Caracas Chronicles

Photo: Roselis González Rosas

When pediatrician Germán Rojas Loyola quit his job as deputy chief pediatrician at Margarita’s Central Hospital in Porlamar in 2018, he spoke of issues we often read about, and yet remain taboo for Venezuelan health professionals working for the government: lack of medicine, supplies, and “being fed up with seeing children dying.” Only in that hospital, the most important in the state of Nueva Esparta (an archipelago on the Northeastern coast with around half a million inhabitants), more than 40 newborns died between January and March of 2016, because the ICU was contaminated with bacteria Klepsiella pneumoniae and fungus Candida albicans. 

The only thing hospital directors are doing is blocking doctors from talking to journalists or opposition deputies. Doctors are under constant threat of being fired or even prosecuted for treason. The president of the region’s bioanalyst board was threatened by the hospital’s director for publishing a statement describing how patients need to provide their own syringes, containers, alcohol and even water; everything but the professional running the tests. 

The only thing hospital directors are doing is blocking doctors from talking to journalists or opposition deputies.

This analyst, by the way, is paid a ridiculously low wage. Now they have no reactives and they can’t offer X-rays; many doctors (and especially nurses) are leaving the public hospital network—just at the Central Hospital in Porlamar, 18 pediatricians quit, dire news to a country with 10% of acute malnourishment in children up to five years old.

However, many others insist. Dr. Rojas is keeping his private practice while helping NGOs pro bono. When he decided to leave his post, he was already demanding an immediate solution, joining an alliance of doctors, nutritionists and nurses to decry their working conditions, with no drinking water or alcohol, and babies who, at birth, get diseases from their mothers. 

When Germán Rojas left the hospital, a newborn died every three days. Now, they just don’t know. The regime stopped publishing the epidemiology bulletin years ago, so Venezuelans don’t know how hard they’re hit by outbreaks. We depend on NGOs and other sources, while Dr. Rojas and his colleagues estimate that 15,000 people need humanitarian assistance in Nueva Esparta alone. 

Paralyze the Network

Margarita’s Central Hospital is overwhelmed, but people could reach the other hospitals in the island (at Punta de Piedras, Juan Griego, El Espinal and Salamanca) if they actually worked. And although they have nothing else, they do have two directors at the same time: one appointed by the governor and one “protector”. 

The “protector” would be Dante Rivas, PSUV candidate for governorship, defeated in the regional elections of 2017, named de facto governor by Maduro. He gets the few funds and real authority available, while the governor elected by the people, Alfredo Díaz, is stripped off of his functions by Maduro and his Supreme Tribunal. The same pattern we’ve seen for years wherever the opposition gets elected. 

No matter what the Constitution says, the Nueva Esparta legitimate governor has no budget or power to work on restoring the health network—a Maduro decree on October 12th made sure of that. The protector endorses the dictatorship’s policy of denial, meaning that everyone who can’t afford paying in dollars, in cash, must go to almost useless and clearly dangerous health centers. And few people in the islands have seen a dollar, ever.

Don’t Fix What’s Broken

In 2012, the Health Ministry opened a brand new oncology unit, just next to Porlamar’s Central Hospital, able to treat a hundred patients a day. The high-tech radiotherapy equipment failed a year later, never to be repaired; chemotherapy cannot be offered for lack of supplies. Cancer patients in Nueva Esparta must pay in U.S. dollars or reach the mainland, where there’s a lot more people looking for the same thing. Transportation, lodging and other expenses must be considered, if you’re even lucky enough to get tickets in the few remaining airlines or ferries that still connect Nueva Esparta to the rest of the country.

If you can’t surmount these obstacles, your chances for survival will dramatically drop: the state is not there to help. You’re on your own.

No matter what the Constitution says, the Nueva Esparta legitimate governor has no budget or power to work on restoring the health network—a Maduro decree on October 12th made sure of that.

Just picture being a diabetic patient here: you’ll only find insulin on the black market, no official permits of any kind. All meds are expensive and scarce, yes, but if you’re suffering from chronic conditions, you’ll have to choose between eating that day or buying the metronidazole your child needs.  

Margarita and Coche, the most populated islands of Nueva Esparta, have always depended on the mainland for fresh water and energy. In today’s Venezuela, that means severe water and power rationing, which makes it harder for you to keep your house and your people clean, or the fridge going with actual, edible food. Folks are, of course, more vulnerable to the malaria outbreak from Guayana, for instance, with people coming in to sell gold. In 2018, there were at least 5,000 cases of malaria in Margarita, 15% of them in infants. You can also get tuberculosis or dengue fever, but medicine is out of stock or too expensive, while hospitals are understaffed and almost dry of supplies. 

So, yes, it’s pure medieval warfare in the 21st century. The thing is, this isn’t an apocalyptic Netflix show, it’s real life in today’s Nueva Esparta. The Health Ministry says that at least 90 % of the population is covered by the national vaccination scheme. 

Professionals argue that if that were true, Venezuela wouldn’t have a diphtheria outbreak.