Venezuela: Healthcare in Times of Crisis

Venezuela, which prior to 2014 was often regarded as one of Latin America’s most developed countries, in recent years has faced a devastating economic and political crisis. From economic collapse from inflation, to disputed election results and debate around foreign intervention, Venezuela has become known globally as a country in crisis. Experts report that prior to August of 2017, the political conflict alone had left about 70 dead and more than 1000 injured (Bello, 2017). However, in recent years violence has only escalated, reaching international attention as President Maduro continues to restrict public protesting.

Yet the greatest threat to modern Venezuelans is malnutrition. Hyperinflation has resulted in food shortages and inadequate government food rationing (Stevens, 2017). Jung (2018) reports that the average Venezuelan in poverty from 2014 to 2018 lost 18 pounds. Additionally, the crippling healthcare system has posed its own crisis on today’s population, between the lack of medical equipment and medical officials abandoning their posts, demonstrating the devastating effect that a socio-political conflict can have on a population’s health.

The Venezuelan health crisis is perhaps most surprising due to the country’s recent history of radical improvements in health infrastructure and medicine. In the early 2000’s, under Chavez’s rule, Venezuela underwent large healthcare reforms, mostly centered around "Misión Barrio Adentro," or MBA (Cueto & Palmer, 2015). Within these changes, Venezuela centralized healthcare under government institutions, increased cooperation across different sectors within medicine, and improved access to care in poor communities (Carrillo Roa, 2018; Cueto & Palmer, 2015). These initiatives demonstrated a strengthening of health in Venezuela and a movement towards social medicine. In subsequent years, Venezuela became known for its superior health system (Briggs & Mantini-Briggs, 2009; Carrillo Roa, 2018). Yet in less than a decade, Venezuela's reputation and health infrastructure has rapidly crumbled. As Venezuelan Oscar Feo Istúriz (2017) writes “...despite the advances which we can highlight from the last eighteen years, we must admit that the health situation in Venezuela is a disaster.”

Venezuela lacks medical equipment, including medicine. This has resulted in both inflation of the price of medicine available, and the majority of the population unable to access their basic healthcare needs. Most patients must resort to the black market for medical supplies, as pharmacies and medical clinics are no longer able to stock these resources. Stevens (2017) notes that a bottle of saline solution used for sterilization and cleaning that would normally cost US$1 costs US$200 on the black market in Venezuela. While this hyperinflation of medical expenses certainly burdens the Venezuelan population, the absolute lack of medicine is even more troubling. Since 2014 there have been shortages of “insulin, painkillers like aspirin, bandages, anesthetics, surgery tools, gloves, and antibiotics” (Jung, 2018). Additionally, in Venezuela it has become increasingly difficult to gain access to contraception (Albaladejo, 2018). Raphelson (2018) estimated a 90 percent deficit of medicine available in 2018, and this figure has likely only increased in the last year. This shortage affects the entire Venezuelan population, not just the poor. The death in 2018 of Marcos Carvajal, a former professional baseball player, to pneumonia due to a lack of antibiotics illuminated this reality (Raphelson, 2018). Additionally, Feo Istúriz (2017) highlights how often the medicines individuals pursue and may obtain are not actually the needed intervention. The lack of access to medical supplies poses an ever-increasing threat to the entire country. However, it is hardly the only crisis the Venezuelan healthcare system is facing.

In a state where hunger and oppression prevail, hospitals must work overtime to cope with the increased incidence of poor health. However, Venezuela’s hospitals and other medical facilities are constantly understaffed and underfunded. Throughout the crisis, Maduro’s government has increasingly neglected healthcare costs. While in 2010 almost 10 percent of the national budget was allocated to healthcare, this figure had dropped to 5.8 percent by 2014. This dip in finances in many ways precipitated the healthcare crisis Venezuela witnesses today. While government funding dropped, Venezuelan dependence on the public health sector rather than private healthcare increased (Carrillo Roa, 2018). Beyond the lack of funding, Venezuelan hospitals are in desperate need of medical professionals. In just four years the country lost 13,000 doctors to immigration (Raphelson, 2018). One interviewed physician claimed that 70 percent of the individuals she had studied with had left the country to practice elsewhere, and explained how it can be impossible to find a specialist doctor for her patients (Phillips, 2019). Many hospitals in Venezuela are also lacking food and clean running water for their patients. All of these measures indicate a dire crisis in terms of healthcare availability for Venezuelan patients, and it is no surprise that the measures of health in Venezuela have dramatically decreased since the beginning of the crisis.

Lack of adequate medicines and healthcare access have resulted in the reemergence of previously rare infectious diseases, as well as general poor health across the population. Recent years have seen increased cases of measles, diphtheria, malaria, tuberculosis (Phillips, 2019), Chagas, and chikungunya (Hotez, 2017). These outbreaks not only threaten Venezuelan health, but also endanger populations abroad, as more refugees flee the country. Venezuela also now claims one of the highest rates of HIV and teen pregnancy in Latin America (Albaladejo, 2018). Relatedly, infant mortality increased by 30 percent in 2016 alone (Raphelson, 2018). Healthcare outcomes are unsurprisingly dire in the country which has increasingly few medicines and medical professionals, coupled with unreliable food and water sources.

While the political and economic situation in Venezuela often receives the most attention, other societal institutions such as healthcare have also suffered through the recent crisis. Inadequate medicine, funding and doctors have resulted in severe consequences for Venezuela’s healthcare system, reversing the many health improvements achieved in Venezuela in the previous century. A country which once boasted one of the strongest public healthcare systems in Latin America has now faced almost 6 years in crisis, and the dire conditions have generated drastic consequences for Venezuelans in terms of their health. The Venezuelan modern situation demonstrates the implications for a population’s health when political and economic national structures crumble.

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Additional Resources

Fraser, B. (2017). Data reveal state of Venezuelan health system. The Lancet, 389(10084), 2095. doi:10.1016/s0140-6736(17)31435-6. Retrieved from https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)31435-6.pdf.

Krygier, R. (2018, March 19). Venezuelan hospitals are even worse off than we knew, an independent poll shows. The Washington Post. Retrieved from https://www.washingtonpost.com/news/worldviews/wp/2018/03/19/venezuelan-hospitals-are-even-worse-off-than-we-knew-an-independent-poll-shows/?utm_term=.1e21d8e33c95.

Pan American Health Association (PAHO). (2018). Venezuela and neighboring countries Institutional regional response to the health situation. PAHO/WHO Emergency News. Retrieved from https://www.paho.org/disasters/newsletter/index.php?option=com_content&view=article&id=619:venezuela-and-neighboring-countries-institutional-regional-response-to-the-health-situation&catid=304&lang=en&Itemid=390

References

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Bello, R., Damas, J., Marco, F., & Castro, J. (2017). Venezuela's health-care crisis. The Lancet, 390 (10094), 551-551. doi:10.1016/S0140-6736(17)31831-7.

Briggs, C., & Mantini-Briggs, C. (2009). Confronting health disparities: Latin American social medicine in Venezuela. American Journal of Public Health, 99(3), 549-55.

Carrillo Roa, A. (2018). Sistema de salud en Venezuela: ¿un paciente sin remedio? Cadernos de Saúde Pública, 34(3).

Cueto, M., & Palmer, S. (2015). Medicine and Public Health in Latin America : A History. New York, NY: Cambridge University Press.

Feo Istúriz, O. (2017). El deterioro de la salud en Venezuela. Aporrea. Retrieved from https://www.aporrea.org/contraloria/a254438.html.

Hotez, P., Basáñez, M., Acosta-Serrano, A., & Grillet, M. (2017). Venezuela and its rising vector-borne neglected diseases. Plos Neglected Tropical Diseases, 11(6), 0005423. doi:10.1371/journal.pntd.0005423.

Jung, C. (2018, April 24). Venezuela's Ailing Healthcare System: Years Later. Hippocrates Med Review. Retrieved from http://hippocratesmedreview.org/venezuelas-ailing-healthcare-system-years-later/.

The Lancet (2018). Editorial: The collapse of the Venezuelan health system. The Lancet, 391(10128), 1331.

Phillips, T. (2019, January 06). Venezuela crisis takes deadly toll on buckling health system. The Guardian. Retrieved from https://www.theguardian.com/world/2019/jan/06/venezuela-health-system-crisis-nicolas-maduro.

Raphelson, S. (2018, February 01). Venezuela's Health Care System Ready To Collapse Amid Economic Crisis. NPR. Retrieved from https://www.npr.org/2018/02/01/582469305/venezuelas-health-care-system-ready-to-collapse-amid-economic-crisis.

Stevens, S. (2017). When a crisis emerges, look the other way: Venezuela's handling of the health care crisis. Harvard International Review, 38(1), 6.