The condition there is ripe for the comeback of certain previously-eradicated diseases.
‘We’re Losing the Fight’: Tuberculosis Batters a Venezuela in Crisis
By
Kirk Semple | March 20, 2018
CARACAS, Venezuela — His family thought he just had a bad cold, nothing serious.
But Victor Martínez kept getting worse. By mid-January, he lay in a hospital ward, wasting away from tuberculosis. A month later, at his wake, stunned relatives tried to reckon with the resurgence of a disease that many Venezuelans thought had been mostly confined to the history books.
“I really don’t know what to think,” said Nileydys Yesenia Aurelia Martínez, his niece. “Even the last thing you’d imagine is happening.”
Tuberculosis, a disease that until recently seemed to be under control in Venezuela, is making an aggressive comeback, overwhelming a
broken health care system ill equipped for its return, doctors and infectious disease specialists say.
The illness — like
malaria, diphtheria and measles — has surged in Venezuela during a profound economic crisis that has battered almost every aspect of life and driven an
exodus of Venezuelans, including many experienced doctors.
Though normally associated with the very poor, tuberculosis has begun to stalk a broader population of Venezuelans, including the middle class. Declining nutrition from food shortages and rising stress throughout the country may be weakening immune systems, doctors say, leaving people more susceptible to illness.
And with more families sinking into poverty, people have been forced to double up in increasingly crowded homes, accelerating transmission of the disease.
“Tuberculosis is the shadow of misery,” said Dr. José Félix Oletta, a former Venezuelan health minister. “If there’s a disease that is a marker of poverty, it’s tuberculosis.”
The Venezuelan government has not released health statistics since early last year, part of a sustained effort to keep the extent of the country’s decline secret.
But at two vital tuberculosis centers in Caracas, the capital, the share of new patients who tested positive for the disease increased 40 percent or more in the last year alone. Some experts fear that the death rate associated with the illness has increased as well.
“Tuberculosis is hitting us hard,” said Dr. Jacobus de Waard, the director of the tuberculosis laboratory at the Institute of Biomedicine in Caracas, the busiest public testing center in the capital.
“We’re losing the fight,” he said.
The Venezuela government’s tuberculosis prevention and control program was once among the most robust in the hemisphere, with the nation boasting one of the lowest rates of infection in Latin America, experts say.
But as the country has fallen apart under President Nicolás Maduro, who took office in 2013, the government has let the tuberculosis threat slip from its control, losing decades’ worth of gains.
Doctors have also observed the return of particularly complicated varieties of the disease, as well as more cases involving strains that are highly resistant to drug therapies.
“All these forms of tuberculosis that we forget about are starting to reappear,” Dr. de Waard said.
Experts now fear that the nation is teetering on the brink of a tuberculosis epidemic that could spill over its borders as Venezuelans flee in record numbers to escape the economic and political crisis, potentially exporting the illness with them.
https://mobile.nytimes.com/2018/03/20/world/americas/venezuela-tuberculosis.html