Caracas Chronicles

Human Rights Watch (HRW) recently launched a 67-page report with exclusive footage and photos exposing the current humanitarian crisis in Venezuela. Researchers interviewed over one hundred people: healthcare professionals, patients, people queueing to purchase goods subject to government-set prices, community members, former detainees, and human rights defenders in Caracas, Maracay, Valencia, Barquisimeto, San Cristóbal, Capacho, Betijoque, Trujillo and Maracaibo.

This report looks like nothing HRW has done in Venezuela before: their researchers had to work virtually undercover.

That took some doing, because HRW is no longer welcome in the country. Back in 2008 when trying to launch a country report, their presence was “not tolerated”: security officials literally escorted their executive director, José Miguel Vivanco, to Maiquetía and kicked him out of the country. 

So this report looks like nothing HRW has done in Venezuela before: their researchers had to work virtually undercover. HRW skipped their house rules this time around and deliberately chose not to get in touch with any government official to avoid putting anyone at risk. Seasoned Human Rights researchers know how to operate in this kind of context, though: they’ve learned it in places such as Azerbaijan, Belarus, Zimbabwe.

I called Daniel Wilkinson, HRW Americas Managing Director, to ask about the report. “The only other country in the region where we can’t work openly,” he told us, “is Cuba.”

In most countries, we meet regularly with government officials to get their views of the issues we’re working on. It used to be that way in Venezuela, too. We’d meet with officials at every level of the government, including President Chávez himself. But as his administration slid toward authoritarianism, that became increasingly difficult.

But they did reach out to the government in writing (with no response, of course) and also got their hands on official reports from the Ministry of Health that reveal that neonatal mortality skyrocketed: 79% increase in the last 7 years. That’s going from 73 deaths per 1,000 births in 2009 to 130 in 2016.

One infuriating aspect of this is an explosion in mother-to-baby HIV transmission. Lack of medicines, prenatal vitamins and implementation of protocols to prevent transmission during childbirth have left obstetricians with virtually no choice, the report found. A doctor in a hospital near the Colombian border tells HRW:

We have recent cases of four pregnant, HIV-positive women who underwent vaginal delivery simply because there was no [safety equipment] available for obstetricians to protect themselves from possible infection [during a caesarean].

And a doctor in Valera thinks babies’ deaths have increased due to infections related to overcrowding, “You may find two, three babies in the same cradle; two or three babies in [the same incubator]”.

Another testimony on the healthcare crisis comes from a psychiatric hospital in Trujillo that has received virtually no medicines in 2016, making it extremely hard to treat patients with schizophrenia or bipolar condition. A nurse tells HRW:

Patients who exhibited aggressive behavior, were permanently locked inside cell-like rooms. We don’t have antipsychotic drugs, we don’t have anticonvulsants, we don’t have anything at all. The institution does not have [medicines] to treat patients, which is why the majority end up in the [isolation] area, so that they don’t escape and harm other patients or us.

The report also looks at food shortages and HRW not only documents the lack of reliable statistics on the issue but also points out the irony: the people who benefited from the creation of Mision Mercal, a programme designed by Hugo Chavez 13 years ago to provide low-income Venezuelans access to goods and food, are the hardest hit today.

Illnesses associated with poor nutrition were on the rise and were reaching levels that he had not seen in the hospital since the 1960s or 1970s.

Several doctors told HRW that they were starting to see symptoms of malnutrition in patients, particularly children. They said illnesses associated with poor nutrition were on the rise and were reaching levels that he had not seen in the hospital since the 1960s or 1970s.

The report dives deep into the stories of ordinary Venezuelans who have been affected by this humanitarian crisis. There is Lizbeth (30) from Caracas, who lives with Crohn’s disease and has taken expired medication when she couldn’t find her medicines in pharmacies; Sandra (33) the mother of a toddler who frequently develops high fevers with convulsions and who has been buying paracetamol in Colombia, paying 10 times its price; or Elaine, the mother of a 16-year-old with Down’s Syndrome who can’t find medication for him and keeps sending all her 4 children to bed without dinner.

Many others are not only struggling to find food and medicines but have also been jailed for taking part in protests over food shortages. Some have been prosecuted in military courts, and HRW rightly says that these are not isolated cases, but it’s a pattern that started developing after ‘La Salida’ series of protests.

Many of these protesters are doctors themselves.

After a protest staged by healthcare staff outside a hospital in San Felipe, Yaracuy, surgeon Johan Gabriel Pinto Graterol was detained by the militia for carrying medical supplies (needles, syringes and a catheter) in his bag. It just so happens that Pinto, just as many other professionals, routinely carried surgical materials he had purchased with his own money to be able to provide medical care at the hospital, where they were unavailable.

Shortages, crackdown on dissent and the healthcare crisis don’t seem to be improving in the days to come, as the recall referendum, the only legal avenue left for Venezuelans to channel their discontent has been closed. As Wilkinson puts it,

Obviously the Maduro government would have none of it, and once again it’s used its control of the judiciary to ensure its authority remains unchallenged. As long as it can do that, it seems extremely unlikely the government will accede to demands it take the humanitarian crisis more seriously.

“So, what’s next?” I asked him.

[OAS members] should convene another special session of the OAS Permanent Council to assess the Venezuelan crisis and identify specific steps that the Maduro government should take, such as releasing jailed opponents and seeking international humanitarian assistance. True, the Maduro government has been very dismissive of Almagro, but when the message is coming from a majority of the region’s democracies, it should be much harder for President Maduro to ignore it.

OAS, the clock is ticking. P’ayer es tarde.