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RR RUEHAO RUEHROV
DE RUEHCV #2044/01 1911546
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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. 
 
--------------------------- 
"Medical Day" in the barrio 
--------------------------- 
 
¶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. 
 
------------------------------- 
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. 
 
--------------- 
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. 
 
-------------------------------- 
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. 
 
---------------------- 
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. 
 
------- 
Comment 
------- 
 
¶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