Zika swamps Venezuela’s ailing healthcare system

A health worker stands in the Sambadrome as he sprays insecticide to combat the Aedes aegypti mosquitoes that transmit the Zika virus, in Rio de Janeiro, Brazil, on Tuesday, Jan. 26, 2016.
A health worker stands in the Sambadrome as he sprays insecticide to combat the Aedes aegypti mosquitoes that transmit the Zika virus, in Rio de Janeiro, Brazil, on Tuesday, Jan. 26, 2016. AP

When Yelitza Oberto’s legs started cramping a few days before New Years, she thought she was paying the price for standing in line for hours to get a car battery in her lack-of-everything Venezuela.

It soon turned out she had the virus of the moment: Zika. No drug would alleviate her fever, headache, skin rash and painful joints. By January, she couldn’t even walk by herself. 

Oberto was taken to the Maracaibo University Hospital, the largest public health facility in western Venezuela, where she was rushed to the ICU. There are currently 26 other patients like Oberto in intensive care at the hospital alone. One of them is a 17-year-old woman partially paralyzed.

The latest crisis to swamp Venezuela’s struggling healthcare system is being carried by an army off mosquitoes. Venezuela’s emergency rooms are filling up with Zika patients. Brazil has received international attention for Zika infections there but some civil society groups and medical organizations say that with hundreds of thousands of Venezuelans suffering from the virus, the country may be facing the worst Zika crisis in the Americas.

Vulnerable Hemisphere

The World Health Organization (WHO) claims that every country in the western hemisphere, other than Canada and Chile, will be affected by Zika, a virus transmitted by the aedes aegypti mosquito or ‘white leg.’ 

The mosquito-borne disease has raged in South America and other regions for months. The World Health Organization said it continues to spread.

Studies prove links between Zika and Guillain-Barre syndrome, which produces muscle weakness. Fears that the affliction can cause deformations in infants, have led countries like Colombia and Brazil to urge women not to get pregnant. 

Doctor Nereida Valero, the head of Zulia University’s Institute of Clinical Investigations, said the Zika-carrying mosquito is present in Venezuela on a scale four times larger than maximum safe limits established by the WHO.  

No other country in the hemisphere exhibits these levels, Valero said. 

Critical Shortages

To complicate matters for Venezuela’s Zika patients, there are almost no drugs available for treatment, particularly immunoglobulin shots. 

“It’s been horrible,” said David, Oberto’s son, of the lack of medicine.  

David has had to resort to what Venezuelans call “green roads,” reaching out to people who have access to medicine thanks mainly to their government connections. When the drugs can be found, they’re expensive. 

“I paid 15,000 bolivares [about $16 at the black market exchange rate] for 25 shots of immunoglobulin in early January, and now I heard they are selling them for 100,000 bolivares [$104],” David said in a hushed voice, for fear of the intelligence officials that are reportedly deployed at the hospital.  

While everyone knows and talks about the health crisis and the shortage of medical supplies, discussing it openly — or trying to cover the crisis for the media — is considered an attack on the administration’s socialist “revolution.” 

Administration Silence

To complicate matters, epidemiological data is virtually a secret in Venezuela. The Ministry of Health has not published its monthly report on communicable diseases since 2014. 

The word ‘Zika’ has not been mentioned by President Nicolas Maduro or by his secretary of Health, Luisana Melo, seven months after the WHO warned about it. While the term is buried in some government websites, it’s virtually taboo in official discourse. 

“The government, with its silence, shows that it hasn’t learned the lessons of emerging diseases,” complains Jose Felix Oletta, the former secretary of Health during President Rafael Caldera’s second term (1997-1999). 

He leads the Venezuelan Society for Public Health, a civil-society organization that has refuted official epidemiological data in recent years. 

Maduro’s cabinet, for example, told the Pan American Health Organization that Venezuela had only 36,000 cases of Chikungunya — another mosquito-borne illness — in 2014. However, there were at least 2.4 million reported cases between June 2014 and March 2015, according to unofficial data obtained by a network called Let’s Defend National Epidemiology, where Oletta is a spokesman. 

Since July, Oletta’s group estimates that 404,000 people have contracted Zika. 

Compounded Crisis

The crisis couldn’t come at a worse time for Venezuela. Plunging oil prices and an economic crisis have created shortages of all sorts of basic goods, including medicine. 

Freddy Ceballos, president of the Venezuelan Pharmaceutical Federation, said 149 types of medicine have vanished from Venezuelan drug stores. 

Quimbiotec, the only immunoglobulin producer in the country, has been out of business since August due to lack of raw materials. Antibiotics are also scarce and national production of acetaminophen only covers a third of the country’s demand, the federation said. 

“This situation is extremely serious,” Ceballos said.  

Even so, the administration says it’s providing the most critical of drugs. 

On Friday, Melo, the secretary of health, offered her own theory about the lack of medication: “It’s due to the irrational use of medicine [by Venezuelan patients].” 

On Tuesday, the opposition-led National Assembly called the decaying healthcare system a “humanitarian crisis.” 

Deputies Luis Lippa and Jose Oliveros, both doctors, called the breakdown a “silent genocide.” 

Calls for Aid?

Carmen Melendez, Maduro’s former secretary of defense and a current ruling party deputy, admitted the administration was coming up short on the issue.   

“People are asking us for medicine on the streets,” she said. “We have never lied. There is a crisis but the government is working to solve it.” 

Jesus Pereira, president of Scientific and Medical Societies’ Network, has suggested the WHO should step in — a bold call in a nation where the government repudiates any kind of foreign intervention. 

The WHO and the Pan American Health Organization have programs “that contemplate drug donations for countries in a state of emergency,” he said. “We have high-level professionals, but we don’t have supplies to help them with.” 

“We have to be at the bottom of countries that can’t fulfill their public health needs,” said Oletta, the former health secretary. 

Luis, a medical assistant at the University Hospital who would not provide his full name for fear of retribution, said that on his daily rounds he has the shameful duty of telling patients to purchase their own catheters or other basic supplies. 

“Sometimes,” he complained, “we don’t even have hospital gowns to wear.”