Venezuela

In a Venezuela hospital, a doctor improvises to save patients despite shortages

Neurosurgeon Edgar Sotillo in his office in Caracas.
Neurosurgeon Edgar Sotillo in his office in Caracas.

The hospital looks like it has been recently looted. Rooms meant for patients are stuffed with clutter, and there are piles of concrete and brick rubble in other areas.

The J.M de los Rios Hospital, a children’s hospital in the San Bernandino neighborhood of Caracas, has become a symbol of Venezuela's public healthcare system, now in shambles.

As the economic crisis hit Venezuela, the doctors here were forced to change their approach. To save their patients, they have to improvise. In May for example, blackouts shut down life-saving machines for about a half-hour, so doctors kept the incubators in the neonatal intensive care going by manually pumping oxygen into the tiny bodies of prematurely born babies.

“We keep improvising, because we live in a war-like situations,” says neurosurgeon Edgar Sotillo in an interview with El Nuevo Herald. The soft-spoken doctor, 50, has recently witnessed suffering he never thought he’d see in his country, where the healthcare system has always been a source of national pride.

Today, pride has turned into an embarrassment and worse. Even highly-trained Venezuelan doctors working in public hospitals cannot do much given the lack of medical supplies, medicines and technology.

The list of missing items is long. The J.M los Rios Hospital has no antibiotics, no insulin for patients with diabetes, no inhalers for people suffering from asthma. There are no bandages, syringes or surgical needles. The hospital even lacks an X-ray machine, leaving Sotillo unable to make quick diagnoses about brain injuries or tumors.

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Miriam Garcia with her daughter, 7-month-old Alondra Lucia Garcia Ramirez, in Caracas. The child has hydrocephalus, or water on the brain. Rosali Hernandez

Checking on his patients every day is hard for Sotillo. In one room, eight-month-old Danielys is resting. She suffers from a condition known as hydrocephalus, an excessive amount of water on the brain resulting in an enlarged head.

Sotillo knows that a relatively easy surgical intervention could get rid of Danielys' pain and also prevent possible serious health complications like dementia or reduced mobility. Every day the odds of such mental and physical impediments only increase. Already, Danielys has been waiting three months for the surgery.

“She could go home in five days but because I don't have a shunt we have to wait.“ he says, referring to a small, thin tube by which the fluids can be drained away.

According to the doctor, the tube costs about $200 but for most Venezuelans today, that’s an astronomical amount of money — too much even for a highly experienced neurosurgeon like Sotillo, who makes just $110 a month.

The economic crisis is having a dire effect on the health of ordinary Venezuelans. Sotillo is particularly worried about conditions in the slums clustered on hills around Caracas.

There, a poor diet and limited or no access to drinkable water have damaged the immune systems of many, exposing them to infections. Sotillo has seen many long-eradicated illnesses make a comeback, like tuberculosis.

And there are new diseases like Zika, a virus that can cause babies to have abnormally small heads and permanent brain damage.

“Last year we had 30 cases and as of now, we have already treated 20 newborns affected by Zika,” Sotillo says in his dilapidated office.

There’s no air-conditioning, the water coming from faucets is yellow and chairs are all broken or worn out. Still, he’s determined to stay. He doesn't want to join those Venezuelans who, in recent weeks, have been leaving the country in droves. Even his own staff is getting smaller. In last few years, five out of 11 neurosurgeons at the hospital have immigrated.

“If I could give back speech to a one child out of 10, it is worth it to stay and help,” he says.

Some of his patients feel differently, and if they had an opportunity to leave, they would do it tomorrow. They feel threatened by today's Venezuela with its lack of food, medicine and security and the prospect of a bleak future as President Nicolas Maduro heads toward a dictatorship.

Even the hospital can turn out to be a dirty and dangerous place. Sandra Galindez's son, Deivis, suffers from kidney failure and needs the support of a renal dialysis machine. While her son was given the treatment at this hospital, he got an infection because the machine used stagnant, dirty water from huge tanks placed in the hospital's basement.

“When they came to clean it, we found inside the tanks garbage, old shoes and even a dead cat,” Galindez says.

Her boy wasn't the only one infected. According to her, up to 24 children got sick and six died. Galindez, like other mothers, has been living at the hospital since the infection outbreak in March to assist her sick child and make sure he cared for. He’s still in bad condition, with peeling skin and a mouth so parched he can't drink without pain. He doesn't sleep well, complaining about his body being itchy and hot.

Galindez speaks about her son's suffering without anger. She just looks exhausted and overwhelmed.

Out the window, a billboard promotes the Constituent Assembly, a pro-government group installed just a few weeks ago. It took away all the legislative powers from the National Assembly, which had been controlled by the opposition. The opposition fears that the Constituent Assembly is moving quickly to establish a dictatorship in the country.

According to some of the mothers of the infected children, some Maduro officials came to the hospital to “encourage” the women to vote for the Constituent Assembly.

“I thought they were kidding,” says Vicki Fernandez in disbelief. She will, she asserts strongly, never ever vote for Maduro. As she says this, her eyes fall on Andres, her 14-year-old son. His slight body gives the impression that he’s no more than 8 or 9. Even so, he bends his thin arms in a boxing pose to show off his muscles.

Like Galindez, Fernandez is busy getting medicine for her son. “He needs like 12 different remedies. The hospital can provide just two or three,” she says with a sigh.

These mothers were never compensated for the filthy water that infected their children. The government response was dismissive, they complain.

“The only thing we heard from them was that the infection could not have possibly happened,” Fernandez says.

Sotillo, who is aware of the cases, comes into the room to check on Danielys.

“How are you doing, my princess?” he greets his little patient. Danielys is resting her head away from the doctor and is not very responsive.

Later in the day, Sotillo receives good news. There is a tube available, paid for by a foundation. The doctor is visibly happy — but just for a moment. There are two other baby girls with the same condition on the waiting list, a list that never seems to end.

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