Caracas Chronicles

Lost in the news whirlpool of open letters, diplomatic summits and military exercises, there’s the news that Nicolas Maduro has named a brand new Health Minister: PSUV Falcón State MP Henry Ventura.

Until a few days ago, Ventura was the chairman of the National Assembly’s Health Committee. He admitted in a recent interview with State TV that at least 50% of medicines in the country are not available to the public, but he placed the whole blame of the problem to a “war” staged by pharmaceutical companies, drug stores, and “…the multinationals which have decreed the death of our citizens.”

#AkOk

Ventura won’t have it easy, as he’s the fourth Health Minister Nicolas Maduro has named in just two years. He’ll try his best to stay on the job longer than his predecessors: Isabel Irrutia (April-November 2013), Francisco Armada (November’13-September’14) and Nancy Perez (September 2014-March 2015).

At first glance, the challenge he faces is nothing less than monumental: EfectoCocuyo’s Vanessa Arenas offers some harsh data on the biggest problems. For example, a report by the NGO Red de Medicos por la Salud show that 44% of all operating rooms are currently not operational and there’s a 68% shortage of surgical instruments. The shortage of medicines is now 70% and malaria is already reaching historical highs in early 2015. Just to see the state of our public hospitals, the Caracas University Hospital has been forced to shut down operations two times in the last nine months.

But the best recent piece in order to understand the state of our healthcare system comes from abroad. Wall Street Journal’s South American correspondent Juan Forero (a friend of the blog) recently wrote an extended, front-page article about how the lack of many medical supplies is putting lives at risk. Sadly, its English version is suscription-only, but there’s a full free version in Spanish. The highlight of the riveting piece:

Of 45,000 beds in Venezuela’s public hospitals, only 16,300 are operational. Private hospitals, with another 8,000 beds, have helped overwhelmed public facilities, but they, too, are hurting. The association representing private hospitals says elective surgery at private facilities—from knee operations to gastric bypasses and other procedures that aren’t life-threatening—are down by 90%. That is because falling currency reserves are making it nearly impossible for hospitals to get the dollars needed to pay for imported medicine and medical equipment.

Venezuela needs about $1 billion annually in medical equipment imports, said Antonio Orlando, president of the Venezuelan Association of Medical Equipment. But in 2014, the cash-strapped government provided less than $200 million—a sharp drop from 2010, when the sector imported $807 million.

Last March, the Central Bank said that there was a 50% scarcity of medicines; it has since stopped publishing such data. The Venezuelan Pharmaceutical Federation, which represents the pharmaceutical sector, estimates that as much as 70% of all medicines are in short supply or unavailable.

Doctors and administrators at public hospitals say life-and-death operations—to unclog an aorta, for instance—have plummeted. Compounding the problem is a lack of staff. Hospital officials say up to half of medical school graduates, who earn less than $50 a month at the country’s black market rate, are fleeing the country.

At the University Hospital, a symbol of the health-care system since its opening in 1956 and the first hospital here to carry out cardiac surgery, doctors performed as many as 40 open-heart surgeries a month a decade ago. Last year, that average had fallen to about seven each month. Heart catheterizations, another common procedure at big hospitals, have fallen from 1,200 annually to about 100.

“How can we treat a patient when we can’t operate, or even give them a drug to take care of the pain?” said Dr. Ivan Machado, a veteran cardiologist at the hospital.

The human toll of the hospital’s plight is underscored by Carmen Quiñones, 51. In early December doctors at a private clinic discovered she had an abdominal aneurysm, bleeding in the lower part of the aorta, the major blood vessel that supplies blood to the body.

She was rushed to the University Hospital’s emergency room and told she needed a small tube called an aortic prosthesis to repair the rupture.

But the hospital, dry of resources, informed the family that it would be up to them to procure the necessary supplies—including the aortic prosthesis. By the next day, they had found one, which was donated by a doctor at a private hospital who knew the family.

While the prosthesis was successfully implanted, another complication arose during the operation. Doctors discovered another aneurysm, requiring a second surgery and a second prosthesis. The family failed to find another.

“I’ll operate, but what am I going to put in her?” Dr. Durand told Jhon Jairo Perez, Mrs. Quiñones’s 24-year-old son.

Without surgery, she began to worsen and by Dec. 26 was slurring words and losing consciousness. The blood was seeping from the weakened artery into her lungs, two doctors who treated her said, but the hospital didn’t have extra stocks to replace what she was losing.

“She bled to death,” said Dr. Durand. “We didn’t have a prosthesis. No blood. It was very hard to help her.”

The article is full of sad anecdotes such as this one. Kudos to Forero for highlighting the human aspect of this terrible state of affairs.