For those of us who have been following the deteriorating socioeconomic situation in Venezuela, it is alarming to see the extent of deterioration in the quality of life of Venezuelans over the past three to four years. This is a country that was once the world’s largest oil exporter, rich in natural beauty, ecological diversity, natural resources and beautiful, friendly, resourceful people. Venezuela is experiencing a major humanitarian crisis at present, the economic collapse giving rise to food shortages, a rapidly deteriorating health care and education system, hyperinflation and almost complete depletion of foreign reserves. The International Monetary Fund (IMF) predicts Venezuela’s inflation rate will reach one million per cent by the end of 2018 (1,000 per cent 2017, 112 per cent 2015). The economic conditions are so bad, I had to be careful taking photos and ran the risk of being killed for my camera to get food for a family. I was also at risk of the government confiscating photos and imprisonment if any anti-government content was discovered. In order to function, grow and prosper, a society requires certain basics such as good access to food and clean water, an adequate health care and educational system, security and a stable economic and political environment. Venezuela over the last five years has had none of the above. I recently visited Venezuela to see how accurate many of these reports were and I talked with many people working on the front line of health services. In particular, I visited a number of city hospitals and a rural health centre and I talked with patients, family doctors, hospital and public health specialists, nurses, ambulance drivers, teachers and some people on the street. I saw an eight-year-old boy that looked barely four years old with marasmus – a condition related to severe general chronic malnutrition and more associated with the severe famines of Sub-Saharan Africa in the 1980s. I saw lots of examples of empty hospital beds, not because of lack of patients but because of lack of medicines, medical and surgical supplies, malfunctioning equipment, power outages and compromised water supplies. I saw a number of basic X-ray machines not working because the wires had been cut to sell, equipment had broken down and no replacement parts were available. I saw an ER that had to survive without adrenaline for one week. I saw many patients waiting on cots in ER for admission – some of these patients had active TB and were putting other patients and staff at risk because there weren’t any isolation options. I saw a psychiatric ward that resembled some of the old Stalin Gulag prison camps. I talked with a very competent head surgeon who was demoted because he reported to the Health Ministry that the mortality of patient’s admitted to the hospital had increased to an alarming 20 per cent from five per cent because of the lack of medicines and diagnostic tests. The Ministry of Health blamed him for the alarming increase in patient mortality and demoted him. I talked with the medical director of a city hospital who was on a salary of $9 US a month and often the payment was delayed by two to three months. He was a well-trained medical specialist and hospital administrator. Most of the people I met, both medical and non-medical, ate one meal per day, which was usually a thin “arepa” – corn pancake traditional in Venezuela. Rarely can people afford meat or vegetables. My impression is rural people have a little better access to food than urban dwellers, but they still rarely get to eat meat. Rural dwellers tend to have even less access to medicines, medical supplies and medical staff. My impression is people have a significant protein and micro-nutrient deficient diet. There is still a significant amount of food available in Venezuela but as a result of spiraling inflation it is not affordable. For most, I saw fridges with one to two carrots or potatoes. People’s diet are high in carbohydrates and low in protein, fat and micro-nutrients. As a result, some people look healthier than they really are – similar to what I have seen on the Tibetan Plateau. I heard of cases of patient’s being kept alive with manual pumps because ventilators were faulty or power outages prevented them from operating. These are very difficult conditions for patients and staff. It’s amazing how those medical staff who have stayed keep going every day in such conditions. It is a testament to their commitment to their people and country. Not all medical and nursing graduates stay. An alarming 50 per cent of graduates from one medical school I visited, left the country, before internship. No doubt the statistics are similiar in nursing and other medical professions. Who can blame them when they are working in such circumstances? I saw an astronomical lack of appropriate medicines and diagnostic equipment at primary, secondary, and tertiary care facilities. Many infections are treated on the blind without access to diagnostic tests, often with inferior and sometimes inappropriate antibiotics because that’s all that’s available. It’s not surprising that we are seeing such an increase in infectious diseases across the country. This has the potential to markedly increase multi-drug resistant organisms across Venezuela, it’s neighbouring countries and the world. The mass migration of more than 2.3 million people out of Venezuela in the past three years accentuates this risk. As a result of the complete breakdown in the health care system, one can not rely on current health statistics and numbers. My impression is the prevalence of many diseases and multi-drug resistant infectious disease especially is underestimated and under-reported to Venezuelan citizens, the WHO and the rest of the world. The consequences of a broken health care system and economy are having a huge impact on Venezuelans, their neighbours and most likely the rest of the world. Venezuelan President Maduro was quoted at the UN in September 2018 saying, “Venezuela is a victim of world media attacks designed to construct a supposed humanitarian crisis so as to justify a military intervention.” Up until recently, he has refused to acknowledge a crisis and has refused to accept international humanitarian aid. The Lima Group is a multilateral group of neighbouring Latin American countries and Canada, established in August 2017 to work towards a peaceful solution to the current Venezuelan crisis. It works towards release of political prisoners, offers humanitarian aid, calls for free elections and promotes restoration of democracy in Venezuela. Within the past two weeks, there has been a glimmer of hope. The United Nations recently announced it would provide $9.2 million to Venezuela from its Central Emergency Response Fund to go to UN agencies within Venezuela. Maduro has recently invited Michelle Bachelet (former Chilean president and now head of the UN’s Office of High Commissioner for Human Rights) to visit Venezuela. Venezuelan’s secretive central bank, which has refused to share financial information for a long time is reportedly preparing new data for the IMF. Hopefully this is grounds for a spark of cautious optimism in a country that has had a lot more darkness than light for such a long time. Please donate to Basic Health International Foundation at www.basichealthinternational.org and indicate “Venezuela Relief.” Tax receipts are available for Canadians. Dr. William Hanlon is a doctor in Cochrane who has dedicated the past 35 years of his life to bringing medical aid to some of the most remote and turbulent parts of the world – from the deserts of Afghanistan to the Arctic tundra. The socio-economic impact of this meltdown is reflected in some of the following statistics: Food Shortages:
- 90 per cent of the population lives below the poverty line (WHO).
- The average Venezuelan has lost 24 lbs in the past year. "61 per cent went to bed hungry in 2017"
- Acute and chronic malnutrition, especially in children, 300,000 children at risk of malnutrition related death(OAS)
- 85 per cent of medicines were either impossible or difficult to find in 2017
- Hospitals are reporting less than 10 per cent of needed medicines and medical supplies available
- Radiology and lab services markedly diminished or shut down completely.
- A recent national survey of 40 hospitals showed a 1/3 of hospital beds were non functioning
- 50 per cent of emergency rooms don't have vital medicines and 95 per cent of CT scans and 51 per cent of X-ray machines were not working
- Increased outbreaks of infectious diseases such as diphtheria, measles, HIV, malaria and TB (highest in 40 years)
- Reduced access/availability of vaccines and potency concerns
- Acute and chronic diarrhea related to poor water
- Brain Drain: more than 13,000 doctors and more nurses have left Venezuela over the past four years along with many others
- Human migration: More than 2.3 million people (seven per cent of population) have left since 2015 to Colombia, Peru, USA, Spain, Chile, Panama, Brazil (UN)
- World's second highest homicide rate 57/100,000 (Canada 1 .68/1 00,000) insecurity, robbery (40 per cent) extortion
- Poor salaries, electricity blackouts, fuel shortages, teacher migration
- Reduced economic over past four years
- Tourism reduced to almost zero
