Published on and written by Cyril Jarnias
Moving to Venezuela today, whether for work, investment, or to join family, means confronting a healthcare system in deep crisis. For an expatriate, the question isn’t just about finding a good hospital in Caracas, but about whether one can receive proper emergency care, obtain necessary medications, or undergo pregnancy monitoring without taking unnecessary risks.
This article provides a concrete analysis of the current state of the Venezuelan healthcare system, details the options realistically available to foreigners, and proposes strategies to mitigate risks, based on recent data and the historical evolution of the sector.
A Once-Exemplary Healthcare System, Now in a State of Collapse
For much of the 20th century, Venezuela was considered a regional model. The Venezuelan Institute of Social Security provided free or low-cost care, the country made progress in eradicating malaria, and its public hospital network was one of the most developed in Latin America. In the 1970s, there were about 250 hospitals, more than half under the responsibility of the Ministry of Health and Social Welfare. Mortality from infectious diseases was declining, and the state heavily invested in new facilities, rehabilitation programs, and managing cardiovascular diseases, already the leading cause of death.
Total number of physicians nationwide between 1978 and 1980, a figure already insufficient to meet demand.
Subsequent reforms, including the Barrio Adentro program launched in 2003 with the support of tens of thousands of Cuban doctors, initially improved access to free care in disadvantaged neighborhoods. However, due to a lack of sustainable investment, maintenance, and transparency, these gains collapsed along with the economy. By 2017, an estimated 80% of Barrio Adentro clinics were closed or abandoned.
A Sharp Decline in Health Spending
At the heart of the problem are the economic collapse and dependence on oil revenues. While health spending still accounted for 8.1% of GDP in 2006, it fell below 1.2% in 2017, well under the 5% threshold recommended by the WHO to ensure an “adequate” system. Simultaneously, hyperinflation exploded, reaching hundreds of thousands of percent, and even up to 10 million percent in 2019, before the introduction of the bolívar soberano and a partial dollarization of the economy.
For an expatriate, the public healthcare system is drained, with hospitals operating well below capacity. Private care involves difficult-to-predict costs, often requiring payment in dollars and in advance.
The Real State of Hospitals and Clinics: A Two-Speed Country
The Venezuelan healthcare landscape can give a contradictory impression. On paper, there are still large public university hospitals, like the Hospital Universitario de Caracas, historic maternity hospitals, specialized children’s hospitals, and a high-level private sector in some major cities. In reality, there is a vast chasm between what a facility promises and what it can actually deliver at any given time.
A Public Sector on the Brink of Breakdown
The available figures, despite the statistical censorship imposed by the government since 2010, speak for themselves. Surveys conducted between 2014 and 2019 show:
Number of intensive care unit beds available for the entire country, illustrating the extreme crisis of the healthcare system.
Doctors lack everything, from gloves and syringes, to sometimes even sheets. Families must bring food, water, soap, syringes, scalpels, medication, and handle some basic care themselves (washing, feeding, medication). Many surgeries are canceled due to lack of supplies; at Caracas University Hospital, surgeons stopped all procedures while nearly 3,000 patients awaited surgery.
Between 2012 and 2017, approximately 22,000 doctors left Venezuela, a situation exacerbated by a health crisis described by 98% of them in 2018 as the worst in thirty years. Derisory salaries, often less than 10 dollars per month for a specialist, drove thousands of healthcare professionals to emigrate to countries like Colombia, Brazil, Chile, or European nations.
For an expatriate, this means that turning to the public sector is only conceivable, at best, for an immediate life-threatening emergency when there is no other option, and with an awareness of conditions close to those of a war zone.
A Higher-Quality Private Sector, But Under Pressure
Faced with the public collapse, the private sector has become the refuge for those who can pay – including expatriates. In major cities like Caracas, Maracaibo, and Valencia, several private clinics maintain a level of care close to international standards for many specialties: surgery, cardiology, obstetrics, oncology, traumatology, imaging.
Here is a simplified comparative overview of some emblematic facilities, primarily in Caracas:
| Facility | Status | City | Estimated Beds | Approximate Number of Doctors | Key Areas (examples) |
|---|---|---|---|---|---|
| Hospital Universitario de Caracas | Public | Caracas | ≈ 600 | > 500 | Complex cases, surgery, internal medicine |
| Hospital de Niños J. M. de los Ríos | Public | Caracas | 203 | > 150 | Pediatrics, pediatric oncology |
| Hospital de Clínicas Caracas | Private | Caracas | ≈ 700 | > 400 | Cardiac surgery, robotics, highly specialized care |
| Policlínica Metropolitana | Private | Caracas | ≈ 700 | > 400 | General medicine, emergencies, int’l standards |
| Centro Médico Docente La Trinidad | Private | Caracas | ≈ 350 | > 200 | Surgery, imaging, obstetrics |
In these facilities, operating rooms are functional, imaging departments are modern (CT, MRI, high-quality ultrasound), and it’s easier to find English-speaking doctors, particularly in departments serving international patients. Some clinics report high satisfaction rates, offer bilingual support, and collaborate with international insurers or intermediary services like MyHospitalNow (appointment booking, medical record transfer, support in English or Spanish).
However, these facilities are not unaffected:
– They also suffer from medication and supply shortages, as approximately 85% of the country’s pharmaceutical needs are imported, along with nearly all equipment and spare parts.
– Currency controls and the weak bolívar long made purchasing supplies nearly impossible, leading many local pharmaceutical companies to reduce or cease imports.
– During periods of tension (sanctions, port blockages, flight suspensions), certain vital medications – anti-cancer drugs, insulin, antiretrovirals – become scarce, even unavailable, in the most reputable private clinics.
This constant tension in the supply chain means that an expatriate treated in an excellent facility may suddenly face a lack of medication or supplies, forcing consideration of a transfer abroad for continued care.
Medication Shortage: The Weakest Link
For anyone living with a chronic illness – diabetes, hypertension, cancer, HIV, epilepsy – Venezuela today is an extremely risky environment. The country imports about 85% of its medications, while 90% of the raw materials needed for their production are also imported. However, this supply chain has been broken by currency controls, corruption, unpaid debts to suppliers, hyperinflation, and sanctions.
Figures cited by the Venezuelan Pharmaceutical Federation and other sources indicate:
– An overall medication shortage of approximately 80 to 85%.
– Only 10% of the medications needed to treat chronic conditions like cancer are available.
– A deficit of nearly 60% in pharmacy stocks.
– Major shortages of antiretrovirals for at least 50,000 people living with HIV in the mid-2010s.
This is the average price in dollars for a box of medication, nearly triple the Latin American average.
A Concrete Example: The Case of Diabetes
The case of people with diabetes brutally illustrates the situation:
– Disappearance of basic supplies: glucometers, test strips, lancets, syringes, needles, glucagon.
– Insulin often offered expired; insulin pumps were even banned.
– Patients are forced to reuse the same syringe for two or three days.
– The recommended diet (rich in protein, low in simple sugars, balanced) has become financially inaccessible for most households.
Here is an indicative chart, based on testimonies and estimates, showing the economic absurdity for a resident paid at the local salary:
| Product (diabetes) | Estimated Average Price (USD) | Official Average Monthly Salary (≈ 19 USD) |
|---|---|---|
| Insulin pen (e.g., Humalog) | ≈ 1.5 | ≈ 8% of salary |
| Box of 25 lancets | ≈ 2.5 | ≈ 13% of salary |
| Glucometer | 6 to 25 | 30 to 130% of salary |
| Box of 25 test strips | ≈ 20 | ≈ 105% of salary |
An expatriate earning income in dollars or euros is not in this financial distress, but remains exposed to the physical shortage of the product, even when offering to pay cash.
Public Health and the Return of “Forgotten” Diseases
The vaccine and antibiotic shortage, combined with the degradation of drinking water and sanitation, has led to the return or surge of diseases the country had managed to control, or even eradicate:
The number of malaria cases rose from about 106,000 in 2008 to over 1.3 million in 2018, illustrating a dramatic resurgence of the disease.
This data concerns the general population, but directly affects an expatriate: the likelihood of contracting an infectious disease (malaria, dengue, measles, tuberculosis, hepatitis A, etc.) is objectively higher in Venezuela than in most other countries in the region, especially outside major cities and in certain endemic zones.
Access to Healthcare for Expatriates: What to Truly Expect
Legally, the Venezuelan public system – the Sistema Público Nacional de Salud – is supposed to be accessible free of charge or at very low cost for everyone, including legally resident foreigners. But in practice, the value of this right has collapsed with the crisis. For an expatriate, it is imperative to approach the health issue not as a theoretical right, but as risk management.
Public: Only for Extreme Necessity
In a public hospital, an expatriate could theoretically:
– Be seen in the emergency room.
– Receive basic hospitalization.
– Get some basic tests if the equipment is working.
But they will very likely have to:
Travelers must anticipate providing a large part of the medication and consumable supplies themselves, accept hygiene, comfort, and safety conditions well below European or North American standards, face long waiting times even for serious conditions, and contend with the absence of reliable statistics, creating opacity about the real risks.
Internal data from late 2015 reported one death for every three patients hospitalized in public hospitals, a mortality rate reflecting the systemic nature of the crisis.
Private: The Reference Solution, But Requiring Advance Preparation
For all non-life-threatening situations and for most expatriates, the answer to the question “where should I get treatment?” is simple: in a private clinic, in a major city, with a prepared appointment and good international insurance.
Positive aspects for an expatriate in these facilities:
Main assets of private healthcare for patients seeking quality and efficiency in Venezuela.
Higher quality care with doctors often trained in the US or Europe, up-to-date with international standards.
Quick consultation with a cardiologist, neurologist, or gynecologist without going through a general practitioner.
Advanced technical facilities with high-performance imaging, reliable labs, and well-equipped operating rooms.
More accessible bilingual medical staff, especially in facilities catering to foreign patients.
Organization of surgical interventions or obstetric follow-up with reasonable timeframes.
But these advantages have drawbacks:
– High cost, often payable upfront and in foreign currency.
– Persistent risk of shortages: certain medications, blood bags, contrast media, implants, or consumables may be lacking.
– Possible saturation: clinics in Caracas and other major cities are heavily used by local elites and foreigners, sometimes with little room for new patients.
To avoid unpleasant surprises, an expatriate should identify, before arrival, one or two reference private facilities in their city of residence, and find a primary care doctor there (often an internist or general practitioner working in a clinic). Many private hospitals have an international department or a secretariat able to respond by email, at least in Spanish, sometimes in English.
Health Insurance and Medical Evacuation: Non-Negotiable
In most countries, good health insurance is recommended; in Venezuela, international insurance with medical evacuation coverage is essential. Not only because private costs are high, but especially because in the event of a serious problem – multiple trauma, complicated heart attack, severe stroke, cancer requiring heavy treatment – the best option will often be to leave the country for treatment in Colombia, Brazil, the United States, or elsewhere.
Why Medical Evacuation is Crucial
International organizations and specialized insurers point out that medical repatriation can cost between $25,000 and over $250,000, depending on distance, type of transport (medically staffed commercial flight, dedicated air ambulance), severity of condition, and required medical accompaniment. In some extreme cases (intensive care, ventilation, long distance), the bill can exceed this ceiling.
In Venezuela, direct air links with the United States are suspended and several major airlines have reduced or ceased flights. Maritime traffic is also disrupted by blockades and sanctions. Organizing a medical evacuation, even for a solvent patient, is therefore more complex and requires experienced partners.
The main recommendations from specialists for an expatriate:
– Subscribe to international health insurance including a minimum of $100,000 in medical evacuation coverage, and ideally $250,000 or more.
– Verify that the contract explicitly covers Venezuela and does not exclude it as a high-risk zone.
– Ensure that evacuation is covered for “medical necessity” (lack of adequate treatment on-site) and not just for “convenience.”
– Note and keep on hand the insurer’s 24/7 medical assistance numbers.
– Inform those around you (family, colleagues) of the procedure to follow in an emergency.
Health Insurance: What Should an Expatriate in Venezuela Cover?
A suitable policy should, at a minimum, include:
For a worry-free expatriation to Venezuela, it is crucial to have international health insurance covering the following areas, considering the local context.
Direct coverage (third-party payment) in Venezuelan private clinics and hospitals.
Specialist consultations, laboratory tests, and medical imaging.
Full coverage for hospitalization and surgical interventions.
Coverage for pregnancy, childbirth, and potential complications, if a pregnancy is planned.
Coverage for psychology or psychiatry consultations and care, essential in a context of permanent crisis.
Coverage for dental care, from basic to complex, in local private clinics.
Possibility to continue treatments (cancer, dialysis, specialized surgery) in a neighboring country if locally unavailable.
International insurers like Cigna Global, IMG, GeoBlue, or other major players in the market are often cited as suitable for expatriates in Latin America, with specific options for evacuation and care outside the country of residence. Specialized expatriate insurance brokers, based in the region, can also help dissect exclusions (e.g., some policies outright exclude Venezuela for new contracts).
Maternity, Pediatrics, and Women’s Health: A Major Point of Concern
The official data briefly published in 2017 by the Ministry of Health, before being withdrawn and costing Minister Antonieta Caporale her position, gives a cruel idea of the risks in the public system:
– Between 2015 and 2016, maternal mortality increased by 65%.
– In the same period, infant mortality (under one year) rose by 30%.
– Infectious diseases and malaria also surged during this time.
In a country where an estimated 17% of children under five suffered from acute malnutrition in 2018, these figures reflect a collapse of maternal and child protection.
Number of Venezuelan women taken in for childbirth by a Colombian border hospital in the first quarter of 2019
For a pregnant expatriate in Venezuela, several facts are clear:
Public maternity wards can no longer be considered safe environments, except in the total absence of an alternative. Private clinics offer significantly better conditions, but they too can suffer from occasional shortages (blood bags, medication, neonatal supplies). It is therefore recommended to undergo pregnancy monitoring in the private sector, while having an explicit plan B: a scheduled transfer to a neighboring country in case of complications or supply disruptions.
Legally, voluntary termination of pregnancy is only permitted under limited circumstances (notably life-threatening risk to the mother), and practical access to these services is restricted in a social context largely influenced by conservative Christian values. For expatriates considering an abortion for medical reasons, it is often simpler and safer to organize care abroad.
Infectious Diseases, Environment, and Daily Prevention
Beyond infrastructure, living in Venezuela also means dealing with an environment where the probability of exposure to certain diseases is heightened. The country has experienced, in recent years, a marked increase in:
The region presents a high risk of vector-borne diseases (malaria, dengue, chikungunya, Zika, yellow fever). There is also a sharp increase in respiratory and digestive infections (a 35% rise in diarrhea and 40% in acute bronchitis between 2014 and 2016), linked to the deterioration of water and sanitation. Finally, tuberculosis, diphtheria, and measles are re-emerging due to the collapse of vaccination campaigns and screening programs.
In this context, individual prevention measures take on decisive importance for an expatriate:
To travel safely, it is essential to get vaccinated before departure (hepatitis A and B, yellow fever depending on the area, typhoid, measles-mumps-rubella, diphtheria-tetanus-pertussis, and possibly rabies if exposed to animals). In at-risk areas, use repellents and mosquito nets to protect against malaria and dengue. Regarding food and hydration, avoid untreated tap water and prefer sealed bottled water. Choose well-cooked foods and avoid raw vegetables or street food without hygiene guarantees. Finally, prepare a well-stocked first aid kit (painkillers, antiseptics, materials for minor wounds, treatments for diarrhea, etc.), as local pharmacies may be out of stock.
For expatriates assigned to remote regions – oil operations, mining, agricultural projects – the combination of lack of infrastructure, vector-borne diseases, dangerous roads, and insecurity makes the presence of an expatriate doctor or nurse on-site, with a direct link to an international network, almost indispensable.
Mental Health and the Psychological Burden of Expatriation During Crisis
The Venezuelan crisis doesn’t just affect the body, it also impacts mental health. Rising unemployment, criminal violence, shortages, and mass exile weigh heavily on the population: the suicide rate has increased in recent years and local NGOs report a sharp rise in anxiety-depressive symptoms, even among children.
Expatriates, often isolated and confronted with insecurity and logistical difficulties, are particularly vulnerable. The local mental health system, already fragile before the crisis (with only 1.15 psychiatric beds and 0.4 psychiatrists per 10,000 inhabitants in the mid-2000s), is now overwhelmed and unable to meet growing demand.
To protect oneself, several levers exist:
To maintain psychological balance in Venezuela, it is advisable to include mental health coverage (consultations with psychologists or psychiatrists, in-person or via teleconsultation) when subscribing to an insurance contract. It is also possible to use online therapy platforms serving the country, offering sessions in Spanish, English, or French for rates typically between $30 and $60. Relying on support networks, such as expatriate communities, groups run by NGOs, or online forums, is another valuable resource. Finally, adopting stress management routines, including regular physical activity, relaxation techniques, and establishing clear boundaries between professional and personal life, is fundamental for adapting to the local context.
The Venezuelan authorities have set up helplines (national suicide prevention number, services for violence against women), but actual access to specialized care remains very limited, hence the importance for an expatriate to organize largely outside the local system.
Dental and Ophthalmological Care: Better to Plan Everything
In dentistry, the pattern is similar to the rest of the system:
– The public sector theoretically offers care, but with very significant shortages of materials and equipment.
– The private sector offers treatments of good to very good quality, sometimes at attractive prices for an expatriate compared to Europe or North America.
Some clinics, like DENTAL VIP in Caracas, offer specific protocols for foreign patients, including rapid diagnosis, a treatment plan condensed into one or two weeks, hotel partnerships, and airport transfers. For an expatriate, this is an option to consider for scheduled care, provided you verify beforehand the availability of necessary materials (implants, prosthetics, bone fillers, etc.).
For ophthalmology, with local care having become unpredictable, some Venezuelan patients turn abroad for procedures like cataract or refractive surgery. Hospitals like EyeMantra in India even explicitly target this clientele by highlighting lower costs than those of Venezuelan private clinics. An expatriate considering major surgery of this type would benefit from comparing conditions and quality on-site with those of an international center in another country.
Concrete Strategies for Expatriates in Venezuela
Given all these elements, health management for an expatriate in Venezuela relies less on finding the “good” hospital than on an overall strategy, centered around a few key axes.
1. Medical Preparation Before Departure
Before even boarding the plane, it is essential to: prepare all your travel documents.
– Update all recommended vaccinations for the region.
– Gather medical records (hospital reports, test results, list of treatments), ideally translated into Spanish or English.
– Obtain a sufficient reserve of medication for several months, or more, if suffering from a chronic illness, while checking import rules.
– Discuss with your primary care doctor the specific risks (pregnancy, heart conditions, immune disorders, etc.) in the Venezuelan context.
2. Choice of Insurance and Reference Hospitals
Once the expatriation decision is finalized:
Before your stay, subscribe to international insurance that explicitly covers Venezuela, including medical evacuation and a network of local partner clinics. Identify and note the contact details of at least one reputable, well-equipped private clinic near your place of residence, such as Hospital de Clínicas Caracas or Policlínica Metropolitana in Caracas. Book a preventive appointment with a local general practitioner or internist to establish a first contact and have a medical reference if needed.
3. Daily Management On-Site
Day-to-day, a few simple habits reduce risks:
For safe travel, especially in isolated or high-risk regions, it is crucial to avoid travel to remote rural areas without appropriate medical accompaniment (doctor, nurse, emergency kit, and reliable means of communication). Prioritize quality bottled water and follow food precautions. In relevant areas, actively protect yourself against mosquito bites. Always carry a card with your insurance details, emergency contacts, and your current conditions and treatments. Finally, stay informed of security and health developments via embassy alerts, international organizations, and expatriate communities.
4. Planning Scheduled Care Outside the Country
For certain planned procedures (major surgery, complex oncological treatments, high-risk childbirth, major prosthetics), it is often safer to:
– Schedule the procedure in a well-equipped neighboring country (Colombia, Brazil, sometimes the United States or Europe depending on means).
– Use Venezuela solely as a living base, but not as a place for complex care.
– Verify with the insurer coverage in these countries and reimbursement conditions.
Conclusion: Living in Venezuela Without Closing Your Eyes
Healthcare for expatriates in Venezuela can no longer be approached as in a “normal” country. The public system resembles that of a war-torn country: massive shortages, dilapidated infrastructure, censored health data, mass exodus of professionals. The private sector still holds, with pockets of medical and technological excellence in a few major clinics, but under the constant threat of stock ruptures and power cuts.
For an expatriate, it is essential to build a robust strategy including: solid international insurance with medical evacuation, advance medical preparation, identifying reliable local clinics, building a personal medication reserve, rigorous prevention of infectious diseases, and a clear plan for receiving treatment abroad if necessary.
Only at this price can one consider living and working in Venezuela while minimizing exposure to a healthcare system in a lasting crisis, while still benefiting from the islands of competence and dedication that remain in the country’s private sector.
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Cyril Jarnias is an independent expert in international wealth management with over 20 years of experience. As an expatriate himself, he is dedicated to helping individuals and business leaders build, protect, and pass on their wealth with complete peace of mind.
On his website, cyriljarnias.com, he shares his expertise on international real estate, offshore company formation, and expatriation.
Thanks to his expertise, he offers sound advice to optimize his clients' wealth management. Cyril Jarnias is also recognized for his appearances in many prestigious media outlets such as BFM Business, les Français de l’étranger, Le Figaro, Les Echos, and Mieux vivre votre argent, where he shares his knowledge and know-how in wealth management.
