical schools for more adequate supply of personnel and equipment materials. In education, the Plan calls for reducing the level of absenteeism in elementary schools, and aims for an adult literacy campaign in order to lower the illiteracy rate of the population aged 14 and over.5 These goals are similar to the goals of the Ministry of Health and Social Assistance (SAS), and the Ministry of Agriculture and Livestock (MAC), the Ministry of Education, 5 CORDIPLAN, Plan de la Nacion 1965-1968 (Caracas: Oficina Central de_500rdinacion y PIanificacion, 1967), pp. 11-23. and other institutions and organizations of the Federal Government of Venezuela, and their programs for rural and urban areas of adult population of the country. The effort made by Latin American countries to im- prove education among their people has not adequately come to grips with the problem. There certainly has been in- creasing enrollment in school pupils, number of classrooms, and teachers, but that improvement has been diminished by the fast increasing rate of population growth, by the high level of school dropouts, and by budget limitations. So far, the effort made to reduce the illiteracy prob- lem of Latin American adult population has been ineffi- cient. According to Adam, one cause of the failure of the adult education is the fact that it is not an integrated system, that is, a system that covers all levels of educa- tion and one that emphasizes education for the development of the country offering all kinds of opportunities to satisfy the needs of the adult population. Many times, adult education has been something synonymous with literacy teaching, ignoring vital needs of the students, giving them education against their interest and against the socio- economic realities of their countries.6 A sincere effort to solve the problem of Latin Ameri- can adult education has been made by the radio schools. 6AdaIm, op. cit., p. 7. 7 The fundamental purpose of the radio schools in Latin America is basic education to reduce illiteracy in rural areas. The Sutatenza Radio Schools of Colombia, have disseminated to many Latin American countries information about radiophonic (radio) schools and how they can be made to work among their respective people. The idea of radiophonic teaching has been caught in Latin American countries, and today every one of them can boast of its own radio schools. Some Latin American countries, like Peru,7 have found that television appears to be achieving its best results in providing fundamental education to a number of adolescents who have drOpped out of high school at an early age and who have become domestic servants. In view of the experience of the use of radio and television not only in Latin America, but also in other countries of the world, as will be shown later in this study, and knowing their effectiveness as well as their weaknesses, the present study will focus on the use of radio and television in cooperation with other available resources to help solve the identified needs of the Vene- zuelan adult population. 7Jack Lyle, et al., "La Telescuela Popular Americana de Arequipa, Peru.“ New Educatignal Media in Action: Case Studies for P1anners--II. Paris: UNESCO, 1969. Purpose of the Study This study will be focused on the application of radio and television and other media to meet the needs of the Venezuelan adult population. It will prOpose an in- structional radio and educational television and multi- media system to help solve, with other resources available in the country, the Venezuelan adult population needs. An example of a health problem, namely population ex— plosion, will be presented to illustrate how the media systems proposed can be used with other available health resources of the country to help solve this particular problem of population explosion. Objectives The objectives of the present study will be to show: That the instructional media systems pr0posed can help educate the adult population of venezuela by provid- ing them with related good information; That the population explosion problem and other health needs can be improved by the dissemination of sound information through the instructional radio and educational television systems proposed; That other related needs of adult venezuelans can also be improved by using the same communication systems; That population explosion constitutes one of the most important and urgent problems of the adult population of venezuela, that should be solved by all available means; And thus, the population explosion problem will be presented as an example to illustrate how the media sys- tems proposed can be used with other available health re- sources of the country to help solve this particular prob— lem of population explosion, and by the same token, other needs of the Venezuelan adult population. This study will show: Why the solution of pOpulation explosion and other health needs are so important for improvement of the physi- cal, moral, and mental health of the adult population of the country; Why many adult people are victims of these problems due to lack of relevant information; Why the systems proposed can become a meaningful in- strument to help solve such problems; and Why, by the same reason, the same proposed systems will also be useful to help solve other related needs of the Venezuelan adult population. The study will also show: Some available health resources of the country and how the systems porposed can cooperate with those re- sources on the solution of population explosion problem and other needs of the adult population. Means of feedback, such as questionnaires, quizzes, evaluation sheets, mail, short-wave radio, telephone, and 10 other devices will be proposed to assure the educational impact of the systems proposed. An important point to be taken into consideration in the design and broadcast of health education programs is the central control of the educational health materials exercised by the Ministry of Health and Social Assistance (SAS), which will produce programs that will be centrally relayed under the close supervision of the Ministry of Health and Social Assistance (SAS). This study will also show that the same system or combination of systems can help solve other related needs of the Venezuelan adult population. The aim of this study is not to review all needs of the adult population of Venezuela. It will examine popu- lation explosion as an example of a health need and pro- pose a program of operational procedures in order to show how proposed programs using instructional media can help solve the population explosion problem as well as other related needs of the venezuelan adult population. It is hOped that the study would indicate basic considerations and necessary procedures to successfully comprise communication programs about: 1. Specific target audiences 2. Definition of audiences 3. Definition of objectives and learning situations ll 4. Appropriate ways and means in adopting communi- cation programs, and 5. Evaluation programs. CHAPTER II POPULATION EXPLOSION, HEALTH NEEDS, AND AVAILABLE RESOURCES TO SOLVE THEM There are many health problems in Venezuela. A study of the health problems of the Venezuelan adult population reveals that there are five main areas of special concern. These areas are: environmental sanitation, infectious diseases, nutrition, population explosion, and the many causes of mortality. It is not the aim of the present study to explain in detail each and every one of the five areas, but because it is understood that such information might be useful, a review of these health problems is to be found in a special section of Appendix A. For purposes of this study, however, one health related area, namely population explosion, has been selected. This chapter analyzes the population explosion situation in vene- zuela and presents evidence that there exists such a prob- lem, and that indeed, it is grave in its health and social consequences. The chapter also presents available health resources and ways such resources are used by the govern- ment and other private agencies to solve such health prob- lems. 12 13 The available resources of the country are not enough to solve population explosion and other health problems, and thus, the use of the media systems is proposed to help solve these health needs. The present study does not basically intend to analyze population explosion and its consequences especially upon health, but it uses the population explosion problem to illustrate how the media systems proposed can work with the health resources in the solution of the population ex- plosion problem. The same general principles presented for the solution of population explosion problem can be applied in the treatment of other health and social needs of the Venezuelan adult population. Population Explosion The last two censuses taken in Venezuela show the following population information: Census VIII taken November 26, 1950: 5,034,838 population--Census IX taken February 26, 1961: 7,523,999 population, and the population projection estimated in June 30 of the years shown on Table 1. In 1963 Venezuela had a raw rate of increase of 43.4 per 1,000 which represents an annual rate of pOpulation increase of 3.6 per cent, and 3.5 for the whole period 1963- 1967.1 1United Nations, Demographic Yearbook 1968, p. 106. 14 TABLE 1.--Projection of the urban and rural population for 1961, 1965, 1970, 1975.* I ** *** Year Total Urban Rural Population Total % Total % 1961 7,523,999 5,078,624 67.5 2,445,375 32.5 1965 8,722,212 6,240,544 71.55 2,481,668 28.45~ 1970 10,398,907 7,874,763 75.73 2,524,144 24.27 1975 12,433,970 9,866,623 79.35 2,567,347 20.65 * Venezuela, Ministerio de Fomento, Oficina de Analisis Demografico, Proyeccion de la Poblacion Urbana y Rural de Venezuela Y de sus Ciudades mas Importantes, Caracas, 1964, p. 20. ** Urban: centers of more than 1,000 population. *** Rural: centers under 1,000 population. The population is distributed in the following areas of the country: along the North Coast and the Andean mountains which is 19.6 per cent of the area of the country live 78.0 per cent of the Venezuelan population; and in the Central Plains and in the South Guayana Region which is 80.4 per cent of the total area of the country live only 22.2 per cent of the total population2 (Figure I, p. 15). An important factor related to health needs is the dispersion of the population. This population dispersion is characterized in Venezuela by people living isolated or in centers of less than 1,000 population. In 1961, such 2Levi Marrero, Venezuela y sus Recursos, Cultural Venezolana S.A., Caracas, 1964, p. 241. 15 a lade- oau goo ‘- 33.3: cc 3639 one: .a .030!— gm none-0.38 05.x— aoom 9 2553233: ..oum wwwuwwm can» 9.3. ' ..--- o» «so u. .5... 68an" 3 "8593" "HAS. 8 8 3 «8. o as!" gum” 3 n8. 0 "not 80.~ o» 08; o SEEExfifia mHIDmflmmH O.m0h_¢¢w.r ggggt Inn» .. 'g" 8 D: ‘011‘.’ ‘1'-.- uofi ..i‘ool’ we... . . ( JIII. l/lsmrh. .0 .. .o . .....o..... omau mo GOADSQHHumHQ cofluwasmom Henna one cmnHDII.H ondmwm - o . V 16 dispersed population comprised about 1/4 of the total popu- lation according to Tables 2 and 3. * TABLE 2.--Centers and rural population, 1961. Groups Centers Population % Dispersed 97,256 1.3 Less than 50 Popul. 11,101 287,242 3.8 From 50 to 99 5,497 390,512 5.2 From 100 to 199 4,157 583,607 7.7 From 200 to 499 2,372 696,880 9.3 From 500 to 999 567 389,878 5.2 TOTAL 23,697 2,445,375 32.5 * Venezuela, Ministerio de Fomento, Direccion Nacional de Estadistica y Censos Nacionales, IX Censo Nacional de Poblacion, Caracas, 1962, p. 11. * TABLE 3.--Centers and urban population, 1961. Groups Centers Population % From 1,000 to 1,999 217 287,902 3.8 2,000 to 2,499 39 85,434 1.2 2,500 to 4,999 103 365,716 4.9 5,000 to 9,999 51 352,600 4.7 10,000 to 19,999 33 437,749 5.8 20,000 to 49,999 24 765,386 10.2 50,000 to 99,999 11 762,879 10.1 100,000 to 199,999 3 498,645 6.6 200,000 to 499,999 421,166 5.6 500,000 and more 1 1,101,147 14.6 TOTAL 483 5,078,624 67.5 * l 0 Venezuela, Ministerio de Fomento, Direcc10n Nac10nal de Estadistica y Censos Nacionales, IX Censo Nacional de Poblacion, Caracas, 1962, p. 12. 17 The urbanism phenomenon, that is, the fast growth of urban population from the rural population is a universal phenomenon, but in Venezuela the rate of growth is greater than the world average. In 1936, about 65 per cent of the total population of the country were living in rural areas, in 1961 about 32.5, and in 1970 about 24.27 per cent (Table 1). See Table 4. * TABLE 4.--Migration from rural to urban areas. 1950-1961 792,000 Population 1961-1970 805,000 Population (estimated) * Julio Paez Celis, "Explosion Demografica en el Caso de Venezuela," in Revistg;Venezolana de Sanidad y Asistencia Social, Vol. 31, No. 3, Caracas, September, 1966, p. 521. As a result of the population increase and rural migra- tion to urban areas, several cities have doubled their popula- tion during the last ten years with serious slum problems without appropriate health services as shown in Table 5. Table 6 shows that about half of the pOpulation is under 14 years old. In 1961, each person potentially active had to sustain 194 persons including himself. In the United States in 1950, the index was 155.3 The economically active population in 1961 was about 47.7 per cent of the total popu- lation; 76.5 per cent were men and 18.0 per cent women.4 3L. A. Angulo-Arvelo, Jorge Arevalo, Julio Paez Celis and Jose B. Leon 0., "Composicion de la Poblacion Venezolana," in Revista Venezolana de Sanidad y Asistencia Social, Vol. 31, No. 3, Caracas, September, 1966, p. 485. 4 IX Censo Nacional de Poblacion, Caracas, 1962. 18 'I: TABLE 5.--Typica1 city expansions, 1950-1961; and estimated in 1970 (in thousands). Percentage 1970 City 1950 1961 Gain Population Maracaibo 235 421 79.1 690 Cabimas 42 93 121.4 155 San Carlos del Z. 7 14 100.0 San Cristobal 54 99 83.3 157 Barquisimeto 105 200 90.5 282 Valencia 89 164 84.3 225 Maracay 64 135 110.9 193 Caracas Met. Area 694 1,336 92.5 2,176 Acarigua 16 31 93.7 46 8. Juan de los M. 14 37 164.2 43 Puerto La Cruz 28 59 110.7 82 Maturin 25 54 116.0 97 Ciudad Bolivar 31 64 106.4 110 *John Friedman, "Economic Growth and Urban Structure in Venezuela," in Ekistics, Vol. 17, No. 102, May 1964, p. 320. And the estimated for 1970 is taken from Prgyeccion de la Poblacion Urbana y Rural de Venezuelagy sus Ciudades mas Importantes, OfiCina de Analisis Demografico, Caracas, 1964, pp. 57-58. About half of the female population are not married, but they have children. And this leads to grave consequences especially today when there is a low mortality rate. When a woman starts to reproduce at 15 years old, without the use of contraceptives, she can have an average of 12 children, but, taking into consideration that many of the women start .wmnmm .om .mmma .mmomumo .maoSNocm> mo coflowaoom Ma mo cowoouwoum .moamcoflomz mOmcoU % coaumflowumm on Homecoo c0flooouflo .maosnm:o> fl l9 hom.mmm.oa m¢~.HNH.m mmm.hhmam hmm.mam.h mmm.mv>.m vammmm Reece www.mma mmm.maa mmm.mh mom.mma mmb.mh onamw +Io> mna.mma www.mm www.mm Hmb.~m N¢H.vv mmmmm mmlmm Hmh.mna oam.mm HHH.om Hma.mma www.mh mmmwm velom omh.mmm Hmm.hma mam.ama mmm.HhH vom.mw mmmmm mmlmm omh.vom emm.vea mmh.mma Hom.H~N Hmm.moa oaomaa vmlom Hum.v>m mmw.mha mvm.mma oma.mmm mma.mva Hoomma vamv eva.w>¢ mmm.mmm mvo.mvm th.mmm omH.mmH «mused velov www.mmm mmo.mmm mmm.mum mmh.oHv omo.mmH mmmvam mmlmm ham.mmm vmm.mmm mmv.mmm mew.oam mou.vv~ onmmom vMIom HmH.mhm vmo.~vm hmo.mmm omm.mmm mmm.on~ mhmhmm mmlmm omm.amm ~mn.omv wmo.amv www.mmm vom.mom Nmmmam vmlom vmn.mmo~H www.mmm 5mm.mmm mmmaomh oma.vmm mmmwmm mHImH oav.>wm.a 5mm.o~m mam.mvm who.HHm www.5ve mmvmmw vauoa mwm.mvm.a Hom.mmh mmo.vmh bmm.vea.a oao.hmm hampmm m Tm oma.mmm.H www.mvm Hom.mmm oaa.mmm.a omm.mmm mmvmmm v To Hmuoe onEom mam: Hopoe mHmEom was: 0 $4“ onma Hmma ..osma .om mass ooumfiflumm one Homa ca xom com won an coflusofluumflo coflumHsmomII.m mam<9 20 * TABLE 7.--Marriages and divorces by age, 1966. Marriages Divorces Age Bridegroom Bride Husband Wife —15 27 2,851 15-19 4,361 18,677 3 98 20-24 17,376 14,528 109 371 25-29 13,220 6,636 388 531 30-34 6,435 3,385 436 396 35-39 3,911 2,375 427 271 40-44 2,471 1,522 258 155 45-49 1,551 981 172 77 50-54 1,103 514 91 42 55-59 745 305 49 24 60- + 927 305 46 11 Unknown 2 23 274 277 TOTAL 52,102 52,102 2,353 2,353 * United Nations, Demographic Yearbook 1968, p. 518. * TABLE 8.--Marital status, 1961. Male Female Status Number % Number % Singles 963,775 46.5 766,450 37.8 Married 695,725 33.5 689,650 34.0 Common-Law 368,625 17.8 412,250 20.4 Widowers 35,025 1.7 138,100 6.8 Divorced 9,950 0.5 19,975 1.0 Undiclared 28,525 25,225 TOTAL 2,101,625 100.0 2,051,225 100.0 * IX Censo Nacional de Poblacion and Ministerio de Fomento, Memoria y Cuenta 1962, Caracas, Venezuela. 21 to reproduce at 12 and 13 years old, and with an expectation of a lifetime of 66.0, the situation is indeed critical.5 We may see from Table 8, that there is a difference between the numbers of couples living by common-law. The statistics showing the status of the females is more reliable than those showing the status of the males because according to some studies many men prefer to declare themselves as single, because of the social sanctions. Many Widowers marry again after the death of their partners. There is correla- tion between local residence areas and level of instruction with respect to couples living by common-law, such situations are more frequent in rural areas and among people of low education. The Venezuelan population is increasing at about 3.5 per cent annually. This is because the rate of birth is very high, about 42 per 1,000, and the rate of mortality is very low, about 7.0 per 1,000. The result has been a young population. See Table 9. TABLE 9.--Number of born alive and rate per 1, 000 p0pulation, 196l,1964,1965,1966, 1967.* ‘ Year 1961 1964 1965 1966 1967 ¥ Number 344,989 365,340 379,530 376,367 406,468 Rate 45.3 43.4 43.5 41.7 43.5 __ * United Nations, Demographic Yearbook, 1968, p. 336. ¥ 5Hernan Quijada, "Aspectos de la Psicologia Social en Venezuela," in Revista Venezolana de Sanidad y Asistencia §2§$§1_,Vol. 31, No. 3, Caracas, September 1966, p. 579. 22 TABLE lO.--Number of births alive by the age of the mother, 1965, 1966. Age 1965 1966 less than 15 1,004 915 15-19 53,720 54,635 20-24 107,200 106,236 25-29 94,687 93,443 30-34 62,196 60,719 35-39 43,127 43,017 40-44 12,206 12,382 45-49 2,478 2,439 50 + 225 207 Unknown 2,617 2,374 TOTAL 379,530 376,367 * United Nations, Demographic Yearbook, 1968, p. 347. TABLE 11.--Late foetal deaths and rate per 1,000 alive births, (28 weeks of gestation at least) 1963-67.* Year 1963 1964 1965 1966 1967 Number 6,903 7,199 7,568 7,733 7,807 Rate 19.5 19.7 19.9 20.5 20.2 * United Nations, Demographic Yearbook, 1968, p. 357. In the Maternity Concepcion Placios of Caracas, from 1959 to 1964 the foetal mortality was 53,000 out of 255,003 pregnant women attended. Out of 100 pregnancies, 78 children were born alive and 22 deaths. Outside the Caracas area, out of 84,577 pregnant women, 93 per cent were born alive and 23 TABLE 12.—-Principa1 indexes of fecundity in Venezuela, 1963. Age Fertile Women Number of Fertility Births Rate per 1000 15-19 392,537 49,957 127.26 20-24 324,897 104,087 320.36 25-29 281,655 88,138 312.92 30-34 253,215 59,395 234.56 35-39 214,278 38,580 180.04 40-44 170,131 10,870 63.89 45-49 146,577 1,519 17.18 TOTAL 1,783,290 353,546 1,256.21 Total rate of fecundity: 6.28 Raw rate of reproduction: 3.08 Neat rate of reproduction: 2.74 Raw of general fecundity per 1,000 women: 198.25 Raw birth-rate: 43.4 Rate of increase: 3.6 per cent. * Fayad Camel Vargas, "Natalidad y Fecundidad en vene- zuela," in Revista Venezolana de Sanidad y Asistencia Social, Vol. 31, No. 3, Caracas, September, 1966, p. 409. 7 per cent dead. In 1964, there were 300 abortions for each 100 children born dead.6 We may see that fertile women of all ages contribute actively to the actual demographic expansion of the country. From these data (Tables 13, 14) we may conclude that the rate of births decrease as the income of the population increases. 6Quijada, op. cit., p. 599. 24 TABLE 13.—-Federal States per capita income 1958, and raw rate of births 1963.* ** Income In Bs. Population Births Raw Rate of Births Venezuela 8,143,629 353,546 43.6 -1000 (a) 2,076,106 100,056 48.2 1000-1499 (b) 663,753 33,034 49.8 1500-1999 (C) 1,277,848 59,129 46.3 2000-3999 (d) 746,666 31,878 42.7 4000-4999 (e) 3,379,256 129,456 38.3 * Fayad Camel Vargas, "Natalidad y Fecundidad en Venezuela," in Revista Venezolana de Sanidadgy Asistencia Social, Vol. 31, No. 3, Caracas, September, 1966, p. 417T **The Bolivar (Bs.) worth about $0.22. (a) States: Lara, Merida, Nueva Esparta, Sucre, Tachira, Trujillo. (b) Apure, Cojedes, Portuguese, Yaracuy, Amazonas, Delta Amacuro. (c) Barinas, Bolivar, Falcon, Guarico, Monagas. (d) Aragua, Carabobo. (3) Anzoategui, Zulia, Distrito Federal and Miranda. TABLE 14.--Average of legitimate children per *family by occupation of the father, 1963.* Father's Occupation Average Children Per Family Professionals and Technicians 2.91 Managers, Administrators and Directives 3.75 Office Workers 2.86 Salesmen 2.90 Farmers and Hunters 5.24 Mine Workers 4.59 Drivers 4.12 Craftsmen and Factory Workers 3.80 Other Craftsmen and Working Men 4.17 *Fayad Camel Vargas, "Natalidad y Fecundidad en Venezuela," in Revista Venezolana de Sanidad y Asistencia Social, Vol. 31, No. 3, Caracas, September, 1966. 25 TABLE 15.--Percentage of legitimate and illegitimate live births, 1962, 1963.* Year Total Legitime Illegitime % Illeg. 1962 341,324 158,693 182,631 53.5 1963 353,546 163,619 189,927 53.7 * United Nations, Demographic Yearbook, 1965, p. 524. This table shows the precocity of the sexual life of the Venezuelan women and the low diffusion of anticonceptive practices among them. A study in Apure State among 136 family groups7 is shown in Table 16. TABLE 16.--Interviews in relation to the number of fathers in each of the 136 group of families by age of women. Number of Age of Women fathers in each family 20-29 30-39 40-49 50-59 Total No. % No. % No. % No. % No. % 20 14.70 21 30.14 24 17.64 3 2.20 88 64.68 7 5.14 28 20.58 7 5.14 3 2.20 45 33.06 3 2.20 3 2.20 TOTAL 27 19.84 72 52.92 31 22.78 6 4.40 136 99.94 In many cases the interviewed females lied by reducing the number of fathers of their children. Polyandry is appar- ent in 33.06 of the cases and is clear in 2.20 per cent. If polyandry increases among 30 and 39 year olds, and since at 7Quijada, op. cit., p. 601. 26 present 64.68 per cent of the sample population is between 20 and 29 years old, the probability is that polyandry will increase. The low mortality rate (Table 17) is influenced by the fact that the Venezuelan pOpulation is predominantly young (Table 18). This fact has influenced, at the same time, the high level rate of births (Table 9). TABLE l7.--Deaths and death rates per 1,000 population, 1965-1969. Year 1965 1966 1967 1968 1969* Number 60,857 61,521 62,083 64,572 65,462 Rate 7.1 7.0 6.8 6.9 6.9 * Ministerio de Sanidad y Asistencia Social, Memoria_y Guenta 1969, Caracas, 1970, p. 182. The mortality rate of children under 5 years old accounts for 40.2 per cent of the total pOpulation. The mortality rate is higher for children of less than 1 year old, 28.1 per cent. There is a Clear margin for the increase of mortality rates for age groups of less than 45 years old if we compare these groups with those of the same age of the United States. A study of the causes of death among those groups will help to orient a sound health action to reduce the mortality rate among such groups. From Tables 19 and 20 we may appreciate that the ex- pectancy of life in general has increased during the last few years, which reflects better health conditions. 27 TABLE 18.--Mortality rate per age in Venezuela and in the United States, 1965. Age Venezuela United States Less 1 Year 28.1 4.9 l - 4 12.1 0.9 5 - 9 2.6 0.5 10 - 14 1.4 0.4 15 - 19 1.6 0.6 20 - 24 1.6 0.6 25 - 29 1.8 0.6 30 - 34 2.0 0.9 35 - 39 2.7 1.4 40 - 44 2.7 2.2 45 - 49 2.9 3.1 50 - 54 3.9 4.3 55 - 59 3.8 5.5 60 - 64 6.1 7.1 65 - 69 4.6 9.6 70 - + 22.2 53.7 *Pan American Union, America en Cifras 1967, Situation ngografica: EstudiogyfiMovimiento de la Poblacion, Union Panamericana, Secretaria General de la OEA, Washington D.C., 1968, pp. 111, 105. 28 * TABLE 19.--Life expectancy by age, 1961. Age Expect. Age Expect. 66.41 45 30.34 68.75 50 26.25 10 66.34 55 22.52 15 61.76 60 18.86 20 57.02 65 15.85 25 52.38 70 13.03 30 47.84 75 10.55 35 43.33 80 8.16 40 38.88 85 6.49 * United Nations, Demographic Yearbook,.l968, pp. 436-37. * TABLE 20.—-Life expectancy for different periods. 1950-1951 1960-1962 1964 1967 58.0 66.1 65.8 66.0 * R. Bernieri, "La Situation de la Sante au Venezuela et quelques orientations pour 1'action sanitairef‘in Annales de la Societe belge de Medicine tropicale, Vol. 48, No. 3, 1968, p. 351. Summary One crucial aspect of the problem of population in Venezuela is the dispersion of population. About 1/4 of the total population live isolated in remote areas or in centers of less than 1,000 population. This fact makes the improve- ment of health needs by ordinary means increasingly difficult. 29 On the other hand, migration from rural to urban areas has caused the fast growth of urban population and has doubled the population of several cities during the last ten years. Serious slum problems have resulted. The population explosion of Venezuela is due to differ- ent factors: the precocity of the sexual life of Venezuelan women who begin to reproduce in the early teens, who are either married, live in common-law marriages or are single. There is also a low diffusion of anticonceptive practices among the many low income people. One result of this sexual activity and lack of contra- ceptive methods is the increasing number of illegitimate children, 53.7 per cent of the total 353,546 children born in the country in 1963. This fact, and the low mortality rate, about 7.0 per 1,000, has influenced the high level rate of births, 43.5 per 1,000, in 1967. Both factors have caused the Venezuelan population to be predominately young. About half of the total population is less than 14 years old, which has increased the burden of each person potentially active who had to sustain about 194 persons including himself in 1961. Population Explosion and Family Planning The present situation and future trends of population explosion and family planning in Venezuela are as follows. 30 Demographic Aspect There are reasons to believe that the problem of popu- lation explosion which is grave in so many countries, has extreme gravity in Venezuela. Although the several arguments exposed above prove that the demographic explosion of Venezuela is extremely grave, the historic trend of the Venezuelan family is show- ing marked inclination toward voluntary birth control. There are additional facts proving such inclination: urbanization, use of apartments, continuous increase of general level of life and education, knowledge of more effective techniques TABLE 21.--Fecundity survey of Caracas metropolitan area, 1963.* Method Not Not ** Have Been In No Known Used Used Use Answer Douche 251 773 132 202 23 Sterilization 251 1,025 0 80 25 Diaphragm 700 592 27 33 29 Jelly 1,026 294 19 10 32 Oginnus 527 574 109 141 30 Condom 271 664 160 260 26 Withdrawal 479 571 110 193 28 Pill 1,305 37 12 4 23 Others 1,305 36 10 5 25 *Julio Paez Celis, op. cit., p. 523. **Known, but not used. 31 to avoid pregnancy, feminine work, etc., which show the need and inclination to foment birth control.8 The trend and the convenience of birth control or family planning is positive. Those who believe State pro- grams encouraging birth control will include: (1) help to control or diminish abortion, (2) help to increase the edu- cational level of the peOple and reduce excesive population growth, (3) temper the attitudes of people to accept the appropriate action conducting to healthy family life sup- porting the birth control programs.9 Health and Medico-Social Aspect Four fundamental functions constitute the modern family planning: contraception, fecundity promotion, detection of pathologic processes, and education. Birth Control in Venezuela: A. Population Attitude: In Venezuela there exists voluntary birth control in 10 That is proved by: increasing numbers. 1. Differential Fecundity: A fecundity survey in Caracas Metropolitan Area conducted by the Demographic Analy- sis Office of the Direction of Census and Statistics of the 8Julio Paez Celis, op. cit., pp. 522-26. 9Julio Paez Celis, op. cit., p. 524. 10L. A. Angulo-Arvelo, "Actitudes ante la Fecundidad en General y Particularmente en Venezuela," in Revista Venezolana de Sanidad y Asistencia Social, 31, 1966, p. 616. 32 Ministry of DeveIOpment in collaboration with the Demographic Latin American Center, and from other studies, shows that the level of fecundity decreases as the cultural and economic level of pOpulation increases (Tables 14 and 22). TABLE 22.--Average of pregnacies of women according to their grade of instruction, Venezuela 1963. Grade of Instruction Average of Pregnancies Without Studies 5.86 Primary Instruction Incomplete 4.62 Primary Instruction Complete 3.51 Secondary Instruction Incomplete 3.05 Secondary Instruction Complete 2.84 University 2.20 *L. A. Angulo-Arvelo, "Actitudes ante 1a Fecundidad en General y Particularmente en Venezuela," in Revista Vene- zolana de Sanidad y Asistencia Social, 31, 1966, p. 617. 2. Attitude of Women: The same survey shows that, between 40 and 70 per cent of women practice birth control, and that birth control is higher in high socio—economic classes than in lower classes. A study by Oscar Aguero among 1,021 patients from the Maternity Concepcion Palacios of Caracas, and 308 patients attending private clinics, shows that 90 per cent of private patients practice birth control, and from the Maternity Concepcion Palacios group with an average of 6.1 pregnancies, about 14.7 per cent practice birth control and 77.5 per cent "do not want to have more 33 children, they want to know about more efficient methods of birth control."11 Religious practices seem to have no relationship with attitude about birth control according to the following Table 23. TABLE 23.-~Use of anticonceptive methods among Catholic women according to their reception of communion, 1963.* Reception Frequency % Women Using Birth Control of Communion Caracas Bogota Mexico One or more times a month 56.7 39.9 34.8 Less than once a month 64.2 37.7 34.8 Never 54.8 49.7 39.5 *Miro-Rath, "Preliminary findings of comparative ferti- lity surveys in three Latin American countries, Annex, Table 14," in Perez Ramirez, Gustavo, La Iglesia Catolica y La Planificacion Familiar, Asociacion Colombiana para el Estudio Cientifico de la Poblacion, Bogota, Colombia, 1965. The bishops of Venezuela in a Pastoral Letter reject any kind of drastic imposition of birth control by the state. They explicitly condemn abortion, sterilization, and utiliza- tion of compulsive methods to impose birth control. Speaking against illegitimate children, they recognize that "the state has the obligation to oppose uncontrolled and anarchical increase of illegitimate children." They also llAngulo-Arvelo, op. cit., p. 619. \ 34 say that the state should see that the needy, especially Catholics, receive appropriate information and education about those methods permissible by the Christian doctrine. They conclude that, "in a pluralistic society like Venezuela, where there are non-Catholics and non-believers, the state institutions can give information about other birth control methods to those who are determined to use any other method according to their own conscience."12 3. Use of anticonceptives: Studies conducted by the Population Division of the Ministry of Health and Social Assistance (SAS) in collaboration with the Pharmacy DiVision, the Pharmacy Industry Chamber, and houses delivering pharmacy products of Venezuela, agree with the above findings and also prove that birth control practices show a definitive tendency in increase.13 4. Clandestine abortion: There exists an increasing attitude against unwanted pregnancies among Venezuelan pOpula- tion (Table 11), which also determines the existence of different kinds of antinatalistical attitudes. B. Official Attitude: Venezuela in 1964 reported to the United Nations that it "considered population increase, in general, as a positive 12Pastoral Letter of the Catholic Bishops of Venezuela, La Religion, Caracas, November 23, 1969. 13 Angulo-Arvelo, op. cit., pp. 619-22. 35 factor in economic development,"14 early in 1965 established a Department of Population in the Ministry of Health and Social Assistance (SAS), early in 1966 held a large con- ference on population problems and public health, and in 1967 played a host and cosponsor for the Organization of American States Population Conference.15 There are two official dependencies which are engaged in population policy: The Venezuelan Family Planning Associa- tion (AVPF) from the Public Welfare Council of the Federal District, and the Population Division of the Ministry of Health and Social Assistance (SAS). The philosophy of the Family Planning Services of the Venezuelan Family Planning Association (AVPF) is briefly the following: (1) The extension of the service to the p0pulation is purely free without compulsion by the Venezuelan Family Planning Association (AVPF) on them, (2) the services do not impose a method against a person's conscience, nor deny any one of those methods scientifically probed as efficient and innocous, (3) abortion and permanent sterilization are not within the domain of the Venezuelan Family Planning Associa- tion (AVPF), (4) it is a fundamental function of the Family 14United Nations Economic and Social Council, Inquiry among governments on Problems resulting from the interaction of Economic DevelOpment and Population Changes, 64-26191, November, 1964. 15Mayone J. Stycos, Human Fertilityiin Latin America: Sociological Perspectives (Ithaca, New York: Cornell Uni:’ versity Press, 1968), P. 306. 36 Planning Services to exercise a broad educational role in order to promote its objectives and show its personal and family advantages. This educational work is not limited only to those who voluntarily avail of the services, but rather it should be projected to the community."16 The Venezuelan Family Planning Association (AVPF) was founded in 1963. The Population Division was established in 1965, and until 1967, its main activities were mainly promotional. Both institutions are working in close col- laboration in 39 centers, in which 32 are running by the Venezuelan Family Planning Association (AVPF), and with an estimated of a total of 50 at the end of 1969.17 TABLE 24.--Methods of birth control in family planning centers of Venezuela, 1966-1969. _—————..._.._ Methods Year 1966 1967 1968 1969 Intrauterine Devices 4,859 7,260 8,719 3,815 Medicines 2,146 4,190 Rhythm 1 20 Other Methods 213 317 TOTAL 4,859 7,260 12,079 13,342 * Ministerio de Sanidad y Asistencia Social, Memoria y Cuenta 1969, pp. 193-94. l6Pablo Liendo Coll, Contenido de un Programa de Planificacion Familiar, Editorial Texto, Caracas, 1970, pp. 25-27. 17Ministerio de Sanidad y Asistencia Social, Memoriagy Cuenta 1969, p. 192. 37 The results of this table show an increase in family planning methods in different centers of the country. Other activities of the Population Division during 1969; were: (a) Demographic studies, (b) a two week course about medical demography at the School of Public Health for the post-grade students of Hygienic Medical Doctors, (0) in sexual education: some talks and short courses to a selected groups and in an experimental basis. Health Resources The World Health Organization defines health as "a state of perfect physical, mental, and social well being, and not only the lack of disease." It further states that "the highest level of health that can be reached is a funda- mental right of every man, without distinction of race, religion, political creed or economic or social condition."18 The National Constitution of Venezuela, 1961, states that "all Venezuelans have the right of health protection," thus defining the responsibility of the Venezuelan state of protecting its nationals without any social, political, economic or geographic limitation.19 In order to guarantee health to the community, the Venezuelan state administers and financies functions of 18Abigail Romero Medina, and others, III Congreso Vene- zolano de Sanidad Publica, "Orientaciones para un Plan Nacional de Salud," in Revista Venezolana de Sanidad y Asistencia Social, Vol. 31, June, 1966, p. 209. 19 Venezuela, Constitucion Nacional, 1961. 38 medico-health actions through the Ministry of Health and Social Assistance (SAS), and such actions have resulted in health improvement of the country. These health functions are divided by Gustavo Molina, 20 for didactic purposes are as follows: Functions of Health Protection: 1. Control and provision of water 2. Control of insects, rodents, garbage, and 4. Elimination of excretories 5. Sanitation of housing, industry, and other 6. Control of infectious diseases Improvement Health Functions: 1. Hygiene of mother and child 2. Food and nutrition sanitation 3. Hygienic work: prevention of work risks 4. Mental health and general hygiene of adult Functions of Health Restoration: 1. Medical and primary-aid of the patient, general and special attention in medical buildings I. animals 3. Food control places 7. International health II. III. 20 Gustavo Molina, and Guillermo Adriansola, Principios de Administracion Sanitaria, San Juan de Puerto Rico, 1961. 39 2. Assistance to the aged and cripples 3. Rehabilitation 4. Pharmacy and odontology In order to implement these health functions, the state has the following general and administrative activities: 1. Statistics: demographic, social and administrative 2. Laboratory: Diagnosis, production, control, and research 3. Education and publications 4. Infirmary 5. Social service 6. Formation of personnel in all types and levels 7. Legal: legislation and application of laws and regulations 8. Engineering and architectural work 9. Auxiliary services 10. Research of techniques and procedures 11. Coordination of functions and activities in all levels. The national health programs are performed in Venezuela by institutions of the national, and state governments, and by some municipalities. The institutions are: Ministry of Health and Social Assistance (SAS) Venezuelan Institute of Social Security Public Welfare Council of the Federal District Social Directions of the States and Federal Districts 40 Army Health Services Medical Services of other Ministries National Institute of Sanitary Works (INOS) Medical Services of other Municipalities. The Ministry of Health and Social Assistance (SAS) performs integral health functions in cooperation with state governments and some municipalities; the other institutions have, in general, programs of restitutive medical attention. The National Institute of Sanitary Works (INOS) is an autono- mous institute of the Ministry of Public Works, and deals with the construction and administration of aqueducts and sewerage systems for cities of 5,000 and more population. There are, also, private institutions working in: 1. Medical and health services of iron and petroleum companies * TABLE 25.--Number of hospitals in Venezuela, 1969. Dependence Hospitals Beds Ministry of Health and Social Assistance (SAS) 88 19,597 States 60 2,591 Social Security 17 1,677 Ministry of Defense 5 1,323 Municipalities 13 2,376 Charitable Foundations 8 759 Oil Industry 13 620 Private 129 2,908 TOTAL 333 31,851 * Ministerio de Sanidad y Asistencia Social, Memoriagz Cuenta 1969, Caracas, 1970, p. 138. 41 2. Private lucrative clinics 3. Private benefit clinics.2 Number of Rural Medical Centers (Medicaturas): 488 Number of Rural Medical Posts (Dispensarios): 939. In general, the "Medicaturas" have local resident medical doctor, who also attends to some of the "Dispensarios."22 TABLE 26.--Number of medical doctors and population per M.D. in federal dependencies, Venezuela, 1969.* Dependence No. of % No.of Pop. M.D. per M.D. TOTAL VENEZUELA 9,114 100.00 1,101 Caracas Metrp. Area 4,204 46.13 544 States: Anzoategui 258 2.83 1,836 Apure 53 0.58 3,197 Aragua 242 2.65 1,715 Barinas 76 0.83 2,772 Bolivar 214 2.35 1,525 Carabobo 501 5.50 965 Cojedes 48 0.53 2,000 Falcon 199 2.18 1,872 Guarico 123 1.35 2,714 Lara 369 4.05 1,540 Merida 331 3.63 990 Miranda (Without Sucre District) 167 1.83 1,795 Monagas 162 1.78 1,904 Nueva Esparta 93 1.02 1,037 Portuguesa 113 1.24 2,575 Sucre 185 2.03 2,612 Tachira 258 2.84 1,978 Trujillo . 214 2.36 1,757 Yaracuy 77 0.84 2,666 Zulia 1,194 13.10 1,134 T.F. Amazonas 16 0.17 795 T.F. Delta Amacuro 17 0.18 2,014 *Ministerio de Sanidad y Asistencia Social, Memoria y Cuenta, 1969, Caracas, 1970, p. 138. 21Romero Medina, op. cit., p. 211. 22 Revista de Sanidadgy Asistencia Social, 31, 1966, p.222. 42 The main characteristics of Venezuelan health public institutions are: 1. Technical, administrative, and budget autonomy 2. Lack of coordination of health actions at the recipient level 3. Great normative variability 4. Executive centralization 5. Poor connection and communication among dif- ferent levels--centra1, regional, and local of each institution.23 Such a situation causes dispersion of efforts, duplicity of services, low efficiency, and frustration among health services peOple and the community recipient. The policy of health and the need for planning such a policy in Venezuela is characterized by the following facts: 1. The national government of Venezuela performs an integral function in the protection of health with pro- grams for the improvement, protection, and restoration of health; 2. The Ministry of Health and Social Assistance (SAS) exercises the direction of health services in the 23Francisco Urdaneta, "La Organizacion y Funciona- miento de los Servicios Medicos en el Presente Quin- guenio," paper presented at the Second Venezuelan Con- gress of Public Health, February-March, 1961. 43 nation, and is responsible for all health programs in cooperation with states and municipalities of the country; 3. There has been progress during the last few years, but there still exists a great percentage of dis- eases by certain infectious diseases like tuberculosis, gastroenteritis, helminthiasis, etc., that shows the existence of an inadequate environment and justify the need for continuing and increasing programs for environmental sanitation, health education, and immunization. On the other hand, the increasing importance of degenerative and mental diseases, accidents and violence creates new situa- tions and the need for efficient methods. These health problems and their possible solutions cannot be taken into consideration apart from other economic and social prob- lems. The Heads of the American States in their meeting at Punta del Este, Uruguay, 1967, agreed that the improve- ment of health conditions is basic for the economic and social development of Latin America.24 They said that, according to the needs of each country, the available sci- entific knowledge should be utilized for the following objectives: 24Union Panamericana, Reunion de los Jefes de Estado Americanos, Punta del Este, Uruguay, 1967 (Washington, D.C.: Secretaria General de la Organizacion de los Estados Ameri- canos, 1967), pp. 21-22. For this, a. 44 Control and eradication of transmissible dis- eases Improvement of programs for water supply, sewer- age, and other essential services for the en- vironmental sanitation of rural and urban areas, especially for those areas with low income population Improvement of nutrition level in poor areas taking advantage of national and international cooperation Improvement of mother—child programs, and educa- tion about integral family orientation Formation of the professional, technical, admin- istrative, and auxiliary personnel, and health research Integration of the national health programs in the national economic development programs. the Heads of the American States decided: To develop planning and execution of national plans aimed at the improvement of health To mobilize internal and external resources for financing these plans, and To ask the collaboration of the Pan American Union Health with governments of the region in preparing programs to acquire these objectives.25 25 Ibid., p. 22. 45 The Inter-American Economic and Social Council at Punta del Este, in matters of health planning, declared the need: To create planning and evaluation units in the Min- istries of Health with representation before the national organizations of general planning for economic development and social progress in order to coordinate both programs. So, the national government of Venezuela, answering these compromises, stimulated the creation of the Health Planning Office at the Ministry of Health and Social Assist- ance (SAS) which should work in collaboration with the Central Coordination and Planning Office of the Nation for the economic and social improvement of the country. By Decree No. 492, December 30, 1958, the national government of Venezuela created the Central Coordination and Planning Office (CORDIPLAN) under the direct super- vision of the office of the President of the Republic. CORDIPLAN's functions are to advise the national govern- ment in establishing plans for the economic and social im- provement of the country.26 By Resolution No. 15, June 19, 1964, the Ministry of Health and Social Assistance (SAS) created the Sectorial Planning Unit (Unidad de Planificacion Sectorial), which functions are: to advice the Ministry of Health and Social 26CORDIPLAN, Plan de la Nacion 1965-68 (Caracas: Oficina Central de Coordinacion y Planificacion, 1967), p. 11. 46 Assistance (SAS) in formulating all health plans which should be in close relationship and coordination with social and economic plans of the country.27 There have been difficulties in formulating a Health National Plan of short term by the Sectorial Planning Unit, especially because of the existence of other Ministry of- fices with similar functions like the: Planning Office of the Bureau of Malariology and Environmental Sanitation; Commission of Programs for Medical Health Buildings, MOP- SAS; Foment of Studies Commission; Research and Scholar— ships; and some functions of the Direction of Personnel and of the Direction of Administration. Other reasons are: That the country has no adequate instruments in health planning, and government administration is characterized by partial programs and without coordination.28 So, the present public health activities are formu- lated and executed in an institutional way without the establishment of priorities interrelated and without satis- factory coordination with social and economic development plans.29 27Ministerio de Sanidad y Asistencia Social, Memoria y Cuenta 1969, p. 89. 28Revista Venezolana de Sanidad y Asistencia Social, 31, 1966, p. 304. 29Ministerio de Sanidad y Asistencia Social, Memoria y Cuenta, 1969, pp. 89-90. 47 Thus, health national plans should be the responsi- bility of all health institutions as well as the national government's through executive and legislative powers. Health Needs Priorities In formulating different health needs and priorities we might look at the programs and goals of the five gen- eral Divisions of the Ministry of Health and Social Assist- ance (SAS) and combine them in some way with the objectives of the Plan of the Nation stated by CORDIPLAN. The health objectives of the Plan of the Nation, 1965-68, are directed to obtain a significant improvement 30 And, in en- of the life conditions of the population. vironmental sanitation, the Plan aims at providing water to 90 percent of the urban pOpulation in cities of more than 5,000 population and in establishing aqueducts for centers from 500 to 5,000 population, with a total of 8,468,000 peOple served in 1968; and sewerage services for 2,547,000 population at the end of 1968. In the construction sector, the plan aims for the construction of 240,000 housing units for lower income people with direct or indirect help from the state and other private institutions. The Plan also aims for the construction of hospitals, popular vacational and recreational centers, and other facilities for the im- provement of life of the people. It also aims at the 30CORDIPLAN, Plan de la Nacion 1965-68, pp. 19-23. 48 construction of hospitals with an increase of 3,900 more beds for the period. In view of the lack of a national health plan, and the ways the health needs are met by the health agencies of the country, it would be difficult to state a set of health needs priorities. For purposes of the present study, we will take into consideration the health programs of the different depart- ments of the Ministry of Health and Social Assistance (SAS), other health institutions, and the health objectives stated in the Plan of the Nation 1965-68 by CORDIPLAN. We will follow some kind of rationale approach in judging the priorities. We understand that by looking at the gravity of the problem and its need for a rapid solution, some cri- teria can be established by which educational media can play a bigger and better role in helping to solve the identified health needs of the adult population of Vene- zuela. These criteria include: (a) the number of people affected by the needs and the number reached by mass media, (b) the need for education as an integral ingredient for solving health needs, (c) the dispersion of population af- fected by health needs and percentage reached by mass media, and (d) the health needs and the need for a quick presenta- tion of solutions to more people. With these criteria in mind, we may divide health needs according to the following priorities: 49 1. Population Explosion and Family Planning 2. Environmental Sanitation: a. Use of water: aqueducts, sewerage and sani- tary services b. Housing and industrial sanitation c. Rural endemic diseases: Chagas, Malaria, Aedes Agypti, etc. 3. Nutrition 4. Dental Care and Odontology problems 5. Pediatric care 6. Infectious and Venereal diseases 7. Alcoholism and drugs 8. Accidents and violent deaths 9. Hospital and Medical Buildings; coordination services 10. Medical Schools: personnel and materials 11. Heart diseases and cancer 12. Mental diseases. The above priorities are also in agreement with pro- grams recommended in the Plan of the Nation 1965-68 by CORDIPLAN31 which expresses the opinion of the national government leaders, and with programs proposed by medical authorities of the country recommending certain guidelines for a health national plan.32 311bid., pp. 363—390. 32Romero Medina, op. cit., pp. 205-237. 50 In order to c0pe with the above needs and priorities, an action plan has been recommended which in general guide- lines are: 1. Population Explosion and Family Planning:33 Present situation in Venezuela: a. Demographic and medical-social reasons b. Present activities, private and public atti- tudes, c. Sexual education. 2. Environmental Sanitation: CORDIPLAN:34 a. Elimination of environmental factors that cause diseases b. Program of aqueducts and sewerage services c. Programs against Chagas, malaria and other endemic diseases; 3. Nutrition: Fomentation of nutrition programs, especially the pre—school programs, 4. Dental Care and Odontology: a. Fluoridation of some rural and urban aqueducts to prevent or cure the existing caries in about 95 percent of the population, b. Odontology needs of the community 33Angulo-Arvelo, op. cit., pp. 607-644. 34CORDIPLAN, Plan de la Nacion 1965-68, pp. 364-370. 51 c. Educational aspect: (1) professional and auxiliary personnel (2) general population Pediatric Care: a. Increasing the quality and quantity of pre— natal control services b. Use of existing hospital beds when they are not used for other services c. Increase of premature-born services other than those existing in Caracas Maternity "Concepcion Palacios." Infectious and venereal diseases: Preventive programs, hygiene and vaccination Alcoholism and Drugs: Educational aspect: causes and effects Accidents and violent deaths: Traffic regulations, consequences of violence. Hospitals and Medical Buildings; coordination services CORDIPLAN aims for the need of: a. Construction priorities: cost, medical ser- vices, geographic areas b. Administrative personnel c. Coordination of services d. Social Security 52 10. Medical Schools: Educational facilities and graduate studies Teaching techniques 11. Cardiologic and Oncologic services: a. b. Construction of oncologic centers Formation of personnel in statistical data gathering about cancer Preventive programs Cardiology services and personnel improve- ment, 12. Mental Programs: emphasis on: a. b. Environmental health in coordination with all institutions working in that area Policy based on: (1) Extension of psychiatric care (2) Integration of family (3) Treatment to be done if possible in family environment (4) Increasing in the number of beds (5) Formation of personnel to treat such disease. EgeliminaryConsiderations To cope with the above objectives and in harmony with the programs underlined by CORDIPLAN, we would propose the use Of radio, television, and other media, as well as 53 interpersonal communication to help solve these identified and other related needs. The systems proposed and aimed to help solve these needs in Venezuela will be composed of a wide radio and television system covering the nation geographically and reaching its adult population with its educational mes- sages. Both instructional radio and educational television will be complemented with other educational materials, and/or substituted by other educational techniques like visits of community leaders, conferences in schools, clubs, etc., and workshops, special courses, etc. There are many ways by which the proposed system could work to help solve population explosion. The follow- ing is one of them. We would propose that the Family Planning program start as a pilot project in some cities of the country. These are some reasons in choosing this: a. Slum areas of these cities are overcrowded and their living conditions are poor b. Resources of medical and media personnel are more prevalent in cities than in other places in the country c. Medical supply facilities are in abundance in these places, and access to them is easier for the in- tended users due to better communication facili- ties 54 d. The fact that there exists some positive activ- ity in the identified need (about 39 centers in the cities). Behavioral and social factors.--The cooperation of the public is essential, and interest in the project is connected with the educational level of people involved. Success will depend to a great extent on the attitude of the intellectuals and professionals of the country. Administrative problems.--Education of the public. Education should be as a nationwide program and all avail- able resources should be used to motivate the public in order to teach methods and guide them to birth control facilities.35 General functions of a basic Family Planning Pro- gggm.--(a) Instrumental functions: provision of services and supplies, provision of information, and generation of social support; (b) Control functions: top leadership, peripheral supervision, and evaluation; (c) Supporting functions: training, financial support, and research.36 35Bernard Berelson et al., Familnylanning and ngu- lation Programs: A Review of World Developments (ChiCago: University of Chicago Press, 1966), p. 301. 36 Ibid., p. 333. 55 Informational and educational programs.-- 1. Target Population: We would presume that people between 15 and 44 years of age are the target audience. According to estimates the population of this age group in Venezuela is about 4,208,656 people in 1970 (Table 6), of which, about 1,064,350 people are married or living in common-law marriage in 1961 (Table 8). One of the jobs of public information channels is to help the professionals in the field to reach this group. 2. Channels of Communication: a. Mass media: In a sample survey taken in Korea in 1965 among couples under 44 years old indicated that almost 46 percent of the eligibles stated that they heard about the family planning program over the radio, and 25 percent read about it in newspapers, and 16 percent read about it in magazines.37 Other means of communication used in Korea were: b. Two family planning movies and one short trailer, which was often attached to news- reels, c. Public meetings, which included: showing of movies and distribution of literature and 37Paul Hartman, "Informational and Educational Pro- grams," in Family Planning and Population Programs: A Review of World Developments, ed. by Bernard Berelson (Chicago: University of Chicago Press, 1966), p. 347. 56 talks over the local radio amplifiers, there were also some audiovisual mobile units, d. Special events, like Mothers' Day, Children's Day, songs, posters, etc., e. Workers in the field: They used equipment and supplies in their work, and also, they sought the cooperation of local news agencies and mass media, f. Word-of—mouth: neighbors, friends, and rela- tives. Results from an action-research project in one area of the city of Seoul show that about 45 percent of the total who visited one of the four family planning centers in the area stated that they had been influenced to do so by neigh- bors, friends or relatives; about 12 percent came as re- sults of an invitation by radio; 5 percent by newspapers; and 1 percent by television.38 The Korean program also held meetings with key agen- cies and groups to keep them informed and change ideas; they distributed reference materials to newspapers, maga- zines, radio and television stations, and held news con- ferences to report develOpment and progress. 38Ibid., p. 349. 57 Operational Relationships Between the Systems Proposed and the Family Planning Programs Educational media should be a component of a teaching and learning system which works best when all components of the system are integrated and balanced. Family Planning programs consist mainly of three parts: (1) information, (2) action, (3) functional research-evaluation. Assumptions: Family planning is mainly a problem of decision making by a man and his wife. Therefore, a pro- gram should be directed towards educating families in mak- ing decisions. Initially the program should be one of intensive edu- cation of the adult population. So, one specific opera- tional approach would consist of: 1. Development and promotion of a program of adult education in all areas related to the identified need 2. Preparation of materials 3. Preparation and training of personnel 4. Counseling and distribution of contraceptive supplies 5. Research on health problems and means of evalua- tion. The function of mass media is more closely related to number one above than it is to the other points. 58 The job of mass media in this particular case would be to spread information and a sense of social rightness about the practice of birth control in order to develop the perception of social support within the community. In terms of media to be used, we may divide the pro- gram into three steps: (1) First year: Use of audio- visual materials, (2) Second year: Use of audiovisual materials and radio, and (3) Third year: Extension of the family planning program to other areas of the country, and use of television. First Year This would be dedicated to the formation and training of personnel (Berelson, 1966). Medical Aspect of the Family Planning: A. Professional Level: 1. Workshops for: a. Hygienic medical doctors at the Public Health School of Caracas, and medical students of Caracas universities b. Medical school students at the Universities of Merida, Maracaibo, Valencia, Barquisimeto, and Oriente, 2. Workshops at Family Planning centers already in Operation in the country, and for the following personnel: B. 59 a. Medical doctors and pharmacy personnel b. Nurses and paraprofessional personnel, Workshops in capital cities of each state for: a. Medical doctors of each city and pharmacists b. Medical doctors and pharmacists of the state rural areas c. Nurses and paraprofessional personnel of the city medical institutions d. Nurses and paraprofessional personnel of the state rural areas. Professionals in the field: 1. Workshops for: Training personnel directly involved in the program, like house visitors or motivational workers, and auxiliary personnel. Conferences: Using the above personnel, a more ex- tensive program would be developed of conferences attended by leaders of the community like: a. Government officials b. Industrial and commercial directors c. Military personnel d. Religious groups e. Political groups f. Educational groups g. Union workers h. Radio and TV monitors and other media people. 60 D. Media Aspect: 1. Materials needed for workshops and conferences: f. g. Filmstrip projectors and material for them Slide projectors and slides Tape recordings and tapes Movie projectors and films (8mm and 16mm) Pamphlets and other printing materials Posters and boards Exhibit materials 2. Materials needed for workers in the field: a. Filmstrips, slides, charts, tapes, pamphlets and other printing materials, demonstration materials. 3. Material-content: All materials to be used should be revised or selected by the health authorities of divisions of Health,Education and POpulation of the Ministry of Health and Social Assistance (SAS). Available resources of both divisions can be used for .making of materials and distribution of audiovisual equip- ment. Second Year Besides all methods and techniques of the first year of (Operations, we would recommend the use of radio for two rmain purposes: promotional and general information, and 61 instructional education. We would also recommend other techniques like: home visits, group meetings, mother's courses, audiovisual mobile units, printing media, news- papers and magazines, and interpersonal communication, and sexual education in schools (Hartman, 1966). Mass media should work in close collaboration with all of them. I. Radio: The use of radio at this stage should be functional in two main aspects: promotional and general information, and instructional education. 1. The promotional and general information campaigns should be directed at the target population and in combina- tion with other media, like articles in newspapers and maga- zines, posters, and other means of advertising about family planning. These promotional campaigns would be directed to: A. General Public; and they will be in the form of: 1.) Short messages directed to encourage further in- quiry on the part of the audience, 2.) Radio interviews with family planning workers and other authorities about different aspects of family planning programs and other aspects of sexual edu- cation, etc., 3.) Shows or dramatic "novels" presenting different aspects related to family planning, 4.) Songs stressing the need of birth control, 5.) General information in the family planning area. 62 2. Instructional Radio A. Special Audiences (Rogers, 1969): l.) Radiophonic (radio) schools: We would not recommend the organization of a radiophonic school for the only pur- pose of solving this Special need, because in addition to their great expense in time, personnel, and money, such a technique suffers the disadvantage of attracting only the most highly motivated. Group meetings, according to Puerto 39 should be employed only Rican and Jamacian experience, for opinion leaders in the community, for those most highly motivated, and for those already practicing contraception. So, radiophonic schools can serve to sustain and reinforce the motivation and behavior of those who started, and to form a small highly motivated elite which could stimulate others by means of the normal person to person channels of communication. Radiophonic schools formed to help solve other health needs we recommend also to be used to bring education to these particular group audiences. Teachers and monitors at the point of reception should be well trained and informed in family planning area for discussions, and sometimes, when circumstances will (permit, an expert in the family planning field will be Ibrought in for further discussion after the radio lesson. LMedia aids like filmstrips and slides in those places with 398tycos, op. cit., pp. 95—97. 63 electrical power facilities, and charts and boards for places without electrical power, will be recommended for lessons and discussions. We recommend the use of some means of feedback. We suggest correspondence between literate students and the radio source and tests or examinations for radio students. We also recommend that known and proven techniques of in- struction for accentuating student interactions with sub- ject matter be used extensively. Emphasis should be put on raising questions, stating issues, defining conflicts and controversies, requiring students to make judgments or inferences from demonstrations, etc., and send back to radio source their questions and answers by mail, tele- phone, or short-wave radio. We would recommend that the themes treated in radio schools be about family planning, and related areas, like sexual education, child care, home economics, savings, and all aspects related to family environment. 2.) Home-based audiences: i.e., those who do not want or cannot meet in certain places to listen to radio les- sons. In order to stimulate their learning, a visiting teacher supervising their progress will be recommended. Home visiting family planning professionals would be recom- :mended for this job. Motivational techniques should be devised to make them listen to the radio. To foment radio listening, programs by word-of-mouth would be recommended. 64 3.) Courses for mothers: Development and promotion of a program of women's education and home development should include the following areas: (a) home sanitation, (b) child health, (c) maternity diseases, (d) family planning, (e) kitchen gardening, (f) saving, etc. We recommend that this program be presented at the same gathering places of the radiophonic schools for those mothers able to assist, and use same radiOphonic school facilities; and those who do not want or cannot assist at these gathering places, we should encourage them to listen to the programs in their homes by developing promotional campaigns directed to the general public. For more effective use of audiovisual materials in both radiophonic schools and special courses for mothers, the monitor teacher will follow those techniques that best serve him, either showing a filmstrip or chart before each unit for a general introduction, or coordinated with broad- cast program, or after the broadcast at a convenient time for detailed study. Tape recordings of the broadcasts for review and rein- forcement of the lessons at time suitable for some special students and as individualized instruction would be recom- mended. II. Home Visits; to special couples or small groups: An integral part of the family planning is carried out by professionals in the field who bring information, 65 help and supplies to the couples in their homes (Hartman, 1966). We would recommend that the workers use the follow- ing media: flip charts, flannel boards with illustrations, or filmstrips and slides, and demonstration models, and printing materials like pamphlets and leaflets. They need adequate practical training in this area and media training should form an integral part of their general training. Individualized instruction to some couples would be recommended. III. Audiovisual Mobile Units: Another information media that we would recommend will be the use of several audiovisual mobile units (Hartman, 1966). Materials on these units will include films, film- strips, records, printing materials, and birth control supplies. The personnel taking the units from place to place in the area of birth control centers, besides driving, will operate the audiovisual material and be experts in the family planning field. The main purpose of these units will be the dis- semination of information and collaboration with other ;professionals in the field. 66 IV. Other Media: The media proposed above would not be so effective in promoting and moving the people to use family planning practices if they do not Operate in close collaboration with other informational and educational means (Berelson, 1966). 1). Family planning and the school curriculum: The possible contributions of the education system are based on the assumption that the population explosion is a long- ranged problem and that basic understandings and attitudes by the young are basic in the area of family planning. Attention should be oriented toward those goals of the education system which will support the objectives of family planning and those courses of action seem to be the most promising. One course of action would be to try to influence curriculum peOple giving priority to teacher- training institutions and particularly those institutions training elementary school teachers. Special programs like short courses or conferences on family planning for teachers held at strategic points in the country are some of the means in reaching them. 2). Posters in different locations, like public gather- ings, recreational centers, factories, markets, transpor- tation facilities, etc. 67 3.) Public announcements through loud speakers, clubs, churches, syndicates and unions, etc. can help to en- courage people to hear radio. 4.) Personal letters mailed to members of different organizations. Third Year Besides all methods and techniques of the first and second years of operation we would recommend the use of television mainly for urban areas where there is electri- cal power and a number of sets are available (Schramm, 1969). Just as we recommend the use of the radio for pro- motional and general information, and for instructional education, so do we recommend the use of television. I. Television: In the promotional and general information area, television would be used in developing family planning campaigns directed to the target population and in com- bination with the radio, newspapers and magazines, and other means of communication already described. Programs directed to: A. General Public: 1). Brief educational messages to encourage further inquiry on the part of the audience 2). Television interviews with authorities and pro- fessionals on family planning about different aspects of the program 68 3.) Films on family planning and sexual education 4.) Short educational dramatic presentations in areas related to family planning and other related areas like child education, home sanitation, etc. 5.) General information on family planning. B. Special Audiences: 1). Television schools: For special groups of com- munity leaders, for those already practicing contraception, and those most highly motivated. Further discussion will be recommended with the teacher monitor after the lesson presentation on the theme presented. We recommend the use of some means of feed- back. We suggest correspondence between literate students and television studio teacher; evaluation from the class- room teacher about the behavior and learning progress of students, tests and examinations for literate television students; special sections on TV-Guides for the classroom teacher to fill in about class progress and behavior, etc. We also recommend that known and proven techniques of in- struction for accentuating student interactions with sub— ject matter be used extensively. Emphasis can be put on raising questions, stating issues, defining conflicts and controversies, requiring students to make judgments or inferences from demonstrations, etc., and send back to the television station teacher their questions and answers by Inail, telephone, or short-wave radio. Visits from the 69 television station teacher to the classrooms will also en- courage feedback. We also recommend that the themes treated by tele- vision be about family planning, and related areas, like sexual education, child care, home economics, savings, etc. 2). Home-based audiences: i.e., those who do not want or cannot meet in certain places to watch television les- sons. In order to stimulate their learning, a visiting teacher supervising their progress will be recommended. Home visiting family planning professionals would be recom- mended for this job. Motivational techniques should be devised to make them watch television programs. To foment television watching, programs by word-of-mouth would be recommended. We would recommend that during this third year of family planning program operations, the whole program be extended to other areas of the country besides the city centers already in operation. The television program might be extended to other parts of the country during its second year of operation if the evaluation research indicates the need to do so. Summary This chapter has analyzed as an example of the health problem the population explosion problem in Venezuela and family planning activities in the country. Available .health resources to solve the health needs of Venezuelan 70 adult population have been presented. Due to the lack of a national health plan, and for purposes of this study, a set of health priorities have been established, popula- tion explosion being the foremost priority of the country. The available health resources, being inadequate to cope with health needs, and a proposed media system and how it can be used with the other health resources of the country to help solve the population explosion problem have been presented. A program designed to be used by the proposed radio and television systems as a part of the total communica- tion program on family planning will be presented in the next chapter. CHAPTER III FAMILY PLANNING PROGRAM Family Planning is the control of human reproduction, the planning of conception in each circumstance, without leaving this important biological phenomenon to the ir- rational actuation of the sexual instinct.l So, family planning consists in delaying birth of children or in spac- ing pregnancies. In both cases, the interested parties should analyze if the born-to-be child will have an ade- quate biological protection, and if he will be able to develop his personality in a socio-educational process appropriate to human dignity. There is a need for a national campaign in Venezuela to use all available communication media to form a con- sciousness of the problem. The campaign should create the conviction that to bear a child in circumstances which do not assure him minimum conditions for his development would constitute an enormous crime against the most elementary rights of the procreated child, and against the integrity of society.2 1Pablo Liendo Coll, Contenido de un Programa de Pla- nificacion Familiar (Caracas: Editorial Texto, 1970): p. 9. 2 Ibid., pp. 94-95. 71 72 The primary objectives of the educational aspect of family planning for users are:3 (a) To (b) To (c) To utilize efficient methods of family planning be persistent in the use of them, and recommend family planning services to their friends To implement their objectives, they should know: (1) (2) (3) (4) (5) (6) Personal and family advantages of family planning methods That such methods are harmless, but some of them may cause inconveniences or failures The need for periodical check ups The danger of clandestine abortions The inefficiency of home-made methods, and Personal advantages of detecting early pathological processes. Thus, the educational role should prepare the users: (a) To of (b) To (c) To handle the elected methods with a minimum visits to family planning services know when they are in danger utilize temporary substitutes. Ibid, p. 51. 73 PrOpgsed Units for an Educational Family Planning Program in Venezuela Unit 1, Family Orientation: l. Irresponsible parenthood: consequences for children 2. Difficulties in satisfying all needs of a large family with a low income 3. Difficulties of providing education to a large number of children 4. Desolation of neglected children 5. Moral and social problems of forsaken unmarried mothers 6. Economic problems of abandoned mothers 7. Working impossibilities of abandoned mothers, due to the need of taking care of their children 8. Open, forced, or hidden prostitution of abandoned mothers 9. The predicament of orphans 10. Dangers of pregnancies when they are against medical recommendation ll. Dangers of clandestine abortions 12. Advantages in detecting early pathological pro- cesses Unit II, Family Planning: 1. Knowledge of minimum elements of anatomy and sexual physiology for the correct use of the elected method of birth control Unit III, 74 Methods of birth control available by doctor's prescription: description and limitations Methods of birth control obtainable without a doctor: description and limitations Philosophy of Venezuelan Family Planning Ser- vices Consequences of Lack of Family Planning Services in Venezuela: 1. Social consequences Educational consequences Health consequences: physical and mental Demographic consequences Economic consequences Religious implications Unit IV, Sex Education: 1. Family planning and sexual education Unit V, Nutrition—-Consequences upon Health: 1. 2. Unit VI, Nutritional problems in Venezuela Nutritional needs of pre-school children Home Education: Home education and matrimonial counsel Home sanitation Kitchen gardening Child care Buying and saving Participation in family planning services. 75 It would be beyond the scope of the present study to explain in detail the procedures to be recommended for each and every one of the themes listed above. In order to give a general idea about how the proposed systems will work with family planning programs, we will show an example: IR- RESPONSIBLE PARENTHOOD: CONSEQUENCES FOR CHILDREN. The example will include a filmstrip, radio, and television scripts and a possible program with follow-up materials and related methods that could eventually be used as a part of a total communication program. UNIT I, FAMILY ORIENTATION SUBJECT: 1. IRRESPONSIBLE PARENTHOOD: CONSEQUENCES FOR CHILDREN AUDIOVISUAL MATERIALS I. Filmstrip $2513; "Introduction to Family Plannipg" Idgg: Irresponsible parenthood brings children into a physical and social environment of degrading conditions. Birth control is presented as one good means for achieving responsible parenthood. Purposes: The intended audience in order to be re- sponsible parents will be induced to: (a) Make the peOple receptive to ideas about birth control (b) protect the life of children already born. 76 G231: To convince the audience that family planning services are the best answers for a responsible parenthood. Audience: Adult population of Venezuela in small or big instruction groups, for workshops, conferences, audio- visual mobile units, radio schools, and special courses for mothers. This filmstrip is intended for mixed audiences, but when used for women alone, emphasis should be put on those birth control methods more directly related to women. When the audience is composed of men only, methods of birth con- trol more related to women should be presented with less detail. Form and Methodology: Filmstrips are good visual aids to reinforce instruction. Their compactness, fixed se- quence, easy handling for projection, and low cost for addi- tional copies are some of their advantages in instruction (Wittich and Shuller, 1967). This first filmstrip, "Introduction to Family Plan- .ning," will have two well-defined parts. The first as an introduction covering Unit I, No. l, "Irresponsible parent- .hood: consequences for children," and the second part, covering the whole Unit II, pp. 73-74. The pictures can be used for many purposes. The use (pf enlarged photographs, drawings, titles, and slides ar- :ranged and photographed in sequence with a suitable 35 mm. 77 single frame copy camera for production of filmstrips will be recommended (Kemp, 1963). A complete printed and/or taped commentary will accompany each strip. The recorded narration will be ac- companied by an audible signal to indicate frame changes-- either with a tape or disk sound unit. Thus, it can be used for home-visiting instructions, for workshops, and conferences or radio programs. Music from Venezuelan com- posers will be used at the beginning and at the end of the filmstrip. Individual and group discussions during and after the presentation will be recommended (Schwalbach, n.d.). These programs will be tested with sample test audiences in urban and rural areas to measure their adap- table capabilities to different audiences in order to cor— rect deficiencies and improve their educational impact. §PEE§‘ The following photography shots will be used in covering the scenes to be described: Long Shot (LS), Ineans that the subject is at a distance from the camera; .Medium Shot (MS), when the camera covers the subject and :nothing more; Close-up (CU), brings the camera in to con— <:entrate on a feature of the subject. 10. 11. Visual Main title: INTRO- DUCT ION TO FAMILY PLANNING Credit title: Pre- pared by . . . Credit title: With the cooperation of. CU Father and mother kissing their happy baby. . MS New born child. MS Mother holding her baby, and his father looking at him. CU Baby in the same picture. CU Dish of food and the word: FOOD. MS Boy looking through a window. CU Medical doctor. CU Open book. 78 Script Narration Background music Music Music out. There should be joy in children because they bring happiness and pride to a family. The child is born naked, incapable of his own survival and development. He needs a family to help him survive, to protect him, and to develop his body and his mind. The child has the right to live, and his father and mother must take care of him until he is able to take care of himself. His parents must provide him with food to grow up strong and healthy. He needs also shelter, a home to stay, to play, to live in. He needs health care, a baby should be brought to a doctor to be protected against dis- eases. He also needs education to better prepare him for life. 12. 13. 14. 15. l6. 17. 18. 19. 20. CU LS CU MS CU CU MS LS MS Drawing of a heart. Drawing of a church and house. Hands of man and woman inter- weaved. Naked children in front of a miserable hut. A child. Face of a child crying. Child sitting down on the ground near a hut and looking far away. Child crying and looking far away. Boy wandering in a city street. 79 But, above all, he needs to be loved. He should be loved, recognized, and helped by both his father and mother. The child also needs spirit- ual and moral guidance. The school and the church can pro- vide education, but he should receive the most important part of his education at home. These needs must be pro- vided to a child by those who brought him into the world: by his father and mother. When a man has children in different homes and with dif- ferent women, he cannot take care of them. Thus, there are so many children abandoned in Venezuela who live in miser- able conditions. More than half of the child- ren born in Venezuela come from common-law marriages, where the father does not take care of them, and the mother cannot provide them with their basic needs: food, shelter, health care, and education. When the child is abandoned, he becomes sick, and may even- tually die from lack of care. If he grows up, his physical health is poor, and his mental health suffers from lack of love and affection of his father and mother. Being abandoned and without affection, the child lives in despair and poverty. Most of the time he becomes a juvenile delinquent. Our cities have many of them, children without fathers. 21. 22. 23. 24. 25. 26. 27. 28. MS MS Title: Children naked and playing in a slum. Pregnant woman holding a baby and four more naked children around her. PART II, FAMILY PLANNING SERVICES MS MS MS MS CU Couple entering a family planning clinic. Woman behind desk attending a couple. Woman talking to the telephone in front of a couple. Doctor talking to a couple. Couple listening. 80 Overcrowding and loose sex morals of city slums increase the number of abandoned mothers and new illegitimate children, issues of irresponsible fathers. The abandoned mother becomes pregnant again and again, be- cause she does not know methods of contraception, and the phenomenon is repeated creat- ing each time a more desperate situation. To prevent this sad situa- tion, family planning offers its services to those who want them. Family planning services want to help build for you a happy and healthy family by preventing unwanted preg- nancies. Family planning offers you birth control services and other related services. These birth control services allow you to have children when you want them, and avoid preg- nancy when you don't want it. When other health services are needed we will send you to the right place to get them. The methods of birth con- trol offered at family plan- ning services are harmless and do not interfere with your sexual life. Every method of birth control works differ- ently. The doctor at the family planning clinic will help to select the birth control method that will work best for you to have children only when you want them. 29. 30. 31. 32. 33. 34. 35. 36. 37. MS CU CU Drawing of woman. Drawing of man's reproduction organs. Drawing of several Sperm cells. CU CU CU CU CU CU Drawing of woman's reproductive organs with sperm cells in the birth canal. Same drawing with sperm into the womb. Same drawing, and ovaries with eggs. Same drawning, an egg into the tube and sperm meets it. Same drawing. Foetus into the womb. Drawing represent- ing a wall between egg and sperm. 81 To understand how birth control works we should know how a woman becomes pregnant. But, first, let's see how the reproduction organs of a man work: the man's seeds called sperm are produced in his two sex glands called testicles and located in a sac-like thing called scrotum. There are millions of sperm cells in every teaspoon of male fluid. They have a head and tail, and move. During sex relations the man's seeds pass from his sex organs into the woman's birth canal called vagina. And these seeds enter the womb also called uterus through a small opening called cervix. There are two ovaries, one at each side. Every month they release an egg into the tube that travels towards the womb. If one sperm of the man meets the egg, both move into the womb, and the woman be- comes pregnant. And a child starts to grow into the mother's womb. To prevent pregnancy the man's seeds must not meet the egg. There are many methods to stop them from meeting. All methods of birth control offered at family planning centers are designed to keep this from happening. 38. 39. 40. 41. 42. 43. 44. CU CU CU CU CU CU CU Open box display of methods of birth control. Open box of birth control pills. Calendar marks on days. Calendar marks on Calendar marks on day. with twenty with 21 days. with every Open boxes of birth control pills. Different types of I.U.D. 82 There are different birth control methods that work dif- ferently. These are the ones offered at family planning services. birth control stOp the ovary eggs, so preg- occur. They are and millions of world are taking These are pills. They from forming nancy cannot very popular women in the the pill. The doctor will prescribe the pill for the woman. He will explain that some pills must be taken every day for twenty days. Some pills must be taken every day for twenty one days. Others must be taken every day. A woman does not have to use anything else if she takes the pill. But, if she for- gets one, she may become preg- nant. The woman should have an internal examination from her doctor at least once a year. Intrauterine devices, or I.U.D., are small plastic or metal shapes which the doctor places inside a woman's womb. They come in different shapes and they are one of the best and more popular methods of birth control especially in Venezuela. 45. CU Drawing of woman's 46. 47. 48. 49. 50. CU CU CU CU CU reproductive organ and IUD in her womb. Diaphragm. Drawing of the female repro- ductive organ with a diaphragm placed in the en- trance of the womb. Condom. Cream, jelly and vaginal foam con— tainers with their appli— cators. Drawing of woman's reproduc- tive organ and applicatorful entering the vagina. 83 They can remain inside for years without interferring with sexual relations. Some women may feel uncomfortable, but this is temporary and only during the adjustment period. If she wants to be— come pregnant, she should go to her doctor and he will simply remove the IUD. Another method of birth control is the diaphragm. It is a thin sheet of soft rub- ber stretched over a metal ring in the form of a dome placed in the entrance of the womb preventing the sperm from entering the womb. It comes in different sizes. The doctor must tell the woman what type she needs. He will also teach how to put in the diaphragm. It does not interfere with your sex relations. The condom or rubber, is made to be placed over the male organ just before sex relations. It keeps the man's sperm from entering the birth canal. It is safe, reliable, and can be bought without doctor's prescrip- tion. These are special creams, jellies, and vaginal foams. They are made of harmless chemicals which stop the moving action of sperm. An applicatorful is put into the vagina no more than one hour before sexual rela- tions. A woman must use another applicatorful before each sexual act. 51. CU Word: DOUCH crossed-out. 52. CU Calendar with some bold numbers sig- nifying the men- strual period. 53. CU Word: WITHDRAWAL 54. MS Scientist in a laboratory look- ing at an experi- mental tube. 55. CU A child between his father and mother. 56. CU Words: FAMILY PLANNING SER- VICES. 57. Words: END. 84 It is not necessary for a woman to douch after using vaginal birth control methods. Doctors agree that douching is not an effective birth control method. The rhythm or safe period method depends upon not having sex relations during the fertile time. It is based on the fact that a woman can be- come pregnant only during that part of her menstrual cycle when the egg is released from the ovary. To follow this method, a woman must keep carefully records of her menstrual periods during eight to 12 months. In the withdrawal method the man withdraws his sexual organ just before it "comes," so none of his sperm can go into the vagina. This method is not completely reliable. There are other methods now under study, like injections, more pills, and new devices. If you want a baby,stop using birth control methods. To have a baby when you want one, and when you can give him the love and care that he needs, is a wonderful experi- ence for both of you, his mother and father. Family planning services will help you plan a preg- nancy when both of you are ready to welcome a child; when you can provide for all things that he needs in order to survive, to be protected, and to develop his body and his mind as a happy human being. Music. 85 Follow-upraterials and Methods The whole Family Planning Program will be covered by four filmstrips. 1. "Introduction to Family Planning" as above. 2. "Unwanted Mothers" covering Unit I, numbers 2 to 12 of the proposed Family Planning Pro- gram, page 73. 3. "Sociology and Birth Control" covering Units III, IV, and V, p. 74. 4. "My Happy Family" covering Unit VI of the Pro- gram, p. 74. Form and Methodology: The filmstrips "Unwanted Mothers," "Sociology and Birth Control," and "My Happy Family" will include 40 color reproductions each, which will illustrate the themes of each Unit indicated on pages 73—74. These filmstrips will present birth control practice as a socially acceptable and personally beneficial behavior, taken for granted as a part of good and wise life by people. They will present birth control practice as a logical and desirable solution to the problems exposed, and they will conclude with an invitation to visit Family Plan- ning Services for orientation and help. They will follow the form and methodology already described in the filmstrip, "Introduction to Family Plan- ning" on pages 76-77. 86 A careful revision will be recommended, from time to time, to cope with the up-to—date birth control develop- ments. Some suggestions: for effective use of filmstrips in home visit instructions, workshops, conferences, and radio lessons (Schwalbach, n.d.). 1. Visiting family planning professionals should show their own favorable interest and attitude by providing stimulating environment for listen— ing and viewing the presentation. 2. They should check the equipment in advance to be sure that the materials are ready. 3. Use the filmstrips in the best way they can serve. So, they might: a. Show a filmstrip before each unit without sound and as a general introduction b. Show the frames coordinated with narration c. Show the frames for detailed study after the coordinated frames and narration have been presented. And above all, try to follow the pace of your audience as close as you can. II. Radio Title: "Responsible Parenthood Builds Happy Families" 87 Goal: The final goal of the radio lesson is that the intended audience use the family planning services as a means to a happy family life. Objectives: The audience,after the completion of the program,should be able and determined to: a. Make people perceptive to ideas about birth control b. Protect the life of children already born. Audience: Adult population attending radiophonic schools, courses for mothers, and home radio programs. Form and Methodology: The script will be written in "straight talk" style (Hilliard, 1967). This is the first of the lessons to be presented, and it corresponds to Unit I, No. l, "Irresponsible Parenthood: Consequences for Children," p. 73. The presentation of the lesson will be coordinated with the filmstrip "Introduction to Family Planning," frames 1 to 27, and 55, 56, pages 78-80, and 84. The general pattern of the presentation will be as follows: Before the Program: Class leader or monitor teacher should prepare the audience for the program (Rogers, 1969). He should take care of the physical learning environment, and the teaching materials like filmstrip projectors and accessories. He should motivate the students for the program (Schramm, 1969) asking questions such as these: 88 How many children do you think an ideal family should have? Are there some abandoned children in your neighborhood? Who has the obligation to support the child when he is born: his father, his mother? Both? How? What does he need? What do you think about birth control?, etc. Then, if he feels it necessary, he can present the filmstrip "Introduction to Family Planning," frames 1 to 27, and 55, 56, for general information (Schwalbach, n.d.). During the Program: The monitor teacher should listen to the radio lesson with the students and to attend to the proper functioning of the filmstrip projector, and follow the pace of the radio teacher in presenting the appropriate strip. He should be alert to the reactions of the students, and foment their oral answers to the ques- tions of the radio teacher (Rogers, 1969; Schramm, 1969). After the Program: The monitor teacher should dis- cuss the ideas presented in the lesson with the students (Rogers, 1969), present the filmstrip at a slow pace, if he thinks it necessary, and encourage students' comments on the presentation (Schramm, 1969). For students who are illiterate, and when the ade- quate media are available, questions and answers from stu- dents with radio teacher by way of short-wave radio and/or telephone will be recommended. The monitor teacher should ask literate students to answer in written form the following questions: Was the 89 lesson clear to me? What are the basic needs of a new- born child? What size should the ideal family be? When do I intend to go to the family planning services for help? Other remarks. These lessons are prepared to be presented by radio, but they can also be presented by phonograph and/or tape recorder in order to control the sound, and to work in combination with the slides proposed. Script Musical theme Announcer: "The . . . radio station presents: LET'S MEET TOGETHER, by Robert X, M.D." Medical "Good evening, dear friends. doctor: (1)4 Tonight, we are going to talk about something that concerns all of us: Respons- ible Parenthood Builds a Happy Family. (2-3) (Music)' '(4) Of course, you say, we all want to be good parents, don't we? Well, let's see. Certainly, we all know how a child comes into the world, and when he comes his family is happy and proud of him. He's my son, we say, he's my blood, just like me. (5) But, we must remember that all children come to the world naked. They cannot survive, they cannot do anything without help, but cry. (6) What does it mean? In order to survive, the child needs a family to protect him from 4Numbers in parentheses represent the corresponding frame of the filmstrip presented in coordination with the lesson. 90 danger, to help him grow up strong, happy, and socially adjusted. (7) All of us agree that the child has the right to live. But, he cannot take care of himself. His parents gave him life, they also have the obligation to take care of him until he can take care of himself. (8) What does the child need in order to grow up strong and healthy? Food, of course. If his parents don't give him food, he cannot continue to live. (9) What else does he need? He cannot live in the street, so he needs shelter, a place to live in, to stay, to play. (10) And when the child becomes sick, his parents have the obligation to bring him to the doctor, because he also needs health care, to be protected against disease. (11) But, life has become more complex. Today, we have to know many things, to do many things in order to survive. How can a child be prepared for a better life? By providing him with good education. (12) There are other needs more important for a child. He needs to be loved and recog- nized by his parents. How can a father love his son if a father does not recognize him as his son? (13) There are many misguided children these days with so much confusion going on. Since they are inexperienced in life, they need spiritual and moral guidance. While they go to the church and to the school, and receive good advice there, what they get there is not enough. They should receive the most guidance from home. (14) 'There is no place like home, and no- body like my own family,‘ we always say. Be- cause, we feel secure at home. We have food, shelter, and love. But, there are many children in Venezuela who are not happy at home, because they do not have adequate food, shelter, and loving care. They do not know who their fathers are. 91 (15) There are many children in Venezuela who live in sadness and sorrow, whose souls are sad, and whose bodies are sick. Innocent children who suffer hunger in their stomadhs, sickness in their bodies, and sadness in their souls. Children abandoned by their own fathers. (16) They are children from irregular, momentary unions, where their fathers do not take care of them, and their mothers cannot provide them with their basic needs: food, shelter, health care, and education. Children without love and moral guidance. (17) Children abandoned by their fathers, and who when they become sick their mother can— not provide appropriate attention, because she has no time, no money to take care of them. (18) The abandoned child cannot grow up in good health because of lack of appropriate care, and thus, his body becomes weak and his mind disturbed. The child needs the love of his mother and the strength of his father, be- cause to him, his mother represents tenderness and to him, his father means strength and goodwill, firmness and reason. (19) The abandoned child suffers from an inferiority complex before his friends. The society rejects him because he is not legiti- mate. The black mark of being illegitimate will haunt him for the rest of his life. He will live in despair for a crime that he never committed. (20) Hundreds of abandoned children roam the streets of our cities asking for money in order to eat. They meet other children in the same sad conditions, and due to the lack of moral principles, and crippled by their sad conditions they become juvenile delinquents. (Music) (21) Overcrowding and loose sex morals of our city slums increase the number of abandoned mothers and more illegitimate children, issues of irresponsible fathers. 92 (22) The abandoned mother becomes pregnant again and again, because she does not know efficient methods of how to prevent pregnancy, and the phenomenon is repeated, creating each time a more desperate situation. (23) Certainly, you don't want to have more children than you can support. You don't want to be a mother or father if you know that your child is not going to be happy. Sometimes, a man says: 'Sure, it is true, I want to be a responsible parent, but how can it be done? A man is a man. There is no other way to avoid it, as far as I know.' (24) Yes. There is a way to prevent this sad situation. There is a service called Family Planning that offers its help in build- ing a happy and healthy family by preventing unwanted pregnancies and without interferring in your sexual life. Many people like you come every day to their services and they are happy to do so. (25) Family Planning Services offers you not only birth control, but other related ser- vices. (26) So you can have children when you want them, and avoid pregnancies when you don't want them. (27) The methods of birth control offered at family planning services are harmless. But, they work in different ways. So, these family planning services have doctors who will help you select the birth control method that will work best for you to have children only when you want to. (55) To have a child when you want one, and when you can give him all the love and care that he needs, is a wonderful experience for both of you, his father and mother. (56) Family Planning Services makes it possible for you to plan a pregnancy when you know that your child will be born into a home where he will be welcome, when he has re- sponsible parents who can provide him all that he needs: food, shelter, health care, 93 education, love and moral guidance. A child needs all these things to survive, to be protected, and to develop his body and mind as a happy human being. Come! Join the thousands of people like you and me who, every day, go to the Family Planning Services across the nation! Thank you. I'll see you tomorrow." Announcer: "Thank you Dr. X for your talk." (Musical theme). Announcer: "LET'S MEET TOGETHER comes to you each day at this time, from your . . . Radiophonic Station . . . " Follow-up Materials The radio lessons will be presented in combination with the four filmstrips specified on page 85 (Skornia, 1965). Each theme listed on pages 73-74 is in principle intended to be presented as a separate radio lesson as a possible theme—guide to be included in a family planning program. Some of the themes, nevertheless, might be treated in a more extensive manner. The success of the pilot programs might indicate that more radio programs related to all aspects of health improvements should be produced. Methodology: It is recommended that the procedures before, during, and after the radio presentation follow the pattern of the one already explained on pages 87-89. Before the Program: The monitor teacher should pre- pare the mental set of the students for the lesson (Schramm, 1969). He should take care that the physical 94 environment be adequate for learning, that the teaching materials like filmstrip projector and accessories be ready for the presentation. He should motivate the stu- dents for the program with questions related to the theme to be treated. And, if he feels it necessary, he may take a preview of the frames to be studied that day. During the Program: The monitor teacher should listen to the radio program with the students, attend to the proper functioning of the filmstrip projector, and follow the pace of the radio teacher in presenting the appropriate strip. He should also be sensitive to the reactions of the students, and foment their oral answers to the radio teacher's questions (Schramm, 1969; Schwalbach, n.d.). After the Program: The monitor teacher should dis- cuss ideas presented in the lesson with the students (Schramm, 1969). He should go over the strips of the corresponding filmstrip at slow pace, if he things neces- sary, for further explanations, and encourage students' comments to the presentation (Schwalbach, n.d.). The literate students should write the answers (Rogers, 1969) to such questions as the following: Was the lesson clear to me? What were the basic ideas exposed in the lesson? How would I solve the problem presented? Why is birth control the best solution to the problem exposed? When 95 did I go or when am I going to go to the Family Planning Services for help? Other remarks? In case of illiterate students the use of short— wave radio and/or telephone for questions and answers of the students with the radio station teacher will be recom~ mended (Carpenter and Greenhill, 1965). Types of Scripts: Most of the subjects for the lessons will be written in a "straight talk" form. Never- theless, some radio scripts will be written in other script types, like "interviews" with doctors, important personalities in the area, and workers in the family plan- ning field. There will also be scripts in form of "panel or round table discussions"; "actuality broadcasts," like description of visits to clinics of birth control; "demon- strations," like child care and home improvement programs; and "dramatizations," treating themes related to abandoned Inothers and children (Hilliard, 1967). A very effective way of presenting scripts is by {presenting different cases and/or situations of daily life and discussions between the students and the class monitor, (or between students and the radio studio teacher by short- xmave radio or telephone. The students might have very :Lnteresting questions, and the teachers will have very en— Jlightening clarifying answers. Means of Feedback: Where short-wave radio and txalephone are available, they will be used as feedback 96 devices to measure students' improvements before and after the programs. Radio monitor teachers will encourage literate adult radio students to write back to the radio station their questions and answers for further explanations (Schramm, 1969). The radio station should send the literate students two evaluation sheets (Schramm, 1969). One, at the begin- ning of Unit I, and the other, at the end of the Family Planning Program. The first will serve to diagnose knowl- edge of the students before the program, and the second to evaluate his achievement after the program on family planning has been completed. They will be in test form. Two separate evaluation sheets will be recommended for the monitor teachers (Schramm, 1969). The first, at the end of Unit I, to see the progress and reactions of the students through the eyes of the classroom teacher; and the second, at the end of the Family Planning Program, for an overall evaluation of the complete program and the student improvement before the eyes of the monitor teacher. For home-based audiences, home visits of the family lglanning professionals and some monitor teachers from the :radiophonic schools will be recommended. Other means of evaluation feedback will be a study inesearch about the increase or decrease of births from the 97 participating population in the radio program in a lapse of 10 months. One important consideration is to assure coordination and cooperation of services and materials from the health centers with the information and education programs of the radio system proposed (Schramm, 1969). Educational Messages: Brief educational messages to the public as part of the general promotion will be broad- cast: The Family Planning Services helps each family to have only those children that it can support and will help to keep your family in the right size. Three hundred thousand children are abandoned in Venezuela! Family Planning is working to solve this problem. Support Family Planning! The Family Planning is the service that helps you to plan the children of tomorrow; so visit Family Planning Services! Family Planning helps you to have only those children that you want; hence support Family Planning! Do you want a happy family, a happy country with- out abandoned children? Family Planning is pro- viding its services for this goal! We plan our business, our trips, our entertain— ments, why don't we plan the size of our family? Family Planning helps you to plan your family! III. Television Title: "Irresponsible Parenthood and Its Conse- quences Upon Chi 1dren . " 98 Audience: Adult population attending television schools, courses for mothers, and home-based television audiences of Venezuela. G931: The final goal is that the audience use birth control methods; that the audience approach Family Planning Services as the best solution to avoid irresponsible parent- hood. The immediate goal is to present a clear picture of the problem and its consequences. Objectives: The intended audience after presenta~ tion of the program should be able and be determined to: a. Protect the life of children already born b. Make people receptive to the ideas about birth control c. Go to the Family Planning Services for help. Form and Methodology: The script will be presented in a "documentary" style (Hilliard, 1967). Slides and films will be used. This is the first of the lessons to be presented, and it corresponds to Unit I, No. l, "Irresponsible Parent- hood: Consequences for Children," p. 73. The classroom teacher or monitor at the receiving point should follow similar procedures stated for radio lessons on pages 87—89. Before the Television Presentation: The class teacher should prepare his students by taking care of the physical and mental learning environment (Schramm, 1969). 99 He should display interest and enthusiasm in the lesson. He should motivate the students by explaining something related to the theme to be presented, with such methods as introducing the personality of the television teacher to the students, asking questions related to the presenta- tion (Schramm, 1969; Gay—Lord, n.d.). During the Presentation: The monitor teacher should take active part in the program by listening with his stu- dents, and attending to the appropriated functioning of the television set. He should also pay attention to reac- tions of the students, and encourage them to answer the questions of the television teacher (Schramm, 1969). After the Program: The monitor teacher should dis- cuss with the students those areas of the lesson presented which need reinforcement, clarification, or expansion, and encourage students to give some comments about the presen- tation (Rogers, 1969). After the discussion, the monitor teacher will ask the students for a written answer to such questions as: Can a child grow up physically well in an overcrowded "rancho" or hut? Can a child with many brothers and sisters go to school? Can a mother support all children that she might have? How many children should a happy family have? When should a boy be put to work in order to help his mother? Who should support the family? Where should the parents go to have only the babies they want? 100 The information and education programs of the tele- vision system proposed should work in combination and cooperation with the services and materials from the health centers CU Doctor in class behind CU Video his desk. Title: THE UNHAPPY CONSEQUENCES FOR CHILDREN OF AN IR- RESPONSIBLE PARENT- HOOD. Dissolve. MS Doctor in playground of an elementary school. Children playing in the back- ground. Dissolve. LS Different views of slums surrounding Caracas city. (Schramm, 1969). Script Audio I am Dr. Robert X, and this is your Family Orientation Pro- gram. Today, we will talk about one of the most important problems of our country: The unhappy consequences for children of an irresponsible parenthood. This is Andres Bello Ele- mentary School in Caracas, capital of Venezuela. Our country with 10 million people is one of the youngest and fastest growing nations in the world. Venezuela, with 3.5 annual rate of population in- crease, about half of the population is under 14 years old. More than half of the children born in the country are illegitimate. The fast growth of urban population at expenses of rural centers has increased in Venezuela at a greater rate than the world average. In 1936, about 65 percent of the total population of the country were living in rural areas, to- day, only about 24 percent of the people remain in rural Venezuela. MS Doctor in a slum. The camera shows different aspects of the slum focusing on garbage and dirtiness. CU Huts, garbage. CU Doctor. CU Pregnant woman at the door of her hut. CU Doctor walking to another "rancho." 101 About a million people have emigrated from rural to urban areas during the last decade alone. The results: over- crowding belts of misery sur- round Caracas and other cities of the country. This is Caracas' notorious slum, "La Charneca." Its inhabitants left this miserable dwelling place down to the city to overthrow the dictatorial regime of Marcos Perez Jimenez in 1957, hoping for a better life. But, La Charneca remains the same. The same misery, the same unhealthy huts, and more over- crowding. They came here from all re- gions of the country. From the eastern part of the nation as far as Carupano and Margarita island; from Mara- caibo and the mountains of the far west, in the Tachira state. "Why did they come here?" We asked a pregnant woman mother of six: "We came here from Tachira state. We had three children. Life was hard over there. We sold our 'rancho' or but and everything. We thought Caracas would be better. I became pregnant and my 'common-law husband' ran away with another woman. A man came, he said he was going to help me. All of them run away, and I have six babies and a coming one. I can't work. I don't know what to do." The same story once again. Meanwhile, thousands of children with temporary fathers are brought into the CU Inside a hut with six children. Dissolve. LS Doctor traveling in a car. The car is presented in dif- ferent points of a road; up the Bolivar mountain, on the Andean high- land, in a valley, and on grassy plains with cowboys watch- ing hundreds of cows. The camera shows several huts. CU Manolo, while driv- ing the car. The camera focuses al- ternately on the huts and on Manolo. 102 world and abandoned to their fate in these overcrowded city belts of misery and de- gradation. Let's see how these huts look like inside, and who are their habitants: -"How old are you"? -"I am eight years old, and these are my brothers: Juan, Pedro, Freddy, Luisa, and Coromoto, the baby. My mom went to work and I am taking care of them." -"Where is your father"? -"He's living with another woman. He only comes here once in a while." Venezuela is a land of all seasons: the winter of perennial snows 5,000 meters above sea level, on Bolivar mountain; the fall in the Andean highlands with almost no vegetation and its frozen nights; the spring of its valleys, and the hot summer of the never-ending plains of "Los Llanos." These are the "Llanos," the Plains of Venezuela. With its rivers and grassy plains where the never-tired "llanero," cowboy, watch the cows of his boss, his "amo," the lord of the land. The owner of cows and horsemen. The master of their women and wives. We asked Manolo, our chauffer: "Who live in these unhealthy huts?" -"There are many families liv- ing in these 'ranchitos,' small huts in the 'hacienda.‘ Almost none of them are really families. Most of them are just common-law unions." -"Does the 'amo' also live here?" Dissolve. CU Doctor in front of Caracas' Children's General Hospital. Dissolve. Inside a doctor's waiting room. Women and children are sitting and waiting for their turn. CU Woman poorly dressed and holding a baby enters and goes to the receptionist desk: CU Receptionist (NJ The woman holding her baby goes to a chair and sits down between a fat lady and a small girl. 103 -"His family lives in the big house of the 'hacienda,‘ but he has many illegitimate children with his 'queridas,’ mistresses living in these huts. He's a very rich man. He's the boss all across the land. Because of his health and power he appoints the mayor, and the chief of police, and even the judge in the nearby town. The only authority who is above him is the President of the Council of the District, but, who is also his illegitimate son." This is Caracas' Children's General Hospital. Medical care is paid by the state, and hundreds of children come here every day for medical care. Some of them undergo diffi- cult surgeries; most of them are treated for avitaminosis and gastroenteritis. Many others, like this three-week old baby called Juan: -"Good morning. I want to see Dr. X, my son is very sick." -"Dr. X is busy, right now. I am sorry, but you have to wait until I call you." -"Thank you." MS The woman talks to the fat lady: CU Fat lady holding the baby: CU The woman standing: CU Fat lady: CU The woman kisses the baby and leaves: Dissolve. CU Fat lady alone in the room holding the baby. To the receptionist: Dissolve. CU Doctor. 104 -"Excuse me, madam. I have to go to the drug store and pick up a prescription for Juan, my baby. He's only three weeks old and he's very sick. Would you like to do me a favor, and hold my baby until I'll be back with his prescription?" -"Sure, it's a pleasure! I'll take care of him. He's beautiful and nice!" -"Thank you, so much, I'll be back as soon as I can." -"Don't worry. I'll take care of him!" -"Thanks, so much. Bye, my baby!" -"It has been more than an hour that the woman is gone. I think she's not coming back!" The woman never came back. The baby was abandoned by his own mother! Later on, the authorities of the hospital gave the child to a foster parent for his care. The same story is repeated every day hundreds of times in all charity centers of our cities. "What is the future of the abandoned child?" We ask Dr. X, president of the Venezuelan Council for Children, the governmental institution which takes care of the abandoned children: "How does the Vene- zuelan law protect the aban- doned child?" CU Doctor B: Dissolve. CU Doctor on the street. People passing by. CU Children asking for money in a corner of a Caracas street. CU Children cleaning shoes in Caracas main square. MS Children walking through Caracas streets. Dissolve. CU Doctor in the same scene of the begin- ning behind his desk. 105 -"Our Constitution guarantees the abandoned child his right to live under those condi- tions by which he can have appropriate physical, intel— lectual, and moral develop- ment. The state also guar- antees him the right to know his parents, to be assisted and nourished until his com- plete development. The child is also protected from being exploited." Venezuelan laws protecting under-aged children are well written, but almost never en- forced. In order to be en- forced properly,hundreds of Venezuelan Councils for Children should be built to receive more than three hundred thousand abandoned children. Hundreds of abandoned children, against the law, go begging for something to eat. Children are forced to work when they should be in school. Children, who frequent bars and movies, who roam the streets of our cities, and without moral or spiritual guidance by those who brought them into the world, become juvenile delinquents. Thousands of innocent child- ren and poor abandoned mothers are condemned every day to a miserable life due to the ir- responsibility of so many men. The situation is grave, and needs rapid and drastic solu- tion. Slide title: FAMILY PLANNING SERVICES . Slide: A child between his father and mother with happy faces. Slide: Couple enter- ing the door of a family planning clinic. Follow-up Materials 106 Family Planning Services will help you to alleviate this problem. Family Planning offers birth control services and other related services. These birth control services allow you to have children when you want them, and to avoid pregnancy when you don't want them. You can plan a pregnancy when you know that your child will be born into a home where he is welcome, when you can provide him with all care and love that he needs in order to survive, to develop his body and his mind as a happy human being. Come! Join the thousands of people like you and me, who go to the Family Planning Services across the nation every day! Thank you. Music. Each of the themes listed on pages 73-74 are, in principle, intended to be presented as a separate televi- sion lesson, and as an example of materials that can be used for a Family Planning Program. Some of the themes, nevertheless, might be treated in different sessions, according to the teacher's judgment. The success of the pilot programs might indicate that more television programs should be produced related to all aspects of health improvements (Schramm, 1969). 107 Typgs of Television Scripts: Other types of televi- sion scripts will be recommended, besides the "documentary" type presented above. Among them there will be "inter- views" with doctors, experts in ecology and other related fields, and workers in family planning services; "panel and round table discussions"; "actuality," like visits to clinics of birth control; "dramatizations," like themes related to abandoned mothers and children; and "demonstra- tions," like those programs related to home improvement and child care (Hilliard, 1967). Methodology: Procedures concerning before, during, and after the television presentation will be recommended similar to those recommended for the television lesson explained on pages 98-100. Before the Program: The monitor teacher should pre- pare his students physically and mentally for the lesson being presented. He should motivate students for the program with questions related to the theme to be treated, displaying interest and enthusiasm in the lesson, making the material ready to be used, etc. (Schramm, 1969; Smith, 1961; Gay-Lord, n.d.). During the Program: The monitor teacher should attend to the appropriate functioning of the television set. Listening with students, encouraging them to answer the television teacher, and pay attention to their reac- tions (Schramm, 1969). 108 After the PrOgram: The monitor teacher should dis- cuss with the students those areas which need to be rein- forced, clarified, or expanded, thereby encouraging stu- dents to present their own comments and suggestions to the program presented (Rogers, 1969; Schramm, 1969). This class period should be devoted to activities which will help students to understand the concepts presented, and draw their own conclusions, clarify misunderstandings, and encourage students to seek answers to questions through research and independent study (Schramm, 1969). The pos- sible use of other audiovisual devices, like filmstrips on page 85, might be helpful in reinforcing learning activ— ties, and/or provide for individual differences. Some- times, it might be recommended that the literate students give written answers to questions related to the presenta- tion (Rogers, 1969), and to be specified on the Teacher's Guide. The monitor teacher should draw some conclusions and follow-up activities as a person and as interpreting the opinion of the whole class. The main source for the follow-up activities will be indicated on the Teacher's Guide. Means of Feedback: Television teachers and monitors should encourage adult literate television audience to 'write back to television studio teachers asking for fur- ther explanations to their questions (Schramm, 1969). In those places, like cities where telephones are available, 109 the use of telephone will be recommended as a more con- venient and faster feedback device (Carpenter and Green- hill, 1965). The use of short-wave radio is also recom- mended for illiterate students so that they will ask ques- tions directed to the television studio teacher. 'Also a program with television studio teacher answering the ques- tions turned in by the students (Carpenter and Greenhill, 1965), could be employed. Evaluation sheets will be recommended (Schramm, 1969) to literate students, and as a test, at the beginning and at the end of the program. The first, to diagnose their knowledge before the program starts; the second, to evalu- ate their improvement after the program has been completed. Two separate evaluation sheets for the monitor teacher will be recommended (Schramm, 1969). The first, at the end of Unit I, to see the reaction to the program and progress of the students through the eyes of the teacher; the second, at the end of the program for an over- all evaluation and further recommendations. Both evalua- tion sheets will be included in the Teacher's Guide. Visiting family planning professionals as well as some monitor teachers will be recommended to supervise the progress of television home-based audiences, encouraging them to write or call television teachers for further ex- planations when they are needed. 110 Other means of evaluation feedback will be a study research about the increase or decrease of births from the participating population in the television programs. Summary A program designed to be used by the proposed radio and television systems as a part of the total communica- tion program on family planning was presented. The pro- gram consists of a filmstrip, radio, and television scripts for the first unit to be presented with follow-up materials and related methods for other units of the pro- gram. The media to be proposed and the possible ways to be used and the Federal requirements of Venezuelan Government will be discussed in the next chapter. CHAPTER IV COMMUNICATION CHANNELS When we communicate we transfer ideas from a source to a receiver. In the process of communication we may distinguish four elements: source, message, channel, and receiver. The determination of the channel to be used by the communicator is an important function in order to affect the knowledge, attitudes, and behavior of the re- ceiver in a desired way. The channel is defined as some kind of vehicle in which the source transmits the message to the receiver. Channels of communication may be grouped, according to Rogers,2 in two broad categories: mass media (all electronic and printing channels), and interpersonal (word-of—mouth communication among people themselves). Both channels have their advantages and disadvantages. Interpersonal channels are useful to provide two-way 1David K. Berlo, The Process of Communication: An Introduction to Theory and Practice (New York: Holt, Rinehart and Winston, 1964), p. 64. 2Everett M. Rogers, Modernization among Peasants: 'Fhe Impact of Communication (New York: Holt, Rinehart and Winston, 1969), p. 124. 111 112 interaction and feedback, while for the spread of informa- tion quickly mass media channels are best suited. Research results suggest that "mass media communica- tion is more important in changing cognitions, than in increasing knowledge of ideas, whereas interpersonal com- munication is more likely to cause attitude change."3 Latin American radiophonic schools and study groups in Communist China are in essence a combination of mass media and group discussion. These experiences might con- firm that the effect of mass media messages will be greater when they are combined with interpersonal communication in media forums, because communication channels used by the peasants are mainly interpersonal in nature with an in- creasing utilization of mass media as modernization comes through. In addition to these formal media forums, Rogers distinguishes other groups that gather informally in places like coffee houses, taverns, or homes and not in groups created by an agent of change. These types of informal groups that gather to listen to mass media occur frequently among villagers in less developed countries where the num- ber of media sets is in short supply. Rogers categorizes channels in localite or cosmo- polite according to their origin; so, thus, interpersonal localite channels are: neighbors, village council and 31bid., p. 126. 113 relatives; interpersonal cosmopolite: extension agents, wandering storytellers and salesmen. Mass media channels localite are: village newspaper and wall posters; cos- mopolite: radio, television, cinema and city newspapers. Results of a study conducted among peasants of the three Colombian villages of Pueblo Nuevo, San Rafael, and Cuatro Esquinas about the use of communication channels in the adoption of 2,4-D weed, showed that cosmopolite channels were more important in informing than persuading and for earlier rather than later adopters. Results of this study also suggest that perhaps the cosmopolite- localite channels classification has greater cross-cultural utility in explaining diffusion of an innovation than does the interpersonal-mass media categorization. By combining mass media and interpresonal channels more people can be reached and a greater number of those reached can be persuaded to utilize new ideas.6 Radio forums are in essence organized small groups of people who meet regularly to listen to a mass media program and dis- cuss its contents, that is, a combination of mass media and interpersonal channels. 41bid., p. 132. 51bid., p. 133. 6Wilbur Schramm, Mass Media and National Development: 'The Role of Information in the Developing Countries (Stan- ford, California: Stanford University Press, 1964), pp. 127—144. 114 Rogers sustains the forum approach, because, he says the media forums are more related with the present pattern of values, attitudes, and social organization of life of the peasants; and feedback from the forums can result in better program content more appropriate for the audience. On the other hand, to rely on interpersonal communication from a change agent to reach millions of peasants would be a costly and endless process. Evidence from empirical research shows that such an approach has much promise.7 McNelly sustains that mass communications is most effective when combined with interpersonal and intergroup communication channels, but there are opportunities for direct mass media effects on information and attitude levels. "This position looks at mass media communications as a highly complex, multi-stage, multi-directional pro- cess, with possibilities for both indirect and direct ef- I I 8 fects of mass media messages.“ Types of Mass Media Forums Radio Forums According to Cassirer, adult education through group listening to mass media began with the use of radio in 7Rogers, op. cit., p. 135. 8John T. McNelly, "Mass Communication and the Climate for Modernization in Latin America," Journal of Inter American Studies, VIII (1964), 345-357. 115 9 The basic idea of farm forums Great Britain, in 1928. began in Canada in 1939, and later copied by such nations as Japan (1952), India (1957), Pakistan and Mali (1961), Nigeria (1962), Gana and Jordan (1964), and more recently by Costa Rica, Brazil and others. The basic elements of radio forums are: planners help establish and service the forums; radio station sources send to forum leaders written material guides with information and discussion questions; regular radio programs broadcast to forum members gathered in a place to hear radio; group discussion of the broadcast, and feedback about decisions and clarifications of questions to the program broadcast. The largest and more researchable radio forums be- gan in India in 1956 with 144 radio rural forums on ten 10 At the weeks trial around Poona, in Southwest India. end of 1956 a total of 12,776 forums were reported with an enrollment of a quarter of a million villagers and a goal of 15,000 forums for March, 1966. The Indian radio forums meet twice a week in the evening. The radio pro- grams broadcasted from an All India Radio Station last 9Henry R. Cassirer, "Audience Participation, New Style," Public Opinion Quarterly, XXIII (1959), 529-536. 10Wilbur Schramm et al., New Educational Media in Action: Case Studies for P1anners--I (Paris: UNESCO, 1969), pp. 107-133. 116 from thirty to forty minutes. The thirty minute discus- sions were led by the chairman. He encouraged the group to decide on some action. He sent unanswered questions back to the radio station for later treatment. In this way the forum is designed to bring action and discussion, and to maintain a two-way communication between the forum members and the station planners. The basic lesson from the radio rural forums of India is that it is a promising and potent tool of national and 11 community development. But, these forums require con- tinuing care from professional planners, the forum mem- bers dropout, and the radios break down.12 Radiophonic Schools in Latin America The fundamental purpose of the radio schools in Latin America is basic education to reduce illiteracy in rural areas. The Latin American radio schools are simply an organized group of peasants led by a trained monitor who helps the students learn and encourages them to listen to radio lessons. They were initiated in Colombia by Father José Joaquin Salcedo in 1947. The Colombian Radio Sutatenza program claims to have 16,000 radio schools with some 130,000 students, 90 percent of whom are from rural llIbid., p. 132. 12Rogers, op. cit., p. 143. 117 areas. Radio Sutatenza claims that 64 percent of all illiterates enrolled can read and write after a year's course.l3 Martin gives a comparative description of the de- velopment of radio Sutatenza in Colombia. It includes an evaluative pilot study based on a statistically reliable sample of the two kinds of Radiophonic Schools of Sutatenza: the "Organized Schools" that send in statis- tics and whose auxiliary teachers attend meetings; and the "Audition Centers," schools which do not have direct contact with the radiophonic schools of Sutatenza. He presents information on school location and facilities, descriptive information on monitors and local assistants. The report presents 13 indices of the accomplishment of Radio itatenza. The results obtained by the radiophonic sch0( . are very considerable in alphabetization, and even . be so in raising the standard of living of pea- sanr ,;er Vicent M. Primrose, in a study about Suta- tenx. ..aols, sets the objectives of her research in stuig..y uhe educational program of radio schools, in eva- ..g; its effectiveness in the lives of the peasants, 'Joid., p. 138. liferrer S. Martin, Muestra Piloto de las Escuelas Radipi1_icas Rurales, Accion Cultural Popular, Escuelas Radirr.licas de Sutatenza, Colombia (Paris: UNESCO, 1951). 118 and in identifying aspects of the historic-cultural back- ground which contribute to the degree of acceptance of this educational program by the peasants. Among her con- clusions, she says that Radio Sutatenza educational pro- grams are well received by the peasants of agricultural communities, but not so by those peasants who move to a big industrial society; living conditions have changed in the areas of housing, nutrition, agricultural techniques and recreational and social activities where radio classes are attended. Among its recommendations for further de- velopment of radio schools and its effectiveness, the study stresses the need of a socio-scientific study of the needs of the people in different areas; a better literacy material written on the level of the students; up-dating of pedagogical techniques for a mass communica- tion program; more lay leaders to direct the schools; and better testing techniques.15 A group of U.S.A. researchers, headed by John A. Brodbeck, conducted a survey in El Salvador and Honduras radiOphonic schools in 1963. They devoted most of their analysis and discussion to the El Salvador program.l6 lsVincent Marie Primrose, "A Study of the Effective- ness of the Educational Program of the Radiophonic Schools of Sutatenza on the Life of the Colombian Peasant Farmer" (unpublished Ph.D. dissertation, St. Louis University, 1965). 16John A. Brodbeck et al., Use of RadiOphonic Teach- ing in Fundamental Education (Williamston, Mass.: The Public Opinion Research Center, Williams College, 1963). 119 Five hundred and twenty one students were inter- viewed in El Salvador Radiophonic Schools. Fifty-nine percent were able to read, of which 15 percent of the sample said they learned to read at the radiophonic schools. Most of the students said they had learned from the radio school more than they had expected. The Agri- culture subject contributed to the satisfaction about radiophonic schools in a greater scale than reading and writing courses. Researchers attribute this to the fact that the length of the training period prior to interview was relatively short for most students. Rogers explains this by a face—saving miSperception by adult villagers who do not want to admit that they learn literacy in classes, which they consider only for children. This emphasizes the importance of appropriate lesson content as a motivation for participation in adult literacy classes.17 The lack of facilities for training teachers was a major problem for school administrators. In general, the radiophonic system was considered an important contribu- tion to community improvement considering the newness of the system in both countries. Reasons given by the stu- dents and administrators in regard to failure to enroll students and dropouts of the radio schools, were laziness, l7Rogers, op. cit., p. 139. 120 indifference to becoming literate, and distance to the class. A study prepared by Jack Lyle based on a research mission to Honduras in 1965 explains the organization, facilities, financial inputs and outputs of the Honduras 18 Of the total enrollment of 7,820 RadiOphonic Schools. students in 1965, a total of 89 percent of the 3,370 stu- dents examined passed the tests. Several reservations must be made with regard to this result. First, literacy students upon entering school and repeating students could take the examination, and second, there may have been ”cooperation" between students. There have been some problems. The dispersion of the population in some areas made difficult the organiza- tion of groups large enough to support a radio school. The participants' hard life and poverty give little in- centive to learn to read or to practice reading skills once acquired. Educational organizational problems usually include using less than desirable broadcasting times because commercial stations dictate the schedules. The appropriate use of frequencies on radio receivers was lacking because there were frequency problems, some sets had been tampered with, and because of increasing repair 18Jack Lyle et al., "The Radio Schools of Honduras," in New Educational Media in Action: Case Studies for Planners--III (Paris: UNESCO, 1969), pp. 95-110. 121 costs. There was lack also of proper administrative and financial support. Some support was received from the Peace Corps, U.S. A.I.D., and the Federal Republic of Germany Church. However, the radio school staff felt that there were adequate resources in Honduras to support the schools adding the psychological advantage of being supported by the national society. The study concludes that for many villages the schools have provided the means of organizing the pea- sants into cooperative efforts to improve their communi- ties. The program cannot be considered as a measure for literacy teaching because the program has operated under too many handicaps. The Ministry of Education and Health of Brazil has an educational broadcasting service which broadcasts 19 The programs are literacy and educational programs. more educational than instructional in nature and have a local flavor with the greatest concern of the type of audience, their customs and preferences. The station also broadcasts courses in adult educa- tion. The students are regularly enrolled and do all the exercises at home, following the programs and sending their work to the station correction services. Experience 19Fernando Tude de Souza, "Educational Broadcasting Services of Brazil," Fundamental Education Quarterly Bulletin, II, No. 2 (April, 1950). 122 showed that the best teaching technique for these courses at the intermediate level was that of a simulated class- room consisting of a teacher and two or three pupils. There were also three types of rural programs: one for children, another for farmers and a third for house- wives from rural areas. The station sent seeds, miniature tools for the children to plant gardens, books and pamph- lets for housewives on food, cooking and fruit canning. Similar materials were sent to farmers on problems of animal-raising and planting seasons. Many loud-speakers in small rural communities relayed the programs to hun- dreds of listeners assembled as collective audiences in the local squares. About 70 percent of the total popu- lation of Brazil lives in rural areas and an estimated 55 percent of the country adult and young population are il- literate, which makes the value of radio teaching evident. So far, the results have been very encouraging.20 "Cruzada ABC" (crusade for literacy) centered at Recife, Brazil is a program which presently has over 200,000 adults enrolled each night of the week, and is aimed to have five million adult literates over the next . 21 five years. 201bid., p. 35. 21Rogers, op. cit., p. 139. 123 Television Forums In some countries television has been used in the same way as radio as the mass media channel for their forums. An experimental "teleclub" program was sponsored by UNESCO for the French farmers in 1954. In 1958, UNESCO also organized television viewing groups in Italy. The not so encouraging results of Italian "Telescuela" were attributed to lack of group participation and passive viewing although it was considered highly successful as an experience in basic education.22 In some ways "telescuela" represents the ideal technical model. It does not, however, apply the tech- nology effectively based on the geographically diSposed population. The purpose of "It's never too late" program stimulated students' interest, providing visual aids to the classroom with some instructional materials. Such a program appears to have been successful in providing a means for people out of school to remedy inadequacies in their education at the primary level.23 La Telescuela Popular Americana of Arequipa, Peru (TEPA) was organized by a group of civic-church people who decided to do something by using television with 22Cassirer, op. cit., pp. 529-536. 23Wilbur Schramm et al., The New Educational Media in Action: Case Studies for P1anners--III (Paris: UNESCO, 1969), p. 39. 124 regard to the problem of a number of adolescents who had drOpped out of high school at an early age and had become domestic servants in Arequipa city, Peru. Jack Lyle and others, in an International Institute for Educational Plan- ning research mission to Peru in 1965, found that TEPA appears to be achieving its best results in providing fundamental education via television to those youngsters. This shows that it is meeting a real need and is achieving real results, although much of the progress is due to the extra help which these youngsters receive from training teachers about two hours each Saturday. TEPA is working, according to the research mission, under a great number of disadvantages like lack of equip- ment and technical skill, others like lack in training and advice from some other centers of television research and development. TEPA has attempted to relieve a number of educational problems without consolidation of one series before another series of programs were undertaken, posing the question whether it is better to try a little in many problems or to concentrate on only one.24 24Jack Lyle et al., "La Telescuela Popular Americana of Arequipa, Peru,“ in New Educational Media in Action: Case Studies for Planners—II (Paris: UNESCO, 1969). 125 Chinese Communist Study Groups 25 about 60 percent of the adult According to Hiniker, Chinese population participates in study groups using news- papers and magazines among Communist Party members as a means of political indoctrination and promoting development effort among citizens in general. The study group con- sists in essence of a Communist leader who reads the print- ing material to a group of five to 30 members and main- tains control of discussion forcing every member to take a position on the issue discussed. Such study groups are considered essential in the special communication campaigns of the Communist Party which suggests their great import- ance in the communication strategy of the Chinese Communist government.26 Effects of Media Forums According to Rogers, all media forum programs uti- lize mass media, are small-sized groups, participate in discussion and seem to be effective in diffusing knowledge in informing and changing attitudes. The effectiveness of mass media with interpersonal communication in forums seems to depend upon: content of the program which should be 25Paul Hiniker, "The Mass Media and Study Groups in (Communist China," in Mass Communications and the Development of Nations (East Lansing: Michigan State University, International Communication Institute, 1966). 26Rogers, op. cit., p. 140. 126 relevant to the problems of peasants and at the same time, appropriate to their level. Visual aids can add effec- tiveness to learning; the discussion after the program emphasizes local application; feedback from audience reac- tions, interests, and clarifications of lessons to the radio station; careful organization, operation, and main- tenance procedures; and include village opinion leaders as members of the forums to assure the spread of informa- tion to other members of the village.27 Venezuelan Broadcasting Regulations The broadcasting systems of Venezuela are regulated by the "Ley de Telecomumicaciones" (Telecommunications Law), "El Reglamento de Radiodifusion" (The Broadcasting Rules and Regulations), and by other more specific Reso- lutions about broadcasting issued by the Ministry of Com- munications. For the purposes of this study we will point out only those articles of the Broadcasting Rules and Regula- tions and other special Resolutions of the Ministry of Communications directly related to our interest. Informa- tion related to the federal requirements of the Venezuelan Broadcasting Regulations are to be found in a special sec- tion of Appendix B. 27Ibid., pp. 140—144. 127 Educational Broadcasting Stations All educational broadcasting stations of the country are governed by Resolution No. 1,622 from the Ministry of Communications which states that:28 For purposes of installation and functioning they are subjected to applicable resolutions of the actual Broadcasting Rules and Regulations, and to future regula- tions of the Ministry of Communications.29 The Educational Broadcasting Stations have as a goal to educate, to broadcast culture, and to disseminate useful information and provide good entertainment. Such stations will then broadcast philosophic, literary, his- torical and geographic works; scientific and technical publications, high quality international music, native Venezuelan music, and music from national composers; works for the improvement of education, and every thing that contributes to raise the morality of the Venezuelan people for their cultural, social, and individual improve- ment; those things that contribute to the improvement of human relations and to the promotion of peace and universal solidarity (2). 28Republica de Venezuela, Ministerio de Communica- ciones, Direccion de Telecomunicaciones No. 1,622 Resolu- cion Relativa a1 Establecimiento de Emisoras Exclusivamente Culturales. Caracas, October 30, 1964. 29Of the Educational Broadcasting Stations Regula- tions. Numbers of subsequent articles cited will be given in the text. 128 They cannot broadcast political or religious themes fomenting dissent toward some sectors of the audience or against their particular convictions, or news and com- mercial advertising whatsoever (3 and 4). The power of the Educational Broadcasting Stations will be permitted according to the needs and importance of the areas to be served by them (6). Educational Broadcasting Stations are classified by power and frequencies as in the following table (5 and 7): TABLE 27.-—Classification of Educational Broadcasting Sta- tions by power and frequencies. Class Power Frequency Kc Class "A" Above 10 kilowatts 540 to 950 Class "B" From 1 to 10 kilowatts 960 to 1,300 Class "C" From 500 Watts to l Kilowatt 1,310 to 1,400 Class "D" From 250 Watts to 500 Watts 1,460 to 1,600 Only Educational Broadcasting Stations class "D" can in certain cases operate with their transmission plants inside cities with antennas Marconi of 1/4 wave length, and as long as they do not interfere with other services (8). All installations of Educational Broadcasting Sta- tions must be made according to modern techniques and maintain their functioning characteristics according to the Recommendations of the Ministry of Communications and to the international requirements (CCIR), (9). 129 A Venezuelan broadcasting technician with a certif- icate from the Ministry of Communications will be re- sponsible to the Ministry for the good functioning of the station (10). Installation permits for Educational Broadcasting Stations will be extended only to Venezuelan citizens (11). Educational Broadcasting Stations can not broadcast programs from commercial stations, but they can broadcast programs from a similar educational broadcasting station up to 50 percent of their total broadcasting time (12); they can not be transformed into a commercial station under any circumstances (13). The Ministry of Communications can dictate comple- mentary regulations to solve cases not included in the present resolution (14). Radiophonic Schools of Venezuela The Radiophonic Schools of Venezuela are an educa- tional service from the Division of Adult Education of the Ministry of Education, and they are characterized by 'the rational utilization of radio as an informal educa- tional instrument to serve the adult population of the country . 30 30Republica de Venezuela, Ministerio de Educacion. I)ireccion de Educacion Primaria y Normal. Division de Imducacion de Adultos. Escuelas Radiofonicas. Cursos liadiales de Alfabetizacion y Mejoramiento Cultural. Ziaracas, 1970. 130 There are at the present time about 500 radiophonic schools. In their initial step they teach literacy and some courses of elementary education and their influence is limited to some rural areas. They broadcast from two radio stations located at San Fernando de Apure city, about 258 miles south of Caracas. One of the stations broadcasts on 120 meter band, frequency of 2,430 kilo- cycles and one kilowatt of power; the other one transmits on 60 meter band, frequency of 4,910 kilocycles with 10 kilowatts of power. That zone has been selected, accord- ing to radiophonic schools sources, because the geo- graphic characteristics of the region assures considerable decrease of death audition areas.31 The national office of the radiophonic schoOls is centralized in Caracas, and it keeps direct contact with the stations by remote control. The planning of the pro- grams is made in the central office by specialized per- sonnel and the lessons are taped at the Audio Vusual Center of the Ministry of Education. 'The schools have at the present about 500 radio sets of fixed frequency operating in the same number of radio schools. Each school, accord- ing to the same sources, has assigned its own teacher 3properly trained for this, and the schools are controlled .by the Ministry through the Regional Offices of Adult Education. 3lIbid. 131 The present programming is restricted to literacy and some specific areas about subjects of the first aca- demic year of the Popular Cultural Centers and Cultural Extension Centers. The literacy program has the following goals, accord- 32 to contribute to ing to sources of the central office: teach literacy to many Venezuelans; to bring information to promote cultural improvement of the students in order to strengthen their national conscience, betterment of their health habits, and help their home and production. Programs are broadcast from Monday to Friday 7:00 to 7:45 p.m., and they have three parts: (a) Introduc- tion: educational and cultural slogans in combination with music; (b) Literacy lesson from the basic book "Abajo Cadenas" (Down with the Chains) from the Adult Education Division of the Ministry of Education, and the monitor teacher talks about one of these three aspects: health, production or civic education. Programs for these areas use material prepared by the Health Education Divi- sion of the Ministry of Health and Social Assistance (SAS). Among other recommendations, and as a part of the literacy program, the monitor teacher should motivate students before radio programs, listen with the students to the radio, and take one hour work after the radio class 321bid. 132 answering questions, helping students in written lessons, or in case the lesson is discontinued, they should talk about one of these three aspects: health, production, or civic education. The monitor teacher should read the corresponding lesson and prepare the necessary auxiliary material to establish a better relationship between his job and the radio to guarantee the maximum educational results. Radio lessons recommend along with the radio other auxiliary materials like blackboards and feltboards. The Division of Health Education of the Ministry of Health and Social Assistance (SAS) developed a Child- welfare program in relation to the specific problem of health in rural areas of Venezuela. Such a program had two types of actions, one on a national scale and using as a basic material health letters written for the rural medical doctors of the country during one year; the other action was more restricted: directed to 15,671 students of the 427 radio schools of the country, 16 lessons, once a week, during three months. A person in each school was trained to use feltboards and charts especially prepared by the division for each lesson. The monitor teacher showed the charts at the same time with the radio and spent a certain amount of time helping students after each lesson. The campaign enlisted the collaboration and 133 TABLE 28.--Radi0phonic schools of Venezuela: Students and schools by states.* Average Student States Students Schools per School Anzoategui Apure 708 25 28.3 Aragua 129 5 25.8 Barinas 1,363 38 35.9 Bolivar 659 22 30.0 Carabobo 200 5 40 Cojedes 592 17 34.8 Falcon 120 5 24 Guarico 591 18 32.8 Lara 2,129 50 42.6 Merida 1,706 50 34.1 Miranda 1,281 31 41.3 Monagas 1,077 25 43.1 Nueva Esparta 30 1 30 Portuguesa 1,738 42 41.4 Sucre 57 2 28.5 Tachira 49 2 24.5 Trujillo 1,601 45 35.5 Yaracuy 1,472 40 36.8 Zulia T.F.Amazonas T.F.Delta Amacuro 44 2 22 Distrito Federal 125 2 62.5 Total 15,671 427 36.7 *Ministerio de Educacion Nacional, Memoria y Cuenta 1965, Vol. II Anuario Estadistico Table No. 239. Caracas, Venezuela. 134 advise of the local medical doctor in relation with the themes treated, according to Gonzalez Guerra.33 Although it is difficult to evaluate the positive aspect of these lessons, Gonzalez Guerra conceptualizes that the collaboration of radio in the campaign was a positive one. Among the shortcomings of the radio lessons, he says that the audition was, sometimes, weak, that the radio cannot supply the teacher and it is directed to an in- visible audience. An interesting point is that certain schools reacted violently against the use of charts show- ing a mother nursing her child, as an act against good taste. This emphasized the need for selection of appro- priate materials without hurting the sensitivity of the audience. Among its advantages, he cites that radio is an excellent help for education, eliminates distances, and it can cast and form audiences in favor of health con- cepts. Gonzalez Guerra looks with great optimism for the collaboration of the health programs with radio schools as a vehicle for a rational development of an integral 33Miguel Gonzalez Guerra. "Educacion para la Salud en el Medio Rural Venezolano: Un Afio de Labores" (un- published Ph.D. dissertation, Central University of Venezuela, 1967). pp. 348-350. 135 program as a whole, in order to acquire the best results in health education of the Venezuelan adult population.34 Summary Communication channels and different ways to in- fluence peOple were presented. A review of the Rules and Regulations needed for the establishment of Educational Broadcasting Stations in Venezuela was also presented. Information related to the Federal requirements of the Venezuelan Broadcasting Regulations are to be found in a special section of Appendix B. 34Ibid., pp. 354-356. CHAPTER V REVIEW AND RECOMMENDATIONS This study has been focused on the application of radio and television and other media to help solve the needs of the Venezuelan adult pOpulation. An instructional radio and educational television and multi-media system, together with other resources available in the country, has been proposed to help solve the Venezuelan adult population needs. An example of a health need, namely population ex- plosion, has been presented to illustrate how the media systems proposed will be used, with other available health resources of the country, to help solve this particular problem of population explosion, and by the same token, other needs of the Venezuelan adult population. In this regard, in the area of population explosion, the study has presented the fact that 1/4 of the total population live isolated in remote areas of the country making the improvement of health conditions increasingly difficult. Migration from rural to urban areas has caused the fast growth of several cities with serious problems 0f slums without the most elementary health needs. 136 137 The population increase of the country has been pre- sented as due to different factors: like the prolific childbearing of Venezuelan women, living either married, in common-law marriage or single, and the low diffusion of anticonceptive practices especially among low income people. One result of these facts has been the increasing number of illegitimate children. The high rate level of births and low mortality level has caused a predominantly young population--about half of the total population is under 14 years old, increasing the burden of persons potentially active to the maximum. This study has presented the actual situation and its future trends of population explosion in Venezuela. The historic trend of the Venezuelan family is showing marked inclination toward voluntary birth control especially among upper-middle class people. The health and medico-social aspects of birth control have been presented. The attitude of the people toward birth control has been found to be positive, and religious practices seem to have no relation- ship with attitudes of women about birth control. The Catholic Church in Venezuela rejects abortion, steriliza- tion, and utilization of compulsive methods to impose birth control, but admits that the state can give information about birth control methods to those who want to use them according to their own conscience. 138 The official attitude toward birth control is posi- tive and there are now governmental agencies engaged in the population control policy. The functions of these institutions are, among others, to exercise a broad edu- cational role in order to promote its objectives and show its personal and family advantages not only to those who voluntarily avail themselves of the services but also to the whole community. The available health resources of the country have been presented in the study. The policy of health in Venezuela is characterized by the fact that the national government performs through its Ministry of Health and Social Assistance (SAS) an integral function in the pro- tection of health, and that there has been progress in the improvement of health, but there still exists a great per- centage of diseases due to many health problems. These health problems and their possible solutions cannot be taken into consideration apart from other economic and social problems. Due to the lack of a national health plan, and for purposes of this study, a set of health priorities have .been established, pOpulation explosion being identified as the first health priority of the country. The study has shown that the cooperation of the pub- lic is essential in any family planning program, and in- -terest in the project is connected with the educational 139 level of people involved. The study also presented the family planning program as one of intensive education of adult population in all areas related to the identified need. The study presented the job of the mass media in this particular problem of population explosion as to spread information and a sense of social rightness about the per- ception of social support within the community in relation to birth control. In terms of the media to be used, the study distin- guished three main steps: during the first year, the use of audiovisual materials; the second year, the use of audiovisual materials and radio; and the third year, the use of radio and audiovisual materials and television. Different communication channels used by people in the process of communication were analyzed in the study. By combining mass media and interpersonal channels more people can be reached and a greater number of those reached can be persuaded to utilize new ideas. Different mass media formats were reviewed. Radio and television forums and radiOphonic schools of Latin America and their effectiveness in diffusing knowledge in informing and changing attitudes were presented. The ef- fectiveness of mass media in combination with inter- personal communication in forums seems to depend upon: (1) content of the program and its relevance to the 140 problems and intellectual level of the audience; (2) dis- cussion after the program to emphasize local application; (3) feedback from audience reactions, interests, and clar- ification of lessons to the stations; (4) careful organi- zation, operation and maintenance procedures; and (5) in- clusion of opinion leaders as members in order to assure the spread of information to other members of the com— munity. The use of audiovisual materials can add effec- tiveness to learning. The present situation of the Venezuelan Broadcasting systems and their rules and regulations for existing sta- tions for the establishment of a new system of radio and television were presented in the study. The actual regu- lations for the establishment of educational radio broad- casting and educational television stations, their maximum and minimum possible power and frequencies were included in the present study. The Radiophonic Schools of the Ministry of Education of Venezuela are restricted to literacy teaching and some courses of elementary education and their influence is limited to some rural areas of the country. Their educa- tional impact was directed to about 427 schools with about 15,671 students in 1965. The RadiOphonic Schools recommend along with the radio lessons to use other auxiliary mate- rials, like blackboards, feltboards, and flip charts. 141 The study presented a program designed to be used by the prOposed systems as a part of the total communication program on family planning. The program consists of a filmstrip, radio, and television scripts for a program of the first unit to be presented: "Irresponsible Parenthood: Consequences for Children," with follow-up materials and related methods for other units of the program. Recommendations It has become apparent during the course of this study that one of the most crucial jobs of mass media is to spread information and a sense of social rightness about the perception of social support within the com- munity in relation to birth control. The following recom- mendations are relevant to the study: I. To establish a pilot project for the use of media in a restricted basis for the first three years. II. To establish an audiovisual center or require ser- vice from existing centers to provide materials for the professionals in the field, especially materials for radiophonic schools, conferences, workshops, and home visit instructions on birth control. The media center could operate in connection with the divisions of Education and Population of the Ministry (of Health and Social Assistance (SAS) and in collaboration \Mith Family Planning Services. 142 It is understood that all educational materials to be used by the media about health education should be re- vised and selected by health authorities, and in accord- ance with the regulations of the Ministry of Health and Social Assistance (SAS). Thus, the information and educa- tion programs of the television and radio systems proposed should work in combination and cooperation with the ser- vices and materials from the health centers. III. IV. The Family Planning professionals for their home visit instructions should have the following media: flip charts, small flannel boards, filmstrips and/or slides, films, demonstration models, and printing materials. They will be adequately trained in this area by the audiovisual center experts. Three audiovisual mobile units will be used to travel from place to place through the area of birth con- trol centers. The main purpose of these units will be the dissemination of information, promotion for radio listening and television watching, and col- laboration with other professionals in the field. Materials to be included in these units should be filmstrips, records, films, printing materials, and birth control supplies. The establishment of six radio broadcasting stations covering the population of the 39 Family Planning Service Centers of the pilot project. The radio 143 stations will be installed in Caracas and Barquisimeto for the coverage of the northcentral section of the country, in Maracaibo for the coverage of the western section of the country, in Merida for the Andean re- gion, in El Tigre for the southern part of the country, and in Porlamar covering the northeastern section of the country (see Appendix C). The use of radio should be in two broad areas: pro- motional and general information, and instructional educa- tion. Promotional and general information campaigns directed to the target pOpulation and in the form of: 1. Short educational messages 2. Interviews of people related to the subject program 3. Radio shows about subjects related to the area of birth control 4. General information in the family planning area. Instructional radio: The use of radio in combi- nation with audiovisual materials, like film- strips and slides in those places with electrical power facilities, and charts and boards for places without electrical power. These should be directed to special audiences in: 144 Radiophonic schools: establishing radio school centers to operate in the 39 actual Family Planning Service Centers, that is, in the following cities: Caracas with (9) cen- ters, Barquisimeto (3), Valencia (5), Puerto Cabello (3), Los Teques (2), Merida (2), Acarigua (1), Barinas (l), Caripito (l), Cumané (1), El Tigre (1), La Guaira (1), Maracaibo (l), Maracay (l), Maturin (l), Porlamar (1), Puerto La Cruz (1), San Cristo- bal (l), Tinaquillo (l), Valle de la Pascua (l), and Valera (1) (see Appendix C). The function of these radiophonic schoOls is to instruct the adult pOpulation and develop a sense of rightness among them about family planning methods and related subjects. These schools should be equipped with short-wave radio transmitters and telephones for feedback and discussions between students and radio studio teacher. a. Monitor teachers should be trained to direct the radiophonic schools. They should have the following functions: to preside over the class and take care of the physical and mental learning environ- ment of the students before, during, and 145 after the radio lesson; take care of audiovisual materials to be used during the class; discuss ideas presented in the lesson with students and encourage their comments. b. Encourage means of feedback, like cor- respondence between literate students and the radio station, and by short-wave radio and telephone where such communication facilities are available. The radio studio teacher should use known and proven techniques of instruc- tion for fomenting reaction to the sub- ject matter and encourage feedback from the students. Courses for mothers: will consist of develop- ment of a program of women's education in those areas related with family planning pro- grams. The same facilities of radiophonic schools might be used for these courses to mothers able to assist; and those who do not want or cannot assist a promotion program should encourage them to listen to the pro- grams in their homes. Home-based audiences: A visiting teacher should supervise their progress. Some monitor 146 teachers of the radiophonic schools and home visiting family planning professionals can be used for the job. Motivational techniques, mainly by word-of—mouth should be used to foment radio listening in places like clubs, schools, churches, family gatherings, etc., and by other media like posters in different locations, such as public gatherings, recrea- tional centers, factories, markets, trans- portation facilities, etc. For more effective use of audiovisual materials in both radiophonic schools and courses for mothers, the moni- tor teacher should follow those techniques that best serve him, either showing a filmstrip or chart before each unit for general introduction, or during the lesson in combina- tion with the broadcast program, or after the broadcast at a convenient time for detailed study. Tape recordings of the broadcast might be used for review and reinforcement of the lessons at more convenient times for some special students and as individualized in- struction. VI. The establishment of television stations covering the target population of the 39 Family Planning Service Centers of the pilot project. The studios of the main television station should be located in Caracas with repeater stations in La Guaira, Valencia, 147 Puerto Cabello, Barquisimeto, Curimagua (Falcon), Maracaibo, Trujillo, Merida, El Zumbador (Tachira), Barcelona, El Tigre, and Maturin (see Appendix C). Television will be used in the same manner as was done with the radio, for: A. Promotional and general information campaigns directed to the target population in the form of: commercials, interviews, films, dramatic presentations, and general information on family planning. Educational television: directed to special audiences in: 1. Television schools: For special groups of community leaders, for those already prac- ticing birth control, and for those most highly motivated. The establishment of television schools to operate in the 39 Family Planning Service Centers, that is, in the same cities as above for radiOphonic schools on page 144 (see Appendix C). These schools should be equipped with short- wave radio transmitters and telephones for better feedback and discussions between stu- dents and television studio teacher. a. An especially trained teacher should pre- side over the television class and take 148 care of the mental and physical learning environment before, during, and after the lesson presentation; pay attention to reactions of students, and discuss and encourage their comments to the lesson presented. b. Encourage means of feedback, like cor- respondence between literate students and television station teacher, short- wave radio and telephones where they are available. Evaluation sheets for literate students and monitor teachers should be used. Different tests and quizzes should be administered to literate students at the beginning and at the end of the pro- gram. The television studio teacher should use instruction techniques to stimulate reaction of the students to the subject matter, and to encourage feed- back. Visits of the television studio teacher to the classroom will serve pro— motional ends, and foment interaction and feedback. 2. Home-based audiences: Some monitor teachers of television schools and home visiting VII. 149 family planning professionals can be used to supervise the progress of home-based audi- ences. Motivational techniques mainly by word-of-mouth should be used to make the peOple watch television in places, like schools, churches, etc.; and by other media, like posters; by neWSpapers and magazines; and in theaters and movie houses, etc. During the third year of the family planning program operation, and according to results of the evalua- tion research, the program by radio and audiovisual materials should be extended to other parts of the country. The television program should be extended to other parts of the country during its second year of operation, and if the evaluation research indi- cates the need of doing so. In order that both sys- tems, radio and television, can work in close col- laboration with and complement each other, television should be used mainly in urban areas where electric- ity and sets are more available, and the radio in isolated rural areas where electrical power is less available and transitor radio receivers are fairly common . 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Inquiry among Governments on Problems Resulting from the Inter- action of Economic Development and Population Change, 64-26191, November, 1964. , General Assembly, 6th Session, September 2, 1969. Report to the Committee on Housing, Building and Planning: Experiences of the National Rural Hous- ing Program in Venezuela. Urdaneta, Francisco. "La Organizacion y Financiamiento de los Servicios Medicos en el Presente Quinquenio." Paper presented at the Second Venezuelan Congress of Public Health, February-March, 1961. Venezuela, Compilacion Legislativa de Venezuela. Ley de Telecomunicaciones. Washington, D.C.: Embassy of Venezuela, n.d. 156 Venezuela. Constitucion Nacional (1961). Venezuela, Ministerio de Agricultura y Cria. Reforma Agraria: Informe de la Subcomision Social. Caracas, 1959. Venezuela, Ministerio de Communicaciones, Direccion de Telecomunicaciones. Lista de Estaciones de Radio- difusion Sonora. Caracas, March 6, 1970. . Lista de Estaciones de Radiodifusion Sonora: Estaciones Clase "D" de Audiencia Limitada (Ambiente Musical) en Frequencia Modulada. Caracas, March 6, 1970. . Lista de Estaciones de Television. Caracas, March 6, 1970. . Reglamento de Radiodifusion. Caracas, March 6, 1970. . Resolucion No. 9, Gaceta Oficial No. 173.293. Caracas, January 10, 1952. . Resolucion No. 670, Gaceta Oficial No. 27.727. . Resolucion No. 800. Caracas, April 15, 1968. . Resolucion No. 001976. Caracas, April 15, 1968. Venezuela, Ministerio de Comunicaciones, Direccion de Telecomunicaciones, Division de Radiodifusion. Recomendaciones y Normas para la Instalacion de Estaciones de Radiodifusion. Caracas, September, 1957 and 1958. . Resolucion No. 630, Gaceta Oficial No. 27.428. Caracas, April 30, 1964. . Resolucion Relativa a1 Establecimiento de Emisoras Exclusivamente Culturales, No. 1622, Gaceta OfiCial No. 27.586. Caracas, November 6, 1964. . Resolucion Relativa a la Instalacion y Funcion- amiento de Estaciones de Television No. 1621, Gaceta Oficial No. 27.588. Caracas, November 9, 1964. 157 Venezuela, Ministerio de Educacion, Division de Educacion de Adultos, Escuelas Radiofonicas. 'Cursos Radiales de Alfabetizacion y Mejoramiento Cultural. Caracas: Taller de Imprenta, Direccion de Educacion Primaria y Normal, n.d. Venezuela, Ministerio de Educacion Nacional. Memoria y Cuenta 1965. Caracas, 1966. Venezuela, Ministerio de Fomento. IX Censo Nacional de Poblacion. Caracas: Direccion Nacional de Estad- istica y Censos Nacionales, 1962. . Proyeccion de la Poblacion Urbana y Rural de Venezuela y de sus Ciudades mas Importantes. Caracas: Oficina de AnaliSis Demografico, l964. . Proyeccion de la Poblacion de Venezuela. Caracas: Oficina de Analisis Demografico, 1963. Venezuela, Ministerio de Sanidad y Asistencia Social. Informe Anual para 1968, Direccion de Malariologia y Saneamiento Ambiental. Caracas, 1969. . Memoria nyuenta 1964. Caracas, 1965. . Memoria y Cuenta 1969. Caracas, 1970. Wittich, Walter Arno, and Schuller, Charles Francis. Audiovisual Materials: Their Nature and Use. New York: Harper and Row Publisher, 1967. World Health Statistics Report, XXI, Geneva, 1968. World Radio-TV Handbook 1970. Copenhagen: 0 Lund Johansen, 1970. APPENDICES 158 APPENDIX A HEALTH NEEDS OF THE VENEZUELAN ADULT POPULATION 159 APPENDIX A HEALTH NEEDS OF THE VENEZUELAN ADULT POPULATION Causes of Death The five single causes of death and the death rates per 1,000 population in 1968 and 1969 were as shown in Table 29. TABLE 29.--The five first causes of death and death rates per 100,000 population, 1968, 1969.* Causes of 1968 1969** Death Deaths Rate Deaths Rate Heart Diseases 7,052 75.8 7,941 83.2 Cancer 5,265 56.6 5,252 55.0 Gastroenteritis 4,521 48.6 4,814 50.4 Accidents 4,473 48.1 4,665 48.8 Diseases of early infancy 4,244 45.6 4,499 47.1 it Ministerio de Sanidad y Asistencia Social, Memoria y Cuenta 1969, Caracas, 1970, p. 183. ** Prov1510nal data. Despite many discrepancies in death registration and medical death certifications in Venezuela, the study of causes of death is very useful to determine the state of health of the country and to follow the changes that it may present. This table presents the five most important causes of death in the country. Because of the method utilized to 160 161 indicate the principal causes of death, infectious diseases appear rarely in the first five places of any statistics. TABLE 30.--Rates of death by five diseases in Venezuela and the United States, 1965, 1966.* Country Disease Rate (per 100,000) 1965 1966 Venezuela All infective and parasitic diseases 53.8 45.8 U.S.A. 9.2 - Venezuela Heart diseases 69.5 67.2 U.S.A. 368.2 - Venezuela Malignant neoplasms 55.2 55.0 U.S.A. 153.5 - Venezuela Accidents 48.6 48.0 U.S.A. 55.8 58.0 Venezuela Gastroenteritis 45.8 44.2 U.S.A. 4.1 3.9 * World Health Statistics Report, 1968, pp. 24-29, 468—72, 588-91. Infectious diseases produce an important level of disease incidence and mortality (Table 30). The distribution of the Venezuelan age population does not justify the high level of mortality by heart diseases, this, however, can be explained by the fact that some infec- tious diseases, like Chagas disease, produce death by heart attacks, and by diagnostic inaccuracy, many deaths are regis- tered as caused by heart diseases. On the other hand, some 162 doctors give the same cause of death by heart disease when they do not know the actual cause of death.1 The rate of deaths caused by gastroenteritis is also high and it has close relationship with the emvironmental sanitation. Motor vehicle and other accidents are also increasing every year. TABLE 31.--Number and rate of maternal mortality per 1,000 children born alive as compared with that of the United States.* Number Rate Country 1962 1963 1964. 1965 1962 1963 1964 1965 Venezuela 368 335 361 1.1 0.9 1.0 U.S. 1465 1466 1370 1188 0.4 0.4 0.3 0.3 * America en Cifras 1967, pp. 142-43. Pregnancy and child-birth complications caused a rela- tively high rate of deaths as compared with those of the U.S. Summary Heart diseases appear as the greatest cause of regis- tered deaths in the country. This may not be really the case, because of diagnostic inaccuracy, many deaths are registered as caused by heart diseases when they were really caused by other diseases. Due to the limited methods utilized to indicate causes of death, infectious diseases rarely appear as great causes lBernieri, "La Situation de la . . . , p. 354. .mumc Hmcoflmfl>onm .3 .00H .e .000H .mmomumo .mmma .mucmso w MAHOEmz .HMfloom aflocmumwmm h Umwflcmm mp OHHmuchflz « 163 H.00 0.0H 000.0 0.00 0.0 00N.0 qaeoe 0.0 s.0 tam e.m N.H 000 mnmauo 0.0 0.0 m 0.0 0.0 H magnet: «.0 0.0 AH ~.0 0.0 AA leagues 000m 0.0 0.0 0H H.0 0.0 we .aeseeutd 0am 0eoaese 0.0 H.0 0N ~.0 0.0 me meemauameo 0.0 H.0 0H 0.0 H.0 mm mmeneamaemoem 0.0 «.0 NA 0.0 «.0 00 msoenommce mfluehmmwm 0.H 0.0 00 0.H 0.0 00 . meeeaesm 0.H 0.0 00H H.H 0.0 AOH memmeeeeesamm m.~ 0.0 mam «.0 0.0 00m £0000 maeaooez H.0 m.H 00m 0.0 0.0 000 mmammmz 0.0 0.H 000 0.0 0.0 ~00 mammao 0.0 H.H 000 0.0 0.0 000 teamed ocm MHEQOHpmmm 5.0 0.H 000 0.0 0.0 N00 0000069 H.0 m.H mwm m.m N.H mmm mmflumucmmso 0.0a 0.0 00H.H 0.0a 0.~ 00H.H memOasonese 000.00H .Hmeeoz .mmeo 000.00H .Hmeuoz .meeo Hod mumm :60 m Hmunoz sod mumm saw 0 Hmuuoz nummo 000a .emema no 000000 .IIl ‘1‘. vi} .moma .mwma .mvmmmmHO mDOHDOOMCH Hmm hpflamwuozll.mm mqmdB 8. 164 of deaths. Deaths caused by infectious diseases and gastro- enteritis are high and have close relationship with the environmental sanitation. Such relationship demonstrates that it is not appropriate to the health needs of the people. The expectancy of lifetime has increased during the last few years, from 58.0 years in 1950, to 66.0 in 1967. Infectious Diseases The number of deaths caused by infective and parasitic diseases in 1965 was 4,696 at a rate of 53.8 per 100,000.2 Tuberculosis Mortality by this disease has diminished especially after the introduction of antibiotics, but it is still the greatest cause of death. TABLE 33.--Tuberculosis; deaths and rate per 100,000 population 1964-1969. Year 1964 1965 1966 1968 1969 Number 1,236 1,348 1,307 1,146 1,186 Rate 14.6 15.5 14.5 12.0 12.7 * World Health Statistics Report, 1968. Dysenteries These diseases are primarily of fecal origin. Poor distribution of water and lack of health education take an 2World Health Statistics Report, 1968, pp. 24-28. 165 important role in their propagation. Another factor of prOpagation is the lack of nutrition. They constituted about 1.2 per cent of the total deaths in the country in 1969 (Table 32), and 5.5 per 100,000 pOpulation with 523 deaths. Tetanus Three hundred seven deaths out of a total 437 cases reported in 1964 were among the age group of less than one year old. In 1969 there were 402 deaths (Table 32). WhOOping cough In 1966, 8,357 cases were reported and 65 deaths, and in 1967, 8,632 cases.3 persons vaccinated in 1964: 336,549, immunized: 65.0 per cent.4 In 1969 there were 240 deaths and in 1968, 215 deaths (Table 32). Measles In 1964, this disease represented the fifth greatest cause of death for the group 1 to 4 years old. In 1967, 5 about 43,366 cases were reported. In 1969, there were 306 deaths (Table 32). Trypanosomosis or Chagas Disease The vector of this disease, "R. prolixus," is present in 92 per cent of the national territory in roofs, walls, 3Ibid., p. 126. 4Bernieri, "La Situation de la . . . ," p. 367. 5World Health Statistics Report, 1968, p. 523. 166 and furnitures of the housing "rancho" type (hut) in which live 4,387,344 inhabitants who are in danger of infection.6 The study of disease incidence was continued in 1968 and the data obtained do not alter the conclusion of two last investigations of 1964 and 1965 conducted among 7,000 people.7 TABLE 34.-—Program for the control of R. Prolixus, 1969. Areas Estimated % Area in % Population Km2 Venezuela 9,548,977 100.0 912,050 100.0 With R. Prolixus controlled 4,953,185 51.9 185,900 20.4 Parcial control of R. Prolixus 1,928,678 20.2 75,000 8.2 0 Control in project of R. Prolixus 2,667,114 27.9 651,150 71.4 Places and houses examined during 1968, were in the following states: Anzoategui, Aragua, Carabobo, Cojedes, Falcon, Guarico, Lara, Miranda, Monagas, Portuguesa, Sucre, Trujillo, Yaracuy and Federal District, and there was found to be 7.3 per cent of the places were positive to "S.crucy," and 16.4 per cent to "T.range1i;" 3.4 per cent of the 6Ministerio de Sanidad y Asistencia Social, Informe Anual para 1968, Direccion de Malariologiagy Saneamiento Ambiental, Caracas, Venezuela, 1969, p. 419. 7Ministerio de Sanidad y Asistencia Social, Memoria y Cuenta, 1969, Caracas, 1970, p. 374. 167 houses examined were positive to "S.cruzi" and 9.5 per cent to "T.rangeli."8 Malaria According to the XVI Report of the Pan American Organ- ization of Health for 1967, the area eradicated of malaria in Venezuela embraces 519 municipalities with 472,242 Km2, living 6,463,210 population. The situation for September 19689 is shown on Table 35. TABLE 35.--Area of eradicated malaria in Venezuela, 1968. Area Municipalities Km2 Population All country 657 912,050 9,307,107 Originally with malaria 545 600,000 6,932,983 On phase attack 31 138,741 387,882 Maintenance 514 461,258 6,545,101 During 1968, there were 4,258 cases of malaria from which 3,642 were local cases which originated in Venezuela; in 1967, 5,257 cases and 3,980 of which were local cases; in 1966, 5,481 cases and 2,532 were local. The incidence rate per 100,000 population was 0.5 for the whole country in 1968, of which 12.9 per cent for the area in phase of 8Ministerio de Sanidad y Asistencia Social, Informe Anual para 1968, DirecCion de Malariologia y Saneamiento Ambiental, Caracas, Venezuela 1969, p. 421. 9 Ibid., p. 409. 168 attack. There were no deaths caused by malaria. In 1969, there were 6,366 cases reported and one death from malaria. Aedes Aegypti or Yellow Fever The virus of yellow fever is in activity in many regions of the country and in full activity in some forestal regions of the country: Guayana Region, South of Maracaibo Lake, and among the monkeys of the Orinoco-Amazonas regions. At the present, the eradication campaign of the Aedes Aegypti is centralized in an area among the states Tachira, Merida, Trujillo, Apure, Barinas and Zulia. TABLE 36.--Synthesis of the plan for eradication of the Aedes Aegypti, 1967-1968. Spray Verification 1967 1968 1967 1968 Places Total Total Insp. With Insp. With A.A. A.A. States 10 3 12 11 l 1 Municipalit. 35 21 42 33 l9 14 Places 85 68 109 71 76 31 Houses 35,495 75,243 79,319 2606 210,377 259 Transports 15,924 14,073 54,422 37 189,241 68 Tanks 2000,643 4399,383 795,035 4989 1019,825 538 * Ministerio de Sanidad y Asistencia Social, Informe Anual para 1968, Direccion de Malariologia y Saneamiento Ambiental, Caracas, Venezuela 1969, p. 428. A health education campaign is underway among school population and general public in Colon, Tachira State, and E1 Vigia, Merida State to eradicate the vector of Aedes 169 Aegypti in order to avoid mosquito hatchery cleaning the building sites. Helminthiasis Diseases of this group have a relative importance as a direct cause of death: 0.2 per cent of the 9.7 total per cent of all infectious diseases of the country in 1969 (Table 32). They, however, have an increasing importance for the improvement of the environmental sanitation in the country. Syphilis Although the percentage of deaths caused by this disease has decreased during the last years, the number of denounced cases is still high, and this constitutes a sign of the existence of a grave problem of health. The 112 cases of death in 1966 gave a rate of 1.3 per 100,000 population.10 Typhoid and Paratyphoid Fevers In 1969, there were 12 cases of death and a rate of 0.1 per 100,000 pOpulation (Table 32). In 1966, there were 765 cases of death caused by influenza which repre- sented a 8.6 per 100,000 population.11 10Demographic Yearbook, 1967, p. 456. 11Ibid. 170 Diphtheria In 1969, there were 15 cases of death and a rate of 0.2 per 100,000 population (Table 32). In 1966, there were 321 cases reported and 51 deaths. In 1967, 242 cases reported.12 Acute Poliomilities There were 134 cases and 18 deaths in 1966. In 1967, there were 67 cases reported.13 Rabies There has been an increase in cases of death. There were 6 cases in 1961; 21 in 1962; 25 in 1963; and 19 in 1964,14 and 17 in 1969 (Table 32). Summary Infective and parasitic diseases have a high rate of deaths, tuberculosis being the foremost. Poor distribution of water, lack of health education, and lack of adequate nutrition are common factors of propagation of dysenteries and helminthiasis. There is a significant improvement in the eradication of malaria, yellow fever, and Chagas disease, due to health 12World Health Statistics Report 1968, pp. 12, 457. 13Ibid., p. 136. 14America en Cifras 1967, Situacion Demografica: Estudioynyovimiento de la Poblacion, p. 124. 171 campaigns organized by the authorities to eradicate such endemic diseases. Environmental Sanitation The Bureau of Malariology and Environmental Sanitation of the Ministry of Health and Social Assistance (SAS) has as its objectives the utilization of the health activities directed to control the morbid factors of the environment; and its goals are to improve health conditions of the environ- ment in order to eradicate diseases, and to eliminate uncleanliness as a favorable agent of the sources of dis- 15 eases. TABLE 37.--Mortality caused by some diseases due in part to poor environmental sanitation in rural and urban areas, 1961. Causes of Mortality Rate per 100,000 Population Death Rural Zone Urban Zone Gastroenteritis 148.0 70.0 Dysenteries 31.0 10.0 Helminthiases 12.0 4.0 * Bernieri, "La Situation de la . . . , p. 372. The results of this table seems to confirm the common Opinion that there exists a relation between the conditions of the environment and the health of its population. E 15Ministerio de Sanidad y Asistencia Social, Informe Anual para 1968, Direccion the Malariologiagy Saneamineto Ambiental, p. 393. 172 The Social Subcommission of the Agrarian Reform of Venezuela in its report to the Ministry of Agriculture and Livestock reported that elemental measures for environ- mental sanitation in rural areas were the following: better supply of water, construction of housing and sani- taries, improved disposal of garbage, and housing domestic animals away from the people's living quarters and better handling of the animals.16 The people of rural Venezuela have been living in unhealthy housing conditions dispersed all over the country. Such dispersion makes the provision of better housing with elementary services and appropriate medical assistance more difficult. The planning of rural areas with all health facilities will decrease the transmission of diseases which will be reflected in the healthy indexes. Diarrhea, tuberculosis, gastroenteritis and other endemic diseases of the rural areas have been reduced in those areas improved by the National Housing Program.17 Health problems of a community are so inter-related that, a measure to the solution of one of them is intimately related with the other one. Evaluating the relative impor- tance of the helminths, the most interesting factors are those affecting their transmission, so that the degree of 16Ministerio de Agricultura y Cria, Reforma Agraria: Informe de la Subcomision Social, Caracas, Venezuela, 1959, p. 83. 17Ministerio de Sanidad y Asistencia Social, Informe Anual para 1968, Direccion de Malariologia y Saneamiento Ambiental, p. 394. 173 helminthic infections will show the health level of a com- munity. The intensity of the helminthiasis problem has decreased, but we can see less decrease in the general distribution. Time and effort will be necessary to change the way of life deeply rooted in the people. In 1968, 20,618 coprosc0pic exams with 816 positive cases of persons, which represents 4.0 per cent of infection were made. In 1967, about 29,357 exams resulted in 1,577 positive cases of persons, which represented 5.4 per cent of infection.18 In order to fight Ankylostomiasis, the Direction of Ankylostomiasis of the Ministry of Health and Social Assist- ance (SAS) performed the following activities in 1968. TABLE 38.--Activities to fight Ankylostomiasis in 1968.* Housing visits 275,646 Water-close construction 1,124 Latrines construction 19,366 Sanitary talks 6,678 * Ministerio de Sanidad y Asistencia Social, Informe Anual para 1968, Direccion de Malariologia y Saneamiento Ambiental, p. 484. In 28 years of activities, the Division constructed 412,821 water-closet and latrines. The Propaganda Services of the Division increased its activities during 1969 in order to form responsibility in the community, because the 18Ibid., p. 475. 174 Division understands that this kind of job will result in better control of helminthiasis. Rural Aqueducts The National Program of Rural Aqueducts is a part of the Division of Rural Aqueducts of the Ministry of Health and Social Assistance (SAS), and the construction of aqueducts for rural areas is a regular activity of the Division in the field of environmental sanitation. This kind of health action is directed to rural areas of less than 5,000 population and intends to achieve: the improve- ment of health through prevention of diseases of hydric origin and the reduction of the endemic levels of the diarrheic diseases; the improvement of health conditions of the rural environment; change of population habits offer- ing personal and domestic facilities of hygiene; social development and raising the level of life of population in rural areas, and the incrementation of the development of the country. In 1968, the Ministry constructed aqueducts for 250 localities of 108,123 population, and in 1967, 295 aqueducts for 177,074 population. The budget for aqueducts construc- tion has been cut down to 60 per cent which represents a severe cut for the original goal of providing with water to one million persons in the next ten years.19 19Ministerio de Sanidad y Asistencia Social, Informe Anual para 1968, Direccion de Malariologia y Saneamiento Ambiental, p. 493. 175 TABLE 39.--Water supply for rural population, 1966.* Size of Population Centers 4,999 499 to 199 to Less Total to 500 200 pop. 100 pop. 100 pop. pOp.c. Population 1,195,686 836,581 590,197 759,334 3,381,788 With equed. 1,075,786 568,000 44,500 1,688,286 Percentage Pop.served 90 39.8 5.9 49.9 * Bernieri, "La Situation de la . . . ," p. 373. J m.“ Housing ___ v‘ 13 war. In 1966, the deficit of housing was estimated at 800,000 units of which 256,000 comprised the structural deficit plus the deficit caused by the demographic increase; the other 554,000 are those existing housing but considered unacceptable as a social housing. Because of the population increase, the need for housing is increasing about 3 per cent annually, which means that for 1981 there will be a need of 2 million housing units. Demographic increase and the migration of rural population to urban areas has aggravated the housing problem in urban areas. The low level of population coming to urban areas and their incapacity to produce rapid and satisfactory solutions has created a chaotic situation for housing under all phisical, social and economic aspects. About 44 per cent of the urban population live in this chaotic way.20 20Herminio Pedregal,"Poblacion y Vivienda" in Revista Venezolana de Sanidadgy Asistencia Social, Vol. 31, No. 3, p. 531. 176 In 1965, to alleviate the situation in urban areas, five government agencies in four year program called for the construction of 156,000 units. So far, 64,703 units were completed in two years.21 According to the 1961 census, about 2,818,711 people (Tables 2 and 3), were living in 563,000 "ranchos," or shanties. The rural rancho consists of mudpacked walls, thatched roofs, and earthen floors. These ranchos are natural habitats for disease—carrying vectors, such as the "chipo" (Rhodius prolixus) which transmits Chagas disease, at the present the most serious endemic disease in rural Venezuela. Other diseases are diarrheic or caused by intestinal parasites and are also attributed to the un- healthy environment of the rancho. The last known answer to these problems is to provide hygienic housing and ade- quate water supply for the rural population.22 The Ministry of Health and Social Assistance (SAS) from 1959 to 1968 constructed 75,547 housings for a popula- tion of 445,727 and about 10,564 more houses were completed in 1968. A five year plan from 1969 to 1973 calls for con- struction of 74,000 more housing units.23 21Venezuela Uprto-Date, Vol. 12, No. 3, Embassy of Venezuela, Washington D.C., Spring 1968, p. 24. 22Eric Carlson, and Arturo R. Ortiz, "Venezuela uses self-help in rural housing program," in The Journal of Housing, Vol. 20, No. 4, May 24, 1963. 23Cesar Quintana, "Experiences of the National Rural Housing Program in Venezuela," Information Document to United Nations VI Session, Committee on Housing Building and Planning, New York, September 1969, p. 25. 177 The Barrios or slum areas, are located in central or peripheral areas of the cities. They are formed by congested areas of physical decay with universal predominance of uncleanliness and housing heaping without order. They are populated by humble and poor people, workers and middle class employees, who live congestedly, with many forms of social disorganization and precarious life conditions of social, mental, and physical order. Although the physical conditions are poor, it seems that they are a little better than in the rural areas. In 1962, a study about a special rural area of Lara State, showed that the mortality rate of children under 10 years old, was 28 per 1,000 population, as contrasted with 12 per 1,000 in the cities. The life expectancy is 67.4 in urban areas, and 60.6 in rural areas of the country. Comparing the physical health of the bar- rios with other residential areas of the cities, although it is difficult to discriminate the final statistics from the different areas of the same political department, nevertheless, studying the disease incidence, the study found that those important cases of transmisible diseases like, tuberculosis or pneumonias, or others from poor environmental sanitation, like those of diarrheic origin, 24 came from those barrios. Mental health, according to 24Arnoldo Gabaldon, "E1 Problema de los Barrios insalubres, sus cansecuencias sobre la Salud y su alivio por medio del Saneamiento Ambiental," in Boletin Informativo de la Direccion de Malariologia y_Saneamiento Ambiental, Vol. 5, No. 6, Maracay, Venezuela, December 1965, p. 259. 178 specialists is critical; among the problems, the population of the barrios suffer from isolated environment and lack of friends and relatives, loneliness, economic difficulties, crowding, anguish by uncertainty, noise, poor housing, lack of water supply, etc. In social health, unknowing residents begets immorality, and crowding produces delinquency. Summary Dispersion of population in rural areas is an important factor which makes the provision of better housing and health facilities, and medical assistance more difficult. The pro- vision of rural areas with water is aimed to improve health conditions of the environment, by preventing diseases of hydric origin and by reducing the endemic level of diarrheic diseases and raising the level of life in rural areas. About 50 per cent of the total population living in towns 5,000 and under, have been provided with aqueduct services by the government. Lack of healthful housing conditions is increasingly grave, although there exists official and private organiza- tions to solve the problem. The unhealthy environment of the "ranchos" or shanties are natural habitats for disease. Other diseases are also attributed to the unhealthy environ- ment of the "rancho" where the majority of rural population live. About two million housing units will be needed in the near future for rural and urban areas, where lack of 179 housing has created overcrowded slums with poor health con- ditions. The "barrios" or slum areas located in central and peripheral areas of cities are populated by humble people with social disorganization and precarious life conditions of social, mental, and physical order. Nutrition This reserves special attention because a high per- centage of diseases is related with nutrition. * TABLE 40.--Reports on deficiency diseases, 1965. Disease Consultations Anaemias 252,331 Syndrome Plus. Inf. 11,744 Goiter 5,010 Rachitics 3,844 Avitaminosis 3,621 Obesity 2,125 Beriberi 1,662 Arriboflaminosis 1,143 Pellagra 1,208 Scurvy 995 Diabetes 928 Cretinism 200 * I Luis Chaurio Bermudez, "Principales Problemas Nutri- cionales del Pais," Los Teques, Venezuela, 1967, p. 14. Avitaminosis and other deficiency diseases as a direct cause of death were reported in 512 cases and rate 9.1 per 180 100,000 for the whole country, of which 134 cases were among the adult population. The rate with respect to all deaths of the year was 9.1 per 100,000 population, which is low if we compare it with other causes of death. But, many times, lack of nutrition is not registered as direct cause of death, but out of 27 causes of death, 20 were related di- rectly or indirectly to poor nutrition in 1965. In 1968, there were 730 deaths caused by Avitaminosis and a rate of 25 Most of the deaths, 323 of 7.8 per 100,000 population. them were in the group of l to 4 years old. Mortality among this group is regarded as the best indication of the nutri- tional situation of the country. The nutritional situation is regarded as grave when the mortality rate is above 10 per 1,000 among the group.26 The National Institute of Nutrition of the Ministry of Health and Social Assistance (SAS) has some programs directed to the relief of the nutritional problem. Among them: protection of the pre-natals by administering to the registered pregnant women, polivitaminics pills, and also the program for the sick by avitaminosis which in 1964 were reported 3,900; the family nutritive program is directed by the Educational Service of the Ministry to 25Ministerio de Sanidad y Asistencia Social, Memoria y Cuenta, 1969, Caracas, 1970, p. 183. 26 Ibid., pp. 21-23. 181 improve nutritive education for schools and general public against ignorance and bad nutritive habits.27 Summary Avitaminosis, a disease caused by lack of vitamins in the diet, and other deficiency diseases are not so important as direct cause of death, but a high percentage of diseases is related with nutrition. Death from avita- minosis is very high among pre-school children. There are some nutritive programs organized by the Ministry of Health and Social Assistance (SAS), but they are not sufficient to alleviate the gravity of the problem. Summary Health needs have been presented in four big areas: infectious diseases, environmental sanitation, the many causes of mortality, and nutrition. In the area of environmental sanitation, the situation is a precarious one in both rural and urban areas of the city slums. Construction of aqueducts and housing units are, at the present, a significant source for the improve- ment of the environmental sanitation. In the area of infectious diseases, they have high rate of deaths, and poor environmental sanitation plays an important role on their propagation. There has been a 27Ministerio de Sanidad y Asistencia Social, Memoria y Cuenta, 1964, Caracas, 1965, p. 515. 182 significant improvement in the eradication of certain endemic diseases like malaria, Chagas and yellow fever. In the area of nutrition, the lack of adequate nutri- tion is grave because it is an indirect cause of many diseases. Deaths by heart diseases are the greatest cause of certified deaths, but deaths caused by infectious diseases and gastroenteritis are high and closely related to the environmental sanitation. APPENDIX B VENEZUELAN BROADCASTING SYSTEM .REGULATIONS 183 VENE Z UELAN BROADCASTING SYSTEM REGULATIONS The Telecommunications Law is a piece of legislation issued by the President of Venezuela on July 12, 1940 abolishing the old communications laws of 1936 and 1927.1 It has twenty eight (28) articles giving general guide- lines about the telecommunication systems of the country. It has seven (7) Chapters. Chapter I deals with rights, responsibilities, and obligations of the Nation about tele- communications in general; Chapter II, attributions of the National Government; Chapter III, permissions and conces- sions; Chapter IV to VI taxes and penalties, and Chapter VII, some final provisions. It is interesting to note that the first article states that all telegraphic communications systems of the country through writings, signs, images, cables, sound or visual, and any transmission procedures invented or to be invented belong to the State. Nevertheless, the Federal Government grants permissions and concessions to particular persons to establish radio and television broadcasting stations for commercial and/or edu- cational purposes, as long as such services do not endanger lCompilacion Legislativa de Venezuela, Ley de Tele- comunicaciones, (Embassy of Venezuela, Washington, D.CTY n.d. 184 185 the State and other concessionaires, and fulfilling Broad- casting Rules and Regulations will serve a real need of progress. Articles 3 and 42 refer to the prerogative of the government to revoke such concessions when the national interest, public order, individual security, and laws and morals might be in danger. Such permissions and concessions cannot be transferred without federal approval, and will never be transferred to foreign governments, or persons not legally residents of Venezuela. Importation and exportation, construction and fabrica- tion of sets and broadcasting equipment for public services are subjected to the Broadcasting Rules and Regulations stated by the Ministry of Communications (5 and 6). The implementation of International Agreements and Treaties on Telecommunications belongs to the Federal Government. The general taxes to be paid by the owners of commercial broad— casting stations is one per cent of the raw product. On the other hand, the owners of a private broadcasting station have to pay yearly between $89.00 and $667.00 depending on the broadcasting power of the station (15). Construction, installation, possession or use of a clandestine broadcasting station are punished with fines from $111.00 to $889.00 or corresponding arrest and 2The numbers of the subsequent articles cited from The Telecommunications Law will be given in the text immedi- ately after the citation. 186 confiscation of the materials used (20). Other crimes like severe transgression of the Telecommunications Law, of International Agreements ratified by Venezuela, and of the Broadcasting Rules and Regulations of the country are punished with the temporal or permanent suspension of the permission granted; other small transgressions might be punished with fines from $11.00 to $889.00 or proportional arrest plus other penalties that might be applied by other laws (21). The owners or users of instruments producing broad- casting interferences and perturbations to broadcasting stations should take the necessary precautions stated in the Broadcasting Rules and Regulations to avoid such broad- casting disturbances (26). A Resolution of the "Junta de Gobierno" (Council of Government) of Venezuela on January 10, 1952, created "La Comision Nacional Supervisora de Radiodifusion" (The Super- vising Commission of Broadcasting).3 Some of its functions are: to write its own Rules and Regulations; to propose modifications to the Broadcasting Rules and Regulations in order that broadcasting programs be for public welfare, to raise the cultural level of the Venezuelan people by improving science, arts and public morals, and to develop the highest value of human life; to supervise the implementation . éRepublica de Venezuela, Ministerio de Comunicaciones, D1recc1on de Telecomunicaciones No. 9, Caracas, January 10, 1952. 187 of broadcasting rules, and to recommend procedures to attain broadcasting goals. The Commission is formed by five principal members and five substitutes who fill the vacancies of the principal ones. The election of the members is in this way: two principals and two substitutes are elected by the Ministry of Communications, one principal and one substitute by the Venezuelan Broadcasting Chamber, one principal and one substitute by the Ministry of Education, and one principal and one substitute by the Venezuelan Council for Children. The members are elected for one year and they can be re- elected, and their job is remunerated. Venezuelan broadcasting regulations are handled by The Telecommunications Division of the Ministry of Communica- tions. Some of them are issued in form of Resolutions by The Ministry, and the principal ones are contained in a special set of rules called Broadcasting Rules and Regula- tions.4 For special purposes of the present study we will point out only those articles of the Broadcasting Rules and Regulations directly related to our interest. Article 145 says that broadcasting stations can be established with 4 I I I I I I Republica de Venezuela, Ministerio de ComunicaCiones, Direccion de Telecomunicaciones, Reglamento de Radiodefusion. 5Of the Broadcasting Rules and Regulations. Sub- sequent articles cited from this Regulations will be given in the text immediately after the citation. 188 commercial and educational goals. Broadcasts must be in Spanish, although the Ministry of Communications, under certain circumstances, might permit broadcasts in other languages besides Spanish (44). Broadcasting hours are at the best convenience of the concessionary between 6:00 A.M. to 12:00 P.M. Venezuelan legal hour, although the Ministry of Communications can modify the hours at the stations' own convenience (45), as it did so, April 15,1968, by Resolution No. 800 stating that broadcasting stations can operate twenty four hours a day.6 Permits for the establishment of broadcasting stations and use of transmission channels can only be granted to Venezuelan citizens of mature age, as far as such permits are in the public interest. Concessionaries must be formed according to Venezuelan laws. The totality of its board of directors and administrators should be Venezuelan, and 4/5 of the capital investment with voting rights must be Venezuelan. In the case of an anonymous corporation, its voting stock must be nominal. And when the owner of a broadcasting station loses his Venezuelan citazenship, the Federal Government will suspend his permit. In any case, directors of all broadcasting stations must be Venezuelan (14). 6Republica de Venezuela, Ministerio de Comunicaciones, Direccion de Telecomunicaciones No. 800, Caracas, April 15, 1968. 189 All applications for broadcasting station installations should be addressed to the National Government through the Ministry of Communications with: name, age, nationality, profession and address of the applicant; place and maps of the future installations; indication if the station will be commercial or educational; name, nationality and title of the technical director of the station; capital available for its construction and exploitation; explanation why the broadcasting station will be for public interest, and brand and type of the equipment to be utilized (15). The applica- tion should be made in accordance with the following require- ments: A promise under oath to use the broadcasting station for the same purpose for which it was granted; a promise to surrender it to the National Government in case of war or public disaster; a descriptive report of the work to be done containing: a budget, a diagram of the whole installation (antennas, towers, underground installation and power of the amplifier); and securities totalling up to fifty (50) per cent of the projected capital investment (16). After permission is granted, construction of the broadcasting station must start in sixty (60) days and it should be finished in six (6) months, although these fixed terms can be extended under certain circumstances. Such permission will be outdated if broadcasting operations do xuyt begin by the term fixed by the National Government (25). 190 A careful inspection from the Ministry of Communica- tions with the assurance that the transmitter will carry at least eighty-five (85) per cent modulation and that it will not produce more than fifty (50) per cent harmonics of audiofrequency will be needed for the final operation permit (18-20). The installation must be of the most modern system and equipment to assure the best service free from interferences (22). Construction permits are granted for only one broad- casting station to each natural or legal person in the same locality (26), but, a concessionary can broadcast in two bands using one transmitter for each band (27). The Federal Government can authorize the transfer of permits granted to persons or firms to other persons who meet the regulations underlined by these Regulations (28). All broadcasts should be made from authorized studios. Special permission from the Ministry of Communications is needed to broadcast from other places (52). Broadcasting stations cannot invade the privacy of persons, they cannot broadcast anything antagonistic against friendly nations; they cannot incite to rebellion or dis- respect against institutions and legal authorities; they cannot transmit prOpaganda to subvert public order, politi- cal prOpaganda involving polemics among persons or among militant parties, news or messages obstructing action of the justice, immoderate and persistent advertising of the use of alcoholic drinking, such commercials must be approved 191 by the Ministry of Health and Social Assistance (SAS); advise about health, hygiene, treatment and prevention of diseases, prescription about treatment and recovery, and to give medical diagnosis, such broadcastings can only be permitted with authorization of the Ministry of Health and Social Assistance (SAS) or by an official health insti- tution of public assistance; and in general, it cannot broadcast anything that is punishable by Venezuelan law (53). The following are forbidden: language against good manners; immoral scenes or something that can hurt responsi- ble human feelings; programs talking about political, social, or religious subjects insulting convictions of some sectors of the audience (62). Mechanical reproductions should be presented as back- ground or occasionally, otherwise, they cannot account more than 50 per cent of the total broadcasting time (65). A c0py of each broadcasting program should be kept on file at the station up to one year after the broadcast was made (67). All and every broadcasting station must release free time for the government to broadcast themes of national interest, up to one weekly hour, and they should also broad- cast official news bulletins and when the President of the country or members of his cabinet address the nation in the public interest (69). m; =m " "a * I. 192 A special permission from the Ministry of Communica- tions is needed for interchanging materials between foreign and national stations (72). Critics of science and art, and general commentaries should be constructive and objec- tive excluding bias in scientific or artistic analysis (60). All broadcasting stations should pay taxes to the National Government, but they can be modified in some cir- cumstances by the Ministry of Communications. Special authorization from the Ministry of Communica- tions granted to natural or legal persons is needed for i installation, construction or alteration with profitable goals of receivers to tune stations class "D" of limited audience. Such broadcasting stations should provide the Ministry of Communications with a semester list of receivers installed or modified. Failure to implement this is pun- ished with fines of $111.00 to $889.00 or proportional arrest and confiscation of all materials used:7 By Resolution of the Ministry of Communications No. 630, broadcasting stations of frequencies 540 to 1,600 kilocycles are classified into four categories:8 7Republica de Venezuela, Ministerio de Comunicationes, Direccion de Telecomunicaciones No. 001976, Caracas, April 15, 1968. 8Republica de Venezuela, Ministerio de Comunicaciones, Direccion de Telecomunicaciones, Division de Radiodifusion No. 630, Caracas, April 30, 1964. 193 a. Class "A" of general coverage, frequencies 450 to 950 kilocycles and from ten to 100 kilowatts. These fre- quencies cannot be repeated in the national territory; b. Class "B" of regional coverage, frequencies 960 to 1,300 kilocycles and one to ten kilowatts. Two broad- casting stations can operate simultaneously in the country in places where distance and characteristics permit appro- priated protection; c. Class "C" provincial coverage, frequencies 1,310 to 1,450 kilocycles, and one to five kilowatts power. Three broadcasting stations can operate simultaneously in ‘ h the country in places where distance and characteristics permit appropriated protection; d. Class "D" local coverage, frequencies 1,460 to 1,600 kilocycles, and 250 to 500 watts power. In this fre- quencies can Operate simultaneously as many stations as the characteristics of local coverage already studied will permit. The same Resolution states that, one broadcasting station can be installed in those populated areas in which do not exist direct service on frequencies 540 to 1,450 kilocycles if other stations of the same category do not cover the same place and according to the technical rules of Table 41. And one broadcasting station Class "D" local coverage can be installed out of 7.5 miles perimeter, in direct line, 194 TABLE 41.-—Minimum intensity power needed to cover primary zone. Population Areas Intensity' Power City, industrial & commercial areas 10 MV/m. City, residential areas 5 MV/m. Towns from 2,500 to 5,000 population 0.5 MV/m. Towns from 5,001 to 10,000 population 2 MV/m. Towns from 10,000 to 20,000 pOpulation 5 MV/m. Rural areas 0.25 MV/m. {1 ..iz; from any broadcasting station class "A," "B," or "C," fre- | quencies 1,460 to 1,600 kilocycles, in those towns in which such a service does not exist, and according to the following rules: ¢ a. In towns of 2,500 to 5,000 population not covered with 0.5 MV/m. minimum power from nearby stations of the same category. With maximum power of 350 watts, vertical antenna of 45 degrees or Marconi 1/4 wave length; b. In towns of 5,001 to 10,000 population not covered with 2 MV/m. minimum power from nearby stations of the same category. With maximum power of 250 watts, vertical antenna of 45 degrees or Marconi 1/4 wave length; c. In towns of more than 10,000 population not covered with 5 MV/m. minimum power from nearby stations of the same category. With maximum power of 500 watts, vertical antenna Of 45 degrees or Marconi 1/4 wave length. 195 The Ministry of Communications does not grant more than three construction permits for a person to install broadcast- ing stations of this category. But, the Ministry can grant permission to install new commercial broadcasting stations in those cities directly covered by the cited service and according to the following rules. One broadcasting station for each 150,000 population increase for the Caracas Metropolitan Area; one broadcasting station for each 100,000 population increase for Maracaibo city; and one broadcasting station for each 50,000 popula- tion increase for other cities of the country. Such popula- tion increases are estimated according to existing broad- casting stations. The Ministry also recommends that all new broadcasting stations should be installed according to the technical regulations of the Ministry of Communications. The Ministry does not grant permits for the establishment of exclusively repeating broadcasting stations or to transfer an existing broadcasting station into a repeating one. But, stations class "A," "B," and "C" can broadcast programs originated in other stations up to 50 per cent, and stations class "D" up to 20 per cent of their total broadcasting time.9 The Ministry of Communications issued some norms and recommendations for the installation of broadcasting stations 9Ibid. 196 in the country.10 Some of these recommendations refer to: antennas for 540 to 1,600 kilocycles: for long wave bands it recommends antennas on radiating posts, and the minimum length of such antennas should be guided by the rules of Table 42. TABLE 42.--Minimum height of antennas on radiating posts for transmission on long wave bands. Frequency Kc/s Height 550 310' 600 300' 700 280' 800 260' 900 245' 1,000 235' 1,100 220' 1,200 210' 1,300 200' 1,400 195' 1,500 190' 1,600 185' Other recommendations refer to the underground system of the antenna which should be formed by no less than 60 radials of.31.length each; the radials should be of copper wire no less than N.8 AWG diameter and welded to a copper loRepublica de Venezuela, Ministerio de Comunicaciones, Direccion de Telecomunicaciones, Division de Radiodifusion, Recomendacionesgy Normas para la Instalacion de Estaciones de Radiodifusion, Caracas, September 1957, and 1958. 197 rim under the base of the tower; the antenna should be con- nected with the ground system in a weather proof box. A coaxial cable is recommended; the tower supporting the antenna should be constructed to support winds up to 80 miles per hour, and it should be painted and illuminated and protected by its own lightning rods. Antennas for the Tropical Broadcasting Band: they should be located in a convenient altitude, no more than .251;tjuaantennas should be provided with a counterweight of parallel wires 15 to 20 cm. directly underground above the antenna and with no more than guiseparation among them- selves and l/4 of length more than the antenna in order to form a good radiation angle; Hertz antennas or directional combinations of balance dipoles are recommended; the trans- mission line to the antenna should be of the balance type and its joint point should not permit stationary waves more than 1:1.5; the Open transmission lines should be on posts no less than 2.50 m. from the ground and protected by lightning rods. Transmitters and Equipment to be used: for a better implementation of article 22 of the Broadcasting Rules and Regulations that says that the installations must be of the most modern system and equipment to assure the best service free from interferences, the Ministry recommends that.a11 the studio equipment and transmitters of the broad- casting stations be connected to the ground; that all AC 198 conductors should be calculated with 50 per cent of security margin and for a loading no more than 1,500 circular mils per ampere; all power cables, but the high frequency power, should be in conduit; and all broadcasting stations should have measuring and monitorial instruments and corresponding spares. Other recommendations refer to the broadcasting tech- nicians and staff personnel: so, broadcasting stations concessionaires should report during the first month of operations: name and certificate number Of the chief engi- neering technician of the station; name and certificate number of plant and studio staff, and working hours of both personnel and station; when the broadcasting station has technical or staff personnel with no credit certificate, they should present a list with: name, age, number of identity card, time of service and grade of instruction of those willing to apply for a validated certificate. By Resolution from the Ministry of Communications No. 670 those persons applying for a Certificate of Com- mercial Broadcasting Announcers should meet the following requirements: they should be Venezuelan, over 18 years old, and with three years of secondary education, and pass an examination at the secondary education level.11 They llRepublica de Venezuela, Ministerio de Comunicaciones, Direccion de Telecomunicaciones, NO. 670, Caracas, April 20, 1965. 199 should send an application to the Ministry of Communications asking for designation of an examination panel, date, hour and place to take the required examinations for the Certifi- cate of Broadcasting Stations Announcer. The Application should contain: birth certificate or citizenship document, proof of third year secondary education, address of the applicant and signed by the applicant. The required examination is about Broadcasting Rules and Regulations, National and Universal History and Geo- graphy, Functional Spanish Grammar, General Culture and specific knowledge of Broadcasting Announcing. The examina- tion has two parts: a written one, (one hour), and the second, practico-oral ten (10) minutes. Radio Broadcasting Stations There are two hundred twenty nine (229) radio broad- casting stations in Venezuela.12 Stations on Amplitude Modulation (AM) There are two hundred-thirteen (213) stations and they are broadcasting as in Table 43. All of the broadcasting stations in Table 43 are com- mercially operated by private organizations, but the 17 Radio Nacional broadcasting stations which belong to the Ministry of the Interior and the two Radiophonic Schools 12 . . . . . . Republica de Venezuela, Ministerio de ComunicaCiones, Direccion de Telecomunicaciones, Lista de Estaciones de Radiodifusion Sonora, Caracas, March 6, 1970. 200 TABLE 43.—-Radio stations on amplitude modulation (AM). Stations *133 Medium waves 540 to 1,500 27 120 meters 2,340 to 3,395 39 60 meters 4,760 to 6,170 7 31 meters 9,510 to 9,750 4 25 meters 11,725 to 11,970 2 19 meters 15,390 to 15,400 1 16 meters 17,840 * Sixteen (16) radio stations in installment process. stations which belong to the Ministry of Education and broad- cast for the Radiophonic Schools of the National Government. The official stations of Radio Nacional are mainly cultural and informational in character and broadcast in both Spanish and English, and they do not carry advertising. Private-owned stations get their revenue from advertising restricted by the government to about 50 per cent of the total broadcasting time. Programs are in Spanish, and occasionally also in Italian, Portuguese, English, Dutch and German.13 Stations of Frequency Modulation (FM) There are 16 radio stations class "D" of limited audience in the country, one of them still in process of installation. All of them are privately owned and operated. l3UNESCO,'World Communications:' Press, Radio, Tele- vision, Film, Pafis, 1964. '- 201 They broadcast on frequencies from 89.3 to 106.7, and 250 watts power (12 stations), one kilowatt (2 stations), and five kilowatts (2 stations). They cover the principal cities of the country.14 Radio sets in use increased from 260,000 in 1952 to 1,685,000 in 1970, which represents 17.5 per 100 people in the 9,600,000 total population of the country.15 Television Broadcasting Stations According to Resolution No. 1,620 from the Ministry of Communications,16 Television Broadcasting Stations are subject to all applicable resolutions of the present Broad- casting Rules and Regulations, to those of the present Resolution, and to those resolutions that the Ministry will issue in the future.17 Other norms from this resolution state that the Television Broadcasting Stations should follow the following l4Republica de Venezuela, Ministerio de Comunicaciones, Direccion de Telecomunicaciones, Lista de Estaciones de Radiodifusion Sonora: Estaciones Classe "D" de Audigngia Limitada (Ambiente Musical) en Frequencia Modulada, Caracas, March 6, 1970. 15World Radio-TV Handbook 1970, p. 361. l6Republica de Venezuela, Ministerio de Comunicaciones, Division de Radiodifusion No. 1,621 Resolucion Relativa a la Instalacion y Funcionamiento de Estaciones de Television, Caracas, October 30, 1964. 17Of the TV Broadcasting Stations, Regulations, Numbers of subsequents articles cited will be given in the text. M! An. Ans. A ‘ 202 basic rules: Channels to be used in Very High Frequency (VHF) should have a wide band of six megacycles each, as in Table 44. TABLE 44.--Frequency gamut in megacycles for TV channels. Channel Frequency Gamut Number in Megacycles From To 2 54 60 3 60 66 4 66 72 5 76 82 6 82 88 7 174 180 8 180 186 9 186 192 10 192 198 11 198 204 12 204 210 13 210 216 Channels and hours to use them will be assigned by the Ministry of Communications and by petition of the interested party, but the simultaneous use of adjacent channels in the same place is not permissible. Exceptions to adjacent channels and the simultaneous use of channels are stated in the Appendix 2 to this Those frequency bands assigned for television by any other service (2). the use of the common resolution. cannot be used 203 Television broadcasting power as related to the pOpula- tion is assigned as in Table 45. TABLE 45.--Minimum broadcasting power needed to cover population areas. Population of Cities Minimum Broadcasting Power More than 1,000,000 50 Kilowatts (17 db/k) From 250,000 to 1,000,000 10 Kilowatts (10 db/k) From 50,000 to 249,000 1 Kilowatt ( 0 db/k) The maximum permissible broadcasting power is 100 kilowatts (20db/k) for channels 2 to 6, and 316 Kilowatts (25 db/k) for channel 7 to 13. The power of the sound trans- mitter cannot be less than 20 per cent of the power of the image transmitter (3). All television broadcasting stations are required to maintain the technical characteristics and the quality of their broadcastings according to the Recommendations of the Ministry of Communications and to the international com— munications requirements (CCIR) and the most advanced principles of engineering (4). Other norms from this resolution state that television broadcasting stations in color should use a system compatible with black and white system (7); a Venezuelan broadcasting technician with certificate from the Ministry of Communica- tions is responsible for the proper function of the station (10). 204 The Appendix number 2 to this resolution states that the allocation of the remained 14 to 18 television channels belongs to the Ministry of Communications. It also states that displaced channels can be used as follows: about 15 kilocycles when there is possibility of interference with adjacent channels from a nearby area; and half channel or more (3 megacycles), when in the same locality channels have been allocated in such a way that two free channels remain between the inferior and the superior, only for cultural or educational use and limited reception, with transmitters no more than 100 watts power, directional antennas, and if they do not cause interference to channels already operating in the area; Simultaneous use of adjacent channels in the same area are not permitted, exception is made in those cases in which transmitters of less than 100 watts are used with high directional antennas to cover small delineate areas, and when the topography of the terrain and location of the antennas guarantee no interference in primary service areas; Channels 2, 3, 4, 5 and 6 will not be assigned for simultaneous use of the same channel to places of distance less than 186.5 miles in direct line, exception made in the same cases as above; Channels 7, 8, 9, 10, 11, 12 and 13 will not be assigned for simultaneous use of the same channel to places of dis- tance less than 155 miles in direct line, exception made in the same cases mentioned above. 205 Connection between main stations and repeaters or among repeaters stations themselves will be made only by independent means (microwaves or UHF channels). Neverthe- less, the direct method can be used when the amount of assignments in the locality permit so, but when the direct method is causing interference it should be changed to the independent method in a fixed period of 18 months. In regard to the stations already in operation before this resolution, they can only enjoy protection against interferences in their primary service areas regarding the new concessions. There are six main television broadcasting stations and 29 relay-transmitters in the country operating most of 18 And they are located as in them in 525-line definition. the following tables. All of the television broadcasting stations as shown in Tables 46 through 51 which cover practically most of the populated areas of the country, are privately owned and commercially operated, except the Televisora Nacional which is owned by the National Government for cultural and educational purposes mainly. The first telecast was made in December 1952 by the government-owned station, which l8Republica de Venezuela, Ministerio de Comunica- ciones, Direccion de Telecomunicaciones, Lista de Estaciones