Venezuelas health care revolution

In late August President Hugo Chavez of Venezuela announced a new stage in his country’s fight for health care. The government will spend $2.5 billion. “The first and most important use [of the money] is to purchase necessary equipment, the most modern in the world,” said Chavez. “That’s Barrio Adentro III (‘Inside the neighborhood’): a hospital revolution.”

A revolution may be what’s necessary to make good on health care as a human right. As Fidel Castro declared in 1959, “The peasant’s children were allowed to die, because there were no medicines or doctors for them. Peasants’ wives were allowed to die because there was often neither medicine nor doctors for them. … In rescuing the peasants, the revolution is taking its first step toward making itself a true democracy, a democracy without slaves.”

Health care is very much on the agenda for democratic change unfolding in Venezuela. Utilizing Cuban doctors and expertise, plus oil money, Venezuela’s Bolivarian revolution is on the road toward a new era in health services.

Venezuela’s poor, about 80 percent of the population, are probably better off than Cuban peasants were back in 1959. Theoretically, two-thirds of the Venezuelans have access to health services under social security, and Venezuelan infant mortality rates and life expectancy are better than those of many other Latin American nations.

But for the majority, health care has remained unavailable. Many rural villages and isolated settlements are far removed from facilities. Privatization has closed public health facilities and upped the price of services. Until recently only 3 percent of the gross national product went toward health care, whereas most industrialized nations spend 8 percent to 10 percent. Physicians are in short supply.

Of Venezuela’s 55,000 doctors, 10,000 do not work and 22,000 are public health physicians, many of them working part-time. Cuba has sent 20,000 doctors and dentists to Venezuela in exchange for inexpensive Venezuelan oil at the rate of 90,000 barrels per day. Venezuela pays the Cuban doctors $210 per month for food and transportation and Cuba provides their families at home with $750 every month.

For two years, as a first step, the Chavez government has been encouraging communities in poor and remote areas to build their own health centers and has arranged for Cuban doctors to staff them. Under Barrio Adentro I, over 8,000 such centers now offer primary care, health education, and prevention.

The communities have carried out surveys to determine local health needs and have developed comprehensive health care plans. The centers dispense free medicines provided by Cuba.

On June 10, President Chavez introduced Barrio Adentro II. The government will build 600 new diagnostic centers throughout Venezuela, complete with emergency departments, laboratories and operating rooms. Some of the new facilities will offer specialty care and ambulance services. About 1,200 centers for rehabilitation, physical therapy, acupuncture and health education are also being built.

The health ministry has recruited 1,500 Venezuelan physicians to join the new programs. It has arranged for 17,000 Venezuelans to travel to Cuba for orthopedic or eye surgery.

Under Barrio Adentro III, the existing hospital system will be overhauled. The government will buy top quality equipment from abroad for refurbishing hospitals and for patient care that in the future will be provided free. The money comes from a $6 billion development fund that the National Assembly withdrew last July from foreign currency reserves worth $30 billion.

In view of a shortage of 20,000 practicing physicians, medical education is a priority. This year 887 students from Venezuela are enrolled in Cuba’s Latin American School of Medicine, and 1,050 Venezuelan doctors are studying family medicine in Cuba. All Cuban doctors working in Venezuela have two medical students in tow who are enrolled in a “medical school without walls” developed by Cuban and Venezuelan medical educators.

The program began Oct. 3, with 20,000 entering Venezuelan medical students. Their course will emphasize humanistic values and close integration of basic sciences with clinical medicine. Students are taught even in remote, rural areas, because the need for students to go to cities to study medicine often influences them not to return to practice in their home districts.

Venezuelan and Cuban educators are planning to train 50,000 new Venezuelan doctors over the next 10 years, plus 30,000 others from elsewhere in Latin America. President Chavez recently announced plans to develop in Venezuela a second Latin American School of Medicine.