Venezuela’s Shameful Secret

Tamara Pilot is an Assistant Vice President at the University of Chicago, Global Initiatives and Strategy (Uchicago Global).

The young woman covered her face with a shaking hand. She was exhausted and scared. The metal birthing chair did not have a cushion or vinyl covering, and she shivered in the thin, blue cotton gown the hospital gave her after admittance. Since her water broke that morning, she had walked to two hospitals, both miles apart, and had almost given up before collapsing in front of the third, where a security guard noticed her grimacing in pain and helped her in. It is common for Venezuelan women to walk or hitchhike from hospital to hospital where they are rejected before giving birth in a hospital lobby, doorstep or even on the street outside (Turkewitz & Herrera, 2020).

To give birth in Venezuelan’s shattered public health system is to risk death for both mother and child. Basic supplies such as gloves and soap have disappeared, medicines are only available on the black market and electricity is only intermittently available. Since 2016, Venezuela’s economic crisis has exploded into a public health emergency. In response, the US must act quickly to lift their broad-based economic sanctions, and instead implement more targeted sanctions aimed at the Maduro administration while utilizing innovative technology to get aid to the needy.

In some hospitals outside of the Venezuelan capital, Caracas, surgeons don’t have water to wash their hands prior to operating on a patient or wash the operating table after they finish (Casey N, 2016). This lack of hospital equipment, staffing and medical supplies contributed to the death rate for new mothers increasing fives time between 2012 and 2015, according to the last health report released by the Venezuelan Health Ministry in 2016. This same report stated that maternal death and infant mortality reached 65% and 30%, respectively (Ulmer A, 2017). Despite being censored in Venezuela, doctors keep records and provide some details to the World Health Organization, which reported 352 female deaths during pregnancy, childbirth and postpartum (99 deaths per 100,000 births) in 2019. In the same year, an average of 11 deaths per week were reported: 97% were in-hospital deaths (Humanitarian Response Plan, 2020).

This scarcity is not limited to the medical community. With the beginning of the collapse of Venezuela’s economy in 2014, severe shortages of food, water and medical supplies have plagued the country and deepened the humanitarian crisis caused by the country’s failed leadership. Two consecutive U.S. administrations have imposed financial sanctions forcing the Venezuelan government to cut its imports by 70%. Hyperinflation, a limited domestic supply of goods, and excessively expensive imports have added to the shortages in a country where 87% of the population lives below the poverty line, and more than 60% below the extreme poverty line (Bahar, Piccone, Trinkunas, 2018).

After a difficult 2-day labor without pain medication and only one midwife, Ms. Vasquez delivered a 3.3-pound baby prematurely, who without vital sign monitors, ventilators, or proper sanitation, passed away within twenty-four hours. Ms. Vasquez had lost the “ruleta”, the Venezuelan term for the struggle that women are forced to endure when traveling from hospital to hospital searching for one equipped to help them.

Desperate for adequate care and services, pregnant women are increasingly joining the mass migration to bordering countries. In 2019, doctors at San Jose Hospital in Maico, Colombia, delivered 2700 Venezuelan babies, up from 70 deliveries five years earlier (Casey N, 2016). Colombian hospitals along the border are reaching their limits and need significantly more funding to continue assisting Venezuelan women. The three largest host nations: Colombia, Ecuador, and Peru, need more financial support from the international community. In 2018 the U.N. approved $9.2M in humanitarian aid to the Maduro government (Nebehay & Ellisworth, 2019). The funds were for programs addressing children’s nutrition, mothers at risk and emergency health care. While made in good faith, some proponents feared that providing aid directly to the corrupt Venezuelan government could result in the funds being misdirected to personal offshore accounts.

Despite these concerns and challenges, more aid is needed. For example, the UN Refugee Agency (UNHCR) and the International Organization for Migration (IOM) launched a call for US$1.35 billion in funding to support the 2020 Regional Refugee and Migrant Response Plan (UNHCR, 2019). The plan focuses on social and economic integration of refugees and migrants as well as immediate humanitarian needs. In 2020, 2.2 million refugees, migrants and host communities received support despite relief agencies only raising 46% of the required funds (RMRP, 2021).

Days after Ms. Vasquez’s baby passed away, she holds a white baby blanket to her face, the only memento of her daughter she manages to keep. While it is too late for Ms. Vasquez and her child, thousands of other women like her are in desperate need of basic pre- and postnatal care. The US needs to lift broad-based economic sanction to ensure that much needed medical supplies make their way into the country’s hospitals. In place of these broad-based sanctions, the US should coordinate the targeted sanctions they impose on 119 individuals and 47 entities from or related to Venezuela or deemed to be aiding the regime, with the European Union, Switzerland, Canada and Panama. Aggressive investigation and prosecution of the institutions that launder money should be made so that international banks will be less willing to accept money tied to Venezuelan officials. Innovative approaches like using blockchain and cryptocurrency technologies to microfinance churches and community centers can help local representatives distribute funds (Rendon, 2019). A price stable currency such as MakerDao is a promising source of digital money that could be utilized to direct funds appropriately. These innovative technologies can be used in to provide aid to non-government related aid organizations such as the Venezuelan non-profit Accion Solidaria. With its sister organization, Action Solidarity (established in the U.S.), funds can be directed to reduce preventable maternal and infant deaths. Accion Solidaria’s primary mission is to serve HIV infected people in Venezuela, however, it’s existing logistical capacity and infrastructure which include facilities, resources and networks within the country makes it well situated to attend to the health crisis. An effective humanitarian response requires coordination with organizations at the national and regional level, like Accion Solidaria (Humanitarian Response Plan, 2020).

Existing U.S. foreign policy of imposing broad economic sanctions on Venezuela is based on an excessive faith in their effectiveness to enforce regime change (Rodriguez F, 2018) and a misguided belief that sanctions will only hurt the Venezuelan government without negatively affecting its people. Instead, encouraging multilateral adoption of targeted sanctions can effectively weaken Maduro’s political allies (Bahar, Piccone, Trinkunas, 2018). These recommendations can balance concerns of sending aid blindly to Maduro, while providing desperately needed resources to Venezuela’s poor so that fewer Venezuelan women are forced to play the ruleta.

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Bahar Dany, Piccone Ted, Trinkunas Harold, 2018, Venezuela: A path out of misery, Foreign Policy at Brookings, file:///D:/Harris%20School/Policy%20Brief/FP_20181023_venezuela.pdf

Blondell G. B., 2018, “Sentenced to death for the humanitarian emergency”, Accione Solidaria, https://accionsolidaria.info/sentenciados-a-muerte-por-la-emergencia-humanitaria

Casey N., 2016, “Venezuela’s public health emergency”, The New York Times, https://www.nytimes.com/2016/05/16/world/americas/dying-infants-and-no-medicine-inside-venezuelas-failing-hospitals.html