Venezuelan Doctors Are an Unexpected Boon for Latin America’s Poor

(Bloomberg) -- Juan Carlos Riera’s melodic Venezuelan accent coaxed a smile from his octogenarian patient even as he told her she needed surgery. Thanks to Riera's quick diagnosis at the hospital in Chile’s rural central valley, the woman’s wait would be cut by a year.

Crossing patients off lists has become Riera’s mission in La Calera, Chile, where he emigrated in 2015. After hyperinflation under Venezuelan President Nicolas Maduro slashed his once-robust salary and drained supplies of medicine and equipment, he saw no alternative but to leave. Indeed, the exodus of more than 22,000 doctors from 2012 to 2017 is—for now—closing a healthcare gap across Latin America.

“Chile has been welcoming, because patients see the positive impact of having more specialists where there were once none,” said Riera, a 46-year-old urologist from Maracay, Venezuela. Riera is one of four specialists, all Venezuelan, at the public Mario Sanchez Vergara Hospital.

Venezuela has been in a state of upheaval since National Assembly leader Juan Guaido claimed a constitutional right to the presidency after accusations that Maduro stole last year’s election. If Guaido succeeds and Venezuela’s economy stirs to life, some of the 3 million people who left might return. For now, however, the human deluge offers regional governments an unexpected wellspring of talent.

The influx offers an opportunity to strengthen public services in a region of deep inequality, said Andrew Selee, president of the Migration Policy Institute in Washington.

“This is Latin America’s moment to utilize human capital from Venezuela, providing access outside of the capital cities and, in the meantime, helping the migrants find work,” Selee said. “It’s a win-win, but you have to make sure you provide a way for professionals to obtain credentials and get those professionals to areas where there is need for their services.”

Brazil hired Venezuelan doctors last year in Roraima, a border state that receives many of their desperate compatriots. Some Argentinean provinces welcomed Venezuelans willing to work where specialists are few. In Colombia, which has taken in about 1 million Venezuelans, many work for ambulance companies, the worst-paid branch of medicine with the toughest conditions, including 24-hour shifts. Still, one doctor there said he is making 800 times Venezuela’s minimum wage.

In Chile, a temporary permit allows the migrants to work in public hospitals in high-need areas while they validate their credentials, which can take years.

Rodrigo Torres, a Chilean surgeon in Concepcion, said northern mining towns and the southern Patagonia have a chronic need for specialists. The aging population has also amplified pressure on a stressed public system. In December 2017, 1.6 million patients whose conditions weren't life threatening were on the list for consultations and 285,625 awaited surgery, according to the Ministry of Health.

“Patients in marginalized regions have to wait months for a specialty consultation and more than a year for surgical interventions,” Torres said.

Despite Chile’s need, the influx of doctors has caused friction with the local medical community. The temporary permit program was suspended in January after complaints, and the government recently required foreign physicians to get certification from the University of Chile or the Ministry of Foreign Relations in addition to the test they already must take to work in the private sector, Riera said.

Chile isn’t the only country to balance medical needs with protectionism. In Peru, Daniel Martinez, president of the Venezuelan doctors association, said about 2,000 are there, with half in private clinics and the rest working outside medicine. As more Venezuelans arrive, it’s increasingly difficult to obtain permission to practice.

Local physicians “see 2,000 doctors as competition, but the way I see it, we should work as a team,” Martinez said.

In La Calera, Riera checks messages from his family and Venezuelan political news, which he follows by the minute even as he juggles patients. “It has all of us with our souls hanging by a string,” he said.

Riera’s life in Venezuela unraveled after Maduro’s economic policies set off the humanitarian crisis. In 2015, he had finished the night’s last surgery and walked out of his clinic when he felt a gun barrel at his head. The feeling was familiar: It was the third time in two months that he had been robbed leaving the hospital.

His patients were suffering from the lack of medicine. Buying supplies in dollars from across the Colombian border solved the problem temporarily, but the bolivar was becoming less valuable each day and Riera feared he would soon be putting patients at risk.

The breaking point was when he couldn’t afford the extortion payments that were keeping his then 12-year-old daughter from being kidnapped.

He left Venezuela alone, looking for work in Colombia, Panama and the Dominican Republic and then the Chilean Andes, dropping off a resume at each public hospital. He finally got a call to work in La Calera, two hours from Santiago, bringing his daughter and her mother as soon as he could rent an apartment.

Mario Sanchez Vergara Hospital renovated an abandoned surgery ward when Riera arrived. Before that, one out of 10 patients on waiting lists were dying before their appointments, he said. Often, Riera takes home bags of avocados, meats and pastries as gifts from patients who have finally been treated.

“If things get better in Venezuela and if it were possible to return, I would think about it,” Riera said. In the meantime, “our agenda is full every day, and each patient is someone who would not have been treated otherwise.”

--With assistance from Oscar Medina and John Quigley.

To contact the editor responsible for this story: Vivianne Rodrigues at vrodrigues3@bloomberg.net, Stephen MerelmanMelinda Grenier

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