Before the clinic ran out of oxygen, Maria Auxiliadora da Cruz had been showing encouraging signs of progress against Covid-19. On 14 January, her oxygen levels had been above the normal level of 95% but, within hours of being deprived of that vital resource, her stats plummeted to 35%.
At this point, patients would normally be given intubation and oxygen by machine. Instead, the 67-year-old retired nurse died. “It was horrible,” her grieving daughter-in-law Thalita Rocha told the BBC. “It was a catastrophe. Many elderly patients began to deteriorate and turn blue.”
In an emotional video that went viral on social media, she described what was happening at Policlínica Redenção in the northern Brazilian city of Manaus. “We’re in a desperate situation. An entire emergency unit has simply run out of oxygen… A lot of people are dying.”
Brazil has the world’s second-highest Covid death toll with more than 221,000 fatalities. In Manaus, the health system has collapsed twice during the pandemic and deaths doubled between December and January.
Now there are fears the lack of oxygen supplies seen there could unfold elsewhere in Brazil and even in other parts of Latin America, where a second wave of Covid-19, in many countries, is proving to be worse than the first one.
In Peru, some hospitals have been unable to meet the demand brought by a steep rise in cases in recent weeks. As a result, patients’ relatives have had to hunt for oxygen in the black market. In some cases, they come back with nothing.
A black market is also thriving in Mexico, where more than 155,000 have died in the pandemic. To make things worse, there have been reports of thieves taking oxygen cylinders from hospitals and clinics.
According to the World Health Organization (WHO) one in five Covid-19 patients will require oxygen. In severe cases, this rises to three in five. The organisation says some hospitals have seen demand for oxygen increase between five and seven times above normal levels because of the influx of patients with severe and critical disease.
The most dramatic situation in the world is in Brazil, where nearly 340,000 oxygen cylinders are needed every day, according to the Covid-19 Oxygen Needs tracker. The online tool helps estimate the scale of the challenge for policymakers and was developed by the Covid-19 Respiratory Care Response Coordination partnership which includes Path and Every Breath Counts.
Also according to the tracker, Mexico and Colombia each need more than 100,000 cylinders daily.
So how does a hospital run out of oxygen?
Oxygen has been considered an essential medicine by the WHO since 2017, but Lisa Smith, from Path’s market dynamics program, says ensuring adequate supply depends on many “components” falling into place.
This includes not only sources of production, but also training to enable medical staff to monitor and manage oxygen levels.
Medical oxygen is produced in large quantities at plants and delivered to hospitals in two ways: either in bulk in liquid tanks or as pressurised gas in cylinders containing smaller volumes.
Liquid oxygen is the cheapest and best technology available but it requires hospitals to have the right infrastructure to pipe oxygen to the patient’s bedside. This is common in developed countries such as the US and those in Europe.
Cylinders do not require pipes and can be delivered to clinics without a sophisticated infrastructure. However, their distribution on a smaller scale means they are less cost-effective, in addition to being cumbersome to transport and handle, which also carries an increased risk of cross-contamination.
Another source of production is on-site oxygen plants, which produce oxygen to be piped or compressed into cylinders. The WHO says it is currently trying to map how many such plants exist in the countries.
After Manaus reached crisis point, oxygen donations were sent from the federal government and other states – as the local providers said they were unable to increase production – and across the border from Venezuela. But even transporting them became a problem.
Jesem Orellana, an epidemiologist at the Oswaldo Cruz Foundation in the Brazilian city of Rio de Janeiro, said the risk of shortage continued and was exacerbated by global demand.
According to Path, medical oxygen accounts for just 5-10% of the world’s oxygen production. The rest is used in various industries, such as mining, chemical and pharmaceutical.
“We need to think about oxygen as much as we think about electricity, water or other essential utilities,” says Ms Smith. “This can’t be something that we’re only concerned about when it’s bad, because when it’s bad, people will die.”
In the meantime, there are concerns that the strain of Covid-19 on oxygen supplies could have a knock-on effect for the treatment of other diseases.
“Covid has shown us just how essential it is in countries where there is no vaccine against Covid, no medicines,” says Leith Greenslade, who leads the Every Breath Counts Coalition. “Often, it’s down to whether you get oxygen or not, whether you live or die.”
Read from source: https://www.bbc.com/news/world-latin-america-55829424
Honduran abortion law: Congress moves to set total ban ‘in stone’
Parliament in Honduras has initially approved a bill that will make it virtually impossible to legalise abortion in the country.
The new measure will require at least three-quarters of Congress to vote in favour of modifying the abortion law, which is among the strictest in world.
Honduras forbids abortion under any circumstance, even rape or incest.
Its latest move comes in response to Argentina legalising abortion last month.
Across Latin America, there has been increased pro-choice campaigning, known as the “green wave”, based on the colour worn by protesters.
The new legislation in Honduras hinges on an article in the constitution that gives a fetus the same legal status of a person. Constitutional changes have until now been permitted with a two-thirds majority, but the new legislation raises that bar to three-quarters within the 128-member body.
The measure still needs to be ratified by a second vote. However, support was clear on Thursday: with 88 legislators voting in favour, 28 opposed and seven abstentions.
Honduras has a stanchly conservative majority, which referred to the measure as a “shield against abortion”.
“What they did was set this article in stone because we can never reform it if 96 votes are needed [out of 128]”, opposition MP Doris Gutiérrez told AFP news agency.
Mario Pérez, a lawmaker with the ruling party of President Juan Orlando Hernandez, formally proposed the change last week, calling it a “constitutional lock” to prevent any future moderations of the abortion law.
“Every human being has the right to life from the moment of conception,” said Mr Pérez.
Ahead of the vote, UN human rights experts condemned the move, saying in a statement: “This bill is alarming. Instead of taking a step towards fulfilling the fundamental rights of women and girls, the country is moving backwards.”
Abortion has been constitutionally banned in Honduras since 1982.
In 2017, lawmakers voted on decriminalising it in the case of rape, incest or when there was danger to the mother or the fetus, but the move was roundly rejected.
Nicaragua, El Salvador and Haiti also have complete bans on abortion, but Honduras is the only country to also prohibit the use of emergency contraceptives in all cases, including after rape.
Cuba, Uruguay, Guyana and Argentina are the only Latin American countries to permit abortion in the first weeks of pregnancy.
Read from source: https://www.bbc.com/news/world-latin-america-55764195
Mynor Padilla: Killer of anti-mining activist pleads guilty
The ex-security chief at a mine in Guatemala, Mynor Padilla, has pleaded guilty to killing an anti-mining activist in 2009.
Adolfo Ich was killed at the Fénix mine, which was owned at the time by a subsidiary of Canadian mining giant Hudbay Minerals.
He had been campaigning against the mining project and for his community’s land rights.
Germán Chub, a bystander, was also shot, leaving him paralysed.
The guilty plea comes at a retrial after Padilla was cleared of murder at a previous trial.
What happened in September 2009?
The Fénix nickel project was owned by the Guatemalan Nickel Company (CGN), a subsidiary of Toronto-based Hudbay Minerals.
CGN wanted to develop the mine, but the indigenous Maya community objected, arguing that much of the company’s land belonged to them.
The company said it engaged in talks to negotiate their resettlement but members of the Maya community said they were threatened with forced evictions.
On 27 September 2009, security guards at the mine attacked members of the community with machetes and firearms, according to witnesses.
Adolfo Ich was killed, Germán Chub was left paralysed, and at least seven more people were injured.
What was Mynor Padilla’s role?
Mynor Padilla was the chief of security at the Fénix project and witnesses said he was the key man in the attack on 27 September 2009.
Hudbay defended its personnel, alleging that members of the Maya community had turned on each other and that their security staff had acted in self-defence.
Following a three-year murder trial Padilla was acquitted, much to the outrage of the victims’ families who launched an appeal.
What’s the latest?
The court of appeal overturned the acquittal and ordered a retrial which began in December 2020.
After having for years maintained his innocence, Mynor Padilla entered a guilty plea which was accepted by the court on Wednesday.
A lawyer for Adolfo Ich’s widow in a civil lawsuit against Hudbay Minerals in Canada called it a “momentous day”.
Why does it matter?
There are three civil lawsuits under way against Hudbay Minerals in Canada, in connection with the Fénix mine.
One of them was filed by Adolfo Ich’s widow, Angélica Choc, who alleges that the company failed to take adequate precautions to ensure that human rights abuses would not be perpetrated by Hudbay’s security personnel.
In 2013, a court in Ontario allowed the lawsuits to proceed, making it the first time that foreign claimants were allowed to pursue a lawsuit against a Canadian company in Canada for alleged human rights abuses.
Cory Wanless, one of the lawyers for the plaintiffs, said that following Mynor Padilla’s guilty plea “it will be difficult for Hudbay to continue to argue that it does not bear responsibility for the killing and shooting”.
Hudbay Minerals has released a statement saying it would “review the court’s decision once it is released”, which is due to happen later this month.
The company, which sold the Félix mine to Swiss-based Solway Group in 2011, also stated that “any agreements made in the Guatemalan court do not affect our view of the facts of Hudbay’s liability in relation to civil matters currently before the Ontario court”.
Read from source: https://www.bbc.com/news/world-latin-america-55573682
Deepening divisions: Venezuela’s haves and have nots
The Hotel Humboldt sits atop El Ávila, a national park overlooking Venezuela’s capital, Caracas.
At more than 2,000m (6,500ft) above sea level, you have to take a 20-minute trip in a cable car to the top of the mountain to reach it.
From there, a golf buggy drives guests along the ridge to an impressive glass and aluminium structure surrounded most of the day by rolling clouds that suddenly clear to reveal the most astounding view.
The hotel was built in 1956. Finished in less than 200 days, it was the pet project of dictator Marcos Pérez Jiménez, who ruled Venezuela from 1950 to 1958.
At a time of great oil wealth, it was a show of pomp and modernity.
It operated as a hotel for just a few years before falling into disrepair, but it has remained an icon, one that the late President Hugo Chávez wanted to restore to its former glory. After his death in 2013, his successor, Nicolás Maduro, has been intent on finalising the restoration.
“This building means so much for the Venezuelan people,” says Carlos Salas, one of the hotel’s managers.
He shows me around the hotel, which has just started accepting overnight guests after nine years of renovations.
“It’s a representation of a golden era for Venezuela.”
But that golden era is long gone.
The economy is in crisis, oil prices have slumped as has production and around 60% of Venezuelans now live in poverty, according to researchers at the Andrés Bello Catholic University.
Financially sound or a folly?
A stay at the Hotel Humboldt costs around $300 (£225) a night.
Clearly a lot of hard work has been put into restoring this architectural jewel but it is not your typical five-star lodgings. Indeed, the classification was awarded by the government which is promoting it, and the hotel is still a bit rough around the edges, despite having been inaugurated a month ago.
The Marriott hotel chain was given the concession to run it in 2018 but it did not stay long as partner. The team now in place is clearly proud of its achievements but in crisis-hit Venezuela, the hotel’s restoration feels like a folly, promoted by a president with his head buried in the sand.
“One banana here costs triple the price [elsewhere],” Mr Salas says, explaining the logistical challenges of getting supplies up the mountain to the hotel.
“My people here, we have to pay them more, the maintenance of the building, water, electricity, it’s really difficult.”
So what, I ask, is the demand for a hotel like this, in a country where the minimum wage is around $2 (£1.50) a month.
He responds without flinching, arguing that five-star hotels are not within everyone’s reach anywhere in the world. Venezuela is no different, he says.
The hotel is seen by many as a symbol of the rise of a group of newly wealthy Venezuelans, in particular those who have become rich thanks to their close ties to the government.
And Hotel Humboldt is not the only sign of an economic revival in Venezuela.
Faced with US sanctions, rampant hyperinflation and a spiralling economic crisis, President Maduro responded by removing the price controls and easing the capital controls introduced by his predecessor and fellow socialist, Hugo Chávez.
With the local currency increasingly hard to come by due to the sky-high inflation rate – a cup of coffee with milk can set you back almost 1.5m bolivars in Caracas – Mr Maduro also begrudgingly accepted the use of the US dollar.
The result of this easing of economic restraints can be seen across Caracas, where new “bodegas” (shops) have opened up, selling all sorts of imported goods to people long-used to shortages of even the basics.
The Caracas stock exchange is another beneficiary, booming because of an uptick in private enterprise, although it is still comparatively small.
A brighter future?
It has made life a bit more bearable for many, especially in this toughest of years, but not everyone is positive about these changes.
“The government is building on the ashes of this wrecked economic model in a very disorganised fashion,” says economist Tamara Herrera.
“This re-accommodation of the economy is amorphous, disorganised and positive results are difficult to judge. This won’t mend the tragedy that you can see in the population,” she argues.
And there is no doubt that while there may be an emerging class of haves, there are still plenty of have nots – those with little or no access to dollars, or basic services.
In the poor neighbourhood of Catia, on the outskirts of Caracas, I met former housekeeper Diurka González, who is helping out in a soup kitchen. Every day, the kitchen provides lunches for as many as 140 children, including her two-year-old daughter.
“My boss couldn’t keep me on because she was scared of the pandemic,” Ms González tells me.
She did not even earn $2 a month, but now she gets nothing. The soup kitchen allows her daughter to eat one decent meal a day.
A few doors down, Jonathan Fermenal is feeding his two-year-old daughter Samara with the lunch they have just picked up from the soup kitchen. He relies on the free lunches for Samara and his other two children.
Mr Fermenal’s wife, Laila, left to find work in Colombia at the beginning of the year.
The plan was for the rest of the family to follow a few months later, but then came the coronavirus pandemic. They have not been able to see her since.
“At the beginning, it was horrible, horrible,” he says about his wife’s departure. “My youngest was 18 months old, she was still breastfeeding and had to stop suddenly. The first month, I didn’t sleep at all.”
Mr Fermenal has had to learn to play the role of both mother and father. “For my wife it’s also been hard, everything is done by Whatsapp, a photo here, a voice message there, but it’s not the same,” he says.
“And the way I live is how thousands and thousands of Venezuelan families are living,” says Mr Fermenal about the more than five million Venezuelans who have left to escape their home country’s economic hardships over the past six years.
Lives – and hardships – that are far more common than those who invested in the Hotel Humboldt would like to believe.
Read from source: https://www.bbc.com/news/world-latin-america-55364444
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