Around 13,000 doctors have left Venezuela since 2003, and the vacancies have gone unfilled, said Dr. Douglas León Natera, president of the Venezuelan Medical Federation, in an interview with a local radio station last week. It’s a sizable chunk of the medical community: The federation’s most recent census estimated there were about 70,000 Venezuelan physicians in the country in 2007, 25,000 of whom have died or retired since then, León Natera said. The South American nation's population is about 30.4 million.
The crisis in Venezuela’s healthcare sector is “gradually worsening,” he said.
Venezuela’s healthcare sector had already been struggling with medical supply shortages and funding gaps at hospitals, but last year’s steep drop in the global price of crude oil -- Venezuela’s primary source of income -- has cut the already shrinking budget for medical supplies and hospital expenses, prompting more healthcare professionals to leave.
“The budget for healthcare has diminished significantly,” said Dr. Jose Antonio Cisneros, a physician from Venezuela who has been practicing in the United States for more than 20 years. “There are fewer resources to import technology and bring in drugs that are necessary to keep up the quality of care.”
The outflow of doctors is part of a larger exodus of Venezuelan professionals, including engineers who once ran the country's sizable petroleum sector, who are able to market their skills elsewhere. Analysts warn that inflation could climb near 200 percent in 2015, while the International Monetary Fund projected a 7 percent contraction in the gross domestic product. Meanwhile, festering crime and hours of waiting in supermarket lines for scarce goods have weaved into Venezuelans' daily lives.
The impetus to leave is increasingly affecting younger physicians coming out of medical school. Medical students and recent graduates, frustrated by the lack of resources and opportunities to advance professionally, are looking overseas to finish their education and build out their careers, as they see dimmer futures in Venezuela.
But the exodus may be leading to an alarming void in Venezuela’s healthcare sector. “In a few years, you’re going to find a gap,” Cisneros said. “You’re going to either have young doctors coming right out of medical school, or doctors who are too old. Doctors between the age of 35 and 50 -- the most productive times for a physician – are going to be just gone.” The best students are the first to leave, he added.
Pablo Pérez d’Empaire, a Venezuela native who’s currently an anesthesia resident at the University of Toronto, agrees that's where the healthcare sector is heading. “Before I left, I heard a lot of my professors and teachers in medical school saying, ‘I don’t know who’s going to be taking care of us,’” he said. He moved to Canada five years ago, fueled by a desire for professional growth and wariness of the increasing crime and instability in Venezuela.
The economic crisis has already taken its toll in the health sector in extreme ways. Some hospitals reportedly began performing more mastectomies in recent months to treat breast cancer because they were unable to get reliable access to radiation machines. Venezuelans unable to get access to prescription drugs have also turned to social media to barter for medications.
Last year, Venezuela also saw a resurgence of diseases that had long been eradicated. Malaria resurfaced for the first time in 50 years, and dengue fever cases rose nearly 50 percent in 2014 from the year before. The chikungunya virus, a similar mosquito-transmitted disease, also began spreading through the country.
Some of the frustration in the medical community stems from the beginning of Hugo Chávez’s presidency, when his government pioneered a social program known as Barrio Adentro designed to bring healthcare access to poor communities. It was popular among the poor, but also created a parallel system of medical training that critics say is much weaker than traditional medical education in universities and graduate schools.
The administration’s emphasis on those programs, based heavily on primary care, turned government attention away from the traditional health system, including hospital-based and specialist care. The fact that the administration also brought in Cuban medical professionals for the Barrio Adentro program, in exchange for heavily discounted Venezuelan oil, sowed more resentment from Venezuela’s medical community. (Hundreds of Cuban doctors have also defected from their posts in Venezuela and ended up in the U.S. through a special parole program.)
As traditionally trained doctors find options outside of Venezuela, patients will eventually rely more on those community doctors from the parallel system, said Adriana Tami-Grundmann, a doctor from Venezuela now working at the University Medical Center Groningen in the Netherlands.
"The doctors who have experience and can train the younger generations, they are leaving," she said. "The country will keep these new doctors who are not well trained, and it's a huge danger for health. Patients don't know which are trained in the new Bolivarian system or in the traditional, proper university system."
As public hospitals began to feel the economic squeeze, much of the burden shifted to private hospitals and clinics in recent years, overwhelming facilities and burdening doctors with heavier workloads. Exchange rate fluctuations and import restrictions have also prevented those facilities from accessing equipment and supplies they need.
Students who have excelled in school and are proficient in English can generally make their way into the U.S. healthcare sector without much difficulty, Cisneros said. He noted that aging baby boomers and the addition of millions more insured Americans through the Affordable Care Act have amplified U.S. demand for doctors that foreign medical professionals can fill.
But Pérez d’Empaire said a job in the U.S. isn’t always guaranteed. “Unfortunately, spots are not always available for people who want to leave,” he said. Some people unable to get opportunities in other countries have instead gone into research or education -- or changed fields completely. “You can find physicians who are even driving a taxi because they have to support themselves or their families and are not able to practice medicine anymore,” he said.
While Venezuela’s doctor flight is part of the healthcare crisis, Pérez d’Empaire doesn’t think staying in the country will help the situation. “It’s out of their power,” he said. “Unfortunately, the government has shown that they’re not really interested in improving the conditions for traditionally trained doctors.”
Tami-Grundmann said many of her colleagues are still choosing to stay in Venezuela's public hospitals to keep quality care in the system. "Not everybody is fleeing," she said.
"But this is a humanitarian crisis that is happening in Venezuela," she added. "Thousands of people are dying every year, not only from violence but because of lack of healthcare."
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