VENEZUELA: Socialism does make you feel better!

August 10, 2005
Issue 

Stuart Munckton, Caracas

Having come to Venezuela to witness the revolution and the social missions at its heart, I ended up having a closer view of one of the most important missions — Barrio Adentro (Into the Neighbourhood) — than I might have hoped or cared for, when I was "lucky" enough to become one of the 1% of victims of travellers' diarrhoea to be hospitalised.

Barrio Adentro was established around two years ago to bring free, quality health care to the poor majority. In the past, doctors have mostly shunned the poor neighbourhoods, where people often can't afford the fees.

The Venezuelan government invited Cuban medical volunteers to help staff the clinics, after just 50 Venezuelan doctors raised their hands to participate. Most Venezuelan doctors — a product of the old system where doctors used their careers to make themselves more comfortable — declined the government's offer of a US$600 monthly stipend to bring health-care to the poor. The Cubans, who accepted $200 per month, have proven a big hit with the community. Not being in it for the money, but out of real humanitarian concerns, they treat their patients with genuine consideration and respect and have only their best interests at heart. Cuban doctors also teach courses at the free Bolivarian University. There are currently more than 20,000 Cuban medical personnel in the country.

The Venezuelan revolution is creating new ideals in people, and thousands are studying in the Bolivarian University to take the Cubans' places. It is a requirement of this free course, which requires only a year 12 certificate to enter, that those who graduate work in the poor areas, rather than use their skills to set up private practices to get rich.

While out travelling on a bus in the state of Bolivar with 10 other participants of the first Australian-Venezuelan solidarity brigade and a handful of Venezuelan comrades, I was struck down with a particularly bad bug. The usual antibiotic treatments didn't work and I got worse. It became impossible to even take medication, because I was throwing back up whatever I ate.

Private hospitals

Comrades decided to take me to a health clinic to get treatment. There was no Barrio Adentro clinic near where we were in Porto Ordaz, so they took me to the nearest private clinic. The first thing we were asked when we walked in was could we pay. The short answer was, without travel insurance, no way. I didn't have the money available myself, but another comrade helped out.

The doctor came and did a few basic tests, such as hit my stomach and take my blood pressure, and asked me some questions. The doctor then diagnosed me as having E. coli, which turned out to be wrong, and wrote some prescriptions. I was so dehydrated by this stage I was hooked up to a drip. It took no more than two hours, for which I was charged 250,000 bolivars, or a bit under A$200. On top of this, the antibiotics I was prescribed, which didn't work anyway, cost 64,000 bolivars (over A$40).

When we arrived back at Cuidad Bolivar, I was getting sicker still, and couldn't hold down the antibiotics. The comrades took me to a nearby private hospital that gave me various antibiotics via a drip. I had a large, private room with a TV and a bed for my partner to stay in, but the treatment was simply not working. The day-and-a-half I was there cost over A$1000, again way beyond my means.

After a day-and-a-half of not getting any better, the Venezuelan comrades were determined to take me to Barrio Adentro to be treated by the Cubans. The Cubans, looking over the treatment records, were extremely cynical about the private hospital, believing the staff had merely pumped me full of drugs and charged me money, regardless of whether or not I was getting better. They were shocked by the records of what medicines I had been given.

While I thought the Cubans' explanation sounded a little too cynical, one experience brought home vividly what is wrong with how the private hospital operated. One antibiotic in particular was making me throw up and when it was put in the drip in the middle of the night, when I had nothing in my stomach, it had caused me to throw up bile. The next day, my visiting friends explained repeatedly and with increasing urgency to the nurse who was about to put this drug in the drip that I had a violent reaction to it. But the nurse had her orders from the doctor and that was what she was going to do. Eventually she was persuaded to talk to the doctor, who told her to put the drug in the drip regardless. I instantly threw up, including the pills I had just swallowed. It was clear I wasn't going to get better very quickly with this sort of treatment, for which I was being charged an arm and a leg.

The Cuban approach

The Barrio Adentro clinic was built three months ago, part of the extension of the mission through Barrio Adentro 2. It is a modern, clean building staffed by 30 doctors and eight to 10 nurses. There are three hospital beds, plus two beds for intensive care. The doctors, as well as looking after the patients staying there, see people who visit the clinic in the mornings and go out on trips around the communities in the afternoons.

The doctors set me up with a much simpler drug regime, avoiding the drug that I had the reaction to, which they said was wrong anyway. I didn't have a private room and TV; I shared the room with two other patients. It was definitely not as luxurious as the private hospital, but I hadn't come for a holiday — I had come to get better.

The treatment I received from the Cuban doctors was very effective, and I started to feel better by the next morning. I continued to get much better quickly and, although still weak from the illness, I was able to leave in under two days — sooner than they had expected — to continue antibiotic treatment myself.

Despite language barriers, I was able to observe how the Cuban doctors operated and related to the patients. They are extremely friendly, warm and genuinely compassionate. They clearly have real feelings for their patients and have personal emotional investment in them getting better. In the absence of a financial incentive, there is no other explanation for why they do what they do. The formality that surrounds most doctor-patient relations didn't exist, from what I could see, in their relations with the Venezuelan patients. Genuine affection and friendship were shown between them.

The other thing that struck me was the way the Cuban doctors operated collectively and regularly had collective discussions about the patients and treatment. When there is a change of shift, one of the doctors who has been on takes all of those coming on shift to each patient, one by one, to explain their situation. The treatment of a patient is not the responsibility of an individual doctor. A doctor informed me that they had a discussion about me and decided I was well enough to leave.

Propaganda?

One other noticeable thing, compared to pretty much everywhere else I have been in Venezuela, is the absence of political material inside the clinic. This is a country where revolutionary graffiti, beautiful murals and political posters are everywhere and dominate the revolutionary institutions. But it is missing inside Barrio Adentro. The reason is quite simple — health care is for all people, regardless of politics. Anyone who needs treatment is made to feel welcome. The opposition claim the Cubans are here to indoctrinate the Venezuelan people, but I didn't see any evidence whatsoever. Their only propaganda is the propaganda of the deed.

And, of course, all of the treatment was completely free. I was not charged a cent. Not for the bed I slept in, not for the food they fed me, not for the drugs in the drip. When I left, they didn't give me a script for antibiotics to go fill out at my own cost at a pharmacy. They handed me what I needed for free.

It isn't hard to see why Barrio Adentro is so popular with the people, especially when the costs involved in private treatment are considered. What would the poor do without Barrio Adentro?

I am deeply grateful for the treatment I was given. The Cuban doctors are the product of a socialist revolution, and Barrio Adentro is a key program in the struggle in Venezuela to build a "new socialism of the 21st century". I can testify firsthand that socialism does make you feel better!

From Green Left Weekly, August 17, 2005.
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