Houston Chronicle Sunday

Mentally ill in Venezuela are tormented by drug shortages

Lacking food, medicine and doctors, institutio­ns have released thousands

- By Nicholas Casey

MARACAY, Venezuela — The voices tormenting Accel Simeone kept getting louder.

The country’s last supplies of antipsycho­tic medication were vanishing, and Simeone had gone weeks without the drug that controls his schizophre­nia.

Reality was disintegra­ting with each passing day. The sounds in his head soon became people, with names. They were growing in number, crowding the tiny home he shared with his family, yelling obscenitie­s into his ears.

Nowthe voices demanded that he kill his brother.

“I didn’t want to do it,” recalled Simeone, 25.

He took an electric grinder from the family’s garage. He switched it on.

But then, to spare his brother, he attacked himself instead, slicing into his own arm until his father raced in and grabbed the grinder from his bloody hands.

Venezuela’s economic collapse already has deci- mated its health system, leaving hospitals without antibiotic­s, surgeons without gloves and patients dying on emergency room tables.

Now, thousands of mental health patients — many of whom had been living relatively normal lives under medication — are drifting into despair and psychosis because the country has run out of the vast majority of psychiatri­c medicines, leaving families and doctors powerless to help them, medical experts say. Stuff of nightmares

Mental institutio­ns have released thousands of patients because they can no longer treat them, according to physicians. The patients still being cared for now suffer in crumbling wards that can barely even feed them. Doctors and nurses fear violent attacks and say they have little choice but to tie their patients to chairs, lock them up or strip them of their clothes to prevent suicides.

In the city of Barquisime­to, the scenes at El Pampero Psychiatri­c Hos- pital are those of nightmares.

Food shortages had left one older schizophre­nic manemaciat­ed, like a walking skeleton in a concentrat­ion camp. An epileptic man bereft of medication fell into repeated seizures, while another untreated patient lay strapped to a bed, bound at the ankles. An older woman with no drugs to control her schizophre­nia crawled across the floor, past a hungry patient eating fruit that had fallen into a pool of open sewage.

But most patients around the country are in the hands of families like the Simeones, doctors say. Family members must choose between going to work and watching over their loved ones. It is a life of searching for increasing­ly rare drugs, desperatel­y hoping their relatives do not harm themselves, or others, the moment someone looks away.

“When I heard that he could hurt his brother, that broke me,” said Evelin de Simeone, Accel’s mother, recounting the day in June her son grabbed the electric grinder.

Evelin, who had hardly been able to work in order to watch over the brothers, has quit work entirely. Her husband, Mario, fixes cars to pay for medication for his sons, when it can be found, lamenting how far the family’s fortunes have fallen. He wanted someone to blame.

“This is a fanatic state,” he said. “If you really love a country, how could you leave it without food, work or medicine?” ‘It’s like being impotent’

Venezuela, the country with the largest oil reserves in the world, once produced most of its own pharmaceut­ical drugs. In the early 2000s, the president at the time, Hugo Chavez, began a broad nationaliz­ation of Venezuelan drugmakers to produce cheaper medicines. Foreign companies like Pfizer and Eli Lilly filled in the gaps by shipping drugs.

Then oil prices collapsed. The government began running out of hard currency, leaving it unable to import raw materials for the state-owned factories supplying Venezuelan hospitals. Many foreign drug companies stopped sending medicines because the government owed them so much money.

The consequenc­e: About 85 percent of psychiatri­c medicines are now unavailabl­e in Venezuela, according to the country’s top pharmaceut­ical trade group.

“The most elemental things are gone,” said Robert Lespinasse, a former president of the Venezuelan Society of Psychiatry. “It’s like being impotent.”

 ?? Meredith Kohut photos / New York Times ?? Iris Rodriguez, who suffers from psychosis, is confined to a cell at a state-run psychiatri­c hospital. Venenzuela’s economic crisis has left the health system without the resources needed to care for patients.
Meredith Kohut photos / New York Times Iris Rodriguez, who suffers from psychosis, is confined to a cell at a state-run psychiatri­c hospital. Venenzuela’s economic crisis has left the health system without the resources needed to care for patients.
 ??  ?? Nurses at the state-run Pampero Psychiatri­c Hospital in Barquisime­to debate which patients will receive the limited number of pills on hand.
Nurses at the state-run Pampero Psychiatri­c Hospital in Barquisime­to debate which patients will receive the limited number of pills on hand.

Newspapers in English

Newspapers from United States