Click to expand Image Leidy Cordova, 37, with four of her five children at their home in Cumana, Venezuela, June 16, 2016. Their broken refrigerator held the only food in the house: a bag of corn flour and a bottle of vinegar. © 2016 Meridith Kohut

(Washington, DC) – The Venezuelan government has targeted critics of its ineffective efforts to alleviate severe shortages of essential medicines and food while the crisis persists, Human Rights Watch said in a report released today. Regional governments should press the administration of President Nicolás Maduro to adopt immediate measures to better address the profound humanitarian crisis, including by exploring avenues for increased international assistance.

The 78-page report, “Venezuela’s Humanitarian Crisis: Severe Medical and Food Shortages, Inadequate and Repressive Government Response,” documents how the shortages have made it extremely difficult for many Venezuelans to obtain essential medical care or meet their families’ basic needs. The Venezuelan government has downplayed the severity of the crisis. Although its own efforts to alleviate the shortages have not succeeded, it has made only limited efforts to obtain international humanitarian assistance that might be readily available. Meanwhile, it has intimidated and punished critics, including health professionals, human rights defenders, and ordinary Venezuelans who have spoken out about the shortages.

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“The Venezuelan government has seemed more vigorous in denying the existence of a humanitarian crisis than in working to resolve it,” said José Miguel Vivanco, Americas director at Human Rights Watch. “Its failures have contributed to the suffering of many Venezuelans who now struggle every day to obtain access to basic health care and adequate nutrition.”

The Venezuelan government has stridently denied that the shortages rise to the level of a crisis. When officials have acknowledged the shortages at all, they have blamed them on an “economic war” waged by the political opposition, the private sector, and foreign powers. The government has provided no evidence to support these accusations.



Human Rights Watch interviewed more than 100 people about the humanitarian situation in June 2016, in Caracas, the capital, and six states – Aragua, Carabobo, Lara, Táchira, Trujillo, and Zulia – and followed up by phone and other media. Researchers visited eight public hospitals, a health center on the border with Colombia, and a foundation that provides health care. Human Rights Watch interviewed people lined up at several locations to try to buy price-controlled goods as well as health care providers, people seeking medical care, people who had been detained in connection with protests linked to the shortages, human rights defenders, and public health experts.

Shortages of basic medicines and other crucial medical supplies have caused a sharp deterioration in the quality and safety of care over the past two years, Human Rights Watch found. Doctors and patients reported severe shortages – and in some cases, the complete absence – of basic medicines such as antibiotics and painkillers. Supplies lacking or in short supply in public hospitals included sterile gloves, gauze, and medical alcohol.



An August 2016 survey by a network of more than 200 doctors found that 76 percent of the public hospitals where they worked lacked the basic medicines that the network said should be available in any functional public hospital.



In case after case, people facing emergencies and those with chronic medical conditions such as cancer, hypertension, diabetes, and epilepsy, as well as organ transplant patients, said they struggle to find essential medications. The medicines are often unavailable at both public and private pharmacies, are prohibitively expensive if purchased abroad, and are either unavailable or so expensive on the black market – where they also come with no quality guarantees – as to be virtually unobtainable.

Leidy Cordova, 37, with four of her five children at their home in Cumana, Venezuela, June 16, 2016. Their broken refrigerator held the only food in the house: a bag of corn flour and a bottle of vinegar. © 2016 Meridith Kohut Large groups of people line up to purchase difficult to find items, such as sugar, cooking oil, milk, rice, toilet paper, and baby diapers at price-controlled prices during a government event in Caracas, January 24, 2015. © 2016 Meridith Kohut The crowded emergency room at the University Hospital Luis Razetti in Barcelona, April 16, 2016. Doctors said that they lack most of the medicines, equipment, and supplies needed to give patients appropriate medical attention, and that the hospital suffers from weekly shortages of running water and electricity. © 2016 Meridith Kohut Nurses at a hospital in Barquisimeto discuss which patients will receive medicines and which will have to wait due to severe shortages of medicines at the hospital, August 24, 2016. © 2016 Meridith Kohut A bakery worker passes out numbers to scores of shoppers, many of whom had been waiting in line for five hours, entitling them to buy a half-kilo ration of bread in Cumaná, June 16, 2016. © 2016 Meridith Kohut Devices pieced together by doctors, using recycled soda bottles and water jugs as weights, to treat patients with broken legs at the University Hospital Dr. Luis Razetti in Barcelona, April 15, 2016. © 2016 Meridith Kohut Sign on an incubator ("Don't Use - Doesn't Work") in a room full of broken incubators in the maternity ward of the University Hospital Dr. Luis Razetti in Barcelona, April 16, 2016. © 2016 Meridith Kohut Jailimar Laverde, 17, (left) and Yanny Trejo, 19, (right) wait in a queue of hundreds of people outside a supermarket in Caracas rumored to have received a shipment of corn flour and butter, March 19, 2016. Both teenagers said they got pregnant because they could no longer find birth control pills in Venezuela. © 2016 Meridith Kohut A man searches for anything he can salvage from a grocery store that was destroyed by hundreds of looters in Cumaná, Venezuela, June 16, 2016. People took water, flour, corn meal, salt, sugar, potatoes, and cereal, leaving behind only a broken freezer and overturned shelves. © 2016 Meridith Kohut Doctors protest in front of the state-run University City Hospital in Caracas carrying signs describing patients they have not been able to help because they lack necessary supplies, January 15, 2015. © 2016 Meridith Kohut A black market vendor shows the money she earned illegally re-selling price-controlled products at substantial mark-ups in the Petare slum on the outskirts of Caracas, January 14, 2016. Black market vendors are able to make significant profits because of high demand for hard-to-find products such as soap, shampoo, corn flour, rice, coffee, cooking oil, and diapers. © 2016 Meridith Kohut Two ER patients, one with head trauma from a car accident, and another who had been stabbed, in the emergency operating room of the University Hospital Dr. Luis Razetti in Barcelona, April 16, 2016. Both were bandaged up but not otherwise treated because doctors lacked the equipment to take the scans necessary to determine appropriate treatment. © 2016 Meridith Kohut Nicolas Espinoza's young daughter sleeps in the children's cancer ward at the University Hospital Dr. Luis Razetti in Barcelona, April 15, 2016. Mr. Espinoza said he had not been able to obtain the chemotherapy drugs and antibiotics doctors prescribed to treat her illness. © 2016 Meridith Kohut Soraya Rodríguez gets her ear pricked during a blood test for malaria at a clinic in Tumerero, May 25, 2016. More than 100,000 Venezuelans contracted malaria in 2015. © 2016 Meridith Kohut A patient with appendicitis, June 2016. Because of shortages at the hospital, she was responsible for obtaining her own medicines and supplies for surgery. She was unable to obtain antibiotics, leaving her at risk of post-surgery infection. © 2016 Human Rights Watch In a pediatric hospital in Lara State, a hand-lettered sign lists supplies needed at an “Operating Room in Crisis,” June 2016. © 2016 Human Rights Watch A nurse’s handwritten note lists medicines and supplies lacking at a psychiatric hospital in Trujillo State, June 2016. © 2016 Human Rights Watch Doctors had locked up patients at a psychiatric hospital in Trujillo State, where the general absence of adequate health services, including lack of medicines, made it very difficult to address the needs of their patients, June 2016. © 2016 Human Rights Watch A patient lies on the floor in a psychiatric hospital in Trujillo State, June 2016. The facility lacked medications and such basic supplies as mattresses, bedding, clothing, and adequate food. © 2016 Human Rights Watch Patients in a hospital in Valencia, Carabobo State, share the last tank of oxygen; without oxygen supplies, doctors are unable to perform many surgeries, July 2016. © 2016 Human Rights Watch A doctor at Leopoldo Manrique Terrero Hospital in Coche, Caracas, shows vials of expired anti-venom used in the absence of fresh supplies, August 2016. Anti-venom is on the World Health Organization List of Essential Medicines. © 2016 Private In the absence of supplies, doctors at the neonatology ward of the University Hospital Pedro E Carrillo in Valera, Trujillo State, are improvising humidifiers like this one, made of a plastic water bottle, July 2016. © 2016 Private A baby breathes through an improvised oxyhood at the Neonatal Intensive Care Unit of San Cristobal Central Hospital in Táchira State, where such basic supplies are lacking, August 2016. © 2016 Human Rights Watch A woman shows dwindling food supplies in her fridge in Zulia State, June 2016. © 2016 Human Rights Watch An 80-year-old woman shows her fridge, nearly empty, in Zulia State, June 2016. © 2016 Human Rights Watch In Barquisimeto, Lara State, people line up for hours to purchase goods subject to government-set price controls, including food, June 2016. © 2016 Human Rights Watch People in Carabobo State line up for hours to purchase goods subject to price controls set by the government, including food, June 2016. © 2016 Human Rights Watch Fruits and vegetables attract few customers at a market in Trujillo State, where, for those with minimum-wage jobs, food not subject to government-set price controls has become prohibitively expensive, June 2016. © 2016 Human Rights Watch For those with minimum-wage jobs, fish and meat at such markets as this one in Trujillo State, where products are not subject to price controls, have become prohibitively expensive, June 2016. © 2016 Human Rights Watch

The “distress and uncertainty is a daily nightmare,” the mother of a 9-year-old girl with diabetes said about her efforts to find the medicines her daughter needs.

The maternal mortality rate for the first five months of 2016 reported by the Health Ministry was 79 percent higher than the latest available official figures, from 2009. The infant mortality rate was 45 percent higher than 2013 figures. Health professionals told Human Rights Watch that medical shortages and unhygienic conditions in hospital delivery wards are important contributing factors.



Many Venezuelans are finding it increasingly difficult to get adequate nutrition, Human Rights Watch found, particularly lower or middle-income families who rely on items subject to government price controls. Some markets have food and even luxury goods available but at prices that many people cannot afford.

The Venezuelan government has seemed more vigorous in denying the existence of a humanitarian crisis than in working to resolve it. José Miguel Vivanco Americas director

Human Rights Watch researchers found long lines forming whenever supermarkets received goods subject to price controls. People waiting in lines said they were trying to buy items such as rice, pasta, flour, diapers, toothpaste, and toilet paper. Supermarkets often ran out of limited stock long before everyone in line had been served.



In a 2015 survey by independent groups and two leading Venezuelan universities, 87 percent of 1,488 people interviewed in 21 cities throughout the country, most from low-income families, said they had difficulty purchasing food. Twelve percent said they ate only one or two meals a day.



Public health scholars have linked food insecurity in diverse Latin American countries with major physical and mental health problems among adults, and poor growth and socio-emotional and cognitive development in children. In Venezuela, several doctors, community members, and parents told Human Rights Watch that they were beginning to see symptoms of malnutrition, particularly in children.



The government’s narrative of “economic war” has provided a rationale for using authoritarian tactics to intimidate and punish critics. It has lashed out at medical professionals who express concern about shortages, threatening to remove them from their positions at public hospitals. It has threatened to cut off the international funding of human rights organizations. And it has responded both to planned marches and spontaneous demonstrations about shortages with severe beatings, detention, and unjustifiable prohibitions on protests. Some people have been prosecuted in military courts, in violation of their right to a fair trial.



The Venezuelan government should take immediate and urgent steps to articulate and carry out effective policies to address the crisis, including by seeking international humanitarian aid, Human Rights Watch said. It should stop intimidating and punishing critics. Member countries of the Organization of American States should maintain close and continuous oversight of the situation, until the Venezuelan government shows results addressing the political and humanitarian crisis. United Nations humanitarian agencies should publish an independent assessment of the extent and impact of the shortages, as well as what is needed to address them.



“Without strong international pressure, in particular from the region, the Maduro administration may well fail to do what is necessary to alleviate this crisis, and the dramatic consequences of the humanitarian crisis that Venezuela is facing may only get worse,” Vivanco said.

Selected accounts from Venezuelans interviewed by Human Rights Watch: