By Estrella Gutiérrez
CARACAS, Jan 2 1997 (IPS)

The Venezuelan government is considering declaring a state of emergency to deal with a total strike by doctors – including emergency care – that has thrust the country’s public health system into chaos and already left more than 10 victims.

The federation that called the 27,000 physicians operating in Venezuela’s 226 public hospitals out on total strike a week ago has lost control of its members, who in the metropolitan area of Caracas and other states refused to respect a truce agreed on at year-end.

Health Minister Pedro Rincon said President Rafael Caldera was studying the possibility of decreeing a state of national emergency without a suspension of constitutional rights, in order to restore normality in the health sector.

The government has failed in its bid to get the doctors back to the hospitals. A presidential decree, which in theory forces a suspension of the strike under threat of loss of jobs, was ignored with no apparent consequences.

The physicians are demanding that their salaries be raised to around 1,000 dollars a month. The current upper limit is 244 dollars, while the basic level is around 148 dollars.

Aggravating the chaos, the country’s main medical associations turned a deaf ear to the Medical Federation of Venezuela’s decision to institute a truce in emergency care, intensive care and maternity.

The only measure the government has taken was to post military physicians in critical areas of some hospitals. They have been overwhelmed by the situation, alongside medical support personnel, who are not on strike.

Private clinics, meanwhile, have provided no support. They continue to demand the up front payment of exorbitant fees before accepting patients.

The result was an anarchic end to 1996 and a hectic New Year. The head of the country’s main maternity hospital, ‘Maternidad Concepcion Palacios’, attended 100 births on his own on New Year’s Eve, for example, a situation that has shown no signs of letting up.

The public sector attends to more than 60 percent of Venezuela’s 22 million inhabitants, amid an overall decline due to a severe shortage of medicine, equipment and materials and a deterioration in ethics among health professionals, according to several recent studies.

The doctors on strike are also demanding supplies for the health centres, which are often short of even the most basic material like cotton. They have expressed their enormous frustration at having to work in “worse than war-time conditions.”

In 1996, the government earmarked only 33 dollars per capita to health, compared to 55 dollars the previous year, even though the impoverishment of the population thanks to the economic crisis led to an increase in the number of patients turning to public health.

Doctors in the Federal District and the state of Miranda, where Caracas and the largest hospitals are located, as well as the neighbouring state of Aragua, declared themselves “in rebellion” against their national leaders – a politically-motivated move according to denunciations by other doctors.

The “rebellious” physicians belong to the Democratic Action party, which lost the presidency of the Medical Federation in 1996 but dominated the Dec. 26 assembly in which calls for a total strike won out over more moderate positions.

According to Planning Minister Teodoro Petkoff, when several physicians at the assembly expressed their fear that abandonment of the hospitals would result in the deaths of patients, some groups responded “let them die, let them die.”

Petkoff has termed the strike a “decree of war against the poor.” He has urged “due disobedience” to the “immoral” measure.

The attorney-general’s office is investigating deaths caused by lack of medical attention in order to file charges of second degree murder against those responsible, Attorney-General Ivan Badell warned when the emergency care strike began.

The Workers’ Confederation of Venezuela criticised the abandonment of emergency care, which it contended “altered the fundamental nature” of the physicians’ demands, even though the demand for decent wages was completely fair.

In Vargas hospital on the westside of Caracas, doctors who asked not to be named said they had not stopped attending major emergencies. “But there is no medicine here, there’s nothing,” said one. “The military doctors who turned up were scared away.” Another said the “political war” underlying the most radical positions put the professionals “between the devil and the deep blue sea.”

But the doctors on strike insist that the deaths due to lack of medical care are on the hands of the government, which is “responsible for the deterioration of the health system, and the fact that we have reached this situation.”

Those who were seeking care at hospital doors on Thursday told sad tales of scurrying from hospital to hospital in and around Caracas, suffering all kinds of injuries, some seriously life- threatening.

The first child born in 1997, Hector Ospinio, almost became a victim of the strike. In labour, his mother, Damaria Ocanto, visited four hospitals before being attended by the head of ‘Maternidad Concepcion Palacios’, Carlos Cabrera.

Cabrera said that in its 50 years of existence, the maternity hospital had never witnessed such a situation. “Our struggle is very legitimate. But it does not justify jeopardising the life of any Venezuelan,” Cabrera, visibly exhausted, said on Thursday.

The strike has come at the most difficult time of year, when most Venezuelans are on vacation, many are out and about within the country, and accidents and violent crime are on the rise.

In Caracas alone, some 30 people died violent deaths on New Year’s Eve, while dozens more were shot or stabbed, adding to the already overwhelming chaos in the hospitals.

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