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- Shortages of Medicine and Medical Supplies
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Human Rights Watch reviewed official data reported by other governments throughout the region since and found no evidence of similar increases in the reported rates of maternal and infant mortality. However, for most countries no data is publicly available yet for and after, the years for which Venezuelan data show increased maternal and infant mortality rates. Venezuela is facing severe shortages of basic goods, including food. It is increasingly difficult for many Venezuelans—particularly those in lower or middle-income families who rely on items subject to government-set maximum prices—to obtain adequate nutrition.
While vegetables, fruit, meat, fish, and some imported basic goods are available in some markets—and certain stores carry such luxury goods as imported olive oils and wines—many Venezuelans can only afford food subject to price controls, which is now in short supply. Human Rights Watch researchers found long lines forming whenever supermarkets received goods subject to government price controls. Supermarkets often ran out of limited stock long before everyone in line had been served.
The foods and other basic goods—such as diapers, toothpaste, and toilet paper—that people could buy were strictly limited, if available at all. For example, people usually could buy one kilogram of corn flour or rice, or two packs of diapers, per week, if those items were available. Some items, like sugar and toilet paper, have disappeared from supermarkets for months at a time, people in lines told researchers. A survey by civil society groups and two leading Venezuelan universities of 1, people in 21 cities throughout the country found that 87 percent of interviewees—most of whom belonged to low-income households—had difficulty purchasing food.
Twelve percent of interviewees were eating two or fewer meals a day. Public health scholars have linked food insecurity in several Latin American countries with major physical and mental health problems among adults, and poor growth and socio-emotional and cognitive development in children. In Venezuela, several doctors, community leaders, and parents told Human Rights Watch that they were beginning to see symptoms of malnutrition, particularly in children.
Since January , the Venezuelan government has announced a series of initiatives aimed at addressing shortages of medicines, foods, and other basic goods. These include measures to increase local production of medicines, medical supplies, and food. If properly implemented, some of these initiatives could help reduce the shortages. The Venezuelan government has sought humanitarian assistance from abroad, but to a very limited degree.
Nonetheless, it does not appear that the Venezuelan government has sought to obtain additional assistance that might be readily available. On the contrary, the government has vehemently denied the extent of the need for help and has blocked an effort by the opposition-led National Assembly to seek international assistance. Human Rights Watch is not aware of a single large-scale health assistance program run by a major international humanitarian non-governmental organization currently addressing the medical crisis in Venezuela.
Human Rights Watch has had confidential discussions with people working for five major humanitarian non-governmental groups and one working for the United Nations, who reported facing significant obstacles to work in Venezuela during the current crisis. Doctors and nurses reported being threatened with reprisals, including firing, after they spoke out publicly about the scarcity of medicines, medical supplies, and poor infrastructure in the hospitals where they worked.
Human rights defenders reported a climate of intimidation resulting from measures enacted by the government to restrict international funding and repeated, unsubstantiated accusations by government officials and supporters that they were conspiring to destabilize the country. This is particularly problematic in Venezuela because government policies for more than a decade have curtailed free expression, limiting the availability of critical media outlets and cowing the media into self-censorship.
Ordinary Venezuelans reported being arrested during street protests over food scarcity—some organized and some spontaneous—and being subject to beatings and other mistreatment while in detention. These detentions followed a similar pattern to scores of other cases documented by Human Rights Watch in Venezuela in , when the government launched a widespread crackdown on largely peaceful anti-government protests.
Human Rights Watch obtained credible accounts of new cases in six states between January and June involving the arrest and prosecution of at least 31 people, at least 20 of whom allege that they were subject to physical abuse while in detention. In a majority of these recent cases, the detainees were charged in military courts, in violation of their right to a fair trial.
In most cases, prosecutors failed to provide any credible evidence of criminal activity. As in prior cases documented by Human Rights Watch, all 31 detainees were released on conditional liberty, with charges pending, and most were warned not to participate in any further protest activity. Carol Jimenez, 9, has diabetes. Her mother struggles to obtain insulin, reactive strips to measure her blood sugar, and enough food to provide her with adequate nutrition.
Graciela Giron, 30, has breast cancer. Since January , she has been unable to obtain medication through the public healthcare system or private pharmacies and has resorted to organizing events with other breast-cancer patients to raise money to purchase medicines abroad, where they cost ten times more. Jesus Espinoza, 16, has had three kidney transplants and has been receiving hemodialysis since The hospital has run out of medications he needs, including to control his blood pressure, and his mother has resorted to trading medications with other mothers at the hospital.
For more than a year, she has found it difficult to obtain medications and has had to interrupt treatment, causing a worsening of such symptoms as weight loss and hair loss, intestinal problems, and skin eruptions. She was initially treated at a public hospital but relapsed after discharge, when her family was unable to afford the antibiotic she needed.
Carrillo Central Hospital in Valera, Trujillo State, after complaining about a scarcity of surgical materials, medicines, and anesthetics. Oscar Arriechi and Yamileth Mendoza were arbitrarily detained in Lara State in February , when they tried to stop members of the National Guard from detaining their year-old son, whom they had sent to wait in line for food. Both were subject to abuse during detention and were charged in military courts.
Mendoza was released pending trial and Arriechi spent 45 days in pretrial detention in a military prison. Morexmar Chirinos was detained in May , as she was leaving a protest about food scarcity. President Maduro and his administration should take immediate and effective steps to address the humanitarian crisis in Venezuela.
Specifically, President Maduro should:. The president and his administration should end the use of authoritarian tactics to intimidate and punish critics. Specifically, the president should:. The Attorney General should undertake prompt, thorough, and impartial investigations into all allegations of abuse documented in this report—including arbitrary arrests and physical mistreatment of detainees, and political discrimination in the distribution of food and other goods.
These agencies should also publish a comprehensive, independent assessment of the situation on the ground, including on the extent and impact of the shortages of medicines, medical supplies, and food. The assessment should offer a detailed explanation of the needs in Venezuela, as well as the different alternatives available for the Venezuelan government to satisfy those needs through existing programs of these agencies.
This report is based on more than interviews with health care professionals, patients suffering an array of illnesses, people standing in line to purchase goods subject to government-set maximum prices, community members, former detainees, and human rights defenders. Some of the interviews—including with doctors in other locations such as Yaracuy State—were conducted via telephone, email, WhatsApp, or Skype following the fact-finding missions.
We also consulted a number of public health experts in Venezuela and abroad to help us interpret the findings of our research. Interviews were conducted by Human Rights Watch staff in Spanish or with a translator. Interviewees were informed of how the information gathered would be used, and informed that they could decline the interview or terminate it at any point.
In some interviews, Human Rights Watch paid reimbursement for transportation. We interviewed 18 doctors and nurses and two hospital staff members, including one hospital director, working in those public hospitals and three others in Caracas and San Felipe, Yaracuy State, which we did not visit ourselves.
We also interviewed 38 patients, including 20 who were hospitalized at the time of their interviews. In most of the countries where Human Rights Watch works, the practice is to seek meetings with government officials to discuss and seek information regarding the issues on which it is reporting. This has been our practice in Venezuela as well. However, when conducting research for this report, Human Rights Watch deliberately chose not to establish contact with government officials or otherwise draw public attention to our presence in the country.
This decision was made out of concern for possible repercussions for interviewees, the risk of compromising our ability to conduct the research, and the safety of our staff. We had not received a response at the time of writing. We also reviewed public statements made by President Maduro and several of his cabinet ministers, as well as statistics and reports by the Health Ministry about maternal and neonatal mortality. People have to buy the majority of supplies because approximately 90 percent of medical and surgical supplies are lacking at our hospital At all of the hospitals visited by Human Rights Watch—and others where patients we interviewed sought treatment or where doctors we interviewed worked—doctors and patients reported severe shortages of basic medical supplies, sanitary supplies, and medicines.
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They said that these shortages had become much worse over the past two years. The shortages have taken a heavy toll. Hospital staff told Human Rights Watch that the lack of medicines and equipment often prevented them from carrying out basic medical procedures and providing adequate care. Patients and families spoke of their difficult—and sometimes desperate—struggles to find medicines and supplies to treat chronic conditions or obtain urgent care.
While official information regarding the extent of the shortages and their impact is not publicly available, Human Rights obtained internal documents produced by the Health Ministry that suggest infant and maternal mortality rates may have increased substantially in recent years. All reported severe shortages of basic medicines and medical supplies.
These included—in some or all of the hospitals—the following:. In addition, most of the hospitals visited by Human Rights Watch had increasing difficulty conducting basic blood analysis tests, according to the doctors interviewed, and they lacked functioning x-ray equipment. The survey also found a shortage of surgical supplies in 81 percent of the hospitals, an increase from 57 percent in and 61 percent in The head of the Venezuelan Medical Federation estimated in April that more than 94 percent of medicines that would normally be routinely stocked were unavailable at public hospitals.
The president of the Venezuelan Federation of Pharmacies estimated in July that 85 percent of medicines that should be available in private pharmacies were unavailable or difficult to obtain—up from 60 percent in November The Venezuelan government has not released any information about the extent of shortages of medicines. Doctors, nurses, and patients all told Human Rights Watch that, with medicines and medical supplies unavailable at public hospitals, staff must ask patients or their families to purchase elsewhere what is needed for their treatment.
For example, patients needing surgery—including cancer operations or caesareans—are required to bring essentials such as anaesthetics, IV fluids, and scalpels. Delays are putting the lives or well-being of patients in danger. The lack of basic supplies and medicines contributed to an increase in medical complications in hospitals, including an increase in post-operative infections, according to doctors working in different hospitals in Caracas and five states. Similarly, a doctor from the University Hospital Dr. Another consequence of the lack of medications at Venezuelan hospitals is that doctors are forced to give patients only partial courses of antibiotics, doctors working in different hospitals in Caracas and five states said.http://esportsify.net/the-impact-of-the-fdi-on.php
Kevin Fret, Latin trap artist, shot dead at 24
This can result in relapses and may lead to the development of drug-resistant bacteria, a public health risk. Doctors and nurses told Human Rights Watch that they are often unable to provide basic treatment and care that until several years ago they would have been able to provide. The national data suggesting infant mortality rates may have increased substantially is consistent with data and testimony obtained from doctors and nurses at hospitals in various parts of Venezuela.
For example, staff at two hospitals provided Human Rights Watch with internal data showing a jump in infant mortality rates in their hospitals. In the last few years, between around 5, and 5, babies per year were born at the hospital. Previously, the rate had decreased steadily from 6. Doctors working in different hospitals in Caracas and five states told Human Rights Watch that they believe that the unhygienic conditions and medical shortages in hospital delivery wards are important contributing factors to this increase.
One doctor told Human Rights Watch that the practice of prenatal medicine had also suffered in his hospital and in many others. Particularly in the case of premature babies or mothers already suffering nutritional deficiencies, this may increase the risk of death. As a doctor explained to Human Rights Watch:.
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Another related problem is the transmission of HIV from mother to child. Venezuelan medical protocols to prevent mother-to-child transmission recommend the use of antiretroviral medicines by the pregnant mother before birth, a scheduled caesarean delivery to prevent transmission during birth when needed, and prophylactic treatment of the newborn. Many patients with chronic medical conditions including cancer, hypertension, diabetes, and epilepsy—as well as organ transplant patients—constantly struggle to find medications.
The medicines they need are often completely unavailable at both public and private pharmacies, and if they are available on the black market or abroad, they are prohibitively expensive. Human Rights Watch interviewed dozens of patients who had struggled to obtain basic medications and medical supplies they needed for a wide range of illnesses.
We found case after case in which Venezuelans desperately searched for medications they needed through social media, by creating networks of patients with the same illness to share information when medicines become available, or by exchanging medicines with other people in need. Although some had been able at times to access medication through these means, they are not always successful, and those with more limited resources have found themselves in an even more difficult situation. Here are some of the stories of Venezuelans interviewed by Human Rights Watch:. We have nothing for lunch.
While vegetables, fruit, meat, fish, and some imported basic goods are available in some markets—and certain stores carry such luxury goods as imported olive oils and wines—millions of Venezuelans simply cannot afford food that is not subject to price controls, and it is becoming increasingly difficult for them to provide adequate food for their families. The items of greatest scarcity were cooking oil, flour, milk, grains, and hygiene products, according to the survey.
High inflation rates—of percent in April , according to the International Monetary Fund— are eroding buying power. People Human Rights Watch interviewed consistently said that long food lines form whenever supermarkets receive scarce goods, and that the supermarkets often run out of limited stock long before everyone in line has been served.
As described below, there are credible allegations that this method of distribution has led to political discrimination against government critics. Public health scholars have found that there is a link between food insecurity and poor health. In different Latin American countries, food insecurity has been linked with major physical and mental health problems among adults, and poor growth and socio-emotional and cognitive development in children. In addition, research has shown that food-insecure individuals are less likely to adhere to medical treatments due to competing limited resources for diverse basic human needs.
During field research in June , Human Rights Watch researchers repeatedly came across long lines wherever goods subject to government-set maximum prices were on sale.
Shortages of Medicine and Medical Supplies
Some said that they had not eaten meat in months because it had become unaffordable. Others reported that food subject to price controls was no longer available in rural stores, requiring rural residents to travel to the big cities in search of these food items at the large supermarkets that still received them. The Venezuelan government has tried to limit the length of food lines through an informal nationwide system under which anyone can wait in line on weekends, but people are only allowed to wait in line one weekday, based on the final digit of their identity number, according to several we people interviewed in lines.
Each sale is registered by identity number and fingerprint to prevent people from going to multiple food lines, interviewees said. The amount of food and other basic goods—such as diapers, toothpaste, or toilet paper—subject to price controls that people can buy is strictly limited, if available at all, some interviewees said. For example, people can usually buy one kilogram of corn flour or rice, or two packs of diapers. Mothers standing in line told Human Rights Watch that to buy diapers, they had to take the baby or a copy of the birth certificate with them to the store.
Some items, like sugar and toilet paper, have disappeared from supermarkets for months at a time, they said. In Valencia, Human Rights Watch interviewed people in a line of hundreds waiting to purchase goods subject to price controls.
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The National Guard members and policemen guarding the line had written consecutive numbers on the arms of those waiting to prevent anyone from cutting the lines. In Barquisimeto, Omar Monroy, a man in his sixties who was standing in line and had a disability and a heart condition, told Human Rights Watch that he had arrived the previous day at 4 p. He said:.
Perhaps after the 14 hours that I spent overnight here, maybe I will get 2 kilos of corn flour for my family.
Maybe—because it is a lottery. My identity card ends in number seven, so I can make purchases once a week on this day. In my case specifically, because of my health, I only come every two weeks It has been four months since I last ate chicken. Accessing food subject to price controls is even more difficult for the parents of children with disabilities, who often cannot afford the time away from their children or do not have access to family support services in order to wait in long lines. Elaine Navarro, a year-old mother of four, was 8 months pregnant when Human Rights Watch researchers interviewed her.
She told Human Rights Watch:. The impact of food scarcity on the health of Venezuelans remains unclear, as no studies to assess its effects have been conducted to date. A national survey by civil society organizations and two Venezuelan universities published in March found that in , 12 percent of interviewees were eating twice or fewer times a day. Another national survey carried out by a consulting firm in August found that 40 percent of those surveyed had eaten twice a day, while More than half were unable to go to work because they had to go and search for food, A total of S everal doctors told Human Rights Watch that they were starting to see symptoms of malnutrition in patients that had not been present before the shortages began, particularly children, and that they were concerned about potential serious health consequences.
For example, a doctor said that the number of patients diagnosed with malnutrition or with illnesses associated with poor nutrition were on the rise and were reaching levels that he had not seen in the hospital since the s or s.
A doctor at another hospital said that due to the difficulties mothers face in obtaining adequate food, they were currently seeing newborns and babies under 6 months old who were malnourished and required special care. Similarly, community members and mothers told Human Rights Watch that it has become increasingly difficult to feed children. In Lara State, community members from two neighborhoods where hundreds of families live said children were fainting at school because they were not getting enough food. Maria Del Pilar Bosch, 59, who lives with her daughter and two grandchildren in Maracaibo, told Human Rights Watch that to buy a kilo of rice, they have to go to the black market, where they cannot afford it, or wait in line for hours, and even then, sometimes they cannot find it.
The CLAPs are charged with distributing, on a monthly basis, bags of goods that generally include limited quantities of items such as oil, corn flour, sugar, milk, pasta, rice, and margarine directly to the homes of Venezuelans who pay the lower, government-set price. The government claims the CLAPs have provided food to large numbers of people. A national survey conducted by a private consulting firm in August found that the CLAPs were the primary source of food for only 3.
The Venezuelan media has carried several stories alleging that the CLAPs have discriminated against actual and perceived government critics, including opposition supporters. Venezuelans who want to acquire a bag of goods subject to price controls fill out a form that asks them, among other things, whether they belong to the ruling party.
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This, she said, is making it very difficult for parents to feed their children. Word index: , , , More Expression index: , , , More Phrase index: , , , More Developed by Prompsit Language Engineering for Softissimo. Join Reverso, it's free and fast! Register Login. These examples may contain rude words based on your search. These examples may contain colloquial words based on your search. See examples translated by les ayudaba 5 examples with alignment.
See examples containing les he ayudado a 2 examples with alignment. But those people, I helped them too. I helped them rent the equipment. Someone needed me, And I helped them. My secret is if they kill me, it won't be because I helped them. They said they wouldn't charge me if I helped them out sometimes. Dijeron que no me iban a encarcelar si les ayudaba a veces. They said if I helped them , they would reduce my time in prison. I helped them adopt their daughter.
I know because I helped them do it. I helped them find the virus. So, I helped them out.