Doctors say tuberculosis infection rates in Venezuela are probably still well beneath the levels afflicting countries, mainly in sub-Saharan African and Asia, that have the worst tuberculosis epidemics.
Still, experts say, with the disintegration of Venezuela’s health system, there is little to prevent tuberculosis from spiraling out of control.
“The problem is the country doesn’t have the power to stop it,” said Dr. Julian Villalba, a Venezuelan tuberculosis expert.
All of the country’s major public hospitals are supposed to have tuberculosis testing programs, but many have been crippled or forced to close. Last year, lacking the necessary supplies, technicians at Dr. Rafael Quevedo Viloria Hospital, a major public hospital in the northwestern state of Trujillo, stopped doing a basic test in which sputum samples are stained and viewed under a microscope, said Dr. Miguel Fernández, who leads the hospital’s tuberculosis program.
Instead, patients were referred to a hospital in another city four hours away. Many could not afford the cost of public transportation and never went, Dr. Fernández said.
Of six major public hospitals in Caracas that responded to requests for information, only three were still conducting some tuberculosis tests, though not the full range required.
Pulmonologists and tuberculosis specialists praised the current director of the national tuberculosis prevention program for her efforts to keep it going, including using her own money to pay for ingredients to make test cultures.
But they said that the official, Dr. Mercedes España, was hamstrung by an apparent lack of commitment by the Maduro administration to deal with the nation’s various health crises.
“There’s an ethical rupture here,” Dr. Oletta said, accusing the government of showing more concern about its political standing than about public health. He pointed to the Maduro administration’s refusal to publicize health statistics, seemingly because it feared the political costs of more bad news.
“The result of that is more health injustice, more suffering, more illness, more death,” Dr. Oletta said.
The Maduro administration did not respond to emailed requests for interviews.
Each weekday morning, people start lining up at the door of Dr. de Waard’s tuberculosis laboratory to get tested or receive results.
“In the past, they came to rule it out,” said Dr. de Waard. “Now they come to confirm it.”