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Hunger, healthcare, and schools: Reasons to leave Venezuela (along with a Maduro poll win)

‘We are facing the exhaustion of survival capabilities.’

Three people are photographed as they walk in front of a school with the image of Hugo Chavez on the wall. Iván Reyes/TNH
People pass in front of a Caracas school with an image of Hugo Chávez on the wall. Under Chávez's successor Nicolás Maduro, Venezuelans have endured an economic collapse, increased repression, and a humanitarian crisis.

A month ahead of Venezuela’s pivotal presidential election, uncertainty about the future is peaking as people across the country wrestle with increasing authoritarianism and the all-encompassing fallout of an unrelenting humanitarian crisis.

Everything will be on the line on 28 July, when citizens have to pick between President Nicolás Maduro, who won an election widely seen as fraudulent in 2018, and opposition candidate Edmundo González Urrutia.

The campaign has been tense. Maduro banned María Corina Machado from running after she overwhelmingly won the opposition primary and has since intensified his repression against other opposition members, activists, journalists, and NGOs.

Many fear Maduro will steal the election again and are considering migrating if there is no change of leadership. A recent poll conducted nationwide by research firm Delphos showed that about 25% of those polled were considering migrating for economic reasons. Of those, 47% said they would stay if González wins.

Since 2015, the rapid deterioration in humanitarian conditions has led more than 7.7 million people to leave – one of the largest displacement crises in the world. Most migrants and refugees have moved to other Latin American countries where they often live in poor conditions due to lack of opportunities and mounting xenophobia. In 2023, at least 328,000 Venezuelans – more than double the previous year – took the treacherous Darién Gap route to Central America; most of them trying to reach the United States.

“There is an endless circle of overlapping deficiencies that make it more difficult to cope with needs and put people in a continuous situation of vulnerability.”

On 23 June, Maduro called on migrants to return home, promising “growth, prosperity, wellbeing, and humanity”, and announcing the appointment of a new migration minister to help them do so. Conditions within Venezuela suggest it’s unlikely many will.

The 28.8 million people who remain in Venezuela are faced with soaring prices due to inflation rates that were until recently among the highest in the world, and a monthly minimum wage frozen at less than $4. A de facto dollarisation has failed to boost the economy, and the lack of basic services – once limited to the regions and rural areas – is now affecting the capital, Caracas, as well.

“[There is] an endless circle of overlapping deficiencies that make it more difficult to cope with needs and put people in a continuous situation of vulnerability,” said Jo D’Elia, director of the human rights NGO Civilis and a member of HumVenezuela, which monitors and provides data on the humanitarian emergency.

“We are facing the exhaustion of survival capabilities, as well as the traumas and consequences of violence and exploitation,” D’Elia told The New Humanitarian.

Chronic malnutrition sets in

Maduro long denied he is presiding over a humanitarian crisis. Facts tell a different story. Until 2011, there was little to no hunger in Venezuela, but more than five million people now suffer from undernourishment – the highest level in South America.

Since 2015, GDP has fallen by 80% and the minimum wage by 95%, according to the NGO Provea. While Maduro blames the impact of sanctions imposed by the US and others, experts say economic mismanagement and corruption are the chief culprits.

Food scarcity has decreased, but 70% of processed food is now imported and therefore more expensive. With livelihood losses affecting nearly 70% of the population in 2023 – and high inflation – many families find it impossible to meet their basic food needs.

Fuel has become scarce and hard on people's wallets. Filling up a tank of gas at the subsidised price may be cheaper, but you need to wait hours – sometimes days – in long queues to do so. Paying international prices means spending at least $20 when the minimum wage is less than $4. This has also affected agricultural production and food distribution in rural areas, where it’s even harder to get by.

Susana Raffalli, a nutritionist who specialises in food security management, humanitarian emergencies, and disaster risk, said 60-80% of people in poor areas have resorted to negative coping strategies, such as selling belongings to buy food.

Imara Rodríguez, a 37-year-old mother of five with no steady job, said she goes to a trash dump in Caracas every day to scavenge for items of any value she can sell to buy food for the three children who still live with her.

"With what I get, I buy rice, eggs, and some vegetables. That's what my children eat every day,” she told The New Humanitarian.

The money she makes isn't enough for her food needs as well, so she has to eat what she can find on the street. She tends to go to the same spot on one of the main roads, where leftovers of fried chicken from a US fast food chain are discarded on the ground. She is not the only one who scavenges there.

“I don't give it to my children because it might upset their stomachs,” she said.

The day she spoke with The New Humanitarian, Rodríguez had only eaten some mangos and some potato chips she had found in a garbage bin.

“When we talk about young girls, the result is an epigenetic process that could even be inherited by her future children, or that could lead to death during her future pregnancy.”

According to HumVenezuela, the percentage of food insecure people in 2023 was similar to the previous year. However, the number of extremely undernourished and malnourished people increased significantly: Those who went permanently hungry at times during the year rose from 14.4% to 22.3%. Additionally, 86% of the population reported not having enough money to buy the food needed in their household.

Especially worrisome to nutrition and health experts is that chronic malnutrition is surging among children, leading to stunting, wasting, delayed cognitive development, and higher risks of illness more generally.

“Their mothers bring them month after month. We give them treatment. The children reach an adequate weight, they leave, and it’s not long before they come back for another round of treatment,” said Katherine Martínez, founder and director of Prepara Familia, an NGO that assists children and adolescents.

For Raffalli, it’s an underacknowledged issue, and one that carries hidden consequences for mothers.

“The Venezuelan government says that we face 10% chronic malnutrition, but UNICEF claims it’s more likely to be 27%,” Raffalli told The New Humanitarian. “When we talk about young girls, the result is an epigenetic process that could even be inherited by her future children, or that could lead to death during her future pregnancy.”

All this, said Martínez, is forcing humanitarian workers to redefine the assistance they bring: “It means our work has to focus on closer monitoring of families who come to us for support.”

Where’s the international aid response?

In its 2023 yearly report, HumVenezuela reported that 20.1 million people required humanitarian assistance and protection – 400,000 more than in 2022.

During the first half of last year, only 14% of the UN’s Humanitarian Response Plan (HRP) was funded, making it the second most underfunded globally. The level of response improved during the second half, allowing 52.9% of the HRP to be funded.

International aid groups, such as the Pan American Health Organization, USAID, the World Food Programme, and a number of other UN agencies, among others, operate in Venezuela. But they face constant interference and harassment from the government.

The assistance provided isn’t nearly enough to meet the needs.

Last October, UN Secretary-General António Guterres gave the green light for the UN to start administering a trust fund worth an estimated $3 billion to address emergency needs in Venezuela. The funding would come from Venezuela’s frozen assets abroad.

The trust fund, however, was tied to political negotiations between Maduro's government and the opposition. On 17 October, the same day the authorisation to create the trust fund was made public, Maduro and the opposition signed an agreement in Barbados, paving the way for free elections to take place this year and prompting the US to ease Venezuela's oil sanctions.

But as the opposition gained strength, Maduro started disregarding the Barbados accord, the US reinstated the sanctions, and the trust fund has been left in limbo.

At the time of publication, only 9.5% of Venezuela’s HRP for 2024 had been funded.

A denied healthcare crisis

The collapse of the healthcare system has been one of the most obvious and drastic aspects of Venezuela’s humanitarian crisis.

Unprecedented spikes in rates of maternal and child mortality were noted as early as 2016. The following year, Maduro, who denied the severity of the situation, fired his health minister after she disclosed that the number of women dying in childbirth had risen by 65% in less than two years, while child deaths had increased by 30%.

After a decade of underfinancing that saw an exodus of medical professionals and a rapid decaying of infrastructure, the capacity of Venezuela’s health services was already estimated to have been reduced by 70% by the time COVID-19 hit. The pandemic drove that figure to more than 80%, according to HumVenezuela.

Andrea, a nurse at the Ana Francisca Pérez de León Hospital in the Petare neighbourhood of Caracas, said the worst years were between 2015 and 2021. During that period, many doctors left and sometimes only nurses tended to the patients.

“I know many nurses who take up to four jobs to be able to feed their families.”

The situation at her hospital has improved a little since, with young specialists being hired, but even so only some of the operating rooms are functioning and there’s still no blood bank, said Andrea, who requested her name be changed for safety reasons.

Shortages of vital medicines, hospital beds, and equipment – along with poor maintenance of decrepit infrastructure, and the closure of many services due to staffing issues – are all too common across the country.

According to the NGO Convite, medicine shortages in general reached 28.4% by March 2024, and in at least two of the ten hospitals visited by the organisation, there was no treatment for six of the most common problems: diabetes, infectious respiratory diseases, diarrhoea, hypertension, depression, and seizures. Today, 89.7% of the population is dependent on a public health system they can't rely on, according to HumVenezuela.

The lack of electricity and running water also undermines health services, as do poor wages – some of the lowest in the region.

“The salaries are horrible. We earn the minimum wage, like everyone else now,” said Andrea. “I know many nurses who take up to four jobs to be able to feed their families.”

Public workers and retired Venezuelans who receive a state pension are granted an extra $40 bonus for food from the government. Additionally, in 2017, Maduro created the “economic war bond” for pensioners and public workers, to counteract what he said were the effects of sanctions. He raised this bonus from $60 to $90 last month, likely in an attempt to gain popularity ahead of the election. The government also distributes subsidised food aid in what are called CLAP boxes.

But the total income still isn't nearly enough for most Venezuelans to meet the cost of living. A basic food basket costs more than $500, and the minimum wage hasn’t been raised in two years.

Maritza Moreno, president of the College of Nurses in Caroní, told The New Humanitarian that power cuts and water shortages have seriously affected healthcare in her town, which is located in the northwestern state of Bolívar.

“Power generators are reserved for certain hospital services, such as the operating room, intensive care, and the emergency room, while the other services are in failure,” she said.

In its latest survey, Médicos por la Salud, a network of doctors who monitor and document the health crisis, found that four in ten operating rooms nationwide no longer function. Shortages of surgical supplies were at 74%, and of emergency supplies at 37%. Patients undergoing simple surgery had to spend more than $80 of their own money to buy the surgical supplies needed. 
Food insecurity and the lack of basic services also compound the healthcare crisis. For instance, four in ten hospitals can’t feed paediatric patients under two, while water shortages fuel the spread of bacteria and hinder water-dependent treatments such as dialysis.

Power cuts and water shortages

Access to basic services has been highly deficient for years and shows little to no sign of improvement. Gas provision did increase a little in 2023, but access to water and power deteriorated.

Nearly 20 million people now face severe water restrictions, and 86% of the population is exposed to water deemed unsuitable for human consumption, putting them at risk of diarrhoea and other diseases.

Years of government mismanagement, international sanctions, and the economic collapse have exacerbated the power crisis. Venezuela’s grid collapsed completely in March 2019, plunging the country into a week-long blackout, but more than five years later Venezuelans still face daily power cuts.

In 2023, blackouts affected nearly 62% of the population, compared to 25.9% in 2022, bringing activities to a standstill and sometimes putting lives at risk in hospitals.

Liliana Rivas, a 23-year-old student in the northwestern city of Mérida, faces all these challenges. She said she is luckier now as gas trucks do sporadically reach her neighbourhood; but a few years ago she had to cook over a wood fire. She still only has running water from 5-9am and from 7-9:30pm.

The worst part, she said, is the power cuts. In addition to studying, she works as a journalist and experiences anxiety attacks and sleep issues when she has to turn in big assignments under deadline.

“There is no schedule for [the daily power cuts]. It's unstable. Sometimes it's for four hours twice a day,” she told The New Humanitarian. “It affects my work, because with eight hours out of power I can’t be that productive, and when there is power I am always afraid it will go away, that my equipment may burn out. It's intense workwise and emotionally.”

Little schooling means bleak futures

Education has taken a big hit too. Reports show that dilapidated infrastructure, the lack of teachers and of public transportation – combined with the shortcomings of the school meals programme – are driving many students away.

The impoverishment of families due to high inflation is also forcing children to drop out of school to work. In 2023, 40% of students between the ages of three and 17 attended school irregularly.

Teacher shortages due to the exodus have forced public schools to give classes only two to three days a week. In 2023, nearly two in three children had abandoned school or were at risk of dropping out, according to HumVenezuela.

Daniela Verdú, who lives in the low-income neighbourhood of Guatire, on the outskirts of Caracas, told The New Humanitarian that the lessons her 12-year-old daughter gets are insufficient. She said teachers choose to work only on certain days to put pressure on the government to raise their pay. Many also have to take other jobs to make ends meet. “There are teachers who sell cakes, cookies, or things like that,” she explained.

“Children may go to classes every day one week but not have any class the month after,” she added. “Education is terrible.”

Edited by Daniela Mohor.

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