As NGOs negotiate access, dual crises unfold in Venezuela

WASHINGTON — Getting humanitarian aid inside Venezuela has become even more paramount as the country now faces the dual crises of collapsing health and economic infrastructure and the COVID-19 pandemic. While the country's political leadership remains disputed, international organizations must navigate delicate access agreements to distribute much-needed supplies without interference.

After years of denying a humanitarian crisis existed inside his country — while millions of people fled on foot to neighboring countries, inflation skyrocketed, and basic goods became impossible to purchase — Venezuelan President Nicolás Maduro cautiously reached an agreement to allow international assistance into the country in March 2019.

The International Federation of Red Cross and Red Crescent Societies was able to significantly expand its operations inside the country following the agreement, while many other organizations working there still must remain anonymous.

Now, the stretched humanitarian infrastructure is also tasked with responding to the coronavirus pandemic, which could be disastrous for a country where people already lack access to hospitals that are properly staffed and carry basic medicines. According to the Pan American Health Organization’s official count, Venezuela had 21,438 confirmed cases of COVID-19 and 187 deaths as of Wednesday.

To address needs inside the country, the United Nations Office of the Coordination of Humanitarian Affairs last month released its “Humanitarian Response Plan for Venezuela,” which will target 4.5 million of the estimated 7 million people in need. The plan would cost $762.5 million to finance 234 projects with 129 partners. Of those funds, $87.9 million would support the health and socio-economic response to the pandemic.

PAHO, which has a country office in Venezuela, is working both with Maduro’s Ministry of Popular Power for Health and the opposition-held National Assembly to coordinate delivery of medicines, vaccines, personal protective equipment, medical supplies, and equipment to both health services and other institutions. The regional health agency leads the country’s health cluster, a collaboration of 65 organizations that includes other U.N. agencies as well as national and international NGOs.

Amid Venezuela’s deteriorated health infrastructure, PAHO seeks to expand testing, contact tracing, and ensuring effective quarantine measures. The Venezuelan Red Cross, in coordination with its international societies, is also working to prevent the country’s health infrastructure from completely collapsing under the weight of the additional stress caused by the pandemic.

“Twenty-four seven and 365 days of the year we are working on having enough medical supplies and enough protection, because at this stage we don’t know when this is going to end, and we are preparing every day our hospitals and our outpatient clinics to be in optimal conditions,” said Luis Farias, spokesperson at the Venezuelan Red Cross.

“Red Cross hospitals and clinics are not hospitals that will be receiving or treating COVID-19 patients. But they can help the system if we are prepared.”

Making sure volunteers have appropriate PPE has become a priority, Farias said, because without a way to protect people from getting sick, the entire system could come to a halt.

Between January 2019 and March 2020, IFRC and the International Committee of the Red Cross helped the Venezuelan Red Cross get 575 tons of medical supplies into the country. Aid arrives at the Red Cross’ central warehouse, and is then distributed to different states depending upon need. Things like water, sanitation, and hygiene supplies are also in higher demand during the pandemic, and the Venezuela Red Cross continues distributing supplies such as bed nets to address other health threats including malaria.

Ensuring supplies arrive to populations according to need — and not politics — is absolutely necessary, Farias said.

“When you see a Red Cross volunteer, they’re there only to help people who need it the most,” Farias said. “The key has been to show the work and to show that it’s not politicized. Our work is easier and we get to reach more people. Definitely it’s a challenge, because in such a politicized environment, it’s hard to make that clear.”

While the Red Cross reached the agreement with Maduro’s government, interim President Juan Guaidó’s administration is also working to coordinate humanitarian efforts inside the country. Guaidó, who became interim president under Venezuela’s constitution in January 2019, is recognized by much of Latin America as the legitimate leader of the country.

Many humanitarian actors looking to maintain access inside Venezuela must figure out how to work with both governments.

Miguel Pizarro, Guaidó’s presidential commissioner to the U.N. based at the embassy in Washington, D.C., works to coordinate with both PAHO and the Red Cross on humanitarian efforts inside the country.

The embassy is working to repurpose money that has been frozen in the U.S. and Spain because of international sanctions against Maduro’s government. Pizarro said PAHO will receive $10 million and IFRC will receive $5 million. Some of the funds will also be used to pay salaries to frontline health workers.

“We are trying to use all the frozen assets through humanitarian agencies using the humanitarian principles as a guidance and avoiding any kind of political inference,” Pizarro said, noting that the embassy needs a license from the U.S. Office of Foreign Asset Control to redistribute the funds.

“It’s a matter of transparency. It’s the only way to ensure that we are not having any kind of national intermediates … The transfer is going directly from the account where the money is right now to the [humanitarian] organizations without passing through any political actor.”

The access dilemma

Venezuela has only one lab that can process COVID-19 tests, performing up to 1,200 per day, Pizarro said. He said cases are certainly being underreported, with likely higher numbers in states that border Colombia, from which Venezuelan migrants and refugees are returning to their home country as job opportunities dry up during pandemic lockdowns. Guaidó’s government wants to scale up testing to have a better idea of the actual scale of the coronavirus caseload.

The embassy in Washington is working with the private sector to deliver supplies to Venezuela, including used hospital equipment from facilities in Houston that will be transported by humanitarian medical logistics organization Medical Bridges. The Guaidó government has also coordinated delivery of five shipments of humanitarian supplies from various European countries and entities, as well as PAHO and the U.S. Agency for International Development.

USAID is providing additional COVID-19-related emergency assistance inside Venezuela, according to Joshua Hodges, senior deputy assistant administrator for Latin America and the Caribbean at the agency. The U.S. coordinates with the U.N., NGOs, and international donors to determine how aid can be distributed through independent humanitarian organizations.

“While our efforts are making an impact, Maduro has stood in the way of allowing more help to Venezuelans in their time of need by creating numerous obstacles and barriers for international NGOs,” Hodges said Tuesday during Congressional testimony. “Humanitarian organizations face constant harassment from security personnel affiliated with Maduro, and the illegitimate regime continues to impede international expert staff from obtaining visas and registering certain organizations.”

While Pizarro said his government is working with many entities to ensure humanitarian supplies reach people in need inside Venezuela, he expressed frustration with the politics surrounding access. He said some agencies, including OCHA, can be too cautious.

“A lot of times they prefer not to say what’s happening to guarantee the access they have,” Pizarro said. “I’d love to see an OCHA more vocal about access, and about international NGO registration, and about autonomy in [logistics] and about the ability to make importations of supplies without going through any political checkpoint.”

“But also, on the other hand, I understand the regime I am fighting. So we have to make a balance and that fragile balance is what we are trying to build always with them,” Pizarro said.

OCHA declined to comment on its response inside Venezuela for this story, referring inquiries to PAHO.

“PAHO permanently adheres to the humanitarian principles and has demonstrated transparency, impartiality, and accountability in all its interventions, providing technical support to ensure the right to health for all people, leaving no one behind,” PAHO said in a statement.

“Our work is to reduce the impact of the humanitarian situation, ensuring the physical and mental well-being of the most vulnerable people.”