Mission Barrio Adentro



Mission Barrio Adentro (English: "Mission Into the Neighborhood") is a Bolivarian national social welfare program established under current Venezuelan president Hugo Chávez. The program seeks to provide comprehensive publicly-funded health care, dental care, and sports training to poor and marginalized communities in Venezuela. Barrio Adentro features the construction of thousands of iconic two-storey medical clinics &mdash; consultorios or doctor’s offices &mdash; as well as staffing with resident certified medical professionals. Barrio Adentro constitutes an attempt to deliver a de facto form of universal healthcare, seeking to guarantee access to quality and cradle-to-grave medical attention for all Venezuelan citizens.

The Latin American branch of the World Health Organization and UNICEF both praised the program. In addition, Saudi representatives have visited Venezuelan neighborhoods in order to study Venezuelan public clinics and Saudi officials are considering implementing a similar program in Saudi Arabia. However, the program has drawn criticism from the Venezuelan Medical Federation that got a court ordering Cuban doctors to paralize Barrio Adentro. The decision was put on hold by the executive waiting for an appeal.

To date 1,907 centers have been inaugurated overall

Constitutional origins: health care as a human right
Articles 83-85 under Title III of the 1999 Venezuelan Constitution enshrine free and quality healthcare as a human right guaranteed to all Venezuelan citizens. Notably, Article 84 under Title III mandates that the healthcare furnished through such public programs as Barrio Adentro be publicly funded, and explicitly proscribes its privatization. The Hugo Chávez Frías administration has sought to fulfill its constitutional obligations via the Mission Barrio Adentro program.

The program is subdivided into multiple stages, from the most basic called Barrio Adentro I to the more traditional Barrio Adentro III system of public hospitals. Whenever a medical need demands more specialized care, the patient is directed to the appropriate public health clinic.

Mission Barrio Adentro I
The new clinics that comprise the program's first stage, Mission Barrio Adentro I, are concentrated in the poorest and traditionally most medically neglected and marginalized urban and rural districts throughout Venezuela. These new clinics are meant to replace the mostly dilapidated and abandoned health facilities built during previous administrations. Each of these new clinics is intended to serve several hundred families. Besides clean, modern, and well-equipped examination rooms and doctor's offices at on the ground level, the clinics feature modest accommodations for the clinic's resident doctors and nurses on the building's upper floor.

The program was inaugurated in March 2003 in the impoverished Libertador neighborhood of the Venezuelan capital Caracas, and has since then expanded rapidly to include clinics throughout Venezuela. At least 15,000 Cuban family physicians, medical specialists, dentists, and sports trainers have been put to work in the new medical clinics, where they are paid a $250 monthly stipend. The pay received by the Cuban professionals is far less than the average monthly salaries that private doctors earn in Venezuela, and significantly less than the $600 that Venezuelan doctors were offered to participate in Misión Barrio Adentro I. It is considerably more than their expected pay in Cuba. In exchange for the services of the Cuban medical professionals, Venezuela agreed initially to provide Cuba with oil at below market rates. This is one of many such partnerships between Venezuela and Cuba, to provide Cuba with oil and Venezuela with professionals and expertise.

The Venezuelan government claims that 18 million people, or nearly 70% of the population, has been treated through Mission Barrio Adentro.

Mission Barrio Adentro II
The Chávez administration launched Mission Barrio Adentro II in June 2005. This second phase has seen the construction of new intermediary medical facilities to aid the failing public care system. Among these are the Integrated Diagnostic Centers (CDI), and Integrated Rehabilitation Services (SRI). Services provided are emergency services, specialized laboratory assistance, endoscopy, electrocardiography, surgery, intensive care, x-ray and miscellaneous diagnostic exams.

To date 472 CDI, SRI and high tecnology centers have been inaugurated, In total, the Chávez administration plans to situate 600 CDIs and SRIs throughout Venezuela over the coming years. These CDIs and SRIs are intended to complement a new phase of public clinic construction, which will also be built under this second phase.

Mission Barrio Adentro III
The Mission's third phase, announced and launched in 2005, seeks to upgrade 42 existing hospitals and construct new secondary medical facilities. The first phase will be infrastructure enhancements and repairs. The second medical equipment purchases.

The Maracay Central Hospital will be one of the first batch to receive the upgrade, the infrastructure is expected to finish in December 2006, and the equipment purchases include high tech radiodiagnostics, telecommand equipment, six portable and digital X-rays,laporoscopy, ultrasonography and mechanical ventilators.

Mission Barrio Adentro IV
On Nov 16 the Chavez government introduced the next phase of the Barrio Adentro project where 16 hospitals would be built around the country, specially on poor areas.

Criticism
Critics of President Hugo Chávez and Cuban doctors who defected the program say that the Cuban Missión Barrio Adentro medical professionals are required to campaign for Hugo Chávez.. The Venezuelan Ministry of Health says that Cuban professionals are needed because it was unable to find enough adequately-trained Venezuelan doctors willing or able to serve in impoverished districts and barrios. Although many Venezuelan doctors applied to be part of the Mission, they were not admitted until late 2003. There are still more Cuban than Venezuelan doctors in the program.

The Venezuelan Medical Federation, the largest association of medical doctors in Venezuela, has lobbied vigorously against Mission Barrio Adentro, and is in a legal dispute with the Chávez administration over the legitimacy of the Cuban doctors' licensure and practice. Critic and ex-minister of health Rafael Orihuela claims that the number of cases of infant mortality, mothers dying during birth, yellow fever and malaria have risen, even though the program receives a third of the budget of the Ministry, providing statistical proof that the Cuban doctors seem unqualified to practice medicine. However independent WHO statistics claim that infant mortality has dropped from 23 to 20 in males and 19 to 17 in females per 1000 births. Since the program's inception. Public hospitals are reported to be underfunded, and doctors have not received the same salary improvements as other government workers.

In June of 2006, it was announced that Bolivian students would participate in the "Mission" for six years, after just one year of formal university studies.

Defection from the Mission
Cuban doctors have continually defected from the Mission since 2004. In February 2007, at least 38 doctors were requesting asylum in the US embassy in Bogotá after asylum was denied by the Colombian government.

Abandonment
In July of 2007, Douglas León Natera, chairman of The Venezuelan Medical Federation, reported that up to 70% of the modules of Barrio Adentro have been either abandoned or were left unfinished. The claim that at least some modules have been abandoned has been backed by Venezuelan Tv reports and other Venezuelan news agencies, although the state of abandonment and/or unfinished modules has not been independently verified by any other institution.