America

x-ray of a health system in crisis

Orfa Nelly Pineda helps feed her son through a tube.

Caracas Venezuela – In Venezuela, on average, only four out of every 10 operating rooms in the country's main hospitals are operational and the rate of shortage of supplies in emergencies is around 37%, while in operating rooms it reaches 74%, according to a recent report by the NGO Doctors for Health. The figures, although alarming, represent a slight improvement compared to previous years, but the situation is far from optimal. “When we look at the health system globally, we are very far from a health system that a Latin American country would require, comparing ourselves to Colombia, Argentina or Chile,” declared Dr. Julio Castro in charge of presenting the report. What is happening with health in Venezuela?

In Venezuela, 30% of public hospitals do not have any type of disposable material such as lingerie, hats, surgical gowns, face masks, so the patient must bring these supplies to be able to undergo surgery. Users should also provide pain relievers, sutures, and saline solutions.

“On average, we are talking about a patient having to put their hand in their pocket and spend about $80 to undergo surgery, which represents almost six months of a nurse's formal salary. This is the highest health expenditure in all of Latin America,” said Julio Castro.

The National Hospital Survey monitors the 40 largest hospitals in the country type III and IV, including the different service providers in the sector such as the Ministry of Health, Military Health, governorate and Social Security hospitals.

Eight years waiting for an operation

Orfa Nelly Pineda suffers daily from the crisis of Venezuela's public health system. She has been waiting for eight years for an operation for her son Joshua, which would allow him to eat by mouth again. Josué managed to overcome leukemia, but the cancer treatment caused two fistulas that have forced him to feed through a tube since he was five years old. Her health condition worsens with the passage of time.

Josué has spent half of his life hospitalized in at least four hospitals in Caracas. “We spent eight months at the Domingo Luiciani Hospital. The power always went out, the operating room was damaged. When we were ready to take him into the operating room, the operating room was contaminated. (…) In El Algodonal it was worse. The last time I went, there was no mattress for the child,” Orfa told France 24.

The wait has caused Josué problems with his esophagus and multiple pneumonias from eating solid foods in secret. His condition as a child with Down syndrome makes him even more vulnerable.


Orfa Nelly Pineda helps feed her son through a tube. © Daniella Zambrano / France 24

In the interior of the country, the situation is even more critical. Patients must travel to the capital to be treated, since they do not have the supplies or enough specialists who can care for the population.

This is the case of Wilmer José Márquez, who in December traveled from Trujillo (western part of the country) to Caracas, seeking care for his grandson Adrián, diagnosed with a liver tumor. Wilmer regrets that in the entire entity there was no pediatric oncologist who could attend to the case.

“In truth, they asked you for even the smallest thing in the hospital: butterflies, gloves, face masks, all the clothing that nurses wear had to be bought; the hoses to do the tracheostomy, all those little things had to be bought,” Wilmer told France24.

Personnel deficit and service failures

Failures in Diagnostic Support Services in public hospitals continue. Only 10% of hospitals in Venezuela have the possibility of performing a tomography. 30% do not have a simple X-ray service and 47% of the laboratories operate intermittently..

“For a patient to go to a hospital and not be able to have hematology done is something terrible,” denounced Julio Castro during the presentation of the balance sheet for the year 2023.

Failures in public services such as light and electricity are also constant. According to the report, 5 out of 10 hospitals have an intermittent water supply and 47% of public health centers receive water from tanker trucks..

Hospitals are running out of human talent

The shortage of doctors and nurses is a common denominator in the public hospital network. According to the Venezuelan Medical Federation, around 42,000 professionals have left the country due to low salaries and difficult working conditions.

Elizabeth Narváez, a nursing graduate with eight years of service in the main hospital in Caracas. She earns the equivalent of seven dollars a month and with the bonuses granted by the State she reaches 100, in a country where the basic basket is around 500 dollars a month. She says that her work and that of her colleagues has become a social work.

“The personnel situation is quite serious. Sometimes there is only one nurse for 10 or 15 patients and sometimes there are two or three for 20 and 30 patients. They can't cope. We see that hospitals are running out of human talent. Most of them work in parallel with other jobs such as manicurists, pastry chefs, jewelry makers, etc. (…) The new generations no longer want to come to work because the pay is precarious,” lamented Narváez.

The situation of pediatric hospitals

Although most of the nutrition services in public hospitals are currently open, they do not have adequate supplies and food to care for patients.

According to the latest NGO Doctors for Health, Only 37% of hospitals that have nutrition services can cover three meals a day. 36% do it partially, that is, they only give a meal in the morning or during the day.

“Only 20% of hospitals complied with medical recommendations regarding patients' diet; For the rest, they bring them whatever they have. Very far from an indication related to the medical field. “Sometimes it happens that there is food in the morning and no food at night,” denounced Dr. Julio Castro during the presentation of the National Hospital Survey corresponding to 2023.

The Survey also recorded that 41% of Pediatric Hospitals do not have milk formulas to feed children who suffer from illness. Their relatives must buy them.

Image of a maternity ward at the Felipe Guevara Rojas Hospital in El Tigre, Venezuela, on June 3, 2019.
Image of a maternity ward at the Felipe Guevara Rojas Hospital in El Tigre, Venezuela, on June 3, 2019. Iván Alvarado / Reuters

Prepara Familia, an NGO dedicated to supporting children hospitalized with chronic illnesses, constantly monitors the situation at the JMde los Ríos Hospital, the main children's hospital in the country.

The organization has recorded that since 2017, 85 children have died in the nephrology service alone. So far this year there have already been three deaths while waiting for a kidney transplant.

Next June 1 marks 7 years since the suspension of the Organ and Tissue Procurement System, which allowed transplants to be performed with deceased donors. The State suspended the program because it could not guarantee the necessary immunosuppressants to prevent the patient from rejecting the transplanted organ.

According to the NGO Médicos Unidos por Venezuela, more than 90% of the population cannot afford an insurance policy or the costs of care in a private hospital, so the majority depends on a public health system that has been in crisis for some time. more than 20 years and in which patients must bear most of the expenses in order to be treated.

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