Monitoring The Access To Health in Venezuela Newsletter N. 13

HEALTH

TA B L E O F C O N T E N T S ANALYSIS AND INTERPRETATION OF AGGREGATE RESULTS OF THE MEDICINE SHORTAGE INDEX MEASUREMENTS FOR AUGUST 2018

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INDICATOR BEHAVIOR AND EVOLUTION

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AGGREGATE RESULTS NATIONWIDE: AUGUST, 2018

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EVOLUTION AND BEHAVIOR OF THE MEDICINE SHORTAGE INDICATOR EVOLUTION AND BEHAVIOR OF THE MEDICINE SHORTAGE INDICATOR, BY CITY.

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GRAPHICAL DEPICTION OF RESULTS BY CITY AND CAUSE OF MORBIDITY METROPOLITAN AREA OF CARACAS

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BARQUISIMETO

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MARACAIBO

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MÉRIDA

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NUEVA ESPARTA

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#CONVITEDENOUNCES: AUGUST 2018: VENEZUELA: HEALTH UNDER SIEGE, SILENCED VOICES

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ANALYSIS AND INTERPRETATION OF AGGREGATE RESULTS OF THEMEDICINE SHORTAGE INDEX MEASUREMENTS

FOR AUGUST 2018

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INDICATOR BEHAVIOR AND EVOLUTION The objective of Convite A.C. through the Monitoring

that we often perceive as isolated cases involving a family

the Right to Health in Venezuela: An Approximation

member or a neighbor, but that simultaneously impacts

Based on Medicine Shortages, Preventable Deaths

the wellbeing of a significant number of citizens and

and Hospital Infrastructure project, is to provide a

even takes their lives. The results of the measurements

general picture of the shortage of medicines affecting

conducted during the last 8 months of 2018 are shown

the health and quality of life of Venezuelans, a reality

below:

Important data from the August-2018 measurement include: absence of prescribed medicines for the treatment of 1 The Acute Respiratory Infections (ARI) on the shelves remains unchanged, standing at a 95.6 percent during the month of August 2018. Today, suffering from bronchopulmonary

that forces people to burn garbage and poses a latent threat to life, particularly that of vulnerable populations such as infants and the elderly.

2 Antihypertensive drugs remain the least scarce, with a 79.9

percent shortage at the close of the period, but a 79-percent

diseases carries an imminent danger of death, which is

shortage is nonetheless a compelling reason of concern,

compounded by a precarious waste management system

considering that hypertension is a major cause of morbidity

1.For details on the historical data of all the measurements carried out since the beginning of the project, please refer to our Newsletters No. 1 to No. 11, disponibles en: https://conviteblog.wordpress.com/

MONITORING THE RIGHT TO HEALTH IN VENEZUELA AUGUST 2018

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in our population, particularly for the elderly, and that, regardless of age, it affects 3 out of every 10 Venezuelans.

4 The shortage of drugs to treat

Diabetes continues to be a

threat to Venezuelans suffering from this condition. Although

The situation gets worse when one considers factors such

the shortage of diabetes medicine decreased by 7.4 percent

as the poor nutrition and the daily life complications that

as compared against the figures recorded during the month

are routine for Venezuelans in the context of this current

of September of last year, August saw a 4.9 percent increase

complex humanitarian emergency.

relative to the close of July.

3 Disturbingly, the shortage index for drugs to treat diarrheal

5 We need to raise our voices to denounce the threat behind

in the number of cases of this cause of morbidity during

latter means that more than half the people suffering from any

the last few months, motivated among other factors by the

of the causes of morbidity above will not be able to obtain

precarious service of drinking water, its bad management

medicines to treat them; on the contrary, they will see them

and consumption, has led us to qualify this shortage

progress and their quality of life and life expectancy reduced.

situation as alarming, taking into account the threat that

These diseases are perfectly treatable in places where public

it represents to the lives of people with gastrointestinal

policies and health investments really have the well-being of

ailments in the current context of insalubrity.

the population at heart.

syndromes continues to rise above 85 percent. The increase

sustained general shortage indexes above 79 percent. The

MONITORING THE RIGHT TO HEALTH IN VENEZUELA AUGUST 2018

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AGGREGATE RESULTS NATIONWIDE: A U G U S T , 2 0 1 8

Graph No. 1: Behavior of the Aggregate Medicine Shortage Index Nationwide in August, 2018.

EVOLUTION AND BEHAVIOR OF THE MEDICINE SHORTAGE INDICATOR

Graph No. 2: Behavior and Evolution of the General Shortage Index over the September 2017 - August 2018 period.

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Graph No. 3: Behavior and Evolution of the Shortage Index by Morbidity for the September 2017 - August 2018

Graphs No. 3 and No. 4 (below) depict the behavior of the shortage indicator during the September 2017 - August 2018 survey period. The following is worth noting: There is a considerable gap between the shortage index for

in August. The persistent absence of these drugs on the

medication to treat acute respiratory infections and the

shelves seriously compromises the health of the population,

General Shortage Index. The shortage indicator for this cause

considering that there has been an increase in the diagnosis

of morbidity never stood below 90 percent, and the trend

of gastrointestinal diseases from lack of drinking water and the

was sustained over the entire twelve-month survey period.

reappearance of various epidemics.

It is imperative that we speak up and raise awareness on the risk faced by those who suffer from respiratory diseases

For their part, patients with hypertension and diabetes have

and on the fact that the dare environmental conditions that

not been able to count on a regular supply of medication

Venezuelans currently live in, including deficiencies in the

to treat said pathologies. Even when there is evidence of a

waste collection system that lead people to burn garbage —

progressive improvement in the supply of drugs to treat them,

particularly in low-income sectors —, favor the appearance of

the general index shows that the shortage figures were never

diseases of this type.

below 70 percent, which is alarming for people who need constant and permanent access to lifetime treatments.

The shortage of drugs to treat diarrheal syndromes has varied significantly over the entire survey period. However, it was never below 79.9 percent, which was the figure recorded

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EVOLUTION AND BEHAVIOR OF THE MEDICINE SHORTAGE INDICATOR, BY CITY.

Graph No. 4: Behavior and Evolution of the Medicine Shortage Index by City. September 2017 – August 2018.

G R A P H I C A L D E P I C T I O N O F R E S U LT S B Y C I T Y A N D C AU S E O F M O R B I D I T Y

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METROPOLITAN AREA OF CARACAS:

Graph No. 5: Behavior and Evolution of the Shortage Index by Cause of Morbidity: Metropolitan Area of Caracas. September 2017 - August 2018.

2. This is a graphical depiction of the behavior and evolution of the shortage indicator by cause of morbidity and city for every measurement conducted between September 2017 and August 2018.

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BARQUISIMETO

Graph No. 6: Behavior and Evolution of the Shortage Index by Cause of Morbidity: Barquisimeto. September 2017 - August 2018.

MARACAIBO

Graph No. 7: Behavior and Evolution of the Shortage Index by Cause of Morbidity: Maracaibo. September 2017 - August 2018.

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MÉRIDA

Graph No. 8: Behavior and Evolution of the Shortage Index by Cause of Morbidity: Mérida. September 2017 - August 2018.

NUEVA ESPARTA

Graph No. 9: Behavior and Evolution of the Shortage Index by Cause of Morbidity: Nueva Esparta. September 2017 - August 2018.

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#CONVITEDENOUNCES: AUGUST 2018: VENEZUELA: HEALTH UNDER SIEGE, SILENCED VOICES HEALTH SERVICES WITHOUT ELECTRIC POWER Convite demands the competent authorities to guarantee the continuous provision of electrical power to the country’s hospitals.

The blackouts that have been registered in recent months have impacted the operation of health centers, hindering patient care.

Such is the case of Maracaibo’s hospitals, which were subject to constant power cuts all along the month of August and had no back-up power plants or energy supply to take care of patients in emergency units or to power operating rooms.3

NO WATER SUPPLY EITHER: It is the responsibility of the State to take immediate action to

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regularize the provision of drinking water to health centers.

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The constant and unjustified interruptions in the supply of water jeopardize the health and the lives of patients, families and workers. The unsanitary conditions in which hospitals are plunged without potable water compromises processes such as sterilization of surgical equipment and prevents compliance with hygiene protocols in critical areas such as oncology and neonatology.

HEALTH AND HUNGER: As a result of the prolonged blackouts that occurred in the state of Zulia during the month of August, there have been complaints about the irregular sale of rotten meat in popular markets. The fact that the State, its security organs and the comptroller’s office allow the sale and consumption of spoiled food is an attack on the health of citizens, who buy it for its low cost. Needless to say, the consumption of decomposed meat is a potential source of infections by bacteria such as Salmonella and Escherichia Coli which, when compounded with the shortage of medicines

SICK AND MALNOURISHED There has been a dangerous collapse of food services within hospitals. Numerous warnings have been placed by medical

for the treatment of said causes of morbidity, put the lives of 5

Venezuelans at risk.

personnel on the shortage of food for patients hospitalized in healthcare centers in various regions. In some centers, meal services have been restricted to patients with critical cases of malnutrition, while in others the food offered is inadequate, lacks the necessary nutrients and is counterproductive for people with cardiovascular diseases and oncology patients, among others. In some maternity wards serum has become 6

the substitute for milk formula in infant bottles.

3. AVENDAÑO, Shari (August 13, 2018). “Electricity Crisis Worsens the Precariousness of Maracaibo’s Hospitals.” Available for on-line consultation at:

http://efectococuyo.com/

principales/luz-acentua-problemas-hospitales-maracaibo/ 4.Reuters (August 15, 2018). “Without Water: The Battle of Doctors and Patients to Maintain Gygiene in Venezuelan Hospitals”. Available for on-line consultation at:

https://www.

panorama.com.ve/ciudad/Sin-agua-la-batalla-de-medicos-y-pacientes-por-mantener-higieneen-hospitales-de-Venezuela-20180815-0008.html 5.

AP (August 23, 2018). “In Maracaibo, Venezuelans Buy Rotten Meat Due to

Blackouts.” Available for on-line consultation at:

http://www.elimpulso.com/featured/

en-maracaibo-venezolanos-compran-carne-podrida-por-apagones 6.BERMUDEZ, Margioni (AFP) (August 7, 2018). “Eating in a Venezuelan Hospital: A Health Threat.” Available for on-line consultation at: https://www.elnuevoherald.com/noticias/mundo/ america-latina/venezuela-es/article216221915.html

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HEALTH FIGURES ARE A STATE SECRET: Last August, the Venezuelan Center for the Classification of Diseases, a unit attached to the Ministry of the People’s Power for Health, dedicated to the processing of epidemiological data needed to design health policies and strategies, was closed.

The closing was denounced by the Venezuelan Society of Public Health, and it leads to the loss of reliable information regarding 7

birth rates, morbidity and mortality.

Convite denounces the

Venezuelan State’s persistent policy of invisibilizing health statistics in an effort to hinder access to information on the situation of the health system and avoid public criticism and denunciation.

SPIKING EPIDEMICS: Cases of Hepatitis A continue to increase in the national territory. Only in August, 4 deaths were reported in the

BLIND DIAGNOSIS: The persistent shortage of reagents has left hospital laboratories inoperative throughout the national territory. This situation forces patients to pay for examinations in private health centers at extremely high prices, which conditions access to health for a 11

significant number of Venezuelans. The operation of laboratories in hospitals is essential both for the correct diagnosis of patients and for the analysis of critical material, as is the case of blood intended for transfusions, which in many facilities are being performed at risk.

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PINEDA, Julett (August 11, 2018). “Venezuelan Center for Disease Classification Closes.

Leaves Country Without Reliable Statistics.” Available for on-line consultation at:

http://

efectococuyo.com/principales/centro-venezolano-de-clasificacion-de-enfermedades-cierra-ydeja-al-pais-sin-estadisticas-confiables/ 8.SALAZAR, Daniel (August 13, 2018).

“María Landaeta: Cases of Hepatitis A Increase

in Venezuela.” Available for on-line consultation at:

http://globovision.com/article/

capital region due to complications from this disease, which is transmitted through water and infected food. Precarious water management has also spread cases of typhoid fever and diarrhea, which put the health of Venezuelans at risk due to the shortage of medications for their treatment.8 In August, the Pan American Health Organization confirmed 44 9

deaths from diphtheria in 2018 ; measles has also claimed the lives of Venezuelans within vulnerable communities, as is the

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case of the native peoples of Delta Amacuro with 53 deaths.

SILENCED VOICES During the month of August, protests by the different unions in the health sector persisted, claiming that they are being paid insufficient wages and complaining over the precarious

maria-landaeta-hay-un-aumento-de-casos-por-hepatitis-a-en-venezuela

working conditions in which they work. The conditions of

9.PINEDA, Julett (August 2, 2018).”PAHO Confirms 44 Deaths From Diphtheria During the

vulnerability in which the medical profession is exercised

First Seven Months of 2018.” Available for on-line consultation at: http://efectococuyo.com/ principales/ops-confirma-44-muertes-por-difteria-durante-los-primeros-siete-meses-de-2018/

remain unaltered. Another attack was registered in August

10.PINEDA, Julett (August 24, 2018). “Delta Amacuro with Most Measles Cases, Records

against health personnel in the capital city. In the meantime,

53 Deaths.” Available for on-line consultation at: http://efectococuyo.com/principales/

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delta-amacuro-tiene-myoria-de-casos-de-sarampion-y-registra-53-muertes/

doctors, nurses and other professionals are still waiting for

11.SALAS, Andrea (August 20, 2018).

a response from the executive. These degrading working

“ Specialist: Scarcity of Reagents Is 95% in

Hospitals.” Available for on-line consultation at: https://www.panorama.com.ve/ciudad/ Especialista-Escasez-de-reactivos-es-de-95-en-hospitales-20180820-0026.html

conditions are made worse by threats from the executive

12.PINEDA, Julett (August 23, 2018). “J.M. de los Ríos’ Doctor Attacked Because He Could

branch to replace those who protest in the health sector with

Not Take X-Ray.” Available for on-line consultation at: http://efectococuyo.com/principales/ agreden-a-medico-del-j-m-de-los-rios-porque-no-podia-hacer-una-radiografia/

integral community doctors.

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