Venezuela’s health systems are crumbling – and harming women in particular

By Pia Riggirozzi, Professor of Global Politics at the University of Southampton

Venezuela sits on the world’s biggest oil reserves, but in terms of GDP growth per capita, it’s now South America’s poorest economy. It is mired the worst economic crisis in its history, with an inflation rate in the region of 500%, a volatile exchange rate, and crippling debts that have increased fivefold since 2006.

The economic crisis is inflaming a longstanding “economic war” between the government and the business sector – and a dangerous cycle of protest and repression is further polarising Venezuela’s already divided society.

In this scenario, violence of all sorts is approaching what could be a point of no return. The very ability of democracy to combine forces of transformation and resistance is at stake.

The crisis in Venezuela has also taken centre stage in regional organisations. The Union of South American Nations and the Organisation of American States are gravely concerned with the weakness of Venezuela’s democratic institutions, its culture of impunity, and the criminalisation of dissent. But they’re overlooking one of the biggest tragedies of the crisis: the crumbling of Venezuela’s health and welfare systems, which not long ago were beacons of hope. This collapse is truly dangerous and is affecting Venezuela’s women particularly badly.

Venezuela’s promise

For more than a decade, Venezuela was a focal point in the continental promise of a more direct and inclusive alternative to dominant marketised approaches to development and democracy. At the end of the 1990s, governments across South America began embarking on various “post-neoliberal” experiments – and for more than a decade, those experiments seemed to work.

Between 2000 and 2014, the region nearly halved the proportion of its people who lived in poverty, and the bottom 40% of its the population saw their incomes rise dramatically. In Venezuela, social, political and economic reforms between 1998 and 2012 helped cut poverty by a spectacular 50%, and extreme poverty by 65%.

Venezuela also became a regional health and welfare pioneer, greatly expanding the number of primary care physicians in the public sector and offering millions of poor citizens better access to healthcare than ever. Under a flagship programme titled Oil for Doctors, Venezuela subsidised oil exports to Cuba in exchange for deployments of Cuban medics and medical training programmes. The Barrio Adentro programme was set up to provide free basic medical care; Mission Miracle provides free eye care to people across the region, and other Venezuelan initiatives tackle the needs of people with disabilities across Central and South America.

But these remarkable projects all depended on revenue from Venezuela’s oil bonanza and accumulated reserves. Once the country was hit by an international oil industry downturn, the result was a string of shortages, outbreaks and widespread social deprivation – and a spiralling socio-political crisis.

Today, thousands of patients cannot receive essential medical treatments – and thousands more are on the waiting list to undergo vital surgery because doctors do not have the necessary resources. Likewise, diseases such as malaria and diphtheria – previously eliminated or controlled – are now on the rise, with disastrous results.

These assorted crises have implications for all Venezuelans, but women in particular. Their rights and choices are affected in distinctive ways, especially when it comes to reproductive rights, sexual health, and gender-based violence.

Women’s rights and dignity

Even before the economic collapse, Venezuela had one of the highest teenage pregnancy rates in the world. To tackle the problem, the socialist government rolled out entitlements to contraception – but the Venezuelan Pharmaceutical Federation estimates that since 2005, the country’s stocks of contraceptives have fallen by 90%. This is fuelling a rise of sexually transmitted diseases, particularly HIV, and more and more women are seeking out illegal abortions and even sterilisations.

According to Amnesty International, between 2015 and 2016 maternal mortality increased by 65% in Venezuela – wiping out recent advances and returning to the situation that prevailed 25 years ago. Among the main causes are the lack of medicines and basic medical tools and equipment, and the ever-falling number of medical personnel, many of whom are either emigrating or simply unable to work without equipment or pay.

Women find themselves in desperate situations and who fear dying in childbirth are fleeing to give birth in neighbouring Brazil and Colombia. According to the United Nations High Commissioner for Refugees, the overall number of arrivals in neighbouring states steadily increased to 5,000 a day as of early 2018. More than 56,000 Venezuelans crossed the borders in January alone – 40% of them were women.

The ConversationSo far, Venezuela’s South American neighbours and the regional multinational organisations have responded to the crisis principally as an economic and fundamentally a constitutional problem, justifiably worried as they are by the Maduro’s rapidly expanding authoritarianism. They have focused on isolating his government, condemning Venezuela’s farcical elections, recalling their ambassadors and even moving to suspend the country from organisations such as the Organisation of American States. But this is a humanitarian disaster, not just a democratic one. It’s time for other countries to step up and address the crisis’s disastrous effects on women, their rights, and their dignity.

This article was originally published on The Conversation. Read the original article.

Unsettling Patriarchy: Tackling the Gendered Injustices of Colonialism in Liberal Democracies

By Michael Elliott, Visiting Research Fellow in the Centre for Citizenship, Globalization and Governance at the University of Southampton (Academia.edu).


Indigenous women stand amongst the most marginalised and vulnerable of groups within contemporary liberal democracies. This fact has been recognised for some time, but was affirmed again last week in a report published by the UN Committee on the Elimination of Discrimination Against Women (CEDAW). It highlighted the patterns of severe disadvantage, discrimination, and violence – including sexual violence and murder – to which Indigenous women in Canada are routinely exposed, and lamented the general lack of sufficient action being taken to address them. The same story could also be told of other advanced liberal democratic ‘settler’ states such as Australia, New Zealand, and USA.

In the wake of the CEDAW report, and as we find ourselves sandwiched neatly between International Women’s Day (8th March) and International Day for the Elimination of Racial Discrimination (March 21st), this seems as opportune a time as any to reflect upon this issue.

Gendered colonialism

The distinct form of oppression to which Indigenous women in settler societies are today subject is, by any standards, complex. Since the earliest days of European colonial presence in the so-called ‘New World’, through subsequent processes of settlement and state-building, and within the contemporary legislative and policy frameworks of liberal democratic governance, the positions of Indigenous women have come under particular and consistent attack.

To some extent, this must be understood in the context of wider racist and sexist cosmologies that have dominated (and in many ways dominate still) Western societies, and which have conspired to ensure a special disregard for Indigenous women. But there is also another side to this story that is rooted more in the realm of strategic reasons. Undermining the power and status of Indigenous women in a specific sense has formed a key part of attempts to weaken the social cohesiveness of Indigenous groups more generally, and with it their resistance to colonial processes and the advancement of state interests.

Accordingly, measures designed to diminish the power of Indigenous women within their communities (and outside of them), to separate them from important social and cultural networks, and to cut them out of the economy, have been a consistent feature of settler-colonialism. One need only witness the legacy of sexist provisions in the Indian Act in Canada for indication of this. Set in the broader context of colonial domination, these gendered attacks have carried dire repercussions.

Gender relations in many communities have been seriously distorted at the same time that social mechanisms for tackling abuse and discrimination have been dramatically eroded. In wider society, gendered oppression has been compounded by entrenched forms of racial discrimination. The result is that Indigenous women in settler-colonial contexts today find themselves negatively positioned in social relationships of all kinds – that is, in respect of Indigenous men as well as non-Indigenous men and women – and suffer a host of disadvantages and vulnerabilities as a result. In terms of socio-economic status, health, employment, housing, political representation, and in many other areas besides, serious disparities have emerged.

But if the factors underpinning such disadvantage are complex, then taking effective measures to address it is even more so. For, the fact is that colonial domination is not some distant aspect of history for most Indigenous groups in settler societies today. It is, rather, an active feature of daily life. The presence of external authority over Indigenous lands and populations has never been removed, and neither has the sense of injustice and threat that comes with it.

One consequence of this is that efforts to address patterns of female subordination can come into conflict with broader struggles against colonial domination. Where emancipatory movements around gender seem to draw on the resources of dominant society (both material and intellectual), and especially where they serve to cast doubt on the representative legitimacy of Indigenous governments and other organisations pressing for political change, there is real potential for friction with wider ‘decolonisation’ projects.

The result is that gender-based struggles often carry a certain controversy for many Indigenous communities, and have historically tended to become somewhat peripheralised as a result. This does not excuse, but has nevertheless abetted, a general lack of sufficient commitment amongst state actors to tackle such disadvantage – who, for better or worse, are currently best equipped in terms of resources and power to take decisive steps to promote change. The combined result is that disproportionate patterns of injustice and suffering borne by Indigenous women have persisted despite relatively wide acknowledgement.

How can progress be realised?

The very broad brushstrokes I have painted with here undoubtedly gloss over a great deal more complexity, controversy, and contextual nuance. Nevertheless, this rudimentary picture can at least provide traction for some initial thoughts on finding a more effective response to this issue.

And we might benefit here from separating two things: (1) the overall fact of oppression on the one hand; and (2) vulnerability to the most dire consequences of that oppression on the other. This is a precarious separation at best (both conceptually and practically speaking), but nevertheless can be of use in this case.

Taking the vulnerability question first: the CEDAW report emphasised that susceptibility to violence, poor health, and the worst effects of discrimination is exacerbated by the low socio-economic status of Indigenous women. Tackling this dimension of disadvantage must therefore represent an absolute priority.

In the current context, this can only be done with the full backing and support of the state. And whilst some notable steps have been taken in this regard by liberal governments in recent years, continuing patterns of violence and suffering attest to the need for a great deal more action. This will inevitably evoke significant antagonisms for groups struggling against the broader context of colonial domination. However, these might be reduced (to at least some extent) by resourcing Indigenous organisations to take the lead in the design and implementation of response programmes. The state could also take a responsible step here by refusing to appropriate such moves in efforts to consolidate its own position in ongoing disputes of colonial injustice.

However, tackling acute vulnerability is clearly only one part of the issue. And whilst such measures ought to carry broader positive repercussions in their own right, these will be limited if the background conditions of Indigenous women’s oppression are not simultaneously addressed.

This is by far the more difficult question, and one that lacks a clear or simple answer. Undoubtedly, though, without significant advancement in confronting the enduring fact of colonial domination – including the specific scenes of dispossession and disempowerment that currently characterise it – attempts to tackle its consequences are likely to fall desperately short. Gender-specific patterns of injustice certainly cannot simply be subsumed into this broader category of colonial injustice, but neither can they be treated in isolation from it. Achieving significant progress in respect of either inescapably requires addressing them together.

The kind of broad and unified commitment needed to make real moves in this direction presently seems (to put it generously) unlikely. But without it, it is difficult to see how the patterns noted in Canada in the CEDAW report – and felt equally acutely in other settler-colonial contexts – will improve significantly. As difficult as an open and committed confrontation with not only the past but also the ongoing injustices of colonial domination will be for settler societies (and the wider international community), it would seem to be essential if the suffering and rights abuses currently experienced by Indigenous women are to be properly addressed.