Junior Rodríguez is used to seeing death and violence up close because he's a doctor in a public hospital in Venezuela, one of the world's most dangerous countries.
But the violence has been turning more personal for Rodríguez and the rest of the medical staff at the Dr. Luis Razetti de Barcelona University Hospital in the eastern state of Anzoátegui.
The staffers work under constant death threats made by relatives or friends of patients — some of them dangerous gang members — if the patients die.
“Most of the time that's the doctor's worst fear, that the patient dies and the relatives take it out on him,” Rodriguez said in a telephone interview. “The threat of harm if the patient dies is always there. We don't have any kind of protection. You treat a person who turns out to be a criminal, and if that person decides to point a gun at you, there's nothing you can do.”
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Rodríguez quit the hospital months ago and wants to leave Venezuela to escape the crime and economic implosion that has brought widespread hunger to the oil-producing country. He would join the 22,000 other doctors who have fled, according to figures from the Venezuelan Medical Federation (VMF).
The massive exodus of one-third of all the doctors in the country is accelerating the collapse of a health system already hammered by deep shortages of medicines and medical supplies.
Patients having surgery sometimes must bring their own scalpels, and more than 85 percent of basic medicines are in short supply, meaning that some patients have to go to as many as nine pharmacies to find them. The shortages have been especially hard on patients with chronic diseases such as a diabetes and high blood pressure, and those who need antibiotics or medicine for AIDS.
Many medical professionals have decided that they simply cannot continue to work amid threats and shortages, as well as salaries that are often less than $10 a month — not enough to buy two chickens.
The government “has condemned medical personnel to a miserable salary that is erased by inflation. For doctors in public hospitals, the salaries stand at about $4 or $5 per month. That's for specialists,” said VMF President Douglas León Natera,
The medical brain drain is being felt more acutely in public hospitals, already operating at levels comparable only to the poorest countries, with women sometimes giving birth in waiting rooms and wounded patients treated on the floor.
Nearly half of the doctors who worked in public hospitals have left the country, León Natera said.
The impact of all those factors has not been felt as harshly in private clinics because their staff members earn better salaries and work under better conditions. But even that sector has started to suffer from the shrinking pool of medical personnel.
William Barrientos, a doctor and vice president of the Health Committee of the legislative National Assembly, said doctors who leave Venezuela are welcome in other Latin American countries.
“There are 2,000 doctors already working in Chile, and another 1,842 on a waiting list of doctors who want to work there. There are about 2,346 in Colombia and approximately 1,654 in Ecuador,” Barrientos said in a telephone interview.
The options in the United States are different, said Rafael Gottenger, Miami-based president of the Venezuelan American Medical Association, because it's difficult for foreign doctors to obtain U.S. certifications. Many Venezuelans are working as medical assistants or have started different careers.
Even so, few regret leaving their country, especially as the rising tide of street violence flows deeper into hospitals and other medical facilities.
Rodríguez said he knew of three cases of violent attacks on medical personnel. In one case, gang members went into an emergency room in Caracas and ordered the staff to turn their backs while they stabbed to death four patients. One doctor who did not obey was beaten.
“When you see them come inside, you know you have to hide because there's no telling what can happen. There are no police outside any more, and the few who are out there run away because many don't even have guns,” he said.
In another case, Rodríguez said, criminals went to his house to force him to treat a relative, but he managed to run away.
The lack of security at the Razetti Hospital made headlines in early March when Dr. Pedro Quijada was stabbed in the chest by thieves as he arrived at work.
Quijada was lucky his wound was not very deep because a “surgery would have run into a shortage of anesthetics,” Oscar Nava, president of the Society of Internist and Resident Doctors, wrote on his Twitter account.
Follow Antonio María Delgado on Twitter:@DelgadoAntonioM