Some of Venezuela’s public hospitals are closing. Others are ridden with crime. Many physicians are quitting medicine – starting new careers in Venezuela or immigrating abroad, upset at being paid a pittance or not paid at all. Medical supplies are in short supply.
A “confidential” U.S. Embassy cable from Caracas, just released by Wikileaks, says socialist Venezuela’s healthcare system is in “disarray” – and the poor are suffering the most. The document appears to be authentic. However, U.S. officials have flatly refused to confirm the authenticity of any purloined documents published by Wikleaks.
The Embassy cable released in December, 2009, blames Venezuela’s ongoing healthcare crisis squarely on President Hugo Chávez – his Cuban-style health care initiatives and overall mismanagement; not to mention his politicization of the South American nation’s health-care system. Physicians perceived as being anti-Chávez are disciplined, while incompetent military officials are placed in charge of public hospitals.
Looking ahead, the 1,900-word document warns that Chávez may create more havoc by nationalizing Venezuela’s private clinics. They provide high-quality U.S.-style healthcare, something I experienced first-hand at private Clinica de Caracas, when going there for routine care and for some stitches to my forehead after an accident at a local gym. I was a Caracas-based journalist for much of the 1990s, leaving Venezuela in 2000 to go to CNN in Atlanta. This year Chávez has seized 234 companies, according to the Venezuelan Confederation of Industries (Conindustria).
The U.S. Embassy’s blunt anti-Chávez critique comes, ironically, as oil-producing Venezuela enjoys record levels of oil wealth while embarking on Chávez’s version of “21st-Century socialism.” The ongoing healthcare crisis says much about Chávez – and specifically about the way such populist and authoritarian rulers invariably wreck a nation’s economy with bread-and-circus socialism.
Little if any coverage has been given to Venezuela’s collapsing healthcare system, with one exception being a piece in the Los Angeles Times. Accordingly, the cable provides a fascinating insider’s glimpse of how Chávez is transforming Venezuela into a Latin American version of Zimbabwe, as one senior French official put it in a diplomatic cable released by WikiLeaks.
To be sure, Venezuela’s public health-care system was declining years before Chávez became president 12 years ago – thanks to Venezuela’s notorious mismanagement, endemic corruption, and a dwindling supply of petro-dollars to support its huge government bureaucracy.
Yet according to the embassy cable, that deterioration has worsened significantly under Chávez – a former coup leader whom poor and well-off alike voted for in a landslide election victory. He’d pledged to reverse years of decline in the oil-rich nation with a “Third Way” between socialism and capitalism. Venezuela’s economy and quality-of-life had been in a tailspin since the end of soaring oil prices in the mid-1970s. Back then, the country was called “Saudi Venezuela.” It seemed poised for First World status.
Cuba-style heath care
According to the embassy cable, Chávez has undermined Venezuela’s public health-care system by creating a “parallel” Cuba-inspired medical system that most Venezuelans dislike: community medical clinics called “Barrio Adentro” (Mission Inside the Neighborhood) that provide “free” care provided by Cuban physicians.
According to the cable, critics say the missions are inefficient and have drained funding away from public hospitals that poor and middle-class Venezuelans still prefer – thus “lowering the overall quality of medical care” for everybody. Of the 30,000 personnel staffing the Cuba-style free clinics, about one half are reportedly Cuban physicians.
Interestingly, the embassy cable is at odds with two United Nations agencies – UNICEF and the Latin American branch of the World Health Organization. Both have reportedly praised the Cuban-style missions.
Regarding the politicization of Venezuela’s healthcare system, the cable said health authorities have “suspended doctors for speaking out about the crisis while giving former military officers and community councils a greater role in hospital administration.”
Another problem is Chávez’s plans to “eliminate a government healthcare benefit that pays for public workers to receive health care at private clinics, a move that would place even greater strain on already overburdened public hospitals,” the cable notes. This has outraged many middle-class Venezuelans.
“The evidence suggests that all classes of Venezuelans continue to prefer public hospitals to Barrio Adentro, even as the quality of medical services in the former has deteriorated.”
The cable added: “To the extent that President Chavez has acknowledged Venezuela’s health care crisis, (Venezuela’s government) has looked to Barrio Adentro and Cuba – and not the public hospitals – as the solution.”
What do Venezuelans think of Cuban physicians? An answer was suggested by a “secret” embassy cable sent in January, 2006. Its title: “Cuba/Venezuela Axis of Mischief: The View From Caracas.”
The cable’s focus was on Cuba’s growing influence in Venezuela, including by Cuban intelligence agents. But it also dealt with “free” Cuban health care, stating: “Anecdotal reporting suggests the care Cuban doctors provide is often lacking and that many ‘physicians’ are actually medical students.”
Cuban doctors were earning about $400 per month, but they apparently weren’t being paid up front. According to the cable: “A Cuban physician told [the U.S. Embassy’s] medical advisor…that he received room, board, and toiletries but that the Cuban Government was ‘holding’ his salary until he finished his two-year tour. “
Citing an interview with a local legislator, one embassy officer reported that some “Cuban doctors complained bitterly that the Cuban regime held their families hostage while the doctors relied on local donations to survive.”
Cuban Physicians Flee
Not surprisingly, hundreds of Cuban physicians have sought and been granted visas from the U.S. Embassy, according to two separate embassy cables describing the plight of Cuban physicians. The doctors complained of “poor working conditions, inadequate medical supplies, and of constantly being watched and monitored by co-workers,” according to a “secret” embassy cable sent in April, 2009, and titled: “Cuban Medical Personnel Flee Venezuela.”
Most of the asylum-seeking physicians managed to leave Venezuela, but in many cases only after suffering harassment from Venezuelan officials or paying bribes of up to $1,000, according to a “confidential” embassy cable sent in February, 2010, describing increased harassment of asylum-seeking physicians.
Here are some horrific examples of Venezuela’s health-care crisis cited by the embassy cable dealing with Venezuela’s collapsing health-care system:
“Criminals go to the public hospitals to rob, steal, and even kill patients. The emergency room in Hospital Vargas is only open for twelve hours-between seven in the morning and seven at night-because of security concerns.”
In the impoverished Catia area of Caracas, 140 physicians staged a mass resignation at one of the area’s “two largest and most important public hospitals” for poor Venezuelans. They were upset over unpaid wages and benefits, lack of hospital funding – and the Health Ministry’s suspension of four physicians accused of “inciting” patients to protest poor hospital conditions.
An embassy officer was told by an unnamed person (the name was deleted by WikiLeaks or an embassy official) that Venezuela’s government had “suspended doctors to discourage them from speaking out about the health care crisis. Last year four doctors were suspended when they exposed the accidental death of six babies in a maternity ward.” According to the unnamed person, Venezuela’s government “has limited the role of the resident doctors in hospital management and transferred authority to local community councils.”
Shortages of basic medical supplies have prompted physicians “to ask patients to purchase their own needles, disinfectants and gauze.” A Venezuelan whose name was deleted in the embassy cable (presumably by WikiLeaks or an embassy official) told an embassy officer that “doctors sometimes dress wounds with the same dirty bandages. Other patients are told to bring their own X-rays from private clinics. In many areas of Caracas, public hospitals suffer from water shortages, forcing doctors to postpone important operations. In some of the older public hospitals, the plumbing systems cannot pump water above the first few floors of the building.”
“The maternity ward of the Lidice hospital – considered the second most important in Caracas for many years – has now been closed for two years, while Catia’s other major public hospital, Los Magallanes Jose Gregorio Hernandez, has been partially closed for over a year while awaiting renovation.”
Salaries for physicians are “barely enough to cover rent in Caracas.” Accordingly, “many doctors have left the public hospitals in search of other jobs, while some of the most qualified have left the country to earn better salaries abroad. In a December 4 press report, the Venezuelan Medical Federation (FMV) estimated that the public hospitals are understaffed by 43 percent.”
An unnamed Venezuela (his name was deleted) told an embassy officer “that the quality of healthcare in the public hospitals has deteriorated as (Venezuela’s government) has redirected resources to Barrio Adentro. Although Barrio Adentro has translated into political gains for President Chávez , its medical impact is questionable, despite having received massive government investment.”
As revelations of the embassy cable are publicized, expect the hyper-sensitive Hugo Chávez to go into a frothing anti-American rage.
David Paulin, a freelance journalist, is a former Caracas-based foreign correspondent.