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2.26.2019

Miller School Physicians Tackle Venezuela’s Health Care Crisis

Two public health experts from the University of Miami Miller School of Medicine who have intimate knowledge of the health care crisis spilling out of Venezuela are working to build a partnership with a nonprofit agency to provide medical care and supplies to migrants in dire need of aid.

Hermes Florez, M.D., Ph.D., MPH, professor of medicine and public health sciences, and chief of the Division of Epidemiology & Population Health Sciences in the Department of Public Health Sciences, and Denisse Pareja, M.D., MSPH, a former student who is now his research assistant, are working with Chicago-based medical nonprofit MedGlobal, Inc. to organize a series of missions that will take supplies and medical care to Colombia. This coordinated effort will be focused on the Venezuelan migrants pouring into Colombia daily, and who often arrive with debilitating health conditions.

“The situation is very difficult, and basic health care services are not being provided [in Venezuela],” Dr. Florez said. “The whole population has experienced weight loss in the neighborhood of 20 pounds, and getting food and medications is a problem.”

Since 2015, an estimated 3 million people have emigrated from Venezuela, and the majority have fled to Colombia. Even as international pressure is mounting on embattled Venezuelan President Nicolás Maduro to accept humanitarian aid, he has refused to open Venezuela’s borders to any donations. Dr. Florez is hopeful that someday they can actually provide aid directly to Venezuela, yet because of the current restrictions, MedGlobal is focusing on assistance in Colombia.

Dr. Florez, a Venezuelan native, has a keen awareness of the humanitarian crisis facing his country. He is regularly in touch with two former Venezuelan ministers of health who currently teach at medical schools in Venezuela and collect data on the nation’s health care system. This led Dr. Florez to offer a report to U.S. lawmakers and health care experts last summer in Washington D.C. detailing the most extreme health challenges for Venezuelan migrants. At a follow-up meeting, Dr. Florez met Zaher Sahloul, M.D., president of MedGlobal, and in December, MedGlobal Chairman John Kahler, M.D., visited Miami to explore a collaboration agreement with UM.

“Hopefully, we can move the needle to support the country, and health and education are two areas where UM can help Venezuela,” Dr. Florez said.

Recently, Dr. Pareja spent three days in Colombia with MedGlobal representatives to begin planning their first medical mission trip. She spent much of her time in the city of Cúcuta, known as the epicenter of the migration crisis. In Cúcuta, there are three bridges where Venezuelan migrants enter Colombia by foot, and Pareja visited the Simon Bolivar bridge, where an estimated 35,000 migrants walk into the country each day. Since the bridge is so popular, health care groups like the Red Cross, among others, have set up clinics in shipping containers adjacent to the bridge. Patients line up at the clinics as soon as they enter the country.

Dr. Pareja said some of the worst health care issues stem from the lack of food, medications, vaccinations, medical supplies or access to doctors within Venezuela. In Dr. Florez’ report, he noted that since 1999, Venezuela has experienced a 65 percent increase in maternal mortality, a 30 percent increase in infant mortality and a spike in chronic diseases. Especially troubling to him is that diseases often considered preventable — such as measles, malaria, diphtheria and polio — are now reemerging in Venezuela. And since most migrants head west into Colombia, all of these health care woes are now permeating that country.

On her recent trip to Colombia, Dr. Pareja saw a prevalence of HIV among Venezuelan migrants because of the lack of medications there, as well as the scarcity of contraception. Worsening the crisis, without treatment for HIV, mothers are passing on the virus to their babies. And in general, due to the lack of contraception in Venezuela, there are high rates of pregnant women who are ill, or whose babies are sick, and often malnourished. Colombian health care facilities are struggling to treat all of these issues.

“It was impressive to learn that preventable diseases already controlled in Latin America have reemerged in Venezuela,” said Dr. Pareja. “Women and children are a vulnerable group as maternal and child morbidity and mortality have increased, mainly due to lack of nutrients and prenatal control.”

MedGlobal, which works to provide health care for vulnerable populations in areas of natural disasters, displacements and war conflicts globally, is now fundraising to send doctors and supplies to the Venezuelan migrants in Colombia. On their last trip, they visited two hospitals in Cúcuta, where they plan to offer medical care in the future, said Dr. Pareja, who was recently hired as the nonprofit’s medical and volunteer coordinator for the Venezuela-Colombia effort. Once they secure government clearance for MedGlobal doctors to practice in Colombia and to set up clinics, the University of Miami will have more opportunities to help, Dr. Pareja added.

Although the situation in Venezuela is troubling, Dr. Florez said the partnership with MedGlobal may provide a chance for UM students in public health, nursing, and medicine to gain hands-on experience with a health care crisis, while providing needed assistance to the migrants.

“The idea is that in the near future our students can go [to Colombia] for their capstone projects, and with the proper safeguards, be deployed there to offer health care initiatives on vaccination, as well as education on basic nutrition and dietary habits,” Dr. Florez said. “Things that are basic to preventing major outbreaks and to enhancing their perspective as public health students.”

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