“When you are born in Venezuela, you are already sentenced to death,” said Mauricio Navas, a Venezuelan citizen whose six-year-old daughter Mariana is being treated for leukemia in a hospital in Caracas.
During the 20th century, Venezuela was one of the most prosperous countries in the region. It significantly invested in public services, and maintained an effective public health system (arguably one of the best in South America). In 1999, free health care for all was enshrined in Venezuela’s constitution by President Hugo Chavez. Yet, in recent years, the political and economic crisis in Venezuela has led to a complete collapse of its public services—especially health care. The success of Venezuela’s social security system had been largely supported by oil, Venezuela being one of the region’s top oil exporters and the prices of oil being relatively high at the time. But the politico-economic crisis that started in 2008, after the drop of oil prices and with the emergence of international sanctions, has led to a complete collapse of the healthcare system. This crisis is causing dangerous increases in morbidity and mortality all over the country, with most citizens unable to access the services they need and seeking them elsewhere; worse, it is starting to seriously threaten the healthcare systems of neighboring countries as well.
How can a country whose health services are known for being the best in the region experience such a dramatic collapse? As mentioned earlier, Venezuela’s extensive public spendings were primarily funded by oil revenue for the whole second half of the 20th century. However, in 2008, oil prices began to fall, and foreign investors gradually abandoned Venezuela because of Chavez’s revolutionary socialist politics. Excessive government spending was incompatible with lower demand for oil and US sanctions, leading to hyperinflation. The government was forced to radically cut public spending, dropping its annual expenditure for public health from 9.1 percent in 2010 to 5.8 percent in 2014.
As the crisis develops, public expenditure keeps dropping radically. The government has reduced spending on sanitation and electricity, causing 79 patients to die between November 2018 and February 2019 due to electricity shortages in the main hospitals of the country. In addition, the international context and hyperinflation make it increasingly difficult to import necessary equipment, food, and medicines. Ill citizens are not receiving adequate care because of insufficient hospital supplies and lack of medicine, and the food crisis caused by hyperinflation contributes to malnourishment. Lack of medication is also forcing patients infected with HIV to interrupt their therapy. Finally, lack of vaccines has led to a huge decline in childhood vaccinations and a large-scale return of vaccine-preventable diseases, such as measles and diphtheria. Venezuela is suffering through the largest increase of malaria in the world, with over half a million cases in 2018 (even though it had been eradicated in 1961). Suffice it to say, the health situation in Venezuela has become critical.
However, the consequences of this health care collapse are not limited to Venezuela; neighboring countries are also becoming increasingly challenged by the crisis, making it an international emergency. More than four million Venezuelans have now left the country, the "largest [exodus] in the recent history of Latin America and the Caribbean," per the UNHCR. Colombia, Venezuela’s neighboring country, is hosting 1.3 million Venezuelans, the largest number of immigrants from the country in the region. Access to health care for immigrants, especially undocumented immigrants, is a subject of contention all around the world, but the WHO Constitution of 1946 declares that “the highest attainable standard of health [is] a fundamental right of every human being.” Thus, any type of discrimination based on race, nationality, ethnicity, or civil status is a human rights violation. Governments in Latin America commit to this principle to different degrees, but there are challenges to providing universal and accessible health care to any migrants. Emergency departments at the borders are overwhelmed with the number of patients, and are lacking the financial, human and material resources to attend them all. Some families have decided to remain in Venezuela, but consistently cross the Colombian border just to receive vaccinations, seek prenatal care, give birth, purchase medicine, or seek other medical services. Others, such as patients with chronic diseases who are lacking proper medication and treatment, are moving across the borders permanently to seek consistent and lifelong health care.
In addition to the strain caused on neighboring countries' health resources, there are many cases where immigrants are bringing increasing rates of infectious diseases into host countries. Malaria, for example, saw a 359% increase between 2000 and 2015. And in 2016, the WHO declared the eradication of measles in the Americas; a year later, a measles outbreak erupted in Venezuela. Now the disease is spreading to Argentina, Colombia, Ecuador, Peru, and Brazil. Lack of immunizations is making it impossible to control outbreaks, and population flows are making them impossible to contain.
Finally, massive emigration is causing a brain drain in Venezuela—many medical professionals are moving to other countries, leaving Venezuela with too few healthcare workers. In Chile, in December 2018, 5,000 applicants sat down to take the national exam to certify doctors. Almost half of them were Venezuelan physicians. This means that, not only is Venezuela losing the funds and resources it needs to provide adequate health care for its citizens, but it is also losing the expertise and manpower it requires to support what is left of a crumbling system.
The situation in Venezuela and its neighboring countries has become a humanitarian emergency that requires immediate action and a coordinated international response. Such a response would require the international community to take a nuanced approach to the political and economic complexities of the crisis. Whole populations' health, lives, and dignity are at stake.
