Wednesday November 21, 2018

With Medicine Running Out, Venezuelans With Transplant Live in Fear

At least seven have died due to complications stemming from organ failure in the last three months

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Yasmira Castano felt she had a fresh chance at life when she received a kidney transplant almost two decades ago. The young Venezuelan was able to finish high school and went on to work as a manicurist.

But late last year, Castano, now 40, was unable to find the drugs needed to keep her body from rejecting the organ, as Venezuela’s health care system slid deeper into crisis following years of economic turmoil.

On Christmas Eve, weak and frail, Castano was rushed to a crumbling state hospital in Venezuela’s teeming capital, Caracas. Her immune system had attacked the foreign organ and she lost her kidney shortly afterward.

Now, Castano needs dialysis three times a week to filter her blood. But the hospital attached to Venezuela’s Central University, once one of South America’s top institutions, frequently suffers water outages and lacks materials for dialysis.

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Yasmira Castano, 40, who lost her transplanted kidney, lies on a bed at a state hospital in Caracas, Venezuela, Feb. 7, 2018. VOA

“I spend nights not sleeping, just worrying,” said Castano, who weighs around 77 pounds (35 kg), as she lay on an old bed in a bleak hospital room, its bare walls unadorned by a television or pictures.

Her roommate Lismar Castellanos, who just turned 21, put it more bluntly.

ALSO READ: Kidney Transplant becomes New Possibility to cure Terminally-Ill Kidney Patients in the US

“Unfortunately, I could die,” said Castellanos, who lost her transplanted kidney last year and is struggling to get the dialysis she needs to keep her body functioning.

The women are among Venezuela’s roughly 3,500 transplant recipients. After years leading normal lives, they now live in fear as Venezuela’s economic collapse under President Nicolas Maduro has left the once-prosperous OPEC nation unable to purchase sufficient foreign medicine or produce enough of its own.

Some 31 Venezuelans have seen their bodies start to reject their transplanted organs in the last month due to lack of medicine, according to umbrella health group Codevida, a nongovernmental organization.

At least seven have died due to complications stemming from organ failure in the last three months.

A further 16,000 Venezuelans, many hoping for an elusive transplant, are dependent on dialysis to clean their blood — but here, too, resources and materials are sorely lacking.

Nearly half of the country’s dialysis units are out of service, according to opposition lawmaker and oncologist Jose Manuel Olivares, a leading voice on the health crisis who has toured dialysis centers to assess the scale of the problem.

‘Straight to the cemetery’

In the last three weeks alone, seven people have died due to lack of dialysis, according to Codevida, which staged a protest to decry the critical drug shortages.

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Reinaldo Olivares, a kidney transplanted patient, holds a placard with the shape of the map of Venezuela that reads, “Humanitarian emergency. I do not want to lose my organ,” during a protest against medicinal shortages in Caracas, Venezuela, Feb. 8, 2018. VOA

Once-controlled diseases like diphtheria and measles have returned, due partly to insufficient vaccines and antibiotics, while Venezuelans suffering chronic illnesses like cancer or diabetes often have to forgo treatment.

Hundreds of thousands of desperate Venezuelans, meanwhile, have fled the country over the past year, including many medical professionals.

Amid a lack of basics like catheters and crumbling hospital infrastructure, doctors who remain struggle to cope with ever scarcer resources.

“It’s incredibly stressful. We request supplies; they don’t arrive. We call again and they still don’t arrive. Then we realize it’s because there aren’t any,” said a kidney specialist at a public hospital, asking to remain anonymous because health workers are not allowed to speak publicly about the situation.

Venezuela’s Social Security Institute, tasked with providing patients with drugs for chronic conditions, did not respond to a request for comment.

Terrified transplant patients are indebting themselves to buy pricey medicine on the black market, begging relatives abroad to funnel drugs into the country or dangerously reducing their daily intake of pills to stretch out stock.

Larry Zambrano, a 45-year-old father of two with a kidney transplant, resorted to taking immunosuppressants designed for animals last year.

Guillermo Habanero and his brother Emerson both underwent kidney transplants after suffering polycystic kidney disease.

Emerson, a healthy 53-year-old former police officer, died in November after a month without immunosuppressants.

“If you lose your kidney, you go to dialysis but there are no materials. So you go straight to the cemetery,” said Habanero, 56, who runs a small computer repair shop in the poor hillside neighborhood of Catia.

Blaming Maduro, who blames sanctions

A Reuters reporter went to the Health Ministry to request an interview but was asked at the entrance to give her contact details instead. No one called or emailed.

Reuters was also unable to contact the Health Ministry unit in charge of transplants, Fundavene, for comment. Its website was unavailable. Multiple calls to different phone numbers went unanswered. An email bounced back and no one answered a message on the unit’s Facebook page.

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Lismar Castellanos, 21, who lost her transplanted kidney, takes a selfie with her mother and friends during her birthday celebration at a state hospital in Caracas, Venezuela, Feb. 7, 2018. VOA

Maduro’s government has said the real culprit is an alleged U.S.-led business elite seeking to sabotage its socialist agenda by hoarding medicine and imposing sanctions.

“I see the cynicism of the right-wing, worried about people who cannot get dialysis treatment, but it’s their fault: They’ve asked for sanctions and a blockade against Venezuela,” Socialist Party heavyweight Diosdado Cabello said in recent comments on his weekly television program.

Health activists blame what they see as Maduro’s inefficient and corrupt government for the medical crisis and contend that government announcements of more imports for dialysis are totally insufficient.

ALSO READ: Mumbai roads make way for a speedy heart transplant

Despite his unpopularity, Maduro is expected to win a new six-year term in an April 22 presidential election. The opposition is likely to boycott the vote, which it has already denounced as rigged in favor of the government.

Maduro has refused to accept food and medicine donations, despite the deepening health care crisis. Health activists and doctors smuggle in medicines, often donated by the growing Venezuelan diaspora, in their suitcases, but it is far from enough.

In the decaying hospital and dialysis center visited by Reuters, patients clamored for humanitarian aid.

Dolled up for her birthday and surrounded by cakes, the 21-year-old Castellanos took selfies with her friends and spoke excitedly about one day returning to dance, one of her passions.

But fears for her future permeated the room. A hospital worker stopped by to wish Castellanos many more birthday celebrations, but her worried face betrayed doubts.

“Other countries need to help us,” Castellanos said. (VOA)

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Thousands of Africans Fatally Affected Due To Fake Drugs

In Ivory Coast, many cannot afford to shop in pharmacies.

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Drugs, Africa
A street vendor sells illegal and false drugs in a street of Adjame in Abidjan, Ivory Coast. VOA

When Moustapha Dieng came down with stomach pains one day last month he did the sensible thing and went to a doctor in his hometown of Ouagadougou, Burkina Faso’s capital, Africa.

The doctor prescribed a malaria treatment but the medicine cost too much for Dieng, a 30-year-old tailor, so he went to an unlicensed street vendor for pills on the cheap.

“It was too expensive at the pharmacy. I was forced to buy street drugs as they are less expensive,” he said. Within days he was hospitalized — sickened by the very drugs that were supposed to cure him.

Africa
Able Ekissi, an inspector at the health ministry, told Reuters the seized goods. Pixabay

Tens of thousands of people in Africa die each year because of fake and counterfeit medication, an E.U.-funded report released on Tuesday said. The drugs are mainly made in China but also in India, Paraguay, Pakistan and the United Kingdom.

Almost half the fake and low-quality medicines reported to the World Health Organization (WHO) between 2013 and 2017 were found to be in sub-Saharan Africa, said the report, also backed by Interpol and the Institute for Security Studies.

“Counterfeiters prey on poorer countries more than their richer counterparts, with up to 30 times greater penetration of fakes in the supply chain,” said the report.

Substandard or fake anti-malarials cause the deaths of between 64,000 and 158,000 people per year in sub-Saharan Africa, the report said.

Africa
Opiates have some of the most cases of addiction due to their accessibility and intense ‘high’ – mostly beginning from something as simple as painkillers.

The counterfeit drug market is worth around $200 billion worldwide annually, WHO says, making it the most lucrative trade of illegally copied goods. Its impact has been devastating.

Nigeria said more than 80 children were killed in 2009 by a teething syrup tainted with a chemical normally used in engine coolant and blamed for causing kidney failure.

For Dieng, the cost can be measured in more than simple suffering. The night in hospital cost him more than double what he would have paid had he bought the drugs the doctor ordered.

“After taking those drugs, the provenance of which we don’t know, he came back with new symptoms … All this had aggravated his condition,” said nurse Jules Raesse, who treated Dieng when he stayed at the clinic last month.

Fake drugs also threaten a thriving pharmaceutical sector in several African countries.

Africa
Misuse of antibiotic drugs have lead to the threat of antimicrobial resistance, Pixabay

That has helped prompt Ivory Coast – where fake drugs were also sold openly – to crack down on the trade, estimated at $30 billion by Reuters last year.

Ivorian authorities said last month they had seized almost 400 tonnes of fake medicine over the past two years.

Able Ekissi, an inspector at the health ministry, told Reuters the seized goods, had they been sold to consumers, would have represented a loss to the legitimate pharmaceutical industry of more than $170 million.

“They are reputed to be cheaper, but at best they are ineffective and at worst toxic,” Abderrahmane Chakibi, Managing Director of French pharmaceutical firm Sanofi’s sub-Saharan Africa branch.

Also Read: Trump Presents Proposal To Lower the Price of Specific Drugs

But in Ivory Coast, many cannot afford to shop in pharmacies, which often only stock expensive drugs imported from France, rather than cheaper generics from places like India.

“When you have no means you are forced to go out onto the street,” said Barakissa Cherik, a pharmacist in Ivory Coast’s lagoon-side commercial capital Abidjan. (VOA)