By ELIZABETH M. NUNEZ
The Associated Press
Friday, November 24, 2006; 2:28 PM
CARACAS, Venezuela -- President Hugo Chavez calls it one of his greatest achievements: a public health system with new clinics, refurbished hospitals and thousands of Cuban doctors providing free checkups for the poor.
The improvements, funded by Venezuela's oil wealth, have given the poor more medical options and helped the leftist Chavez secure support as he seeks another six-year term in elections Dec. 3. But patients at many public hospitals are still forced to wait weeks or even months for surgeries in dilapidated buildings that are just beginning to be fixed up.
Chavez's top presidential challenger, Manuel Rosales, accuses the government of not doing enough to improve hospitals and says having Cuban doctors in poor areas is no substitute for an effective health care system.
In a row of beds at the decades-old Perez de Leon Hospital, Pedro Pinango has been waiting 20 days for a second operation on a bullet wound in his calf, while Deivi Guillen has waited 18 days for surgery on a broken foot.
"The care is very good, but the hospital is falling down," says Guillen's mother, Neryuris Azuaje, sitting beside her 22-year-old son among beds with peeling paint and open windows with black plastic bags strung up to keep out the rain. A new hospital is being built next door, but for now there is only one operating room.
Nearly eight years after Chavez took office, Venezuela still has a two-tiered health system where wealthier, insured patients can usually afford prompter, better treatment.
But his efforts to improve health care have proven popular. An Associated Press-Ipsos poll conducted this month found about 74 percent approve of Chavez's handling of health care, based on interviews with 2,500 registered voters nationwide.
The government has spent $52 million building a state-of-the-art children's cardiac hospital. Since 2003, more than $1 billion has gone toward fixing up 44 hospitals, building some 600 diagnostic centers and opening more than 2,100 neighborhood clinics for the Cuban doctors who lead a program called "Mission Inside the Barrio."
The Cuban government, under Chavez's ally Fidel Castro, has sent Venezuela about 20,000 doctors since the program started in 2003 while the island receives shipments of Venezuelan oil under preferential terms.
At a crowded, small clinic run by Cuban doctors in a Caracas slum, 55-year-old Orlando Perez says he receives care for his chronic backaches that he would not otherwise get.
"They give me all the treatment I need, and I don't have to pay anything," Perez says with a smile, adding that some medicines run out at times but he has no complaints about the service.
The Venezuelan Medical Federation is sharply critical of what it calls Chavez's improvised methods and the use of Cuban doctors to create a parallel health system. The federation's president, Dr. Douglas Leon Natera, also says many hospitals are operating with a fraction of needed supplies.
Although infant mortality has declined, Natera says dengue and malaria are on the rise.
Heavy government spending is slowly repairing public facilities such as Caracas' giant Perez Carreno Hospital, which has 800 beds and last month opened nine renovated operating rooms.
The remodeling is under way in functioning wards, and squealing drills ring out within earshot of recovering patients. Automatic glass doors separate the hospital's new wings from grimy hallways dating to the 1960s.
In a new operating room, Dr. Pedro Rodriguez complains after sewing up a patient's injured cheek that the surgical tools are old and dull.
"It's urgent that new supplies be bought," said Dr. Jesus Berrios, head of the surgical unit.
Chavez argues the improvements are undeniable and notes some Venezuelans have been flown to Cuba for specialized, sensitive operations.
At least 183 children, many with life-threatening heart problems, also have undergone free surgery at a new children's cardiac hospital, which Chavez opened with fanfare in August.
The Cubans, however, have almost no contact with Venezuela's best private hospitals, which are preferred by people with insurance or the ability to pay. Public hospitals usually do not require insurance.