The United Nations is being urged to declare a full-scale humanitarian emergency in Venezuela in the light of the “utter collapse” of its health system and widespread food shortages.
A major report by Human Rights Watch and Johns Hopkins Bloomberg School of Public Health details the scale of the humanitarian disaster unfolding in Venezuela, once one of the richest countries in South America but now in the grip of a severe economic and social crisis.
It says that health services have been in decline since 2012 – a year before current president Nicolas Maduro took office – but the crisis has accelerated since 2017.
As the emergency has deepened – with supermarket shelves empty and hospitals unable to get hold of basic medical supplies – the president has refused offers of help from outside and protest within the country has grown.
The report, based on interviews with more than 150 health workers, Venezuelans who have fled their country and UN and civil society officials, describes a health care system in “utter collapse”.
The report highlights increased levels of infant mortality, with a study in the Lancet Global Health showing that in 2016 the infant mortality rate was 21.1 deaths per 1,000 live births, compared to 15 deaths per 1,000 live births in 2008 - these high rates show the "degradation" of the health system over a period of time, said Professor Paul Spiegel, director of the Johns Hopkins Center for Humanitarian Health.
Vaccine-preventable diseases have also re-emerged in the country: there was a single case of measles recorded in Venezuela between 2008 and 2015 but by February 2019 there were 9,399 reported cases and 76 deaths. Diphtheria and polio have also re-emerged.
Malaria is also on the rise with the number of cases increasing from nearly 36,000 in 2009 to more than 414,000 in 2017, according to figures from the World Health Organization. The increase in malaria is also a worry to neighbouring countries such as Brazil and Colombia which have made progress in the fight against the disease.
Food shortages and empty shelves have been a hallmark of the crisis and a report by the UN’s Food and Agriculture Organization showed that between 2015 and 2017 11.7 per cent of Venezuela’s population - around 3.7 million people - was undernourished, an increase from less than five per cent between 2008 and 2013.
Rates of severe and acute malnutrition have also increased with one hospital in the interior of the country recording 600 admissions of children under the age of five with acute malnutrition in 2016, compared to less than 200 in 2012.
One survey showed that 89 per cent of households did not have enough money to buy food and 61 per cent of those interviewed went hungry.
The report also highlighted shortages in hospitals: a poll of 104 public hospitals and 33 private hospitals showed that 88 per cent had reported shortages of drugs and 79 per cent reported a lack of surgical supplies.
The government has been in denial about the crisis and "has hidden health statistics and data, harassed health professionals who speak out about the reality on the ground, and made it harder for sufficient humanitarian assistance to reach the Venezuelan people", warns the report.
The authors urge the UN to declare the situation a humanitarian emergency, which would trigger a full-scale response and the provision of food, medicines and medical supplies.
Prof Spiegel said that the crisis should be declared a level three humanitarian emergency - that is, a system-wide emergency and one similar in scale to that of a war-torn country such as Syria or Yemen.
"The return of diseases such as diphtheria, measles and malaria shows how far in terms of public health a middle income country like Venezuela has degraded. You wouldn't expect these diseases unless it's been a long time without vaccinations and basic access to public health," he said.
"This situation is so severe and affecting not just Venezuela but also the surrounding countries such as Brazil and Colombia, whose health services are extremely taxed, that it's time to make very clear that this is a large-scale emergency.
"We would ask the secretary general and the emergency response co-ordinator to speak out and say it's time to allow us to move in and help," he said.
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