The Largest Forced Human Displacement in the Western Hemisphere
It is being described as one of the most massive forced displacements in the Western Hemisphere; arguably the worst humanitarian crisis in Latin America’s modern history. Three million Venezuelans, one in 12, have been compelled to pack up their lives and leave their homes or face certain death due to lack of food, medical attention, and physical safety.
Moving mostly on foot at the rate of five thousand a day, the majority of these refugees, cross into neighboring Colombia. From there some move on to Ecuador, Peru, and Chile. Others have gone south to Brazil.
Three million Venezuelans, one in 12, have been compelled to pack up their lives and leave their homes or face certain death due to lack of food and medical attention.
Venezuela’s neighboring countries are overwhelmed by Venezuelan refugees seeking care not available in their own country. The flow of Venezuelan refugees has been described as one of the most massive forced displacements in Western Hemisphere: the worst humanitarian crisis in Latin America’s modern history.
Between 2012 and 2017, at least 22,000 Venezuelan doctors – 55% of the total –24% of nurses and 30% of lab technicians have reportedly abandoned the country. Virtually no specialists are left.
Last national surveys of hospitals done by the Venezuelan nonprofit Medicos Por La Salud and CEPAZ reported that 51 percent didn’t have functioning X-ray machines, 60 percent were having electricity outages, and 70 percent were suffering water shortages. 53% of Venezuelan operating theatres were now closed, 71% of emergency rooms could not provide regular services, and 79% of hospitals lacked a reliable water supply. Bottom line: between 2012 and 2017, 60% of the medical services provided by public health services to 82% of the population in 2011, does no longer exist.
Health officials in many parts of Venezuela no longer offer children the full cycle of vaccinations that were once given and the government long ago scaled back campaigns to fumigate against disease-carrying mosquitoes. In hospitals such as Caracas University Hospital, for instance, there are holes in doors in the infectious disease ward where measles patients are kept: Venezuela has become an incubator for malaria, yellow fever, diphtheria, dengue, and tuberculosis, as well as the virus that causes AIDS. Venezuela has put not only its citizens but the whole region in jeopardy.
In February 2018 a 1-year-old Venezuelan child with measles was brought over the border to Brazil. Eight months later, as the virus hopscotched across a local population that was not sufficiently vaccinated, more than 10,000 patients contracted the infection in Amazonas state alone. New cases are growing at the rate of 170 a week. According to recent Pan American Health Organization’s report, the measles epidemic is already spreading beyond the Amazonas State to other Brazilian states, as well as to Colombia, Peru and even as far south as Argentina.
Brazilian authorities also cite a 50 percent spike in malaria in Amazonas State to 72,000 cases due to the Venezuelan flow of refugees.
In Colombia, 91.9 percent of the 565 imported malaria cases up to week 41 of 2017 originated in Venezuela. At least eight cases of diphtheria — a bacterial infection that can block airways and cause death — were confirmed in 2018, that nation’s first instances since 2005. All eight were recorded in border regions with a large flow of migrants from Venezuela.
At the General Hospital of Roraima, in Brazil’s northernmost state, bordering with Venezuela, the daily patient population has surged from 400 per day to 1,000 over the past couple of years, overflowing capacity. Approximately 30% of the patients attended in the Erasmo Meoz hospital in Cucuta, the Colombian city which is the main route out for Venezuelans, are uninsured Venezuelans. As a consequence, Colombian health authorities have run into a multimillion debt.
Venezuelan Refugees Trigger Medical Crisis in Brazil
Friends of Ziv Medical Center is asking you to join in bringing teams of doctors and medicines, including vaccines to support public health facilities in Colombian and Brazilian border regions providing medical assistance to the refugees.
The Brazilian government estimates that 800 Venezuelans arrive in Brazil every day and more than 70,000 have crossed the border in the past year. Most cross the border near Pacaraima, in Brazil’s northern Roraima state, and continue for another 200 kilometers to the capital Boa Vista. While the evidence suggests that most Venezuelan migrants head for major cities in Argentina, Chile, Colombia, and Peru, those in Brazil have largely sought to remain in the northern provinces along the border.
There are nine government-operated shelters near the border that provide immediate assistance, such as food, water, and shelter. According to Sergio Marques, who is responsible for the SOS Children’s Villages Brazil emergency response for the Venezuelan refugees, the situation is precarious. The shelters are overcrowded because more Venezuelans arrive every day. Health services are suffering the most. At Roraima’s General Hospital, medical care for Venezuelans rose 2,643 percent.
In December 2016 the governor of Roraima state in northern Brazil declared a health emergency after a threefold increase in the number of Venezuelans seeking hospital treatment.
At the General Hospital of Roraima, the director, Samir Xuad, says the daily patient population has surged from 400 per day to 1,000 over the past couple of years.
That requires working his employees so hard that some of them end up getting sick, too, said Mr. Xuad, adding that he had lost more than 20 pounds from the stress. Medical supplies as essential as syringes and gloves have run out, he said.
International agencies — including the PAHO and the U.S. Agency for International Development, the U.S. government’s overseas development organization — have launched emergency health programs in Venezuela’s neighboring countries to contain the outbreaks, including ramped-up vaccination and detection operations in Colombia and Peru. But nowhere has the response been more massive than in Brazil.
The highly contagious airborne disease was declared vanquished in Manaus 18 years ago. In March, the city had four possible cases. But by early October, there were nearly 1,000 people with measles here and about 2,000 total for this state, Amazonas, and in neighboring Roraima, all having originated with infected Venezuelans who crossed into Brazil, the Health Ministry said. Twelve people have died.
Brazil’s patient zero for measles was a 1-year-old Venezuelan child brought over the border in February 2018. Eight months later, more than 10,000 patients have contracted suspected infections in Amazonas state alone, as the virus hopscotched across a local population that was not sufficiently vaccinated. New cases are growing at the rate of 170 a week.
Officials have scrambled to respond. The government set up a situation room in Manaus. Doctors unfamiliar with measles underwent urgent training. Health authorities went to universities and medical schools, recruiting more than 1,000 trainees who were taught how to give vaccinations. A door-to-door operation began — from moss-covered colonial buildings and teeming slums to jungle settlements reachable only by days-long trips in canoes.
Yet the mobilization failed to prevent a major outbreak — by late summer, medical personnel was receiving 900 suspected measles victims a week. Overwhelmed, health workers moved from sending patients to hospital isolation wards to recommending home containment for all but the worst cases. Emergency vaccination points were set up at schools and churches.
Decades ago, Venezuela was lauded as a global pioneer in combating malaria, eradicating the disease from vast sections of the nation. But malaria cases have tripled in three years to 406,289 in 2017. Brazilian authorities cite that surge and the increase in migrant flows, for a 50 percent spike in malaria in Amazonas state in 2018 to 72,000 cases.
Last year, Dr. Kathleen Page, an infectious disease specialist at the Johns Hopkins School of Medicine, visited border towns in northern Brazil that are now hosting tens of thousands of migrants. Page, who is originally from Uruguay, says the local Brazilian hospitals are overwhelmed with incredibly sick people. In the HIV wards, she felt as if she were stepping back in time to the early days of the AIDS crisis.
“I was not a doctor in the 1980s when the AIDS epidemic started. But I know what happened, and I felt that in these wards I was going back to the 1980s,” Page says.
“People were basically dying of opportunistic infections. They were emaciated, dying of chronic diarrhea, infections in their brain — things that we know are treatable and preventable. And to give credit to the Brazilian doctors, they were doing everything they could to help people, but the hospitals were at capacity.”
She traveled to the Brazil-Venezuela border as part of a fact-finding trip for Human Rights Watch.
“I interviewed over 100 people crossing the border, and I would ask them, ‘Why did you come?’ ” she says. “Ubiquitously the answer was food or health care.”
Many people told her they’d been surviving for months in Venezuela on a diet only of yucca, a rugged shrub that has a potatolike root.
( BEAUBIEN, JASON: “Collapse Of Health System Sends Venezuelans Fleeing To Brazil For Basic Meds,” NPR, Feb 5, 2019)