B1 · Intermediate
12 min
healthpoliticshuman rightsinternational
La Cárcel que Enferma: Prisiones y Salud en Venezuela
The Prison That Sickens: Prisons and Public Health in Venezuela
Fletcher breaks down this story in English. Octavio reacts and expands in Spanish. Follow along with the live transcript, tap any word for its translation. Intermediate level — perfect for intermediate learners expanding their range.
So, Octavio, Venezuela.
Five dead, two hundred injured in a prison riot at a place called Yare Prison, in Miranda State.
When I saw that number, two hundred injured, I stopped.
That's not a riot.
That's a catastrophe.
Bueno, mira, el número es terrible.
The number is terrible, Octavio says.
Pero cuando escucho 'Yare', no me sorprende.
But when he hears 'Yare,' he's not surprised.
Es una de las prisiones más famosas de Venezuela, y no por buenas razones.
It's one of Venezuela's most infamous prisons, and not for good reasons.
Right.
And I want to get into why Yare specifically, because I think the name carries weight.
But first, help me understand the scale of Venezuela's prison problem.
Because from what I know, this isn't an isolated incident.
A ver, Venezuela tiene algunas de las prisiones más peligrosas del mundo.
Venezuela has some of the most dangerous prisons in the world, Octavio explains.
Hay mucha violencia, hay poca comida, y la atención médica casi no existe.
There is a lot of violence, very little food, and almost no medical care.
Es una crisis muy seria.
It is a very serious crisis.
Almost no medical care.
I mean, let's just sit with that for a second.
We're talking about thousands of people locked in a building where, if you get sick, there's essentially nothing.
Exactamente.
Exactly, says Octavio.
Y cuando hay un motín con doscientas personas heridas, los hospitales fuera de la prisión también tienen problemas.
And when two hundred people are injured in a riot, the hospitals outside the prison are also struggling.
No hay suficientes médicos, no hay suficientes medicamentos.
Not enough doctors, not enough medicine.
So it's a double collapse.
The prison is broken, and then the healthcare system it would have to rely on is also broken.
That's the situation you're describing.
Sí, exactamente.
Yes, exactly.
Venezuela perdió muchos médicos en los últimos años.
Venezuela lost many doctors in recent years.
Muchos emigraron a Colombia, a España, a Estados Unidos.
Many emigrated to Colombia, Spain, the United States.
El sistema de salud era bueno en los años ochenta, pero ahora es muy diferente.
The health system was good in the eighties, but now it is very different.
That flight of doctors, the brain drain from Venezuela, is one of the most underreported stories of the last decade.
At peak, I've seen estimates of something like twenty thousand physicians leaving the country.
For a population of thirty million.
La verdad es que es un número muy grande.
The truth is that it is a very large number, Octavio says.
Y los que se quedaron trabajan en condiciones muy difíciles.
And those who stayed work in very difficult conditions.
Muchos hospitales no tienen agua, no tienen electricidad, no tienen los instrumentos necesarios.
Many hospitals have no water, no electricity, no necessary equipment.
Now, let's go back to Yare specifically, because I think there's a history there that matters.
This isn't just any prison, right?
Bueno, mira, Yare es una prisión muy grande y muy antigua.
Yare is a very large and very old prison, Octavio explains.
Está cerca de Caracas.
It is close to Caracas.
En el pasado, hubo muchos motines importantes allí.
In the past, there were many important riots there.
Cuando Chávez era presidente, Yare ya era famosa por los problemas.
Even when Chávez was president, Yare was already known for its problems.
Here's what gets me, historically speaking.
Yare was where they held some of the coup plotters from 1992.
Including a young lieutenant colonel named Hugo Chávez, who then ran the country for fourteen years.
The prison that made him.
Sí, sí.
Yes, and Chávez promised to reform the prisons, Octavio confirms.
Y Chávez prometió reformar las prisiones.
But the situation did not improve much.
Pero la situación no mejoró mucho.
The truth is it got worse in some ways, especially after 2013.
La verdad es que empeoró en algunos aspectos, especialmente después de 2013.
2013 being when Maduro took over after Chávez died.
And then, of course, the economic collapse really accelerated.
Look, I covered that period from a distance and the stories coming out of Venezuelan prisons were horrifying even then.
Es que en las prisiones venezolanas existe el sistema del 'pran'.
Inside Venezuelan prisons, there is the 'pran' system, Octavio explains.
El pran es el líder de los presos.
The pran is the prisoner leader.
Él controla la prisión, no los guardias.
He controls the prison, not the guards.
Los guardias tienen miedo.
The guards are afraid.
The pran system.
I want to make sure listeners understand this, because it's extraordinary.
You're describing a situation where the state has essentially surrendered the interior of the prison to criminal organizations.
Exactamente.
Exactly.
El pran decide quién entra, quién sale, quién come, quién recibe medicamentos.
The pran decides who enters, who leaves, who eats, who gets medicine.
Es un poder total.
It is total power.
Algunas personas pagaban para vivir mejor dentro de la prisión.
Some people paid to live better inside the prison.
So medication becomes a commodity.
If you have money or connections, you get treated.
If you don't, you die from something preventable.
That is, by any definition, a public health disaster.
Sí.
Yes, and there are many diseases in the prisons: tuberculosis, HIV, malaria in some regions.
Y hay muchas enfermedades en las prisiones: tuberculosis, VIH, malaria en algunas regiones.
Overcrowding is enormous.
La sobrepoblación es enorme.
Yare was designed for fewer than a thousand people but holds double that or more.
Yare fue diseñada para menos de mil personas, pero tiene el doble o más.
Tuberculosis.
That one really strikes me, because TB is a disease that we associate with poverty and overcrowding, and it's completely treatable if you have the drugs.
If you have the drugs.
Claro.
Of course.
Venezuela tuvo una de las tasas más altas de tuberculosis en América Latina en los últimos años.
Venezuela had one of the highest tuberculosis rates in Latin America in recent years, Octavio says.
Y no es solo en las prisiones.
And it is not just in prisons.
En los barrios pobres de Caracas también es un problema serio.
In the poor neighborhoods of Caracas it is also a serious problem.
And this is what I want to push on, because I think some listeners might think, well, it's a prison, it's a separate world.
But it's not.
People go in and come out.
Guards go home every night.
Diseases don't respect walls.
Tienes razón.
You are right, Octavio agrees.
Las enfermedades de las prisiones son enfermedades de la sociedad.
Prison diseases are society's diseases.
Cuando una persona sale de la cárcel con tuberculosis y va a su casa, su familia también está en riesgo.
When a person leaves prison with tuberculosis and goes home, their family is also at risk.
The extraordinary thing is that this was already documented, extensively, before the crisis deepened.
Human rights organizations were raising the alarm about Venezuelan prisons back in the early 2000s.
And nothing changed.
It got worse.
Bueno, el gobierno siempre decía que iba a reformar el sistema.
The government always said it would reform the system, Octavio explains.
Pero hay muchos problemas: corrupción, falta de dinero, falta de voluntad política.
But there are many problems: corruption, lack of money, lack of political will.
Y la crisis económica hizo todo más difícil.
And the economic crisis made everything harder.
Let's talk about that economic crisis for a second, because it is inseparable from the health story.
Venezuela had the largest proven oil reserves in the world and managed to collapse its own healthcare system.
How does that happen?
Es que durante los años del petróleo caro, el gobierno gastó mucho dinero, pero no invirtió bien.
During the years of expensive oil, the government spent a lot of money but did not invest wisely.
Cuando el precio del petróleo bajó en 2014, el sistema ya era frágil.
When the oil price fell in 2014, the system was already fragile.
Y después las sanciones internacionales hicieron las cosas peores.
And then international sanctions made things worse.
I'll be honest, the sanctions debate is complicated.
I've spoken to economists who argue the sanctions accelerated the suffering of ordinary people even as they were meant to pressure the government.
And the government, of course, used that as cover.
La verdad es que las dos cosas son verdad.
The truth is that both things are true, Octavio says carefully.
Las sanciones hicieron daño a personas normales, pero el gobierno también es responsable.
The sanctions did hurt ordinary people, but the government is also responsible.
No podemos decir que todos los problemas de salud son culpa de las sanciones.
We cannot say all the health problems are the fault of sanctions.
No, you're absolutely right about that.
The deterioration of Venezuela's hospital system started well before the heaviest sanctions hit.
I've read the NGO reports from 2016, 2017.
The numbers were already shocking.
Mira, en esa época los hospitales no tenían medicamentos básicos.
In that period, hospitals had no basic medicines.
No tenían anestesia para las operaciones.
They had no anesthesia for operations.
Había personas que morían de enfermedades simples porque no había tratamiento.
People died from simple illnesses because there was no treatment.
No anesthesia for surgery.
I spent time in war zones where the medical situation was desperate, and that phrase still lands hard.
Because that's not a war zone, that's a country with oil.
Or it was.
A ver, y todo esto llega a las prisiones de forma más intensa.
And all of this arrives inside prisons with even greater intensity, Octavio says.
Si los hospitales normales tienen problemas, imagina la situación dentro de Yare.
If normal hospitals have problems, imagine the situation inside Yare.
Los presos son las personas más vulnerables del sistema.
Prisoners are the most vulnerable people in the system.
The most vulnerable and the most politically invisible.
Because no government wants to talk about the health of its prisoners.
It's not a vote-winner anywhere, let alone in a country where the government controls information.
Es que hay una idea común en muchos países: los presos no merecen atención médica buena.
There is a common idea in many countries, Octavio says: prisoners don't deserve good medical care.
Pero eso es un error.
But that is a mistake.
Desde el punto de vista de la salud pública, la salud de los presos es la salud de todos.
From a public health perspective, the health of prisoners is everyone's health.
Right, so after a riot like this, two hundred people injured.
Walk me through what actually happens.
Because these aren't going to state-of-the-art trauma centers.
Bueno, normalmente los heridos van a los hospitales más cercanos.
Normally the injured go to the nearest hospitals, Octavio explains.
Pero esos hospitales también tienen problemas.
But those hospitals also have problems.
Y los familiares de los presos esperan afuera sin información.
And the families of the prisoners wait outside with no information.
Es una situación muy caótica y muy dolorosa.
It is a very chaotic and very painful situation.
The families waiting outside.
That's a detail I don't think people picture when they hear 'prison riot.' These are mothers, wives, children, waiting for news about whether someone they love is alive.
Sí.
Yes.
Y en Venezuela, los familiares muchas veces llevan comida y medicamentos a las prisiones porque el Estado no los da.
And in Venezuela, family members often bring food and medicine to prisons because the state does not provide them.
Si hay un motín y no pueden entrar, sus familiares no comen, no tienen medicamentos.
If there is a riot and they cannot enter, their relatives do not eat and have no medicine.
So the family becomes the healthcare system.
The family becomes the food supply.
The state has retreated so completely that ordinary people are filling the gap with their own hands.
That is, I don't know, that is a particular kind of failure.
La verdad es que Venezuela necesita una reforma muy seria de todo su sistema de salud, no solo de las prisiones.
The truth is Venezuela needs a very serious reform of its entire health system, not just its prisons, Octavio says.
Hay personas muy capaces en el país que quieren cambiar las cosas, pero es difícil en la situación actual.
There are very capable people in the country who want to change things, but it is difficult in the current situation.
Look, I'll end on this.
A prison riot in Miranda State might feel like a distant news item.
But it is, if you look closely enough, a snapshot of what happens when a state stops functioning.
The prison is the canary.
And in Venezuela, the canary has been silent for a long time.
Bueno, sí.
Yes, and Octavio hopes listeners remember that behind every number, five dead and two hundred injured, there is a real person with a real family.
Y espero que las personas que escuchan esto recuerden que detrás de cada número, cinco muertos, doscientos heridos, hay una persona real con una familia real.
That, he says, is important not to forget.
Eso es importante no olvidar.