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Feature

Practising medicine amid chaos in Venezuela

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l2040 (Published 03 May 2019) Cite this as: BMJ 2019;365:l2040
  1. Mariana Zuñiga, journalist
  1. Caracas, Venezuela
  1. mariana.ch.zuinga{at}gmail.com

As the country falls apart, physician Oscar Noya struggles to provide medical care. Mariana Zuñiga finds him hard at work

When the Venezuelan infectious disease specialist Oscar Noya started his career almost four decades ago, he treated about 20 patients with malaria a year. Last year the number was 3500. He expects the number to be higher this year. In the past five years economic policy has left his formerly upper middle income country beset by poverty, violence, corruption, hyperinflation, and chronic scarcity of basic goods, leading to a humanitarian disaster.

Recently, a patient visited Noya with textbook symptoms for malaria: high fever, tremor, and chills. The young man, small and wiry with an odd indifferent look, had a good idea of what was ailing him—he’d already had many bouts of malaria in his lifetime. He was Noya’s third patient of the day to show malaria symptoms. In the dark and windowless waiting room, 10 other patients sat in silence.

“Before, it was one patient a month, or two at most,” Noya told The BMJ during a break. “Now it can be 50 a day.” Noya usually sees 15 to 30 patients or more a day in his small office in the Tropical Medicine Institute of Venezuela’s Central University in Caracas, most of them with malaria. A large painting of his mentor, former Venezuelan health minister Arnoldo Gabaldón, sees all.

Before the crisis

Noya arrived in Central University’s hospital, the largest public hospital in the city and known as El Clínico, in 1972. Working at the best hospital in the country was a source of pride that in recent years has faded away.

“It’s shameful and sad,” he says.

The building, mostly constructed in the 1940s, …

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