Hugo Chavez’s apologists have always used his healthcare spending in the early years of his presidency to counter criticism of his appalling human rights and economic records. A cursory google search brings up many fawning articles to this effect.
However, a closer examination of Chavez’s healthcare policy reveals a decidedly ugly picture. Chavez subcontracted a large chunk of Venezuelan healthcare provision to Cuba in a programme called Barrio Adentro, paying huge sums to Cuba for the provision of doctors. Very little of the money goes to the Cuban doctors, the vast majority (96%) is pocketed by the Cuban state. This funding helped Chavez finance Cuban security and intelligence support for his regime. Cuban intelligence has been vital to the Chavista regime’s ability to control both its population and political opposition.
Meanwhile, the Cuban doctors working in Venezuela are close to being slaves. The doctors are not allowed to bring their families with them and are forced to live in terrible conditions. They are only given small stipends with most of their extremely modest salary being held by the Cuban state until they return. They lose that too if they are sent home early by the Venezuelan regime. In 2010, seven Cuban doctors and a nurse who had escaped to Miami sued Cuba and Venezuela for conspiracy to force them to work as “modern slaves”.
Barrio Adentro failed to create a lasting healthcare system in Venezuela and consumed a large part of the Venezuelan budget. Between 2005 and 2014, $29.7 billion (over 50% of all social expenditure) was spent on Barrio Adentro. Most of this money went directly to the Cuban state and much of the rest was lost to pervasive Chavista corruption. By 2014, according to the President of the Venezuelan Medical Federation, 80% of Barrio Adentro’s facilities had been abandoned. Many of these facilities were being used to dump trash or were occupied by the homeless. Of the 20% of clinics still operational most were operated only part-time, often just until 10am. By 2014, after a nine-year programme and tens of billions of dollars, most of the Cuban doctors had gone home or fled to other countries.
Barrio Adentro has also comprehensively failed as a preventative healthcare programme. Since 2010 Venezuela has had the highest teenage pregnancy rate in South America, something that is easily prevented with basic contraception and education. The Health Ministry stopped publishing statistics in 2016, but by then maternal deaths had reached 756 per annum from 346 in 2010, and child mortality had increased by 92% since 2010. Vaccination rates for all the major preventable diseases have collapsed. Vaccination against polio fell from 86% in 2000 to 58% in 2008, and vaccination coverage against tetanus, whooping cough and diphtheria fell from 77% in 2000 to just 22% in 2008. After having been eradicated, diphtheria broke out again in 2017 and is spreading, along with many other previously eradicated diseases.
Essentially, Chavez built Barrio Adentro as a secondary healthcare system based around foreign indentured labour and starved the primary public healthcare system of resources. Following the almost total collapse of Barrio Adentro, Venezuelans are left with a system that is falling apart and unable to provide even the most basic forms of healthcare. Hugo Chavez’s healthcare legacy is a broken system that disproportionately harms the poorest Venezuelans.
More information on the Venezuela Campaign can be found on their website.