Cablegate: Notes From the Barrio: Inside Caracas' Poor

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DE RUEHCV #2044/01 1911546
ZNR UUUUU ZZH
R 101546Z JUL 06
FM AMEMBASSY CARACAS
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RUCNDT/USMISSION USUN NEW YORK 0351
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RUCPDOC/DEPT OF COMMERCE

UNCLAS SECTION 01 OF 03 CARACAS 002044

SIPDIS

SIPDIS

E.O. 12958: N/A
TAGS: PGOV ECON VE
SUBJECT: NOTES FROM THE BARRIO: INSIDE CARACAS' POOR
NEIGHBORHOODS

REF: A. CARACAS 219

B. CARACAS 1897
C. CARACAS 1067

This message is sensitive but unclassified, please treat
accordingly.

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Summary
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1. (SBU) On July 1, EconOff visited the Caracas barrio
(improverished neighborhood) of San Juan, alongside AmiSucre,
an NGO that provides specialist medical care to marginalized
communities. The popularity of these medical services
highlighted the need for this type of care -- and the
inadequacy of existing BRV health care offerings. The BRV
health mission Barrio Adentro (a network of primary care
clinics staffed largely by Cuban medical personnel), was not
present in this neighborhood, and anecdotal evidence from
Venezuelan doctors suggested that a large number of existing
Barrio Adentro modules are inoperative. The barrio,
perceived by outsiders to be a crime-ridden, drug-infested
area, was not as unsafe as expected, and the community was
suprisingly organized in welcoming the visitors and caring
for their neighborhood. Through conversations with
volunteers, EconOff was also able to gain insight into
Chavista grassroots operations and the BRV's community
council initiatives. End Summary.

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"Medical Day" in the barrio
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2. (SBU) On July 1, EconOff visited the San Juan/Guarataro
neighborhood, accompanied by members of AmiSucre (a local NGO
that provides specialist medical care to marginalized
communities) in order to observe the state of community
health care systems. AmiSucre organizes "Jornadas Medicas"
(medical days) in "barrios" (impoverished neighborhoods),
teaming up with medical specialists, and setting up shop in
any building that will house them. USAID is coordinating a
USD 20,000 donation of medications to this organization,
which currently provides free medications donated to the NGO
by domestic and international pharmaceutical labs and other
sources.

3. (SBU) On this trip, AmiSucre convened in a former
classroom that currently houses an independent low-income
medical clinic (the clinic lacked medical equipment, it was
just a room with tables), and in private homes nearby. The
group was comprised entirely of Venezuelan volunteer
specialists, including a cardiologist, a general
practitioner, a pediatrician, a pulmonologist, a nefrologist
(assisting with pre-diabetes checks), dental and pharmacy
students, a legal adviser, a volunteer administering
vaccines, and a team from Fundanemia, an NGO promoting anemia
awareness/treatment.

4. (SBU) AmiSucre's coordinator, Antonio Rodriguez,
explained that specialist care is virtually inaccessible to
marginalized neighborhoods like San Juan. Despite lack of
visible signs or major advertising (some flyers were handed
out locally) to promote the Jornada, the rooms were packed as
soon as the group started. People were very grateful to
receive free medication and a specialist's services. Though
not a medical expert, to EconOff the operation seemed chaotic
-- no set start time, no volunteers triaging the patients,
dogs running loose in consulting areas, doctors doing
consultations in kitchens, or the vaccines being administered
without rubber gloves or an alcohol wipe. Many people

CARACAS 00002044 002 OF 003

brought their pets to be vaccinated (also an advertised
service), but were turned around when the veterinarian didn't
show (the actual vaccines were there). However, for
Venezuelans the hygiene and organization stardards appeared
to be completely acceptable -- and people navigated the
system well to get what they needed. Even children took the
initiative to get their influenza and measles vaccines,
dragging their parents to the vaccination stand. The
popularity of the program hinted at how lacking primary and
specialist care is in this neighborhood. It also suggests
how the minimal health services offered by the
Cuban-administered Barrio Adentro program is so popular in
the poor neighborhoods.

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General observations on barrio life
-----------------------------------

5. (SBU) An outsider's perception of barrio life (even among
middle-upper class Venezuelans) is that these neighborhoods
are plagued with crime, drugs, and social ills. However, the
barrio was not as unsafe as expected. Though on the drive up
there were some visible drug dealers, piles of trash, and
unwelcoming alleys, overall it felt relatively safe to walk
around and people, especially children, were friendly.
Infrastructure was pretty run down (the streets were
operable, but in need of repair), yet houses had running
water and people were sweeping streets as part of what looked
like their daily routine. Despite the poverty, the community
pooled resources and bought enough food to give the 20 plus
doctors and volunteers breakfast and lunch. They also set up
televisions for the group (and themselves) to watch a World
Cup game.

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On BRV missions
---------------

6. (SBU) Despite the BRV's promotion of Barrio Adentro
clinics (a BRV "Mission" comprised of primary care clinics
staffed by Cuban medical personnel), in San Juan there was no
Barrio Adentro (BA) clinic to be seen. A Venezuelan
volunteer surgeon who works out of the independent
neighborhood clinic every Saturday told EconOff (not knowing
that EconOff was from the U.S. Embassy) that when the Cubans
came, most worked out of makeshift offices in people's homes,
and not in the hexagonal clinics that the BRV built
nationwide for this purpose (Ref A). He estimated that more
than 40 percent of the Cuban doctors are gone, and that most
hexagonal modules are empty. EconOff drove past two BA
hexagons on the way back home (on a Saturday morning), and
both were closed. The Venezuelan doctor also added that
Barrio Adentro's doctors were not qualified -- he offered an
anecdote of one of the two Cuban doctors in the area getting
sick, and the remaining Cuban seeking the aid of the
Venezuelan doctor instead of his Cuban colleague.

7. (SBU) According to one AmiSucre volunteer from the area,
the missions were "failing" and people were beginning to see
them for what they were: political propaganda. Regarding
health care, AmiSucre's coordinator told EconOff that when
Barrio Adentro started, it sucked away funding from other
primary care initiatives (either co-sponsored by churches, by
the Ministry of Health, or with NGOs). See septel to follow
on Barrio Adentro.

8. (SBU) In contrast to Barrio Adentro's absence was the
presence of the BRV's food mission, Mercal (Ref B). EconOff
observed some Mercals -- one with an official Mercal sign,
another with a hand-written sign -- and a PROAL, a
government-sponsored cafeteria destined to feed the

CARACAS 00002044 003 OF 003

lowest-income Venezuelans. The PROAL, however, was closed,
and looked like it had been closed for some time.

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On grassroots political activity
--------------------------------

9. (SBU) A volunteer told EconOff that there was an element
of "fear" as part of Chavismo in the barrio -- he said that
the MVR recruited the "malandros" (criminals) of the barrio
to be activists, and that this effectively silenced
opposition-leaning or critical voices in the community.
While EconOff was assisting in the makeshift clinic, a group
of upper-class young people from an opposition political
organization called Grupo Cambio came to talk to patients and
organizers. The group is an opposition NGO that provides
political training to young leaders and carries out social
projects in poor neighborhoods. They typically piggy-back on
AmiSucre events to look for young barrio leaders open to
political training. The visitors raised no eyebrows, despite
their visibly upper-class appearance and political purpose.

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On community councils
---------------------

10. (SBU) An AmiSucre volunteer providing pro bono legal
advice, who identified himself as opposition and living in a
middle-low income neighborhood, conveyed to EconOff that he
attended a Community Council meeting in his barrio and that
they had not followed the law when it came to electing
members on the council's committees (Ref C). However, he
viewed the councils positively, since it meant money going
directly to the community versus trickling down from the
mayor's office. He said that people needed to act now,
because only the most organized groups (pro-Chavez political
groups) were seizing upon the council money. He said there
was a real danger of this money going toward "political
ends." When asked about corruption, he said some money would
of course disappear, but he was optimistic that the funds
could be used for legitimate projects.

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Comment
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11. (SBU) The visit to the barrio of San Juan shed light on
the general state of affairs in Caracas' periphery. The
popularity of the "Medical Day" alone highlighted the need
for primary care (such as vaccinations) and specialist care
in the barrio -- proving that neither the Ministry of Health
or Mission Barrio Adentro are cutting it. Despite perception
of the barrios as crime-infested no-man's lands, the
neighborhoods showed a suprising level of organization and
good will towards visitors. The views of some volunteers
from the area hint that on the ground, the missions and
community councils are relatively valuable and important to
low-income Venezuelans, though by no means are they perfect
or wildly successful enterprises. End Comment.
BROWNFIELD

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