Photo: Efecto Cocuyo retrieved
Although the nation is slowly coming out of the dark, the blackout has lasted more than any of us hoped it would. Truth is, we knew this could happen and everybody was warned with plenty of time ahead. What did the government plan in case of a tragedy like this? Did the Health Ministry create any protocols?
The government is well aware of the complex humanitarian emergency on its lap. Venezuela has the highest maternal mortality rate in Latin America and, since 2015, health care access has been compromised: 60% of medical assistance capacity was lost between 2015 and 2017. Diphtheria and measles made a comeback after being eradicated, when the vaccine program failed and the shortage of vaccines played out. Tuberculosis, HIV, and malaria are on the rise; while no official numbers have been revealed, it’s estimated that 700,000 new malaria cases and more than 5,000 deaths from HIV took place last year. The crisis is so bad that the Center for Disease Control advices to avoid any non-essential travel to Venezuela.
Medicine and food shortages mean chronic patients are against the ropes. People resort to the black market for blood transfusions. The power supply on main hospitals has been failing for years, although the response on the government’s end has been null. As 2019’s National Hospital’s Poll reveals, most hospitals still face major shortages and deaths related to power outages.
It’s safe to assume that the blackout made this catastrophic functionality worse, even when we ignore the damage to hospital infrastructure (where the precious vaccines for national prevention programs are stored, for example). The official reports from Health Minister Carlos Alvarado are just classic denial. Hospitals, he says, were prepared for this:
#ENVIVO | Ministro de Salud de Venezuela, Carlos Alvarado, confiesa que todos los hospitales que se encontraban preparados para atender apagones ya que había enfrentado este tipo de situaciones anteriormente, aunque no en esta magnitud → https://t.co/tqMKHf3oMu pic.twitter.com/8CDZyQqGY1
— teleSUR TV (@teleSURtv) March 11, 2019
José Manuel Olivares, a physician and exiled National Assembly deputy, said on March 11th that the number of deaths directly related to the blackout stands at 24.
IMPORTANTE. Balance de fallecidos hasta el momento. Desde el jueves hasta hoy, 24 venezolanos perdieron la vida, muchos de ellos bebés de pocos días de nacidos. Es inaceptable lo que estamos viviendo. pic.twitter.com/oUmyFEDFbQ
— Jose Manuel Olivares (@joseolivaresm) March 11, 2019
According to a source from the board at Merida’s main hospital, the government hasn’t reached to main hospitals across the country to coordinate a response or provide supplies.
The logistics of life and death
Healthcare is complex and expensive. Hospitals depend on power, running water, supplies and staff to accomplish basic things, like sterilization and sanitation. Services like nutrition for patients is already compromised. Buying food outside hospitals during the blackout wasn’t an option, with no online banking available and all transactions depending on foreign currency, in cash, impossible for most Venezuelans.
In Merida, supplies commonly purchased by patients (like laparotomy kits and syringes) are being sold in dollars or Colombian pesos. Basic blood tests became unavailable as no labs were operative.
Special populations are left on their own to survive. Diabetics began a race against time to find ice for their insulin. The price for ice? $20. Dialysis patients face tougher luck: without power and running water, they can’t get treatment to stay alive. In Tachira, patients got lucky, with a power plant someone donated.
Esta es mi imagen para cerrar un día largo y difícil con solo dos horas de luz… un señor prestó su planta para que pacientes renales puedan tener sus diálisis, muchos desde el jueves no habían recibido y ya estaban hinchados y débiles. #SiHayEsperanza #LosBuenosSomosMas pic.twitter.com/6pjkxiNQDA
— Lorena Bornacelly (@lorebornacelly) March 12, 2019
But most of the 10,000 patients suffering from chronic renal disease in Venezuela aren’t so lucky. NGO Codevida reports 15 deaths have already happened.
VIDEO: 🇻🇪 Power cuts in Venezuela are threatening the lives of kidney failure patients who depend on their daily #dialysis treatment to survive. At least 15 patients have died since the onset of the blackout last Thursday, the Codevida health rights group reported. pic.twitter.com/BmZO8aIK5c
— AFP news agency (@AFP) March 12, 2019
Life-saving surgeries and childbirth could be performed under flashlights, but standard care of newborn babies is impossible without power. According to a source at the pediatric emergency in Merida’s largest hospital, many newborns arrived from smaller hospitals and outpatient clinics, but arrived with no vitals, because there wasn’t power to provide them with basic resuscitation after birth.
Y así, luego de un parto difícil, atendido en la oscuridad, se sutura una vagina, tambien en la oscuridad. Pero, sobretodo, en socialismo… esto está ocurriendo en Venezuela. #Apagon La planta dejó de funcionar hace varias horas. No hay Electricidad. Hospital JMB de la Victoria. pic.twitter.com/029ye5cOZl
— Mate🧬 (@MateMedi) March 8, 2019
There are many, many measures that need to be taken right away, but seven days after the crisis began, the regime is showing no major plans. Without a current assessment of how serious the situation is, how can efficient actions be taken? Communication between the state and health facilities is non-existent, so there’s no cohesive response from emergency teams and no chances of a joint effort from the Public National Health System.
Ever since the blackout took place, every hospital, outpatient clinic, and private health center engaged in a fierce fight against the dark, all on their own, with no coordinated plan or response from the government. That would not be happening if emergency generators had been provided to all healthcare facilities within the first hours, alongside sufficient fuel.
More risks await outside the health infrastructure during a blackout like this one. For instance, water supply has collapsed because distribution pumps require massive amounts of energy. This means a large number of the population has no running water, a situation that’s a disaster for disease prevention. People in Caracas and other places are collecting water from unsafe sources. The water supply in all cities should be checked and cleared for human consumption, people should be provided with information on the exact status of the emergency and instructions on how to behave in order to minimize risks.
Caracas has been crumbling for years, but it finally feels the bottom has completely fallen out. Residents in San Augustin are flocking to a terribly polluted river today to collect water that would ever bathing in — let alone drink. pic.twitter.com/wa6UeYq9cY
— Andy Rosati (@andrewrosati) March 11, 2019
A component of health usually ignored, is that the stress on a population from being exposed to absolute darkness for long periods of time could derive in direct damage to mental wellbeing. A mental health program for the crisis should also be put in place.
In the midst of a crisis, the response in any country would be accepting humanitarian aid and using military forces to help civilians. Just like it happened during the Vargas tragedy in 1999. Every component of the Venezuelan military got involved in the search and rescue operations, and the government received help from various international sources.
As the crisis continues, everybody is on their own, doctors all over the country struggle to make their way to hospitals. The focus is on stopping one death at a time, because that’s all anyone can do. But what should be done is very different: any effective response needs to take place over countrywide, consciously collected data and it needs to happen right now.
If the regime won’t acknowledge the crisis, all that stands between life and death is the Venezuelan people’s spirit of survival.