Reporting
Heading Far Afield to Enter Motherhood
Ony Arrieta, a Venezuelan migrant, walks with her oldest son in the makeshift community she now calls home in Riohacha, Colombia. (ERIKA PIÑEROS)
In the latest expression of the growing crisis at home, pregnant Venezuelan women are flooding into Colombia to safely give birth.
RIOHACHA, COLOMBIA – As he wanders through the various recovery rooms in the maternity wing of the Nuestra Senora de los Remedios hospital, Dr. Lácides Moscote asks how many of the women resting with their newborn babies are from Venezuela. Thirteen of the 16 women say yes – a fairly typical share, he says.
Some cross into Colombia just weeks or months before they are due to give birth. Others, facing food shortages and a lack of medical care in crisis-hit Venezuela, have relocated here permanently. All of the women share the view that they did not want to give birth back home.
“If you go to a hospital there, there’s nothing,” says Nelly Carola Vilchez, a 22-year-old who arrived two months ago and whose baby girl Richer was born the day before this interview in late October. “You have to bring everything: towels, sterilizing solution, the whole birth kit. And it’s expensive.”
One mother, who had three cesarean sections in Venezuela before the low-cost public medical system started to collapse, shook her head when asked how many months’ wages she’d need to pay for a cesarean delivery for her fourth baby if she’d stayed in Venezuela. And that, she says, would be if she could find a doctor.
Migrants and refugees in this northeast border region paint a dire picture of how their living conditions back home have deteriorated in recent years. Many mention the soaring levels of hyperinflation that saw their bus ticket cost more than their salary, or how their wages meant the family daily meal plan consisted only of rice. But one of the biggest concerns for many of those leaving, especially those who are pregnant, is the breakdown in Venezuela’s health care system.
The flood of pregnant women into Colombia is the latest expression of how the crisis in Venezuela is placing economic pressure on neighboring countries. A recent report from the Organization for Economic Cooperation and Development, for example, found that additional government spending in areas such as health, education and other programs for the Venezuelan migrants could cost Colombia around 0.4% of its gross domestic product in the next five years.
Deteriorating Health Levels in Venezuela
Official figures are hard to come by, but a recent study published in The Lancet medical journalsignaled a worrying increase in Venezuela of the numbers of women dying in childbirth in recent years and in infant mortality. “Venezuela,” the authors wrote, “is the only country in South America that has risen back to the infant mortality rate levels of the 1990s.”
This past April, a joint report by the Johns Hopkins Bloomberg School of Public Health and Human Rights Watch found the health of Venezuela’s people were so threatened by food shortages and a broken health care system that it called for international aid to address the humanitarian emergency.
That emergency has ramifications across the region: Doctors here on the Colombian side of the border are starting to see diseases once wiped out thanks to vaccination programs reappear in children and vulnerable adults. Gynecologists say that they are seeing pregnant women who have not had a single checkup. Some who arrive here learn that their baby had died in utero.
Dr. Jorge Borrego uses a quiet day to catch up on office work at Nuestra Señora de los Remedios hospital in Riohacha, Colombia. The previous day, 16 women had given birth; 13 of them were Venezuelan. (ERIKA PIÑEROS)
“Many have had no prenatal assessment, or they’ve only had a sonogram,” explains Moscote, adding that they have also seen mothers with high-risk pregnancies who have not had any medical attention, and women with HIV and syphilis who risk passing disease or infection onto their newborn babies.
“Women come in and we ask them, ‘When did you arrive?’ Some say yesterday, or an hour ago,” says Dr. Jorge Borrego, another gynecologist on the ward, as he scrubs up to perform a cesarean on a 17-year-old from Venezuela whose labor has failed to progress. “There, if they have complications, they don’t have the things they need. The supplies.”
The hospital here in the regional capital of Riohacha is a relatively humble place with low concrete ceilings and a dusty courtyard. Doctors bemoan the lack of an intensive care unit, and nurses worry that a lack of space means some patients wait for treatment in the corridors. Parents of sick children sleep on white plastic chairs by their bedsides.
But for the patients who have come here from Venezuela, hospitals like these offer a lifeline. They have scrubs, gloves, anesthetics, antibiotics, surgeons, pediatricians: all things patients here say they struggle to find back home.
“In Venezuela, you can’t find medicines. And all the doctors have emigrated,” says Delnity Vásquez, a 37-year-old mother of three from Caracas whose 12-year-old daughter has a heart condition. “I spent two years trying to get her an appointment. Last time I went, they said the best thing was to pay privately to get her an appointment with a cardiologist,” she said, speaking in the border town of Maicao.
The problem with that, Vásquez says, was that her wages barely covered their monthly grocery bill. See a doctor, and the family would have starved.
Crossing the Border for Help
For generations, the flow of people between these two countries on Latin America’s northern tip was one way: from war-torn Colombia toward its more prosperous neighbor.
But the crisis in Venezuela – where some 90% of the population is now believed to live in poverty – has created an exodus of people going in the other direction. More than 4 millionhave left in recent years – a figure similar to the population of Ireland. A third of them, some 1.4 million, are living in Colombia.
Here, the government’s open-door policy has seen hospitals give emergency medical treatment to all migrants, regardless of whether they have the correct paperwork to be here. That emergency medical care saves lives, but it still falls short of what some of the migrants need.
“Many come hoping to find medicines or medical help, but it’s not there,” says Jheimmy Naizzir, the coordinator of a migrant shelter in Maicao, the biggest border town in this region, adding that they see many migrants with HIV and cancer for whom health care services cannot help.
Felipe Muñoz, the Colombian president’s special adviser on the border, says that the government’s policy on health care has translated into some 92,000 pregnant women receiving medical care in the country’s hospitals since Venezuela’s health care crisis started in 2012, including 32,000 births. Colombia is doing what it can to help, he says, but the challenge of helping this population has been immense.
“On the border we are facing a pressure on social services that has no comparison in the history of Colombia,” he says, explaining that the situation has become increasingly complex in the past two years as the numbers of people crossing into the country and asking for help have increased.
“People are arriving with very, very delicate health situations,” says Federico Sersale, the La Guajira regional chief for the UNHCR, the U.N.’s refugee agency, who says aid organizations have started to see an increase in the sick and vulnerable crossing over the border. “The hospitals have a growing debt. They are giving emergency treatment to everyone, regular and irregular, and that has a financial impact.”
Mercedes Diaz, a Venezuelan migrant mother of two, is seen at her tent in the UNHCR camp on the outskirts of Maicao, Colombia.(ERIKA PIÑEROS)
Worries Over Human Toll, Financial Costs
Doctors in Colombia have provided 3.9 million medical appointments to Venezuelan migrants since 2017, at a cost of $84.5 million in the public hospitals, according to figures from Colombia’s health ministry.
Those numbers are on display in places such as the hospital in Riohacha, where staff fear that the extra demand on caregivers and resources is creating an unsustainable pressure on the health care system.
Down the corridor from Riohacha’s maternity wards, in the children’s emergency treatment rooms, one of the nurses says that most of the sick children receiving treatment for pneumonia, respiratory problems and bronchitis are now from Venezuela.
“It’s been doubling, then tripling,” she says, of the number of cases they are helping. “There’s times when this emergency ward is just too full, just full of children.”