VENEZUELA: THE HEALTH OF THE PEOPLE OF BOLÍVAR IS BUT A MIRACLE FROM HEAVEN

By Gabriela Buada Blondell

In Bolívar state, the health crisis is getting worse. Its inhabitants face the reappearance of mining-related diseases that had been eliminated. They also face the dread experienced by anyone living with a chronic health condition that cannot be treated.

In Bolívar, the municipalities of Heres and Caroní account for most of the population. Today, as in all of Venezuela, to speak of the right to health is to have to mention the multiple complaints of civil society organizations1 that report the dramatic setback in this matter as a result of a Complex Humanitarian Emergency that affects the entire population. Undoubtedly, this particular right has been severely violated time and time again.

What is happening in this regard has been reported by international agencies, which consider this whole situation to be a massive catastrophe (World Bank, 2019) and an endless spiral of violence (OHCHR, 2018). Venezuela is among the 15 countries that will experience the worst humanitarian crises this year (Europa Press, 2019) and occupies the first places in corruption and lack of competitiveness, with a dramatic collapse of institutions, the economy and welfare, without there having been a war (IMF, 2018).

Since 2013, defenders of the right to health and the right to life have been warning about what is now a reality that the authorities denied so that they would not have to address it. Then, no economic sanctions were in sight and there was time to prevent what we live today or, at least, to react quickly and guarantee health and a dignified life. Today the situation has worsened and there are many obstacles to overcome in this respect.

Hospitals and outpatient clinics in Ciudad Guayana are no longer able to provide services. Many of the private clinics in Puerto Ordaz closed as a result of the severe decline of supply companies. The conditions at the main hospital in Ciudad Bolívar, the Ruíz y Páez Hospital, are inhumane simply because there are no supplies to operate and lives are in imminent danger due to the precarious state of the health facility.

“Yamileth Hernández shares her 12-year-old daughter’s experience with malaria: “At first the doctors couldn’t diagnose her. Few health professionals work at the hospital and they saw her on the third day, when the fever had already caused the girl to have seizures.”

The malaria epidemic in Guayana worsens and the chemicals used in illegal mining, such as mercury and cyanide, have serious consequences for young women and, in particular, pregnant women. The organic mercury (methylmercury) concentrated in fish in polluted rivers affects pregnancies. Mercury affects the fetus, damaging its nervous system and brain. These chemicals, in the bodies of pregnant women, result in the births of children with serious motor, neuronal and brain deficiencies, according to the Bolívar state Complex Humanitarian Emergency report published by human rights organizations.

(Methylmercury) concentrated in fish in polluted rivers affects pregnancies. Mercury affects the fetus, damaging its nervous system and brain. These chemicals, in the bodies of pregnant women, result in the births of children with serious motor, neuronal and brain deficiencies, according to the Bolívar state Complex Humanitarian Emergency report published by human rights organizations.

Today, epidemics and diseases that had been eliminated have progressively spread. A setback that speaks of the collapse of the national health system. The increase of malaria cases in Bolívar, especially since the development of the Orinoco Mining Arc project, as well as the progressive deterioration of the Ministry of Health’s structures for the prevention, control and treatment of the disease, have had serious environmental consequences for the inhabitants and the biodiversity of the region.

There have been several complaints that malaria, measles and diphtheria have spread from Bolívar state as a result of mining.

“The malaria prevention, diagnosis and control program has been gradually deteriorating since 2012, as a result of the political and economic crisis,” which “has led to an unbridled increase in the malaria epidemic,” a research conducted by Dr. María Eugenia Grillet at the Central University of Venezuela indicates.

The World Health Organization (WHO) acknowledged the emergency and decided to support Venezuela along with Nigeria, South Sudan and Yemen, which are facing a similar situation.

“Measles, diphtheria and malaria are at least three diseases that have recently become more prevalent in the region. It seems that they have spread from Bolívar and that is due to mining in the municipality of Sifontes,” warned Manuel Guzmán, Head of the Infectious Diseases department at the Vargas Hospital in Caracas.

All areas of health in intensive care

Jhonathan Castañeda is a surgeon. He says that his professional experience in Bolívar, particularly in the Ruíz y Páez Hospital, is a nightmare that worsens with time.

“There is a shortage of everything, especially health professionals, and that creates a serious problem because it accelerates the collapse. In the hospital we lack everything, and therefore, the impact on primary care is impossible to disguise,” the young doctor lamented.

The physician remarks that the exact same thing happens in clinics and that the right to health is not guaranteed. It is with pain that doctors are faced day after day with a situation that no one can stand and that is often known to be happening because the authorities so want it.

“The figures do not come to light and it is difficult to access them because many people profit from this situation. The incidence of HIV in Bolívar state is high and this is something that has been on the rise, as well as cases of tuberculosis.”

Another example offered by the physician to illustrate the different aspects of the Complex Humanitarian Emergency in the region is what happens to people who have to undergo elective surgeries, such as a hysterectomy.

“The patient has to get everything. From the sterile gauze to the solution to be used, including the anesthetic needed to perform the operation. This means that many people are not treated because they don’t even have the basic tests required for the surgery, and it means that conditions that could be prevented are left untreated. As a result, many people die from preventable causes.”

The unprecedented collapse has a considerable impact on the deterioration of the quality of life of Venezuelans and on the increase in deaths from preventable causes, as this is precisely one of the most lasting effects of the health crisis in the country.

Unfulfilled precautionary measures

Johonnys Hernández, the first Venezuelan beneficiary of a precautionary measure2 granted by the InterAmerican Commission on Human Rights (IACHR), knows that economic sanctions are not the cause of his deteriorating health.

“The precautionary measure was not complied with. At first and for six months, I got the drug, but it wasn’t because they bought it. What they gave me belonged to people with hemophilia in Ciudad Guayana. In other words, I was being allocated medicine from another region, so that they could say they were complying. They could only do that for a while and the measure was not complied with,” Hernández said.

Since December, he has been suffering from a lack of not only medicine but also food. In January, Johonnys lost consciousness for over 15 minutes because he had not eaten in several days. Because he cannot secure treatment for hemophilia, the bleedings are prolonged and he cannot work or take care of himself.

“I’m very affected, not only physically but emotionally. I am my own psychologist and I try not to become depressed. Acción Solidaria has supported me with food and supplements and with that I have been able to survive. I currently weigh 49 to 50 kg and I am weak. It’s not right for an NGO to have to help me. I should have my treatment and be able to work and support myself.”

The legal department of Acción Solidaria is monitoring the health of Johonnys Hernández, since they are considering requesting that the State be asked to comply with the measure and that they also grant him compensation. The latter because he cannot fend for himself due to a health condition which, with a policy that guarantees medicines to the population, is perfectly preventable.

“They must guarantee my health and I deserve financial compensation for all that I have suffered because it is not acceptable that they do not spend on health, but they do invest in weapons and uniforms for soldiers. People are dying and I believe that they should comply with the IACHR’s measure because, without medicines, I am rendered useless and incapacitated,” he added.

An endless emergency in the country’s richest state

The Venezuelan government is failing in its responsibility to protect citizens regardless of their political affiliation and the entire world knows this because of the worsening migration crisis. In Bolívar, people with health conditions are forced to migrate to Caracas to save their lives.

“Among the most vulnerable groups are people with chronic and serious illnesses, pregnant and nursing women, newborns, children under five years of age, indigenous people, the elderly, people at risk and people with disabilities. They arrive at the Vargas Hospital in Caracas to save their lives, but not much can be done here,” said Dr. Manuel Guzmán.

Due to the humanitarian crisis, medical care and fuel supply have been severely affected, as power outages deprive the state of basic services. This results in preventable deaths and the resurgence of eliminated diseases.

“The shortage or absence of medicines and medical attention in the public health services in Bolívar leads us to practices from the Stone Age. Indigenous women and children are not guaranteed access to diagnosis or treatment,” the doctor claimed.

The collapse of basic services aggravates sanitation problems in public health centres and hospitals do not have regular water access. Power outages are a major concern, as there are no emergency power systems to keep life-support equipment on.

The shortage of medicines has also forced emergency specialists to bear costs that they should not. “Many of us, who don’t really earn living wages, pay for gauze, sterile gloves and needles,” said Dr. Jhonathan Castañeda.

An immediate solution and a humanitarian space with international support must be demanded in order to address the healthcare crisis, so that all health situations —which went from being classified as serious, preventable or treatable to becoming a catastrophe that has to stop— can be dealt with. Life in Bolívar and in Venezuela as a whole is a Russian roulette that, in times of economic prosperity, no one expected. Civil society organizations have the fundamental role of continuing to document these cases so that they are not repeated and to make the right to health possible once more.