In Venezuela, dialysis, a race against death

No one speaks, regular car calls seem to impose silence. Fifteen patients are waiting for their dialysis to end at a Caracas hospital.

Hypertensive and diabetic Juan Villamizar, 65, was relatively lucky: he found a place in a community dialysis center. In Venezuela, which has been hit hard by the economic crisis for eight years now, and where the civil service is in a difficult position, finding a place to get dialysis is not an easy task.

A few weeks ago, a spike in blood pressure sent him to the emergency room. He spent twenty days in the hospital.

Diagnosis: His kidneys are no longer working at 10% of their capacity. Then he had to find a place where he could do three dialysis sessions a week.

Due to lack of budget and machines, the university hospital that treated him reserves its own for hospitalized patients. For those who leave the hospital, severe trials begin.

“It’s dramatic (…) There aren’t enough centers,” says Mr. Villamizar.

He owes his place at the Hugo Chavez Dialysis Center in Caracas to the perseverance of one of his sons, Edwin, who spent weeks knocking on the doors of dozens of hospitals, clinics and centers.

Every time the same litany: “There is no place.” The nurse’s response marked him: “Put on the waiting list if someone dies…”

Juan Villamizar, whose kidneys are only 10% working, settles with the help of his daughter in a hospital room in Caracas, March 16, 2022 in Venezuela (AFP – Pedro Rances Mattei)

Those with the means and/or good insurance can practice privately, where each session costs around $1,000. Impossible for the Villamizar family, as it is for most Venezuelans.

According to a report by the Coalition of Organizations for the Right to Health and Life (Codevida), the healthcare system for people with kidney problems has “collapsed” since 2015. “A consequence of the dismantling of basic medical institutions and services,” the NGO said.

– 5000 deaths? –

Approximately 15,000 Venezuelans were treated through Social Security’s dialysis program in 2016. “Many of these people have died. Today (…) there are less than 6,000 patients,” said Francisco Valencia, director of Codevida, AFP.

A patient in a wheelchair leaves the hospital after dialysis on March 16, 2022 in Caracas, Venezuela (AFP - Pedro Rances Mattey)
A patient in a wheelchair leaves the hospital after dialysis on March 16, 2022 in Caracas, Venezuela (AFP – Pedro Rances Mattey)

There are no official numbers. Carlos Rotondaro, a former health minister accused of corruption and now opposed, estimates that 5,000 patients with kidney problems died between 2017 and 2019.

The Concepcion Palacios maternity hospital, one of the largest in Caracas, has only one dialysis machine, and it only works because the patient’s family paid for the repairs.

The “collapse” occurred before the imposition of international sanctions against Venezuela, Mr. Valencia says, while the authorities attribute the flaws in the health care system to sanctions imposed by Washington and part of the international community in protest against the re-election of President Nicolas. Maduro in a vote boycotted by the opposition.

The authorities are trying to correct the situation by reactivating individual centers. A few days ago, he opened a dialysis center and a transplant center, another health sector hit by the disaster.

Juan spends an average of three hours per session in the dialysis room. The patient notes that sometimes there is a lack of water in the center. It does have a 10,000 liter cistern, but the frequent drawdowns in the country mean it can empty faster than it fills…

A nurse watches a dialysis patient with kidney failure at a Caracas hospital on February 24, 2022, Venezuela (AFP - Yuri CORTEZ)
A nurse watches a dialysis patient with kidney failure at a Caracas hospital on February 24, 2022, Venezuela (AFP – Yuri CORTEZ)

Another difficulty is the lack of staff. Thousands of doctors and nurses are among the five million people who have fled the country since 2015. “We have cases where families or the patient themselves have to connect the patient to the machine,” says Mr. Valencia.

Juan has another problem: he has a slight fever, and his relatives think that the catheter placed in his chest (and which he connects to for each session) has become infected. I would like to change to another on the hand, where it will be more convenient. But it costs $120. Too expensive.

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