|In the United States and most other parts of the world, a patient can seek out medical attention at a hospital, doctor’s office or urgent care center with good faith that the institution will have the medical supplies needed to treat their condition. Venezuelan patients, however, can expect their doctors to hand them a list of medical necessities, including catheters and antibiotics, that they need to address their symptoms. The patients and their families will then be forced to visit a number of pharmacies and other health clinics to search for these items, which will likely be out of stock as well. They may perhaps eventually turn to the black market for the supplies, where there are no quality guarantees and no ways to tell if the supplies are right for the specific patient.This trend likely seems like something out of a dystopian novel, especially since Venezuela’s health system has long been a source of pride for the nation’s government. But as thousands of people are unable to access essential medical treatments or wait-listed for life-saving surgeries, human rights organizations are accusing this very government of failing to ensure that needed medicines and medical supplies are available to its citizens, while the country’s currency exchange restrictions and price controls make it impossible to sell them. However, President Nicolas Maduro’s administration is directing blame towards the nation’s businesses and healthcare professionals, even as decreasing oil prices make a terrible situation worse.
According to Human Rights Watch’s associate health and human rights director, Diederik Lohman, the organization Doctors for Health reported in March that Venezuelan public hospitals were shockingly unprepared to help their patients. A network of medical residents in public hospitals across the country, the group reported that 44% of operating rooms in 130 institutions were not operational, and 94% of labs lacked necessary materials. Additionally, 60% of routinely stocked medicines or medical supplies were entirely or partially unavailable in these hospitals, and most of the medicines on the World Health Organization’s Model List of Essential Medicines were not available in pharmacies.
Lohman said that findings from Human Rights Watch corroborated these reports: in recent visits to Venezuela, the organization found shortages of medications to treat pain, asthma, hypertension, diabetes and heart diseases, among others. Similarly, syringes, gauze and needles were undersupplied, and basic lab tests could not be performed. This is to say nothing about common, relatively minor problems, like ear infections, which 75% of children will experience before the age of five. While this condition will usually pass on its own, some cases will require antibiotics and can cause hearing problems and other consequences if left untreated.
This isn’t a major change in some areas of the country, as many rural regions have long experienced difficulty accessing basic medicines and services. However, Lohman says that the situation has deteriorated at a rate comparable only to that of a war zone, with major hospitals and private pharmacies now unable to provide essential medical care as well. Doctors for Health reported that at the end of 2014, approximated 20,000 patients had been wait-listed for surgery. Some pediatric health care professionals have also told Human Rights Watch that they sterilize and reuse masks used to treat children with respiratory conditions, while they cannot even diagnose many patients because they lack lab tubes and test kits.
Unsurprisingly, Venezuelans have expressed outrage at this situation: many citizens have been holding street protests over a number of issues, including the medical shortages, since February 2014. In response, security forces have used a range of unlawful measures against these demonstrators, including arrests, beatings and torture. However, as the situation has worsened, the Venezuelan government has attempted to divert attention from its numerous crises by shifting the attention and blame elsewhere. When the University Hospital of Caracas closed its cardiology unit in January after 10 reportedly patients died waiting for surgery, for example, health authorities briefly provided new supplies of medication so the department could reopen. It closed again two weeks later, when the supplies ran out.
Most notable, however, are the government’s attempts to redirect blame onto pharmaceutical companies, pharmacies and doctors. For example, in early February, Maduro accused a pharmacy chain of waging an economic war against the people after it closed several cash registers at one store, causing a line. The government later detained two of the chain’s directors for 45 days before releasing them to face charges of “boycott to destabilize the economy.” The police have also detained and interrogated a number of doctors who have publicly criticized the shortages or provided care to injured demonstrators.
Commercial and international pharmaceutical businesses have also been targeted by the government, but critics like Lohman say that the government itself is to blame. Because Venezuela does not have a strong pharmaceutical industry, the country imports most medication and supplies, including the raw materials used to make locally manufactured drugs. However, the nation’s own Comptroller General’s Office has criticized the way the government stores the pharmaceuticals it receives: one report found that medicines and surgical supplies in public hospitals that had expired up to six years earlier, while another in September found that the ministry had only been able to obtain 0.84% of medicines needed for 2015. According to the administration, 74% should have been available by that time.
Unfortunately, with the country’s current exchange rules and price controls, there seems to be no way to dramatically increase the nation’s access to health supplies. Foreign pharmaceutical companies require payment in hard currency, but the government is strictly regulating what appears to be a limited amount of financial resources. Likewise, Venezuelan pharmaceutical companies need official authorization to purchase dollars to pay foreign vendors, and even when this is granted, shipments from the Central Bank of Venezuela are often plagued with long delays, resulting in late payments. Now, many foreign suppliers are refusing to send new shipments to Venezuela until their debt is paid. But even if pharmaceutical companies were allowed to buy dollars outside this system, Venezuelan law imposes a maximum price for medicines sold there, which is based on the official exchange rate. This means that companies would pay much more for medicines and supplies than they could possibly charge for them. Meanwhile, the official exchange rate is only 3% of the black market price, causing many Venezuelans to seek out unregulated and potentially unsafe products. As the country’s multiple problems continue, experts agree that the lives of thousands of Venezuelans hang in the balance.