Doctors Flee Venezuela — But Save Lives in Remote Chile
WHY YOU SHOULD CARE
Some countries are struggling to host Venezuelan refugees. But for Chile’s Patagonia, they’re lifesavers.
The first time Luis Vieras Delnardo gazed across Last Hope Sound and saw the icy blue waters ringed by snow-covered mountains, he felt like he was watching a scene unfold from a movie. The then-33-year-old anesthesiologist from Caracas, Venezuela, had applied online for a position at the public hospital in Puerto Natales, a town in Chile’s southernmost region — Magallanes and the Chilean Antarctic. He had never heard of the town’s name before, so on a frigid winter day last July, Vieras stepped off a bus to see if he could envision building a life in a blustery coastal town in the Chilean Patagonia.
This journey isn’t one that many Chilean doctors are willing to undertake. Magallanes is an isolated region that has struggled for years to attract and retain medical professionals. There is no terrestrial connection between Magallanes and the rest of Chile. One must travel three days by ferry, take an airplane or drive through Argentina in order to arrive from Chile’s northern regions. But a growing number of medical specialists fleeing crisis-gripped Venezuela are making this distant region their home, filling important gaps in health care. They’re also flipping the hemisphere-wide narrative of migrants and refugees from Venezuela becoming burdens on countries where they’re moving.
Half of the 24 specialists at Puerto Natales’ public Dr. Augusto Essmann Hospital are non-Chilean, and eight of them — a third — are now from Venezuela. Three of the seven general practice doctors at the Puerto Natales Family Health Center are Venezuelan. They’re driving a rapid increase in the number of non-Chilean doctors in the Magallanes region, up 32 percent over the past four years.
These doctors are part of a broader surge in Venezuelan medical professionals moving in to stock Chile’s hospitals. In 2014, there were only 96 Venezuelan doctors in Chile. Four years later, that number had increased to 2,480. But while that’s allowing Chile to address an overall shortage — 23 percent of the nation’s doctors are foreign medical professionals — it’s particularly helping neglected regions such as the extreme south fill critical positions at understaffed hospitals.
People have been very welcoming.
Nadia Sánchez Oliveros, a Venezuelan anesthesiologist in Magallanes
For the Venezuelan doctors, the region offers a rare welcoming environment in a continent where countries are beginning to tighten restrictions on their entry and lengths of stays. That makes the massive journey — Caracas is as far from Puerto Natales as Reykjavik, Iceland, is from Dubai, United Arab Emirates — worth it.
“I am very grateful to Chile,” says Vieras, recalling how he felt overwhelmed when he first visited a grocery store in the country after arriving from Venezuela, ruled by left-wing governments for two decades now. “I hadn’t seen more than one brand of milk or a variety of yogurt since I was 13 years old.”
Nationally, Chile has improved access to medical specialists in recent years. According to an April 2019 report by the Ministry of Health, the country in 2017 had one specialist for every 791 citizens, compared to a ratio of 1:1,065 in 2008. The number of doctors practicing in Chile increased by 7.6 percent last year, according to the Organization for Economic Cooperation and Development. But the country still has a lower density of medical specialists — except for gynecological obstetricians — than other countries of comparable income, such as South Korea, Mexico or Slovenia. Regional disparities complicate the challenge. “Problems of territorial distribution persist,” says Michèle Guillou, associate professor in public health at the University of Chile.
Chile’s response to the Venezuela crisis, though, is helping it address these problems, at least in part. Until a few months ago, the country allowed Venezuelans to visit for up to 90 days without a tourist visa. While it now requires a tourist visa, Chile — which is calling for Venezuelan President Nicholas Maduro to step down — has in June started offering Venezuelan migrants a “democratic responsibility visa” at all its consulates globally. The visa allows holders an opportunity to stay in Chile for a year, with the possibility to extend that by another 12 months. After Colombia and Peru, Chile has attracted the third-highest concentration of Venezuelan migrants, an estimated 288,233, including the fastest-growing demographic of foreign doctors. Overall, more than 4 million people have fled Venezuela since the start of the crisis there.
And within Chile, the government is incentivizing those who want to work in distant regions like Magallanes. For a foreign doctor keen to practice in Chile, revalidating medical degrees can take years, but with special permission from the Ministry of Health, they can work in public health care in high-need regions during the re-credentialing process. That proved attractive for Nadia Sánchez Oliveros, an anesthesiologist who left the crystalline seas and palm-tree-dotted beaches of Venezuela’s Margarita Island because of her nation’s political turmoil. “I had the opportunity to go to Costa Rica, as I have a sister there, but the recertification process for my profession was more difficult than in Chile,” Sánchez says. After three months looking for work in Santiago in 2016, she accepted a position in Patagonia.
The government also offers higher wages to doctors working in “extreme zones” such as southern Chile to attract medical professionals to these regions.
“The salary here in Magallanes is practically the highest in the country,” says Manuel Hernandez, director of Dr. Augusto Essmann Hospital in Puerto Natales. Despite the subsidies — which also extend to Chilean professionals — doctors from the country prefer the better-paying private health care sector over public hospitals in isolated Magallanes, says Hernandez. Foreign doctors who want to work while their degrees are being revalidated don’t have that option. “So, what happens? We look for help from foreign medical professionals,” explains Hernandez.
Even with the influx of Venezuelan doctors, the public hospital in Puerto Natales — known as the gateway to Torres del Paine National Park, the eighth Wonder of the World — is short-staffed, with seven unfilled positions. Some of those positions might be filled by Venezuelans, suggests Hernandez, though it is challenging to find highly qualified candidates with the necessary paperwork. The absence of a local cadre of doctors also leaves the region vulnerable, if Venezuelan medical professionals decide to return home once the crisis subsides.
But the doctors who have made the trip to Magallanes don’t anticipate leaving anytime soon. Vieras says he doesn’t know “when things will change” back in Venezuela and that he is “pessimistic.” The socialist Venezuelan regime has been in power since 1999. “I can’t wait 20 more years; I want to live my life now,” he says. Sánchez, whose husband and son have joined her, echoes these sentiments of mistrust. “I could be killed there [in Venezuela], just so that someone could rob me,” she says.
In slow-paced Magallanes, by contrast, these Venezuelan doctors are actually valued by the community. The quality of life is appealing too. Sánchez’s son Rodrigo is now in second grade. Her hospital is just a few blocks from his school, so she picks him up and they eat lunch together every day. It’s colder than she had expected, but “the people have been very welcoming,” she says. “There are also fewer bugs here than in Venezuela and less disease.”
Vieras is looking to purchase a house — just one more step toward building his future and setting down roots in a remote seaside town that’s now his new home.