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Moment that mattered: Zika virus Zika is declared a public health emergency by The World Health Organization

A city worker sprays insecticide to kill mosquitoes after class hours at a school in Cucuta, capital of Norte de Santander state, on Colombia's northeastern border with Venezuela, Thursday, Feb. 11, 2016. Norte de Santander is the state with the highest cases of Zika virus cases in the country. (AP Photo/Ricardo Mazalan)

A city worker sprays insecticide to kill mosquitoes after class hours at a school in Cucuta, on Colombia’s border with Venezuela

The World Health Organisation’s announcement came too late. We had known for some time that Zika was a public health emergency in Venezuela. Of course the announcement was welcome because we’re in desperate need of international aid, although nothing has changed since the declaration. Venezuela has still not received any help with its humanitarian crisis.

I was Venezuela’s health minister from 1997 to 1999 and belong to the Network to Defend National Epidemiology, an independent organisation of doctors committed to providing information that the government refuses to share with the public. Since the crisis began the Venezuelan government has barely said a word on Zika. It’s given very incomplete reports and it hasn’t even held a press conference. The Ministry of Health website was inactive for several weeks in the middle of the epidemic. It feels to me like a cover-up.

Our figures suggest that between 2.3 percent and 11 percent of the population – between 670,000 and three million people – may be affected by the virus. Venezuela only confirmed its first cases of the virus originating in Venezuela in December of last year, when the government told the World Health Organisation of the existence of autochthonous cases.Since then, some 790 confirmed cases of Guillain-Barré syndrome – a disease which we now know has clear links to Zika, were reported.

“There are no mosquito nets, no repellent, and, after the drought caused by El Niño in recent months, almost no water and frequent power outages”

In a country where the health system is excellent, this would be a serious situation. But if you take a country where the health system already faces a humanitarian crisis then you’ve got a big problem on your hands.

I’m a practising doctor. People come into my office every day and I can’t treat them. Not one of my patients has continuous access to the medication they need. If you need antibiotics, you can’t get them. You can’t get drugs for blood pressure. There is no morphine, no tramadol, and no analgesics for patients with terminal cancer. The only queues that are longer than the ones for medicine in Venezuela are the ones for food. At least 10,000 Venezuelan doctors have emigrated over the past six or seven years because of the conditions in this country.

Our problems all stem from the economic crisis. Venezuela is completely dependent on the rest of South America for obtaining medical supplies and health products. We import everything: equipment, diagnostic kits, needles, whatever’s needed to deliver medical aid. But Venezuela has huge debts with suppliers and can no longer obtain what’s needed. There are no mosquito nets, no repellent, and, after the drought caused by El Niño in recent months, almost no water and frequent power outages. People are storing drinking water in tanks in their homes, which provides ideal breeding grounds for mosquitos, which carry the Zika virus.

There are hospitals here in Caracas – high-quality institutions on a par with anything in New York, Sao Pãulo or London – that have had to close because there isn’t any water. How could this happen? You could have thousands of bolívars in your wallet and you still won’t be able to get your hands on antibiotics. It’s not a question of money. And you can’t import medical supplies yourself because the government has a monopoly on imports.

We have sick children and pregnant women who can’t get treatment, so they get increasingly unwell until they die. The healthcare situation was already at a critical point, and then you add the arrival of Zika, an emerging disease with epidemic behaviour. It’s a perfect storm.

The most shocking thing about the current situation, however, is the lack of reaction from the government, which is not fulfilling its duty to the people. There is comprehensive censorship of coverage of the situation, not just of Zika but of other diseases such as chikungunya, dengue and malaria, which is also re-emerging. It’s written in the constitution that the Ministry of Health must provide a weekly bulletin on the progress of these diseases, but since last year there has been nothing but silence.

Meanwhile, the government is limiting press freedom. One way they do this is by only supplying paper to newspapers that support them. There’s only one paper producer in the country and it is controlled by the state. In the last year, eight newspapers have gone out of print, while the ones that remain are operating under extremely reduced capacities: fewer pages, reduced staff and a level of self-censorship. There are no totally independent television stations and maybe only two radio stations that can report freely. All you see on the TV is propaganda. You never see any public education services or campaigns about disease prevention.

We need to confront this situation with the tools permitted within a democracy and we are exercising the right of freedom of expression, in spite of all the difficulties that come with that. I know the risks I face, but I’m doing what I can so that what’s happening here is known outside the country.

We are coping as well as possible, but it is a complicated situation. This government is responsible and will be held to account for a humanitarian crime – denying its people access to essential medication.  As long as they refuse to acknowledge that there is a problem then the problem cannot be solved. And if the government will not change its ways, then we need to change the government.

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