Venezuela's Political Medical Services

"There was oxygen, but they didn't let me use it [on elderly patients with heart failure urgently requiring oxygen]."
"I argued with my colleagues over and over. Yes, of course there was oxygen, but they didn't let me use it [to save a life if it was the life of an opposition supporter]."
"The theme was chronic illnesses, the ones where you would die if patients didn't get medicine, and that's how they [the Maduro administration] controlled people." 
"When the elections came, everything appeared: medicine, gas, dressings for bandages, injection serums."
Dr. Yansnier Arias, Cuban doctor working in Venezuela

"You arrived with vitamins and some pills for blood pressure [or the like]."
"And when you started to gain their [patients'] trust, you started the questions: 'Do you know where your voting place is?"
"Are you going to vote'?"
Dr. Carlos Ramirez, Cuban doctor assigned to work in Venezuela

"The Cuban government wants to make sure the Venezuelan regime survives and is willing to do anything in their power to support Maduro."
"It is unspeakable."
Jose Miguel Vivanco, director, Human Rights Watch Americas program

"They come to your house they ask you a series of questions, and you start to think, if I answer 'no', they can cut me from health care."
"It just leaves you overwhelmed."
Unidentified Venezuelan patient

A Cuban doctor treats a patient in Venezuela.

(Fernando Llano/AP)

Cuban doctors who were dispatched under Cuba's program of humanitarian aid to undeveloped and struggling countries to provide them with Cuba's famous 'barefoot doctors' program, set out at their country's behest to help the medically vulnerable, and many, with exposure to the corruption in Venezuela, have found it impossible to carry out their mission of providing optimum, unbiased and expert medical expertise to patients. Venezuela uses the cudgel of withholding care to any of its health-impaired citizens who fail to commit to supporting the Maduro administration.

For Dr. Hansnier Arias who had worked initially in Venezuela under Hugo Chavez, sent there by the government of Cuba, one of thousands of doctors the socialist country routinely deploys in ties between other countries, knew his medical skills could help Venezuelans at a time that its medical system was beginning to collapse. It soon became obvious to him, however, that President Nicolas Maduro's intention was that not everyone would be treated.

When last May's national election was on the cusp, orders were that Maduro must win the vote, whatever the cost. And that cost meant that Maduro needed to ensure votes would come his way, so a dwindling food and medicine, and treatment supply was awarded supporters and denied opponents supporting the opposition. And that determination embroiled Cuba's international medical corps. The system so offended 16 members of the Cuban medical mission to Venezuela that they abandoned their positions.

Cuban doctors at the Jose Marti International Airport in Havana, Cuba on November 23, 2018. REUTERS/Fernando Medina

Ordered to a door-to-door mission throughout impoverished neighbourhoods, the Cuban doctors were instructed to offer medicine to people and at the same time warn their patients that medical services would be cut should they choose not to vote for Mr. Maduro and his candidates. "These are the kinds of things you should never do in your life" a former Cuban supervisor stated under the condition of anonymity.

Dr. Ramirez, a dental surgeon, treated Venezuelans who had never had dental services ever before and revelled in his work in the country. And then came the order to spend weekends along with other medical workers handing out medicine and enlisting voters for the Socialist Party of Venezuela. Because of their abhorrence of this practise in manipulating people's human rights, those 16 Cuban medical personnel publicly revealed the Maduro practise of mixing medicine and politics.

Voters register with members of the ruling United Socialist Party before proceeding to a polling post to vote in presidential elections in Valencia, Venezuela, Sunday, May 20, 2018. (AP)

Health care in Venezuela, according to a new Constitution dated 1999, is considered a universal right. And with that recognition Venezuela turned to Cuba to launch medical missions in their country. Those missions to over 60 countries represent a proud tradition for Cuba and also a very remunerative one, gaining it an estimated $8 billion in cash over time. In Venezuela's case, their medical mission from Cuba was paid for with oil.

The doctors described an identification system named the "homeland card" which the Socialist Party used for entitlements to food subsidies and for voting id. Doctors were instructed to register people for the cards. The cards became a symbol to people of the government's heavy-handed control. That the use of the cards would enable the government to determine how they had voted and then restrict their food as retaliation.

One epileptic patient in the hospital who required treatment refused the homeland card, to Dr. Arias's recollection. She was then sent away without medication "Because she was from the opposition". Dr. Arias left Venezuela for Chile, where he plans to remain. He works now cleaning floors in a hospital since professional work as a doctor has eluded him. "If I can't be a doctor, I at least want to be a person", he declared.

"With [late President Hugo] Chavez it had been hard, but with Maduro, starting in 2013, it was worse."
"It became a form of blackmail: ‘You’re not going to have medicine. You’re not going to have free health care. You’re not going to have prenatal care if you’re a pregnant woman'."
Cuban doctor

Two weeks after 3-year-old Ashley Pacheco scraped her knee, she was fighting for her life as her family scoured the city for rare antibiotics.

(Ariana Cubillos/AP)