Caracas Chronicles

Original art by @modográfico

As a young medical school intern, one of my responsibilities was placing the requests for blood units at the blood bank. My patients’ scheduled surgery, dialysis or chemo recovery depended on the blood arriving on time. The sight of interns desperately running through the hospital with the patient’s charts trying to reach the blood bank as fast as possible is very common. You hear people shouting  “I need blood now!”

But ever since 2017, there’ve been numerous reports of generalized blood scarcity around Venezuela’s public blood banks. The issue is not the blood per se (family members of patients in need of blood are often in charge of getting donors), it’s the reagents needed to screen it for transfusion-transmissible diseases: Hep B, C, Chagas, HIV and syphilis.   

While the health crisis has been talked about for years, and we’re well aware of the shortages, blood scarcity lethally stabs Venezuela’s health system. Just when we thought it was bad, we hit a new low. A very, low, low.

In september 2017, public blood banks got word that the batch of reagents they got that month from the Health Ministry and the Institute of Social Security (these are the government organizations responsible for the purchase and distribution reagents nationwide) would be the last of that year, leaving to each hospital the job of finding and purchasing the reagents pending.

Back in February, the Venezuelan Nurses Society of Hemotherapy warned about how the lack of reagents affected up to 80% of the blood banks nationwide. The society’s advisor, Lia Talavera, claims some patients already died of digestive hemorrhage, as they couldn’t find blood.

The issue is not the blood per se it’s the reagents needed to screen it for transfusion-transmissible diseases.

She also claims some institutions are using expired blood bags, something she deems unacceptable, as the bags contain a number of chemicals that prevent blood from going bad. While people are making blood donations, those tend to decay, as blood can be saved up to 35 days and can’t be used without testing. In desperation, some banks are giving the patient’s family a sample of the blood their relative needs, so they can head to a private lab and pay for the testing. Sometimes they go many times through this, if the blood proves to be incompatible.

And when I thought I’d heard everything,  El Nacional did this piece, in which they interview Maribel Meléndez, secretary general of the Venezuelan Society of Hematologists.

She claims unscrupulous people try to benefit from the 70% paralyzation of blood banks. People in public hospitals, she says, go to patient’s beds and offer them the blood or derivatives they need, at quite the price.

Desperate patients pay up to Bs. 7,000,000 for the blood transfusions they need on the black market. A platelet bag in a private institution is around Bs. 1,000,000. That same bag goes for Bs. 800,000 at public hospitals, according to a source who wished to remain anonymous. When asked where the bags came from, the source claimed ignorance.   

Last week’s WaPo report on the blood shortages featured heartbreaking stuff: patients like César (suffering from thalassemia, a blood disease that causes hemolytic anemia) need blood transfusions on a regular basis. Many must resort to private blood banks for family members with cancer.

Desperate patients pay up to Bs. 7,000,000 for the blood transfusions they need on the black market.

Carla Tovar had to take her daughter (a leukemia patient) to a private clinic, where the child’s father works as a security ward, two hours away, by bus. The transfusion costed six minimum wages; they had to borrow from family and friends to pay it.

“If she needs another transfusion” Tovar said to WaPo in tears, “we have no money left.”

Later, Carla found her daughter did need a new transfusion. It took her five days of begging in public banks to get one.

Last week it was reported that 45 days of supplies and reagents were purchased through Venezuela’s Health Ministry and Institute of Social Security. The Pan American Health Organization (PAHO) is also set to donate reagents enough for a month.

So that’s three months of supplies. What happens later? It’s naive to think the government will fix this for good. The health crisis will affect every single person living in this country and the deeper the hole gets, the harder it will be to get out.