Venezuela crisis hits health care, kills patients
CARACAS, Venezuela For Venezuela’s dueling presidents, Nicolas Maduro and Juan Guaido, this month’s tug of war over humanitarian aid shipments is a test of loyalties and political power. For thousands of their countrymen, meanwhile, it’s a matter of life and death.
Dilapidated infrastructure and a brain drain of medical personnel have already brought Venezuela’s once cutting-edge health care system to its knees. But if the dangerous shortages of drugs and medical supplies persist, even the few who remain will have nothing with which to treat their patients.
Years of economic mismanagement by the socialist Maduro government have been well-chronicled, leaving the government’s finances and credit rating ruined and sending millions of desperate Venezuelans fleeing the country in search of a better life. But the deprivation is particularly vivid down at the street level, in the hundreds of ways big and small that people here struggle just to get through another day.
At the major University Hospital in Caracas, nurses and patients roaming semidark hallways last week were dodging cats hunting for mice. Used to persistent blackouts, doctors at the capital’s storied institution now also have to contend with spotty availability of running water.
The lack of drugs, supplies and even food is such that the sick are given a list of items they need to obtain on their own so the professionals can take care of them, said Jesus Chacon, 28, who interns at the teaching hospital as part of his final year of medical school.
“There’s no [sterilizing] solution, there’s no cotton, there’s no alcohol,” he said. “The patient has to bring them.”
But if the taps are dry, as was the case Feb. 25, there is not much medicine to be practiced anyway.
“We have some pots we carry around to wash our hands before we examine each patient and to clean the bathrooms halfway,” Mr. Chacon said. ”[But] surgeries are scheduled according to the availability of water well, not just that of water, but of [all] supplies.”
Although uniformed National Police and pro-Maduro militia forces keep a close eye on the facilities, the about-to-be physician readily identifies the president as the culprit behind what he calls inhumane conditions.
“I’d blame the government,” he said, underlining the meager pay that the doctors and professors at the hospital take home. “Resources are squandered; there’s theft, there’s thoughtlessness, there’s no empathy and not just in medicine.”
The country’s health care crisis closely tied to the collapse of the economy has been chronicled extensively by international watchdog groups. A November study by Human Rights Watch tracked a surge in such preventable diseases as measles, diphtheria and malaria, and noted that the Maduro government since 2015 has systematically suppressed national health statistics.
“Venezuela’s public health system has collapsed, putting at risk the lives of countless Venezuelans,” Shannon Doocy, associate professor at Johns Hopkins Bloomberg School of Public Health who was part of a team that traveled to the Colombia-Venezuela border, told Human Rights Watch researchers. “The combination of a failing health system and widespread food shortages has produced a humanitarian catastrophe, and it will only get worse if it’s not addressed urgently.”
The mismanagement of the country’s vast oil wealth means the government can no longer underwrite free public health care services or pay the large numbers of Cuban-trained doctors who came to Venezuela in the boom years, though Venezuela may soon get an infusion of Cuban doctors who are pulling out of neighboring Brazil after a right-wing government took power in January.
All agree about the depth of the crisis, but not everyone is ready to fault Mr. Maduro’s government.
Radiologist Ramon Llamosa, a three-decade University Hospital veteran, acknowledges that his tomography unit is “paralyzed” because of a lack of foreign-made materials and spare parts. But unlike most of his colleagues, he does not blame the regime for the near-total meltdown.
“If we didn’t have this ‘blessed’ blockade here, we would have bought tubes for the tomograph,” he said. “Where do you buy those tubes? In the United States. If the United States, the American government won’t permit the sale of the tubes, [we] of course can’t buy them.”
A few miles south, at the Supreme Commander Hugo Chavez Frias Maternity and Children’s Hospital in the working-class El Valle neighborhood, professed loyalty to Venezuela’s socialist leaders even comes with certain privileges.
“Obviously, we kind of have priority because of the name and [as a state-run hospital],” said pharmacy assistant Yorelis, who wouldn’t give her last name. “So we get [supplies] few, but we do get them, while they don’t.”
Still, things are not exactly rosy, said Dayerline, a maid who also wouldn’t give her last name.
“For a meal, we give the patient just one item of whatever is available, [for example] just rice,” she said.
Critical supply shortage
The Venezuelan government has failed to provide statistics detailing the impact of the crisis on its citizens. But a survey by the nongovernmental organization Doctors for Health suggests that more than 1,500 patients have died because of a lack of supplies over the past four months alone, and these may only scratch the surface.
Three in four emergency room physicians said they lacked morphine, while two in three said they had run out of drugs to treat high blood pressure. In 60 percent of hospitals, common over-the-counter painkillers were unavailable.
All but abandoned by their revolutionary government, private citizens are increasingly forced to fend for themselves by procuring drugs from relatives abroad or turning to nonprofits such as Feliciano Reyna’s Solidary Action.
Out of a brightly colored but unmarked single-family house in the capital’s Recreo neighborhood, Mr. Reyna runs a kind of clearinghouse of donated drug imports he distributes to patients and entities across the country.
What started as an effort to help HIV patients get the anti-retrovirals they needed has morphed over the past three years into a 27-person operation that serves up to 14,000 patients with 8,000 otherwise unavailable drugs.
Run on a donated, $35,000 annual budget, Solidary Action offers a hotline and pickup service open to anyone with a prescription while dispatching dry foods and hygiene articles to nurseries and senior homes.
The private nonprofit also clandestinely helps doctors from state hospitals restock their supply rooms.
“The government has refused to admit that there’s a humanitarian situation, and that keeps us from making formal agreements with hospitals,” Mr. Reyna said. “We go in in a very hush-hush way.”
Although the 105 tons of drugs including some 60 tons from the United States that have gone through his nonprofit have undoubtedly saved countless lives, the trained architect is apprehensive about ruffling feathers by accepting offers of fresh donations.
″[Shipments] have entered through ports and airports without impediments ... and we suppose it’s clear this aid is coming in,” he said. ”[But] at some point, they could certainly tell us, ‘You lack authorization to implement this type of program.’”
In the meantime, having thousands of patients depend on his work keeps him from even pondering emigration as other health care professionals have done, Mr. Reyna said.
The situation is more nuanced for Mr. Chacon, who has seen scores of professors and classmates leave Venezuela during six years of training.
“All depends on how things evolve in the coming days because there really are a lot of things happening, and that gives you hope,” the medical student said. “But if you end up seeing little progress, you really consider leaving.”