“What can I say? There’s nothing I can do, and there’s nothing they can do,” he says.
Paint is peeling off the blue walls of the Infectious Diseases Unit in what is supposed to be the flagship teaching hospital of the Universidad Central de Venezuela, i.e., the nation’s top med school. Barely any air comes in through open windows in this very hot Caracas morning. Although Dr. Carvallo says the department is pretty empty compared to other days, it feels quite full.
Uneasy faces wait for answers, and for most-likely-unavailable drugs. The hallway is long enough to fix eyes on the infinite, but narrow enough to notice the unavoidable presence of others, and wonder how much time they have spent in such an obviously anxious state of mind.
Dr. Carvallo is checking on hospitalized patients whose immune systems, because of the months-long lack of antiretrovirals, are too weak to fight Tuberculosis, Meningitis or Kaposi Sarcomas.
“There’s basically nothing to treat these patients with,” Dr. Carvallo says, as we enter a room with four patients covered by blue curtains and about five family members leaning on the walls. There is a little terrace with a couple of seats where two men and a woman are looking outside, to the people in lines, some of them tired enough to sit on the floor.
“It’s the same problem going on in every area in this country. Improvisation, unclear management of everything, change of suppliers all the time that end up not providing the products due to large debts. The WHO (World Health Organization) says we’re not yet Uganda or Ethiopia. We’re not there yet … but we will be soon,” he chuckles nervously.
A woman stands up rapidly when the doctor comes into the room. She approaches him with a broken smile. She waits for his attention while a group of nurses standing inside one of the curtains ask him what to prescribe a patient if most of the drugs he needs are missing.
“How much time did he spend without treatment before coming?” the doctor asks the brown-skinned woman. “Emmm bueno … since like December we couldn’t find one of the drugs in the combination so we couldn’t give him anything. Now we are waiting for drugs to be available. Starting May we have been able to find some, but we don’t know when they’ll disappear again.”
The doctor breaks the twenty-second silent-interchanging of disturbed looks. “How’s he feeling?” he asks, pointing to the sleeping patient whose position isn’t very natural, or at least doesn’t seem comfortable. “He’s a lot better,” his companion answers. She tries to wake him up by touching his uncovered belly, but he half-smiles and signals with his hand to be left alone.
“This is an exceptional case, to have to hospitalize a patient like this. What really happens is that the patient’s deterioration takes long, but that muchacho spent 5 months with no treatment, so he’s now in very bad shape,” the doctor says, walking as fast as he talks.
“There are like sixty-five thousand patients receiving treatment in the country. We receive about ten percent of them,” he says, referring to the Universitario, a public entity supported by the government. “There are normally about twenty types of antiretrovirals in the country, of about thirty that exist in the world. Most of them are now not available.”
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