VENEZUELA..a COVID 19 TSUNAMI

Photo Credt: Dr Jueida Azkoul

As we in Canada transition into a gradual opening up from Covid restrictions  Venezuelans are facing an escalating Covid 19 crisis on top of years of food and medicine shortages, chronic malnutrition, unemployment, hyperinflation and political instability. Over the past 5 years Venezuelans have lost thousands of doctors and nurses and experienced chronic shortages of medicines and medical supplies leading to increases in many infectious diseases such as malaria, HIV, TB, diphtheria and measles and frequent inadequate management of acute and chronic medical problem.

The addition of the Covid 19 pandemic onto this fragile , vulnerable Venezuelan population is very concerning. It is impossible to estimate the prevalence of Covid 19 in Venezuela today as there are severe shortages of testing capabilities, contact tracing, PPE, medicines, ventilators and general hospital and ICU capacity.

It is concerning that the number of reported cases of Covid in Venezuela to WHO as of today is 459 with 10 deaths…in a population of 29 million ( 4 million people have left over past 5 years).

To put things in perspective, New Zealand, with a population of 4.8 million have reported 1498 cases and 21 deaths to date.

Neighbours such as Brazil have reported 220,291 cases( 6th highest in world) and 14,962 deaths, Colombia 14,216/ 546 deaths, Peru 84,495/ 2392 deaths, Ecuador 31,467/2594 and Chile 39,542/ 394

Tightening international sanctions, significantly reduced global oil prices and a poorly diversified national economy contributes significantly to a disastrous response to the Covid crisis.

The IMF recently rejected a Venezuelan request for $5 billion to support a Covid 19 response within Venezuela because of the uncertain political situation.

I am attaching a short video sent by some amazing medical colleagues who have chosen to stay in Venezuela to help their people during the ongoing humanitarian crisis including the recent Covid pandemic….

See Video

They are amazing human beings, who risk their own lives and the lives of their families daily to help their fellow Venezuelans in a very challenging environment.
I visited this hospital and met a number of people in the video in 2018.

As the video is in Spanish I will translate the main points…
These are doctors and nurses who work in the University Hospital de los Andes in Merida , Venezuela.

The hospital is responsible for looking after over a million patients from urban and mountainous rural areas in the Andes.

Prof Maria Odreman talks about improving testing capabilities and contact tracing to identify those infected and reduce the transmission chain.

Photo Credt: Dr Jueida Azkoul

The hospital has well trained , committed staff but limited resources
(A rapid antibody test from China has been used in Venezuela to date to diagnose Covid..it is not a good test to use for diagnosis with lots of false negatives and turns positive 1-2 weeks post onset of infection).

There is a huge shortage of NP and throat swabs + reagent and lab capacity
Dr Jueida Azkoul talks about the need for more lab testing capabilities/ test options including PCR to help diagnosis and shorten diagnostic time and improve PPE/ disinfectant access to protect staff and patients.

I understand it is a very difficult time for many in these challenging times but if you are comfortable in making a donation to help these front line health care workers and the people of Venezuela please make a donation…

You can also make a donation through BASIC HEALTH INTERNATIONAL FOUNDATION

basichealthinternational.org  (Here)

Donations over $25 will be issued a tax receipt for Canadian donors.

Please mark ” Venezuela Covid response” on any donations.

A donor has offered to donate $4 for every $1 donated through BHIF..so every dollar you donate will turn into $5 donated !!

Basic Health International Foundation does not charge any administration fees.

Many thanks to you all !!!

Bill Hanlon MD

Join us! BUILDING BRIDGES CONCERT – Sat. Nov. 16th, 7pm

BUILDING BRIDGES CONCERT
SATURDAY NOVEMBER 16th 7PM

Join us for the Building Bridges concert in Cochrane on Saturday November 16th 7pm
It is a fundraiser for Syrian refugees who have settled in the Bow Valley and Venezuela
The music will include musicians from Syria, Iran, Russia and Canada
Aya Mhana, a refugee from Syria will launch her new album titled “Homeland”
The fusion band Hymm will play some new compositions
The poetry will include the ancient Persian poet Saadi, the Canadian poet/songmaster Leonard Cohen and the Irish poet Seamus Heaney
The stories will come from Syrian refugees describing their life journey, their progress and contributions in making a new life in Canada
The concert will focus on the power of human resilience, the power of the story and the power of music in reconciliation, tolerance and growth for all of us !

Venezuela in Crisis: A country, a people in hemorrhage

For those of us who have been following the deteriorating socioeconomic situation in Venezuela, it is alarming to see the extent of deterioration in the quality of life of Venezuelans over the past 3-4 years.
This is a country that was once the world’s largest oil exporter, rich in natural beauty, ecological diversity, natural resources and beautiful, friendly, resourceful people.
Venezuela is experiencing a major humanitarian crisis at present, the economic collapse giving rise to food shortages, a rapidly deteriorating health care and education system, hyperinflation and almost complete depletion of foreign reserves.
The IMF predicts Venezuela’s inflation rate will reach 1 million % by the end of 2018 (1,000% 2017,112% 2015).

Venezuelan children wait in a food distribution long queue in Caracas, Venezula, on 23 November 2017. Venezuel people lives between the alert, crisis and humanitarian emergency indexes, with a clear negative trend. (Photo by Alvaro Fuente/NurPhoto via Getty Images)

In order to function, grow and prosper, a society requires certain basics such as good access to food and clean water, an adequate health care and educational system, security and a stable economic and political environment.
Venezuela over the last 5 years plus has had none of the above…

The socioeconomic impact of this meltdown is reflected in some of the following statistics:

  • Food Shortages: 90% of the population lives below the the poverty line (WHO)
  • Average Venezuelan has lost 24 lbs in the past year
  • “61% went to bed hungry in 2017”
  • Health Care Meltdown: 85% medicines either impossible or difficult to find in 2017
  • Hospitals reporting less than 10% of needed medicines and medical supplies available, radiology and lab services markedly diminished or shut down completely
    A recent national survey of 40 hospitals showed a 1/3 of hospital beds were non functioning, 50% of ERs don’t have vital medicines and 95% of CT scans and 51% of X-ray machines were not working
  • Increased outbreaks of infectious diseases such as diphtheria, measles, HIV, malaria and TB (highest in 40 years)
  • Reduced access/availability of vaccines…potency concerns
  • Acute and chronic malnutrition, especially in children
  • 300,000 children at risk of malnutrition related death(OAS)
  • Acute and chronic diarrhea related to poor water
  • Brain Drain: >13,000 doctors and more nurses have left Venezuela over the past 4 years along with many others
  • Human migration: > 2.3 million people (7% pop) have left since 2015
  • Colombia, Peru, USA, Spain, Chile, Panama, Brazil…(UN)
  • Crime: world’s 2nd highest homicide rate 57/100,000 (Canada 1.68/100,000)
    insecurity, robbery(40%) extortion 
  • Education meltdown: poor salaries, electricity blackouts, fuel shortages, teacher migration 
  • Economics: reduced economic output x 50% over past 4 years
  • Tourism meltdown: reduced to almost zero

I recently visited Venezuela to see how accurate were many of these reports .

I talked with many people working on the front line of health services in particular.

I visited a number of city hospitals and a rural health centre.

I talked with patients, family doctors, hospital and public health specialists, nurses, ambulance drivers, teachers and some people on the street.

I saw an 8 year old boy that looked barely 4 years old with marasmus…a condition related to severe general chronic malnutrition and more associated with the severe famines of Sub Saharan Africa in the 1980s.

I saw lots of examples of empty hospital beds, not because of lack of patients but because of lack of medicines, medical and surgical supplies, malfunctioning equipment, power outages and compromised water supplies.

I saw a number of basic X-ray machines not working because the wires had been cut to sell, equipment had broken down and no replacement parts available.

I saw an ER that had to survive without adrenaline for one week.

I saw many patients waiting on cots in ER for admission…some of these patients had active TB and were putting other patients and staff also at risk without any isolation options.

I saw a psychiatric ward that resembled some of the old Stalin Gulag prison camps.

I talked with a very competent head surgeon who was demoted because he reported to the Health Ministry that the mortality of patient’s admitted to the hospital had increased from 5% to an alarming 20% because of the lack of medicines and diagnostic tests.
The Ministry of Health blamed him on the alarming increase in patient mortality and demoted him.

I talked with the medical director of a city hospital who was on a salary of $9 US / month and often the payment was delayed by 2-3 months He was a well-trained medical specialist and hospital administrator.

Most of the people I met both medical and non-medical ate one meal per day…Usually a thin “arepa” which is a corn pancake traditional in Venezuela.
Rarely can people afford meat or vegetables.

My impression is rural people have a little better access to food than urban dwellers…still rarely get to eat meat.

Rural dwellers tend to have even less access to medicines, medical supplies and medical staff.

My impression is people have a significant protein and micronutrient deficient diet.
There is still significant amount of food available in Venezuela but as a result of spiraling inflation it is not affordable for most I saw fridges with 1-2 carrots or potatoes.
People’s diet is high in carbohydrate and low in protein, fat and micronutrients.
As a result, some people look healthier than they really are…similar to what I have seen on the Tibetan plateau.

I heard of cases of patient’s being kept alive with manual pumps because ventilators were faulty or power outages.

These are very difficult conditions for patients and staff.

It’s amazing how those medical staff who have stayed keep going every day in such conditions…a testament to their commitment to their people and country.

Not all medical and nursing graduates stay.
An alarming 50% of recent graduates from one medical school I visited, have already left the country, even before internship.
No doubt similar statistics in nursing and other medical professions.
Who can blame them, working is such circumstances.

I saw an astronomical lack of appropriate medicines and diagnostic equipment at primary, secondary and tertiary care facilities.
Many infections are treated on the blind without access to diagnostic tests, often with an inferior and sometimes inappropriate antibiotic because that’s all that’s available.

It’s not surprising that we are seeing such an increase in infectious diseases across the country.
This has the potential to markedly increase multi drug resistant organisms across Venezuela, it’s neighbouring countries and the world.
The mass migration of >2.3 million people out of Venezuela in the past 3 years accentuates this risk.

As a result of the complete breakdown in the health care system, one cannot rely on current health statistics and numbers.

My impression is the prevalence of many diseases and multi drug resistant infectious disease especially is underestimated and underreported to Venezuelan citizens, the WHO and the rest of the world.

The consequences of a broken health care system and economy is having a huge impact on Venezuelans, their neighbours and most likely the rest of the world.

Venezuelan President Maduro was quoted at the UN in September 2018 saying “Venezuela is a victim of world media attacks designed to construct a supposed humanitarian crisis so as to justify a military intervention.”

Up to recently he has refused to acknowledge a crisis and has refused to accept international humanitarian aid.

The Lima Group is a multilateral group of neighbouring Latin American countries and Canada, established in August 2017 to work towards a peaceful solution to the current Venezuelan crisis.
It works towards release of political prisoners, offers humanitarian aid, calls for free elections and promoting restoration of democracy in Venezuela.

Within the past 2 weeks there has been a glimmer of hope!
The United Nations recently announced it would provide $9.2 million to Venezuela from its Central Emergency Response Fund to go to UN agencies within Venezuela.

Maduro has recently invited Michelle Bachelet (former Chilean president and now head of the UN’s Office of High Commissioner for Human Rights) to visit Venezuela.

Venezuelan’s secretive central bank which has refused to share financial information for a long time is reportedly preparing new data for the IMF .

Hopefully this is grounds for a spark of cautious optimism in a country that has such huge potential and has endured so much more darkness than light for so long.

The world needs to pay more attention to the plight of Venezuelans and keep pressure on the Maduro regime to admit there is a crisis, accept international humanitarian aid and start working towards a democracy where people can live in a secure, less corrupt state, where there is good access to nutrition, health care and education and the opportunity for its citizens and country to thrive once again.

Bill Hanlon MD

Hauling for Health: DAY 6

Day 6

Cambridge Bay Day 1

Location: Cambridge Bay

Hello to you all!

I’m writing this final blog from a beautiful, crisp sunny morning here in Cambridge Bay, Nunavut.

As I sit here in the comfort of a friend’s home , a marked contrast to a few days ago when I was struggling in a 70 km/ hr wind and minus 45 windchill to put up my little Hilleberg tent, I marvel at how local residents and ancestors have adapted to the extreme environment of the Arctic.. How communities such as Cambridge Bay live continuously on the edge of survival and thriving in such a fragile environment.

Extreme winters with darkness, cold and prevailing NWesterlies a constant challenge makes it very difficult for many to spend a lot of time outdoors in wintertime.

Grassroots, Frontline backbone of Health Care delivery in Cambridge Bay Nunavut… Dr Chris Dechert and head nurse colleague

Some people still try to get out as much as possible but for most , winters involve spending most of winter indoors.

This is bound to have an impact on people’s physical and mental health.

Food insecurity

There appears to be a higher than average percentage of more extreme, complex medical problems among this resilient community… no doubt the harsh environmental conditions play a part.

It is a big disappointment to have to finish this expedition prematurely.
After a year of planning it was over in 5 days.
It was by far the shortest expedition I have ever done.

In the bigger picture , it was the right decision and I am very appreciative that I was able to make it back self supported without having to involve search and rescue and potentially put other people’s lives at risk.
I could have gone on further but risked turning the expedition into a disaster.
At the pace I was traveling, there was a good chance I would not have made it in time.
I was traveling at about half the pace as last year in Siberia and was pulling about 25 lbs more this year.

Cambridge Bay Health Centre

In my opinion , with the availability today of sat phone communication , there is the increased potential for people pushing the limits in more remote ,extreme environments to rely on rescue services being readily available if needed
This is very inappropriate and risks the lives of the rescue team as well as costs to the system.

My back pain will recover with time… the memories of being up here in this magical environment will persist.

The hospitality and friendship of the local people I will always cherish.

Brent Boddy .. Cambridge Bay kiting guru !!

Many thanks to you all…. Brent and Ian in particular.

As Shackleton remarked to his wife after returning from Antarctica
“ better a live donkey than a dead lion”.

Many thanks to you all for following !!

Bill

Let’s see what tomorrow brings. 

Hobnails, Scellig, Tommy the tent, Sally the stove, Freddy the food, Foxy the fuel, the Siku twins

and Bill

 

 

Hauling for Health: DAY 5

Day 5
Distance traveled: ??
Location: 6 KM out of Cambridge Bay
 
Almost back.
 

 

Northwest Passage on Wikipedia

Until Bill gets back, please direct media inquiries to:
K.Becker,
Mink Hollow Media
hello@minkhollow.ca

Let’s see what tomorrow brings. 

Hobnails, Scellig, Tommy the tent, Sally the stove, Freddy the food, Foxy the fuel, the Siku twins

and Bill

 

 

Hauling for Health: DAY 4

Day 4
Distance traveled: ??
Location: Not quite sure
 
We are very disappointed to report that the expedition has had to be cancelled. Listen to Bill’s report to find out more.
 

 

Northwest Passage on Wikipedia

Until Bill gets back, please direct media inquiries to:
K.Becker,
Mink Hollow Media
hello@minkhollow.ca

Let’s see what tomorrow brings. 

Hobnails, Scellig, Tommy the tent, Sally the stove, Freddy the food, Foxy the fuel, the Siku twins

and Bill

 

 

Hauling for Health: DAY 2

Day 2
Distance traveled: ~53 Km
Location: 68°35’08.7″N 104°49’07.7″W
 

 

Northwest Passage on Wikipedia

Until Bill gets back, please direct media inquiries to:
K.Becker,
Mink Hollow Media
hello@minkhollow.ca

Let’s see what tomorrow brings. 

Hobnails, Scellig, Tommy the tent, Sally the stove, Freddy the food, Foxy the fuel, the Siku twins

and Bill

 

 

Hauling for Health: DAY 1

Day 1
Distance traveled: ~13 Km
Location: 69°03.578’N 104°52.849’W

 

Until Bill gets back, please direct media inquiries to:
K.Becker,
Mink Hollow Media
hello@minkhollow.ca

Let’s see what tomorrow brings. 

Hobnails, Scellig, Tommy the tent, Sally the stove, Freddy the food, Foxy the fuel, the Siku twins

and Bill

 

 

We’re On Our Way!

Hauling for Health: NWT 2018

This was the last pre-expedition day before setting out on the trail tomorrow.

Despite my desire to be as minimalist as possible with gear and equipment Scellig the sled appears to have gained a lot of weight in the last 24 hours.

Scellig will be carrying more than he had planned and Hobnails is not so happy as a result of having the pull this extra gear.

Hobnails is quietly thinking of eating lots of food early on to lighten the load but not too much to be overly attractive to the polar bears and distract them from the seals.

I would like to thank the many people who have contributed enormously to help the team getting to the start here in Cambridge Bay.

Without the advice, experience and generosity of the many friends and colleagues who have given so much in terms of sharing knowledge, experience and expertise .. this expedition would not have come together.

Thanks so much to you all!

Last sunset in Cambridge Bay comfort

Now it’s in the hands of Hobnails, the support team on the ice and the spirits of the NW Passage.

Hope you join us on the adventure!!

Hobnails

The Adventure Begins!

Busy Beaver Lodge, Yellowknife owners Elena And Patrick Such great hosts!! Highly recommend anyone visiting Yellowknife to stay there.

She provided me with berries from her summer garden as sustenance for the trip!!
Elena and Patrick are great hosts!! Thanks guys!!

On way to airport for Cambridge Bay

Hauling for Health: The Northwest Passage 2018

Hauling for Health:

The Northwest Passage 2018

Solo Ski Expedition

In early April 2018 (like, tomorrow!) Dr. Bill Hanlon will embark on the first leg of a multi-year solo expedition to traverse the full 3,300 kn length of the Northwest Passage from Tuktoyaktuk in the Northwest Territories to Pond Inlet on Baffin Island in Nunavut, Canada.

The first leg will start from Cambridge Bay to Gjoa Haven and then onto Taloyoak in Nunavut.

The expedition will focus on highlighting the current health issues of northern indigenous peoples.

The NW Passage is steeped in history, exploration, rich culture and landscape as well as human health, environmental, wildlife, and sovereignty challenges.

This expedition is much more than an exploration of this wild, beautiful, remote, harsh Canadian landscape.

It is about exploration into the harsh reality of the current health status of northern people.

It is about exploring why this low density population living in this vast land mass within our Canadian borders has such poor health outcomes compared to the rest of Canada.

Why the population of Nunavut, with a similar land mass as Mexico and a population of only 36,000 residents has such high rates of diabetes, suicide, tuberculosis, and household food insecurity.

This expedition is about engaging with local communities, elders, front line workers, exploring reasons why these health parameters exist and trying to explore more effective, sustainable solutions at the grass roots level.

It is about navigating through this complex issue by engaging at the community level, respecting every point of view and sharing 30 years of medical experience working with indigenous populations in remote parts of the globe.

This expedition is also about self exploration, paring down living needs, focusing on the basic human needs of food, shelter, water, connectivity with the people and landscape, the spirits of the passage and temporarily disconnecting with the “business” of modern life.

It is about movement within the natural world and trying to keep an aging body sustained and reaching out tot he next horizon. It is about dealing with one’s vulnerabilities in a vast and powerful landscape.

The upcoming expedition will continue the Siberian Lake Baikal “Conversations from the Sled”. The team of Hobnails, Scelig the sled,Tommy the tent, Sally the stove, Freddy the food, Foxy the fuel will be joined by twins Siku the skis, Nanuq the navigator … these vital members of the team are essential for it’s survival.

Stay tuned….

This walk in the wild “Hauling for Health” expedition will start from Cambridge Bay, Nunavut, Canada in early April 2018.

Worth Sharing: Out in the cold: What the TB crisis in Nunavut reveals about Canada

There is no clearer evidence of the maldistribution of wealth and of social services in Canada to the detriment of Indigenous people than the tuberculosis epidemic under way in the Arctic.

Last week, 14-year-old Gussie Bennett, from Nain, Labrador, died of tuberculosis. Nain’s last serious outbreak of TB was just in 2015. In January, 15-year-old Ileen Kooneeliusie, from Qikiqtarjuak, on Baffin Island, died. The screening program undertaken in the weeks following revealed 10 per cent of the population of Qikiqtarjuak to be infected. Across Nunavut, 17 of the 25 communities have cases of tuberculosis. But the largest of these outbreaks so far is the one in Arviat.

Source: https://www.theglobeandmail.com/opinion/article-out-in-the-cold-what-the-tb-crisis-in-nunavut-reveals-about-canada/

Calgary Eyeopener Interview: Getting Ready to Trek the Northwest Passage

 You can listen to the podcast on the Calgary Eyeopener’s website.

 

The 8-minute interview starts at the 16 minute mark (16:00 – 24:00).

Calgary Eyeopener Episode for March 16, 2018

Interview: Bill Hanlon on skiing the Northwest Passage

ExplorersWeb caught up with Bill Hanlon as he prepares to leave on his next expedition: a 900-kilometer solo trek in Canada’s Northwest Territories.

Source: Pythom.com Interview: Bill Hanlon on skiing the Northwest Passage

Telus Storyhive: How a Cochrane Doctor is Saving Lives Overseas

Dr. William Hanlon goes to extremes to bring sustainable healthcare to some of the most remote regions on the planet.