The health crisis in Venezuela is crossing the border
The health crisis in Venezuela is crossing the border
MANAUS, Brazil. The contagion of Venezuela's economic crisis is beginning to spread to neighboring countries, not in financial terms but literally, in the form of life-threatening diseases transmitted by millions of refugees.
The collapse of Venezuela's health system has turned what was once the richest nation in Latin America into an incubator for malaria, yellow fever, diphtheria, dengue and tuberculosis, as well as the virus that causes AIDS, The Wall was told. Medical officials from Brazil, Colombia and Venezuela. Street newspaper.
The diseases, many of which had been considered almost eradicated, are now emerging beyond the borders of Venezuela, even in this Amazonian city 600 miles away.
Earlier this year, Elainy Portela watched with alarm as measles reappeared with a vengeance. The striking red eruptions covered six children near their home in Manaus, just off the road used by Venezuelans who escaped misery at home.
The highly contagious aerial disease was declared expired here 18 years ago. In March, the city had four possible cases. But in early October, there were about 1,000 people with measles here and about 2,000 in total for this state, Amazonas, and in neighboring Roraima, all originated with infected Venezuelans who crossed into Brazil, the Health Ministry said. Twelve people have died.
Elainy Portela is concerned that her 18-month-old daughter, Manuela, will be exposed to diseases transmitted by Venezuelan refugees to her hometown of Manaus, Brazil.
Photo:
Bruno Kelly for The Wall Street Journal
"I understand that Venezuelans do not come here by their own choice, but we must also think about our own protection," said Ms. Portela, who cares for her 18-month-old daughter because of her penchant for hugging strangers. "It scares me".
Measles is already spreading beyond the Brazilian Amazon to other Brazilian states, as well as to Colombia, Peru and southern Argentina, according to recent reports from the Pan American Health Organization. Other diseases that cross communities in Venezuela are now crossing borders and raising concerns among health authorities as far away as the US. UU
"People who are forced to leave the country without proper medical care can transmit a million different things, or have the potential to trigger an outbreak that no one can predict, but that will eventually occur," said Dr. Irene Bosch, scientific researcher who has studied infectious diseases in Colombia and Venezuela with the National Institutes of Health of EE. UU "It's a perfect storm condition for a catastrophic medical situation."
In Venezuela, a collapsing economy that has contracted by half since 2013 has caused widespread hunger, blackouts and a shortage of basic services, such as water supply. Once a leader in the Americas in disease prevention, the country has seen its public health care system deteriorate to the point where hospitals can not provide basic services or medications. Health officials in many parts of Venezuela no longer offer children the full cycle of vaccines that were once administered, doctors say in Venezuela. And a long time ago the government reduced the campaigns to fumigate against the mosquitoes carriers of diseases.
The resulting spread of infectious diseases in the interior of Venezuela has affected the doctors who have watched, impotent, as the number of people affected in that country dwarfs that of Venezuela's neighbors.
"In Venezuela there are at least three epidemics in action, measles, diphtheria and malaria. The crisis is great, "said Dr. Alejandro Risquez, who teaches medicine at the University Hospital of Caracas and is an expert on infectious diseases and vaccination programs, noting that there are even concurrent epidemics, with people suffering from more than one contagious disease. at the same time.
President Nicolás Maduro and his top advisers deny that the health care system is in a hurry and accused of critics fabricating horror stories to justify foreign intervention.
Crossing the frontier
The collapse of Venezuela's health system has turned what was once the richest nation in Latin America into an incubator for measles, malaria and diphtheria. Now the diseases are spreading.
Measles in the Brazilian states of Amazonas and Roraima, 2018
Designed to reach
1 million boxes in 2019
Measles in the Brazilian states of Amazonas and Roraima, 2018
Designed to reach
1 million boxes in 2019
Measles in the Brazilian states of Amazonas and Roraima, 2018
Designed to reach
1 million boxes in 2019
Measles in Brazilian states
of Amazonas and Roraima, 2018
Designed to reach
1 million boxes in 2019
Doctors who have publicly exposed the state of public health have been dismissed and threatened with arrest. The government stopped regularly publishing health and mortality statistics in 2015, except for a rare publication last year of a Ministry of Health bulletin that showed that infant and maternal mortality had skyrocketed. There were no responses to calls or emails requesting information from the health authorities of the Maduro government.
"Here there is a total secret," said Dr. María Alejandra Rosas, an infectious disease and pediatrician at the Central Hospital of the Venezuelan city of Valencia. "There is an epidemiological blackout to shut us up, so the information does not come out."
The ramifications of the serious state of health services in Venezuela are evident in emergency rooms and medical posts in northern Brazil and western Colombia, where many of the 2.3 million Venezuelans who have fled arrived for the first time. of the country since 2014.
A Venezuelan refugee, Maria Alexandra, 6, lives in a center run by the Catholic Church in Manaus, Brazil.
Photo:
Bruno Kelly for The Wall Street Journal
Venezuelans relax in the social area of the Casa de Acolhida Santa Catarina refugee center in Manaus.
Photo:
Bruno Kelly for The Wall Street Journal
In the border city of Pacaraima, in Brazil, a population of 16,000, approximately 180 of the approximately 700 Venezuelans who cross the country daily queue to receive free vaccines at a small health post.
Carrying their worldly belongings in garbage bags or suitcases with wheels, many of the Venezuelans come seeking treatment. Members of indigenous communities in Venezuela are especially vulnerable and difficult to care for. Some have fled Brazilian health officials, fearful of needles and hospitals, officials said.
"They arrive undernourished, weak, and only then do we discover they are sick," said Sandra Palomino, coordinator of a center that serves indigenous immigrants.
Javier Pérez, 34, came from Venezuela last year with tuberculosis, but did not know what his painful cough was until Brazilian doctors examined him. By then, he had transmitted the disease to his twin sons, who had been born in Brazil. One died
"It started as flu, with cough and blood," said Mr. Pérez, speaking at a shelter for Venezuelan indigenous people in Boa Vista, capital of the state of Roraima, where there were children with measles and chicken pox.
In the border city of Cúcuta, Colombia, Yendy Pereira, 24, arrived from Venezuela with his children. The son of Ms. Pereira, Cesar, 3, and the 4-year-old girl, Estafani, had not received vaccines against tuberculosis and tetanus, but she knew the Colombian authorities and the aid groups that vaccinate the children. Venezuelans
"I told my husband, let's do it for the children," he said. "The main reason was for the vaccines, that and the food for them."
On a typical day in the overcrowded main hospital of Cúcuta, Erasmo Meoz, up to 40% of people seeking emergency room assistance are from Venezuela, hospital authorities say. Some have tuberculosis cough, while others have malaria.
Increasingly, doctors see patients with HIV, such as Genesis Carmen Moreno, 27. She went to bed on a stretcher in the hospital emergency room one afternoon and told how she had been taken to Colombia to receive antiretroviral drugs that she could not get into. his hometown, maracaibo. When she had been healthy, she weighed 180 pounds and Mrs. Moreno had dropped to 79 pounds.
"It would have lasted a little longer, a few more days, back in Venezuela," Moreno said, showing a photo of herself before getting sick. "I would have died because I could feel the force leaving me."
The patient with HIV Genesis Carmen Moreno, 27, took a picture of herself when she was healthy in her hospital bed at the Erasmo Meoz hospital in Cúcuta, Colombia.
Photo:
Juan Forero / The Wall Street Journal
Doctors warn that the situation will not improve soon, since the exodus of Venezuelans to neighboring countries is gaining momentum. The Colombian government estimates that between 1.8 and 4 million Venezuelans are expected to arrive in that country by 2021.
While physicians in Colombia have been dealing with infected Venezuelans, it is here in northern Brazil where the rapid spread of measles has been particularly pronounced.
On a recent morning, in a small hospital in Pacaraima, on the Venezuelan border, Venezuelan children and their parents, sick with measles and malaria, sat together in a small waiting room while a young doctor attended them.
"We believe that this kind of thing only happens in Africa," said Dr. Jessica Almeida, pointing to an almost skeletal Venezuelan woman lying in a bed. She had lost more than 65 pounds, and Dr. Almeida said the tests had to be done to determine exactly why.
The doctor also took care of a Venezuelan baby, Valery, who had run across the border with spots all over his body, a sign of measles. He cried uncontrollably while his mother tried to calm her down.
"There are many diseases where we come from," said the mother, Katherine Bellezia, 24, who said she was considering staying in Brazil for the baby's sake.
-Samantha Pearson in Manaus, Brazil, and Maolis Castro in Caracas contributed to this article.
Write to Luciana Magalhaes in Luciana.Magalhaes@wsj.com and Juan Forero in Juan.Forero@wsj.com
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