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Venezuela, the fight against malaria in the gold mines of State of Bolivar: more than 320,000 cases
the ROME – The presence of mines, illegal gold is prompting many venezuelans to emigrate in the state of Bolivar, the largest of Venezuela, to escape the economic crisis. The exploitation of the soil has created the conditions for the spread of malaria because of the large holes dug in the ground filled with stagnant water, create the ideal habitat for the eggs and larvae of mosquitoes. By adding the high mobility of the population and the precarious conditions of life, Venezuela has come to be the country most affected by malaria in the whole of Latin America by 2019, with more than 320,000 cases diagnosed, while fifty years had a leading role in the fight against this disease.

Assisted more than 85,000 people. The team of Doctors Without Borders (MSF), are active in the state of Bolivar from 2016. It is there that develops the national Program on malaria, in collaboration with the local health Ministry, supporting the various diagnostic centers and helping to provide care to the sick. In 2019, the team of MSF cared for more than 85,000 patients suffering from malaria, distributed over 65,000 mosquito nets, fumigated 530 dwellings, helped to perform over 250,000 tests, diagnostic, and reached over 55,000 people with sessions on health promotion, which explains how to identify illness and what you can do at the onset of the first symptoms.

The mosquito that bites and transmits the virus to several people. “The large concentration of people", said Elisa Compagnone, health promotion for MSF, just returned from a 6-months mission in Venezuela - increases the transmission of malaria because a single mosquito can bite and transmit the parasite to different people in a single night. In addition, the disease manifests itself from 7 days to 21 days following the sting, then one who does not reach the treatment center in time can in turn become a vector of transmission. With some of the mines are distant up to 6 hours on foot or 3 hours by boat from the first center of health, this population is extremely vulnerable”

The diagnostic centres in the mines. , With the intervention of MSF, whose strategy is to get as close as possible to the people who could be affected by malaria, the number of cases has decreased approximately 40% in the municipality of Sifontes, an area with numerous mines of gold illegal. Here most of the diagnostic centres and therapeutic, supervised by MSF, in collaboration with the national Programme on malaria, and is located directly inside the mines. “Sometimes we had up to 200 people in the row in front of the diagnostic centers and many of the patients affected by malaria they had to go directly to the clinic because there were no treatments available. Now the situation a little more manageable,” said Monserrat Barrios, bioanalista MSF, responsible for the training of new technicians for microscopic examinations in diagnostic centers.

The rise in users from 20 thousand to 75,000 people. last year, MSF has collaborated with the Institute for the malaria of Carúpano, in the Sucre state, by increasing their capacity. This year MSF also supports a clinic in the local Las Claritas, called Santo Domingo, in the municipality of Sifontes. Initially built for a population of 20,000 inhabitants, must now respond to the medical needs of over 75,000 people who came to live in the area in recent years. MSF provides prevention, diagnosis and treatment of malaria, but is increasing its support to cover other diseases and medical needs.

attention to sexual and reproductive health. “we Know - says dr. Fanny A. Castro, doctor of MSF in Venezuela - that other departments are in need of help to cope with the number of patients, including those suffering from non-communicable diseases, or in case they need to take care of emergencies and transfers to hospital. We are focusing on sexual and reproductive health - it has specified - with services such as family planning and birth assistance. We want to make a difference and increase the chances of the population access to healthcare services". And he concluded: "We have also prepared the water supply and waste management around the structure, which greatly improves the quality of the care provided".

But needs doctors in the area go well beyond. The economic crisis in Venezuela has had a strong impact on the entire health-care system, and is felt almost everywhere. MSF tries to respond to the most urgent needs in the different states of Venezuela, and in Bolivar, will soon begin to support one of the regional hospitals state, which now barely works, in the town of Tumeremo, the capital of the municipality of Sifontes. In one of the corridors of the abandoned of this hospital, Alicia Jimenez, a woman of the indigenous Venezuelan, has just given birth to her tenth child with the help of one of the midwives that remain in the structure. She had to travel by boat and car to reach the hospital, but despite the difficulties of travel and the poor condition of the building, says he is lucky to have the new born in the family. In 2020, MSF will step up the commitment to fighting malaria in Venezuela, but also intends to facilitate and simplify the access to health services, to Tumeremo as well as in other places of the country.

MSF work in Venezuela by 2015. Currently, the team of MSF work in the capital Caracas and in the states of Bolivar, Sucre, Amazonas and Anzoátegui. Between 2016 and early 2018 MSF also provided medical care in Maracaibo, in the north-west of the country. MSF is an independent medical humanitarian organization in the international. Our work in Venezuela is funded solely through private donations, provided by people all over the world.

The stories of Luis Yordan and Yorvis.

Luis Henrique Ripa , dropped by 11 metres at a gold mine, a native of Caracas, left the family to come to work as the miner of Las Claritas, a small town located in the municipality of Sifontes in the state of Bolivar. “This is the second time that I come here - told - to be honest, I like it very much, but the opportunity is too tempting. The first day I arrived, I found the gold. Some people try for months before finding something. Took me a day and I saw that as a sign. Being here is an adventure and it's worth it,” he says.

Yordan Pentoja. On the bed next to Luis there is another young man, called Yordan Pentoja. He is not fallen, is ill. The 27-year-old is being treated in the outpatient clinic for a severe form of malaria. He says that the disease has been diagnosed a dozen times about from when he started working in the mine, over a year and a half ago. “Malaria is like a plague in these parts. I have so many friends and colleagues who have had it that I stopped to count them," says with bitterness. He closes his eyes and adds: “I came to the clinic this morning because I felt bad. The head and the stomach I ache to die".

Yorvis Ascarnio. “This is the place where it all started. Or where everything is finished, it depends on how you consider the situation,” explains Yorvis Ascarnio, an inspector of public health who works for the national Programme on malaria in Bolivar. In the municipality of Sifontes, malaria has become endemic. “The economic crisis in Venezuela has hit hard also the population of Sifontes. Initially, we began to have less and less stock of medicines. Soon we had to decide who to give the few medications available, we could only concentrate on the serious cases. And the same situation was at other clinics and diagnostic centers. Work in this area for twelve years. I have seen the ups and downs in this place. But this period was extremely difficult for us.”

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