Monday, December 21, 2009

Daniel’s unwilling hunger strike

Hunger strike has been a fashionable way to protest, from the students in front of the OAS offices in Caracas to the Saharoui activist in Lanzarote. Now I have a fine appreciation of what it is to be almost a week with barely a few liquids for sustenance.

Two weeks ago I came down with dengue, the fashionable tropical disease, a virus transmitted by a specific mosquito. I already had it once, ten years ago and thus as expected the second time was to be much harder. My platelets went down to 3,500 which means that I was at the mercy of something as trivial as gum bleeding. It was that close. And yet the whole ordeal allowed me for a keen understanding of the mess Venezuela’s health system is at. Mind you, I went through it with the private sector, but I saw first hand how the negative policies of the Chavez administration are affecting all sectors, making me really wonder how low the quality of public sector service has fallen.

It all started in San Felipe where a slight fever the night before required next morning a visit to the emergency room of a local clinic. I spent the day there and was asked to take all sorts of test, from HIV to Epstein Bar, but not dengue. No privacy at anytime, my results would have been handled by whomever came across my papers. I was in bad shape enough that I was given I.V. fever medicine. At the end of the day I was sent back home, asked to come back next day to see whether my platelets would go down, the only dengue criteria available.

Next day was hell. I could not sleep that night, acetaminophen had stopped working. I needed a friend from Valencia to come and check out the situation. Upon her arrival she knew that things were bad, took me back to the clinic for them to stabilize me while she organized ambulance service. See, the people of San Felipe were in the best disposition to help me but all of San Felipe private sector is saturated due to the public central hospital collapse; thus they had no room for me…. At any rate it was wiser to go back to Caracas where I had more people to help me.

I think we left San Felipe around 4 PM. I am not sure because by then I was semi delirious as the evidence of dengue forbade any strong fever medicine. I was fit with my I.V. line and tossed in the only vehicle available in the area, an ambulance of a certain age with a very defective suspension. Thus I was able to enjoy for almost 4 hours every pothole that chavismo has allowed to flourish everywhere for the past ten years. It was hell, and made the worse as the paramedics could not even listen to the radio as Chavez was in cadena.

We reached Caracas at night. In spite of all the preparations my relatives had tried to take the Clinica Metropolitana was collapsing at its emergency and I was left for quite a while in a hallway as the paramedics were trying to have at least me switch to another stretcher so they could recover theirs and leave for another urgency somewhere in Maracay. Finally they tossed me into a trauma room where the other bed was occupied by another dengue case from Valle de la Pascua. The poor guy had been confused for an infection case, plied with antibiotics until finally some relatives decided to seek more competent doctors as there was no improvement.

I was to stay in emergency for 48 hours since I was too critical to be put in a room. I was stuck with all sorts of lines for constant monitoring while eventually the doctors ordered platelets transfusion, something easier said than done. See, of the 10 or so potential donors we managed to line up only 3 were approved and I got the platelets from one of my brothers since he happened to be the first at hand and same blood group.

For 48 hours I was given to observe up close as a participant sport the life of an emergency room. Activity all the time, in that basement you do not know whether it is day light. I must say that I was rather impressed. In spite of an edge of chaos feel, things run, attention does not waver, and people seem composed and knowledgeable enough. And doctors also seemed quite good. I caught myself wondering how good these people could indeed become. When you think at the difficult life we have now in Caracas, when you think about the overflow from the defeated public sector where in spite of Chavez words ministries discretely keep contracting private heath insurance, it is a miracle that the show runs so well. But think a little bit further: if these doctors did not have to spend at least 2 hours a day in traffic, if they did not have to deal with the rain of sanctions and intromissions from the state who resent their success while the state is flunking its own duties, in other words if these doctors had the means to do more research, the Metropolitana could be our own little Mayo Clinic. The experience and the talent they have, still. What they need is the time and means.

I also learned in these hours that there is a dengue epidemic and that you would never learn about it from the state media (and even more unaccountably so from the private media, scared of certain news). The Metropolitana itself is getting 5 cases a week at least. If we add the other major private establishments of Caracas it is easy to speculate that the cases of dengue are in the several dozens a week, enough to justify a major fumigation and prevention campaign. As far as I know only the municipality of Baruta manages some light spraying, the other without the means to do so. Meanwhile the state spends its energy in sending a vulgar and blurting Chavez to Copenhagen when the price of that wasted trip would be enough to spray all of Caracas green areas.

Things are worse than what you think. Once I was in a room, with my neurons firing a little bit again, the scientist in me wanted to know more. See, normally when a dengue case diagnosis is reported the INH (or whatever the name of the epidemiology state system is today) is supposed to visit the patient to ask epidemiological question. You know, to try to locate the focus, fumigate and whatnot. In fact they should even take a blood sample if early enough in the disease to establish the dengue strain. The INH not only has stopped visiting clinics and hospitals for that matter but no official epidemiological bulletin has been published in years. The Caracas doctors and clinics have to rely on themselves for any prevision they might want to take! As far as chavismo is concerned there is no dengue epidemic. Maybe they see epidemiological diseases as just a “sensacion” as the state ombudsman likes to qualify any intractable social problem, a media creation to provoke a feeling of insecurity, food shortage or dengue. I can witness myself first hand on how remiss of its essential obligations the Venezuelan state is, not only unable to heal people, but unable even to do the basic documentation so that other people could help. Make no mistake, if in the private sector dengue is such a problem I let you imagine what is going on in public hospitals and barrio adentro. Never mind the real numbers of swine flu.

And yes, I qualify myself as being a victim of Chavez in this regard, as my disease got worse for the difficulty in accessing care, even private care, as my contagion comes from a general degree in decay in infrastructure and water works allowing for the return of plagues such as paludism, malaria, tuberculosis and others, diseases we thought we had under control 20 years ago.

There was an interesting detail which in a way could explain in part that state indifference to the pandemic. Apparently there are 4 strains of dengue. 1, 2 and 4 have now been long established in Venezuela but 3 is a rather recent arrival. If I understand well it was not documented in Venezuela 10 years ago. The curious detail of that strain is that it is reported to have come to the Caribbean through the Cuban soldiers when they were fighting in Angola three decades ago. The Cubans arrived with Chavez when he turned Venezuela into a Cuban colony. You may draw your own conclusions.

The rest of the story is not as exciting. After 48 hours in emergency with people wondering whether I was going to make it, my body started reacting and I was sent into a room where slowly I waited for my platelets to climb back to 100,000. My only distraction was to enjoy the beautiful Caracas December light though my window, after spending the night trying to find a way to sleep around my IV line (I spent 8 days with all sorts of drips as dengue also does havoc with your electrolyte balance, amen of a liver lesion which will keep me away from booze for at least a month). Not even that much TV, and not looking forward visitors as I tire very fast. I did manage to contact Miguel who very graciously made an announcement. I wish to thank every one who wrote, hoping you understand it might still be a while until I can thank you all properly for your concern. But be assured, what is ahead is only a long rest, maybe up to a month. That I can type again may bring me relief from boredom by posting regularly, if infrequently, soon.

Meanwhile you can take as a home lesson that any numbers emitted from the government on any social affliction are, well, [feel in the blank word]. There is no reliable statistics coming from Venezuelan institutions, the creepier the topic, the less reliable the published number. What is left for us is to figure out what are outright lies and simply “enhanced” numbers. And make sure you have good medical contact and coverage with relatives willing to stand in line for you for hours in case you need to lay on a stretcher.

2 comments:

  1. Anonymous1:48 PM

    Just read your account of the Dengue nightmare with great concern. I am truly happy that you are doing better.

    Earlier in December, I wondered where was Daniel. My first though was that Thugo's gang came knocking. Well Dengue is no much better.

    May 2010 be a good year for you amigo. Please stay healthy and safe.

    Alejo, Venezuela Paraiso Perdido

    ReplyDelete
  2. Anonymous11:49 PM

    Happy new year.2010. this is outstanding comment for posting, thank you.

    webroyalty

    ReplyDelete

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