Health Secretary: Venezuelan Medical Care in Critical Condition

EspañolI had the pleasure of meeting Gustavo Vilasmil at a seminar we both attended a year ago. He is a jack of all trades: a surgeon, liberty activist, and secretary of Health for the Venezuelan state of Miranda, a district led by opposition figure Henrique Capriles Radonski.

Gustavo Villasmil, médico cirujano de Venezolano.
Villasmil: “The situation is getting worse every day.” (Gustavo Villasmil)

I remember a very observant man with piercing eyes, and something nostalgic, perhaps a remnant of his days as a student at the Central University of Venezuela (UCV), one of the most prestigious universities in the country. His personality contains a mix of cunning, Caribbean humor, and a dash of curiosity that he filled with questions about my country, Argentina.

Reasonably, I assumed, it was time for me to speak with him about the fragile state of the Venezuelan health care system, given that he had previously worked in the trenches of Venezuela’s public health sector as director of Urgent Care at Vargas Hospital in Caracas from 1999 to October 2004.

The world has reported on the tiring shortages that persist in Venezuela, from toilet paper to toothpaste, or even products as basic as cooking oil, flour, milk, and chicken.

The same is true with medicine. He says what is happening in Venezuela “wouldn’t even happen in Africa.”

“In Caracas, it is more likely that a street vendor at the hospital entrance will be selling, for example, Vacomycin (an antibiotic), than the pharmacies or drug stores. Now we are also missing even the most basic medicine (antihypertensives, etc.).”

According to Villasmil, many patients will just wait for a relative living in another country to send the medicine they need. “That’s how it is…” he laments.

“The shortage of medicines is one of the clearest examples of the ‘failed state’ of the health care system.” I am over 4,600 kilometers away, but I can imagine him looking upwards and raising his shoulders in a gesture of indifference.

“The state should give us guaranteed minimums of safety and order. The establishment of a regulatory framework with regard to medicine is an essential state function. We are inundated with products from China, Cuba, and Pakistan that barely have a label, or that are unlicensed or unregulated.”

Villasmil continues in utter despair: “There is no way to import critical supplies — catheters and stents for coronary heart disease, cancer treatment drugs, among others — because it is not possible to pay for them in the international market.”

I wondered if, as a doctor in Venezuela, it would still be possible to continue training in different medical fields, or leave the country with any regularity. Villasmil assured me that it is currently almost impossible to travel to or from Venezuela to attend conferences, courses, or academic events. “All of that used to be part of our routine.”

He attributes this difficulty to current trade restrictions. “We don’t own our own money — which continually depreciates — nor can we do what we please with it, whether it’s attending a medical conference or something as simple as buying a book on Amazon that interests us.”

“Secondly, we are isolated. International airlines have reduced the number of flights from Caracas by more than 70 percent. The reason: they cannot repatriate their profits. If I buy a ticket in bolívares from a European airline, the airline cannot get the equivalent amount in euros, as it normally would.”

“This is because the Venezuelan government cannot back the bolívares that are currently in circulation, 70 percent of which is inorganic money. Therefore, Alitalia, Air Europa, Lufthansa, Air Canada, American Airlines, Avianca, and so on have all stopped flying to Caracas. Not even Argentinean airlines want to come!” he says with surprise.

Politics in the Background

The Venezuelan reality is like the lyrics of a tango, he used to tell me.

“The situation has worsened since Maduro came to power. The reason: Chávez dismantled the economy in December 2012 in an effort to beat Capriles. No less than US$12 billion was ‘burned’ in the electoral pyre that year.”

“So, Maduro inherited an exhausted economy, melted international reserves, without international credit, and with default on the horizon. Chavismo managed to break an economy that generated $1 trillion in oil revenue in 15 years. Not even a genius could have done better!”

I asked him how much of the country’s medical staff have either abandoned or are expected to leave Venezuela. Villasmil assure me that no less than 10,000 doctors, and at least the same number of highly specialized nurses, have left to many other countries.

“Being young, well-trained, and multilingual, they are showered with opportunities offered by the global market. This year, 60 percent of a single graduating class in medicine, at the Central University of Venezuela alone, will leave the country.”

Precisely what worries him most is the loss of human capital, as has happened in Argentina and Cuba.

“Perón destroyed the Argentinean university system, that in his day produced a Nobel Prize winner in medicine, the great Bernardo Houssay. The Castros destroyed the Cuban university system, where the primary focus is medicine — the University of Havana — where Agustín Castellanos, one of the greatest cardiologists of all time, was trained. If you go to a hospital in south Florida, you will see professional directories full of Hispanic names, Cubans to be exact — evidence of the incredible human capital that has abandoned the island to be in an environment that respects and appreciates them.”

On the subject of Cuba, I decided to delve into his opinion on the controversial topic of Cuban doctors working in Venezuela, and their supposed academic excellence — an essential aspect of the great Cuban myth, that for him, collapses under a stiff breeze.

“I have had very bad experiences with the Cuban doctors working here. They are poorly trained. They do not handle state of the art medical equipment, and they have a lot of trouble using certain technologies they have never seen before.”

“Years ago, I was furious with them, but I have come to understand that they are hostages of the regime that brought them here. It is a complex human drama….” he continued.

“I absolutely do not take seriously the claims of ‘miracle’ treatments typically espoused by Cuban propagandists. Nobody in the global medical community takes them seriously, and with good reason. Scams like the famous PPG — the alleged cholesterol reduction drug — or the treatment of vitiligo. These are just two of the many medical deceptions that Cubans have sold here.”

In light of the tragic reality of many patients seeking treatment in the country, I asked if the situation is the same for military personnel and high-ranking bureaucrats, who seek treatment at private clinics.

“If an ‘ordinary’ citizen wants similar treatment, he simply could not afford it,” said Villasmil. “The great George Orwell said it best: ‘we are all equal, only some of us are more equal than others.'”

Before we parted ways and promised to meet again, he sighed and said, “What else can you expect from an outlaw regime?”

Translated by Alex Clark-Youngblood.

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