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Known unknowns: The challenge of collecting COVID-19 data in Venezuela

‘If you don't have accurate data, you cannot identify real problems, and plan for a response.’

People wait in line to receive food in Caracas, Venezuela
People wait in line to receive food on 30 April in Caracas, Venezuela. A lack of reliable data is making it difficult for organisations trying to respond to COVID-19, and other disease outbreaks, in Venezuela. (Manaure Quintero/REUTERS)

The World Health Organisation this week declared Latin America to be the new global epicentre of the coronavirus pandemic, and experts are warning that the real death toll in the region could be far higher than what is being reported, due to inaccurate or incomplete data.

While Brazil, Mexico, Peru, Chile, and Ecuador appear hardest hit, it’s difficult to measure the extent to which COVID-19 is taking hold in a country like Venezuela that was already data-poor and engulfed in a humanitarian crisis long before the pandemic arrived. 

Official records show 1,952 confirmed coronavirus cases and 20 deaths as of 3 June. But Venezuela’s Academy of Physical, Mathematical and Natural Sciences published a report in May stating that the low numbers of COVID-19 cases appear inconsistent with the real scale of the epidemic. Venezuelan authorities have called for an investigation of the Academy.

Health workers and journalists have become a lifeline for providing information in a country that stopped producing official health statistics three years ago. But they also face censorship and attacks as they attempt to chronicle the spread of the new coronavirus, while aid and NGO workers struggle to plot a course of action without the necessary facts.

“We are in the dark. Citizens don’t know what is happening in Venezuela, and there is no reliable information for the NGO sector,” said Beatriz Borges, executive director of the Centre for Justice and Peace, a Venezuelan human rights organisation known as CEPAZ.

According to Borges, the lack of information “is a policy, and was a problem even before the COVID-19 crisis broke out in the country”.

Mariana Souquett, a health journalist for an independent Venezuelan news outlet focused on human rights called Efecto Cocuyo, said journalists have to sift through a lot of official misinformation, conduct extensive fact-checking, and do their own legwork to get more realistic statistics about COVID-19. The government releases a tally of confirmed cases and deaths, for instance, but does not share information about the numbers of tests performed or suspected cases.

“We are in the dark. Citizens don’t know what is happening in Venezuela, and there is no reliable information for the NGO sector.” 

“The authorities hide statistics and vital population data. In the last few years, that opacity has prevailed as a government policy,” said Souquett. “We don’t know the current numbers for malaria, measles, diphtheria, HIV, and child mortality either.”

NGO workers warn that incomplete or missing data prevents decision-makers from developing adequate public policies. Accurate and transparent data is crucial for both research and humanitarian aid, and is useful for both local community and international organisations. “If you don't have accurate data, you cannot identify real problems, and plan for a response,” said Borges. “Not having data is almost like being blind.”

The Health Ministry stopped publishing epidemiological bulletins in May 2017. The last available government statistics, for 2016, revealed a 30 percent increase over the previous year for infant mortality and a 65 percent increase in maternal mortality. Former health minister Antonieta Caporale was fired by President Nicolás Maduro after releasing that data.

Physicians, nurses, journalists, and representatives of health labour unions have also reported being arbitrarily detained for publishing information about cases of respiratory illnesses.

“Obtaining data from public institutions has become a task that is almost impossible to do,” said Daniela Alvarado, the general coordinator of the Institute for Press and Society (IPYS) in Venezuela. “They do not publish the information they collect, and, for fear of retaliation, they do not name their sources.” 

The arrival of COVID-19 has brought new challenges at a time when NGOs were already impeded from operating at full capacity to address the pre-existing health crisis in Venezuela, which suffers extreme shortages of trained staff, equipment, and medical supplies.

The struggle to reach those in need

On 16 March, the Maduro regime announced restrictions on movement between Venezuelan states and cities to contain the spread of the virus. The next day, his government suspended all international travel. Land borders with Brazil and Colombia are also closed.

Feliciano Reyna, director of Acción Solidaria, a Caracas-based non-profit that specialises in medicine distribution, told The New Humanitarian that the restrictions on personal movement have combined with months of gasoline shortages to add layers of complexity both for assessing the COVID-19 crisis and responding to it.

Acción Solidaria receives aid from abroad that it then distributes through 114 organisations across Venezuela, using a network of 47 physicians at 28 hospitals. Prior to COVID-19, Reyna said his organisation was able to distribute 80,000 treatments each month for maladies ranging from diabetes to hypertension, and that 150 people would visit the NGO’s office each day. Now, with COVID-19, the organisation is fighting to distribute just 20,000 treatments per month and only 30 people visit its office each day.

“Even though we still receive distributions from abroad, our distributions around the country mostly stand still,” said Reyna. “We have been able to hand out supplies to two or three hospitals at maximum. The roads are controlled by the military, and the instructions are not always clear for all; even if you respect safe conduct restrictions, there are still difficulties with regard to mobility.” 

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But it is harder still when you don’t know where the needs are.

“The possibilities of getting information from independent sources, like technical groups working in the field of information management, is very difficult,” said Reyna. “We try to get information from the ground, but given the risks involved and the restrictions in place, sourcing information thanks to observatories and other tools is risky, as the exercise of power in place is restrictive of liberties.”

Journalists and civil society organisations in Venezuela are hoping that international agencies can help narrow information gaps amid the dearth of reliable government data.

Reyna said he and others have been advocating for the World Food Programme to be brought back into the country to improve logistics and information-gathering. Last year, WFP was invited by the government to conduct a food security assessment to estimate the needs and vulnerabilities of households. The UN agency said it had full independence to design and implement that assessment, and that it had access countrywide to collect data at the household level without any impediment or obstruction.

In its food security assessment, via 8,300 questionnaires, WFP showed that a third of Venezuelans did not get enough to eat. 

Independent data collection

International aid organisations say they have long collected their own data to better assess needs in Venezuela, and that these efforts continue during the COVID-19 pandemic.

“Our teams carry out assessments and collect data; we create our own records,” said Luis Farias, head of communications at the Venezuelan Red Cross. “Our volunteers reach out to local communities and assess their individual needs, as different states might struggle with different problems.”

The International Federation of Red Cross and Red Crescent Societies (IFRC), which coordinates with the Red Cross in Venezuela, has made an effort to communicate both with the Maduro government and the opposition.

“Where there's a lot of controversial issues between the opposition and the government, the risk of relying on information provided by either of these sides is that this decision could be used politically at a local or national level,” said IFRC spokesman Tommaso Della Longa.

Della Longa says that in Venezuela, the IFRC uses “a system” that allows all stakeholders – civil society, religious institutions, opposition groups and the government – to see where the organisation’s medical aid is delivered and used. 

“While the data gathered locally is still relevant, it doesn’t give a full picture of the situation in the country. Official data before and during the COVID-19 crisis has been questioned by numerous NGOs.”

Lucia Arguellova, head of Latin America programmes at People in Need, a Czech-based NGO that supports civil society development in Venezuela, said her organisation also relies heavily on the limited information collected by local civil society groups and universities.

“While the data gathered locally is still relevant, it doesn’t give a full picture of the situation in the country. Official data before and during the COVID-19 crisis has been questioned by numerous NGOs,” she said. “This is one of the reasons why it is so complicated for any international organisation to detect places where aid is needed the most, and plan for any larger humanitarian action.”

Organisations such as CEPAZ, which recently released a report about the alleged persecution of human rights defenders during the COVID-19 crisis in Venezuela, have also been conducting independent research to produce their own data. 

Collaboration among stakeholders can help fill data holes for multiple human rights issues in the country, such as incidents of violence against women. 

Suspecting that violence against women may be on the rise during the country’s worsening humanitarian crisis, and that this violence is underreported by the government, NGOs, including CEPAZ, launched an independent monitoring tool this year. To carry out the research, the organisations gathered media reports and cases reported to NGOs in the country, and then compared them to official statistics. The groups found that, on average, a woman was murdered every 36 hours in Venezuela during the first three months of 2020.

“While we know that our data may not be complete, we have tried to show the reality of cases,” said Borges. 

Prior to the arrival of COVID-19, Efecto Cocuyo quoted medical associations and professionals who said that official health data was unreliable and untrue, contrary to the government’s claims that the health system is “the best in Latin America”. Health experts from Alianza Venezolana por la Salud (AVS) have also reported chronic malnutrition, as well as worrying increases in malaria, tuberculosis, and maternal mortality. 

“Every society should have access to information on issues that have an impact on people's lives,” said the IPYS press institute's Alvarado. “Data allows people and policymakers to take responsibility, and to make better decisions.”

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