Photo by Rayner Peña R

It’ll be fine, I thought. Just another night shift, like the dozens before and the hundreds to come. I’ll sit in Merida’s Hospital Pediatric Emergency Evaluation Room with Gabriel, Patricia and Nay, we’ll take care of asthma crisis with a sole bottle of bronchodilators and we’ll stabilize diarrheas that can’t be properly treated in small hospitals. You know, the usual dose of underdevelopment we’ve gotten used to.

Little did I know, my night was about to turn into a parade of Sub-Saharan diseases.

It started before 8:00 p.m. with a 20-month-old girl named Lucía, from a small town south of Lake Maracaibo. Her mom arrived after a three hour bus ride because Lucía’s legs were swollen. She had diarrhea two weeks ago, received intravenous rehydration and now the 20-something mom feared her girl may have gotten too much liquid. A quick look proved her wrong: Lucía’s heart and lungs were ok, like her blood pressure. She was scared and started crying, so I rubbed her head until a patch of thin, fragile hair stayed in my hand. I took a new look and realized how her ribs were pushing through the skin of her chest. We see so many skinny kids nowadays that sometimes it goes unnoticed. I took her to our weighing scale and my stomach squirmed. It said she was 8 kg (about 18 pounds). That’s the weight she should have… if she were nine months younger! This girl was badly malnourished and her swollen legs were a sign.

“Severe malnutrition, type Kwashiorkor” I wrote as presumptive diagnosis.

In less than twelve hours, I had seen three patients with diseases that most doctors around the world only read about.

Kwashiorkor, which literally means “the sickness the baby gets when the new baby comes” in Ghana’s tongue, is a form of malnutrition provoked by insufficient protein intake. People in Ghana realised it usually appeared in older brothers as their mothers reduced their rations to feed newborns. Low protein levels cause water from blood vessels to escape the neighbouring tissues, swelling them. The disease became famous in the 60’s, when it was commonly seen in Nigeria during the Biafran War. I read about it, heard the news about it, but I was emotionally unprepared for that tiny baby in front of me.

“What do you eat in your house, ma’am?”

I hadn’t finished the question when I was already afraid of the answer.

The closest they got to eating meat was the beef broth they could afford once every two weeks. Other than that, it was arepas and homemade cheese from the farm where her husband worked. She was happy because at least they could eat three times a day and she should be, one third of Venezuelans aren’t that lucky.

A nurse took Lucía to her new bed, next to an 18-month-old baby who got malaria after a trip to the Bolívar mines, where his parents were illegally mining to sustain themselves. A perfect third world combo, pues.

We were almost done with Lucía’s entry form when 10-year-old José crossed the wooden door on a gurney. He had been vomiting for hours, after telling her mom about a headache. Now he couldn’t even talk, his neck was rigid and he had a 40°C (104°F) fever. Textbook meningitis. This disease is traditionally linked to poverty but, most importantly, it can be prevented with vaccines.

The closest they were from eating meat was the beef broth they could afford once every two weeks.

In Venezuela, most meningitis is caused by bacteria and vaccine exists against the three more common strains (Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis). The local vaccine against H. influenzae comes in the same vial as the one against diphtheria, so it’s easy to see how deficient vaccination propels both diseases at once. The vaccines against S. pneumoniae are also included in the national vaccination scheme, but have recently disappeared from most public institutions and are sold privately for up to $100.

11 minimum wages.

Vaccines against N. meningitidis were available through private practitioners, since they’ve never been included in the state-sponsored scheme. There’s no need to tell you how that’s going today.

We transferred José to his bed and started the antibiotics he needed immediately. There were a couple of vials left in the hospital. I guess miracles do happen.

At 2:00 AM, when I thought I could get some sleep, I heard the characteristic sound of an ambulance parking and my colleague Gabriel’s words “that’s definitely for us” were a little too ominous for the pain we were about to face.

María, 5 years old, came in the hospital in her mother’s arms. She had a fever, could barely breathe and her neck looked like a football. Her mom told us it all started the night before, when she said she had a sore throat and refused dinner. The next day she couldn’t even drink water. She was taken to a Barrio Adentro consultory where some Médico Integral Comunitario told her she had a common cold.

Patricia asked the girl to open her mouth and all we could see was pus.

That’s diphtheria” I thought, scared, looking for a disposable mask. There were none.

“Common cold my ass,” she whispered as we felt the smell coming from her tiny mouth. It was like something died in there. We cleaned it with water and we saw it, a grayish bleeding membrane sticking to her swollen throat, obstructing most of her airway.

“That’s diphtheria” I thought, scared, looking for a disposable mask. There were none.

Diphtheria: a disease eradicated in the 80’s. It’s been over a year since the current outbreak started in Bolívar, and things have only gotten worse. María is the third case I see in the last month, and now we have reports from alleged well-being oasis like El Hatillo. Meanwhile, our Health Minister called the situation a “media scam.”

In less than twelve hours, I had seen three patients with diseases that most doctors around the world only read about. Three patients who shouldn’t be sick and who represent all that’s wrong with Venezuela. They don’t care about bondholders or defaults. For them, it’s just suffering.

Things calmed down after María arrived and we managed to sleep a couple of hours before waking up at 6:00 AM, to get things ready for a new day of socialist paradise. A new day with more Only in Revolution stories.

After four days of brave struggle, María died on November 13th, 2017, at the ICU. She was a victim of a perfectly preventable disease for which a vaccine exists since 1920. Her death is inexcusable.

Este artículo es para ti, María, que en paz descanses.

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23 COMMENTS

  1. Wow you had antibiotics? I guess miracles do happen, as you said. In my ambulatorio, it’s become a recurring theme how we have to tell the patients: “No, there aren’t any antibiotics here, and yes, you have to keep looking for them because it’s the only way to cure your disease.”

  2. “After four days of brave struggle, María died on November 13th, 2017, at the ICU. She was a victim of a perfectly preventable disease for which a vaccine exists since 1920. Her death is inexcusable.”

    I believe in most of the rest of the civilized world it’s called murder. But hey, Venny Trader got paid in full and is off to enjoy the Christmas holidays, so all is well.

  3. I don’t have time to elaborate, so I need to make this quick. I asked my wife (physician, Venezuelan expat) about “Kwashiorkor” in passing on the way out the door this morning. She stated “It’s a disease affecting poverty stricken Africa. Fat bellied kids who otherwise look like they are starving. You see them in old National Geographics. Why?” I told her that it was Venezuela.

    The Spanish equivalent of “Venezuela is fucked”. And some other stuff under her breath.

    As much as my in-laws hate the current situation in Venezuela and have basically washed their hands of it, they still can’t believe the people who insist on remaining haven’t revolted.

    • Revolt? They’re signing up in droves for a Carnet de La Patria to be eligible for their 500,000 bs Christmas bonus from the gubmint. All is well.

      • Its frustrating.

        My (expat) family is sitting here thousands of miles away, living in all sorts of creature comfort, with full bellies and fat savings accounts, wondering why the masses aren’t grabbing the pitchforks and manning the barricades. It’s easy to arm chair quarterback from a distance, I know. But seriously, WTF? Are Venezuelans so used to being led around by the nose? Settling for crumbs? Is wealth envy and class hatred that ingrained that having nothing is OK, so long as everyone else has nothing?

        It is such a different cultural paradigm. My wife’s family certainly are not that way.

        • El Guapo,
          Is there any way that your wife could help me get antibiotics to include with shipments that I send to Venezuela?
          My dentist used to be my best connection and he has left the practice that I go to. My new dentist isn’t very helpful.
          I live in NY State. It is possible that the regulations are more stringent here.
          My GP said that he can’t do it as every script he writes is reviewed by the medical clinic that he works for. A friend of mine is an ER Dr. in Michigan and he hasn’t had any luck with the drug salesmen. Another friend is a nurse practitioner. She said that she can’t write me any scripts.
          I have written to drug companies and even chain stores that have pharmacies without luck.
          I’m willing to pay for the antibiotics, I just need to access them.
          I am still successfully getting shipments into the country and I give Caracas Chronicles my permission to give you my contact info.
          Any help would be greatly appreciated. The broad spectrum antibiotics have been the most helpful. I believe that they have played a part in saving a couple of lives.
          The other most needed medicines are diabetes (Glucophage) and blood pressure medicine.

          • Antibiotics can be purchased without a medical prescription in Colombia. I just took some from Bogotá to Caracas 10 days ago.

        • Did you see the news earlier this year? Here’s how it works in case you didn’t:
          Starving and disease stricken people revolt, they are killed like flies, “leaders” funded by Venny Traders and bankers negotiatiate and receive crumbs of oil money and paltry power quotas, the regime cements itself in power, the people’s situation gets worse. Repeat, this time with even weaker people.
          Citizens in arms in the streets have never overtrown governments. NEVER. That’s how it works, specially in Latin America in general and Venezuela in particular. Governments fall in palaces when its powerful supporters (military, industrial, financial) decide to stop supporting the people in power. That can happen for many reasons.
          THAT part, the really important one, the one that brings about changes, IS NOT happening in Venezuela because the elites are still very comfortable with Chavismo in power, paying generous coupons, and giving away dollars for preferential rates at fraction of market value.
          In case you want to blame or point fingers at someone, there are plenty of enchufados living in first world countries for you to do it. Those of us living here, barely making ends meet, dying and suffering horrible diseases, being killed by malandros in every corner are nothing but victims, hostages of criminals who are being supported and kept in power precisely by people with money and beautiful lives in free countries.

      • “Revolt? They’re signing up in droves for a Carnet de La Patria to be eligible for their 500,000 bs Christmas bonus from the gubmint. All is well.”

        Except the carnets are being used as the only valid means to get access to food from the dictatorship’s monopoly (The only food to be found, there’s no more food), and to get the right to have access to vaccines.

        Ah, they’ll also use it as the only valid document for claiming the pensions too.

        It’s “Either you have a carné del hambre to prove we’re more, or you’re dead.”

        Revolt? MUD’s HRA is too busy telling people they should STFU and wait for the next election “because that’s the only option we have”

        • The system of “Carnet de la Patria” is sounding a lot like the state-run ration system in North Korea – though it is probably not as efficiently administered

        • A few months ago people did revolt, young students mostly. That left 120 dead from shots and teargas cannisters aimed at their heads..and more teargas purchases from the government. Revolts are not so easy when you don’t have a 2nd Ammendment.

          • Not revolting people are usually murdered through famine, plague and malandro bullets to the head or the guts by dozens everyday.

            Technically people was safer in the middle of a protest than walking from their home to their workplace.

            The revolt isn’t that easy when there’s a crushing media pressure to destroy the movement.

            Don’t forget that in this year more than 60 people are being murdered by the dictatorship everyday.

            “The system of “Carnet de la Patria” is sounding a lot like the state-run ration system in North Korea – though it is probably not as efficiently administered”

            As everything in chavismo, they’re using it to extort people into blind obedience (After they’ve squeezed their pockets) and then to commit widespread genocide against the population through the means I mentioned in the first paragraph.

  4. The basic socialist fantasy-the government will give me whatever I need. Not happening is it? Now the oil money is even drying up. An old French colonel once told me “every time communists take over a country the population decreases.” They need to dig up Karl Marx and put a stake through his heart for the suffering he brought on the human race with the hapless revolution he borrowed from Robespierre.

  5. The most vulnerable suffer the most. Beyond me how the adults can simply wring their hands and wail. If it were my child somebody would pay. Ah but help is on the horizon as the UN is preparing to form another commission that is expected to pass a new resolution…more of that yearned for diplomatic pressure. Damn Trump’s eyes for his actions against the Stalinesque mustache, had he just ignored Venezuela, like his predecessor and ilk, the diplomatic pressure would still be boiling and these kids could look forward to rescue in about 20 years. Oh wait, this crop will mostly have died from before then. Okay the UN will be there for the next generation. Really they will, just look at the track record.

    • “SeLf dEtErMiNaTioN oF dA pIpOl iS woRtH mOAr tHaN sUm kIdZZZ” Brayed every leftist that loves the privileges of capitalism while spewing their communist manure.

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