For Those Not Fortunate Enough To Enjoy The World's Strongest Immune System

Based on the limited feedback I’ve received from my blog so far, it seems as though my readers most enjoy hearing about my misery and misfortune. I promise I’ll write about more (which means I’ll need to get myself into more) shenanigans, but bear with me for a little longer because believe it or not I sometimes use these posts as a sort of first draft to collect my thoughts for other work. In the meantime you can amuse yourself with visions of me finding more and more creative excuses not to eat breakfast (tuna arepa) or dinner (tuna arepa) even when I’m in the apartment. Also of me trying out a couple of salsa steps by myself in my room before going out on Saturday night, which will be the last time I go to a discoteca while I’m here unless I get visitor. Is that a strong enough incentive, Siobhan?

For now, though, I’d like to return to part two of my mini-series on the biggest issues facing Venezuela. I promise this one will be short, because it is also not a subject with which I am greatly familiar, and because I’ve been writing a lot this week. But I think it is particularly interesting and relevant to an ongoing debate in the U.S. as well.
Number three on the list, following the broken education system and the high cost of living, is the schizophrenic health system here. Interestingly, nearly everyone names the poor quality of health care as a huge problem, but few have severe criticisms of the care that they actually receive. In a way it resembles the common phenomenon in the U.S. where polls always find shockingly low approval ratings of Congress, and yet incumbents continue to get reelected at sky-high rates.

The fundamental problem should be familiar to everyone: if you can afford to attend private clinics here (which usually means you are fortunate enough to have health insurance) then the service seems to be pretty good. However if you are forced to rely upon public hospitals, then best of luck to you. The trouble with public service is two-fold: not only is the care below sub-standard, but the amount of time you have to wait to be attended is intolerable and often leads to severe complications or worse in serious cases. Emergency visits are no different, and even ambulances suffer the same problems due to a combination of poor service, heavy traffic, and poor road conditions. Just as in any country where public health care service is mandatory and free, the quality of care varies widely and people who don’t live in major cities receive disproportionately poor treatment. Because drugs are cost-controlled they suffer from severe shortages, which cause their actual price to rise astronomically. Funding for health facilities is uneven and many should really be condemned rather than giving out treatment. At many hospitals patients must bring their own shots and other medical supplies because the doctors have none.

Interestingly, however, the people who seem to complain the most about the poor care of the public hospitals seem to be those that don’t use them, at least in Caracas. Of course those who dislike the public option will seek an alternative if they can, but still I have been surprised with how satisfied many visitors to public hospitals are. While acknowledging that they need to wait an entire day to be attended, the people I have talked to express no great desire to pay for health insurance or go to the private clinics. Now I have not spoken with someone who has suffered a life-threatening situation and their responses may well be different if they had.

Finally, one aspect of the health system here that receives disproportionate attention in the foreign press is the presence of thousands of Cuban doctors in the country. Venezuela provides Cuba with oil at extremely generous rates and in return Cuba sends brigades of doctors to staff clinics throughout the country, primarily in rural areas. However their presence is not as overwhelming or as noticeable as you might expect. For some Venezuelans their existence is something of a joke. One man called them “mataperros” - devils. But for those without access to other facilities the Cubans can be of great help. Another good theory I have heard, from someone who does visit Cuban clinics from time to time, is that the Cuban doctors are great for certain problems, such as setting broken bones, treating minor infections, etc. But for health issues that require surgery or advanced pharmaceuticals they are no good, and to that she attributed the U.S. embargo which has denied Cuba modern equipment over the years. While I’m not sure how much stock I put in her explanation, I think her conclusion is largely accurate that the Cuban doctors are useful to take some cases from the overworked Venezuelan doctors but that they do not provide particularly high quality service. After all, Cuba is probably not sending its finest doctors out of the country, no matter how well Hugo and Fidel get along.

In any case, improving the health care system is just about always mentioned in political speeches from chavistas and the opposition alike. Unfortunately action, particularly increased funding, does not seem to follow.