The Continuous Struggle for Representation in the Venezuelan State
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THE CONTINUOUS STRUGGLE FOR REPRESENTATION IN THE VENEZUELAN STATE
Gabriel Reyes Reyes 2
THIS WORK IS DEDICATED TO MY PARENTS, ROY AND LUZ REYES Reyes 3
THE CONTINUOUS STRUGGLE FOR REPRESENTATION IN THE VENEZUELAN STATE
Gabriel Reyes has completed the requirements for Honors in Latin American Studies.
Professor Ben Fallaw, Advisor ______
Professor Ariel Armony, Reader______
Department of Latin American Studies Colby College May 2005 Reyes 4
ACKNOWLEDGEMENTS...... 6 LIST OF GRAPHS AND TABLES...... 7 ABBREVIATIONS...... 8 SUMMARY...... 9 ARGUMENT AND STRUCTURE...... 9 CHAPTER ONE: INTRODUCTION...... 11 FROM STRONGMAN RULE TO POPULISM AND THE CALL FOR SOCIAL INTEGRATION...... 11 THE TURN AWAY FROM POPULISM: THE BUILDING OF A CONSOCIATIONALIST DEMOCRACY...... 12 THE APPEAL TO DECENTRALIZATION...... 16 THE PERSISTING CITIZEN PARTICIPATION DEFICIT...... 18 CHAVISMO...... 19 BUILDING A NEW VENEZUELAN STATE...... 23 A MODEL PROGRAM...... 25 CHAPTER TWO: POLITICAL HISTORY...... 28
VENEZUELA’S FORMATIVE PERIOD (1500S -1936)...... 28 RISE OF MIDDLE CLASS COUNTERELITES (1920S)...... 33 GÓMEZ’S PASSING, THE RISE AND FALL OF THE MODERNIZING ESTABLISHMENT (1936-1945)....34 NEW POLITICAL PARTIES (1946)...... 37 FROM A REFORM DEMOCRACY TO MILITARY INTERVENTION (1945-1948)...... 38 PUNTO FIJO (1958)...... 40 THE CREATION OF A PARTY DEMOCRACY (1958-1988)...... 41 VENEZUELA IN THE BOOM (1970S)...... 44 VENEZUELA BUSTED (1980S)...... 46 THE BEGINNING OF THE END FOR PUNTO FIJO (1989)...... 47 DECENTRALIZATION: THE UNEXPECTED OUTCOME OF THE 1989 RIOTS...... 50 THE RISE OF HUGO CHÁVEZ...... 54 APRIL 11TH AND THE “SIEGE ON DEMOCRACY”...... 59 ONE MORE CHANCE, A WHOLE NEW GAME...... 61 CONCLUSION...... 62 CHAPTER THREE: CREATING AN OPPORTUNITY FOR REPRESENTATION...... 65 A BROKEN SYSTEM...... 66 FIXING A BROKEN SYSTEM...... 69 A HALT ON DECENTRALIZATION:...... 70 THE LEGAL RECONSTRUCTION OF VENEZUELA’S HEALTH SYSTEM...... 70 THE TRUE STATE OF REFORM...... 72 REACHING OUT TO “THE PEOPLE”...... 74 THE FOUNDING OF BARRIO ADENTRO...... 76 THE UNCALCULATED COSTS OF BARRIO ADENTRO...... 78 THE FORMAL OPPOSITION OF BARRIO ADENTRO...... 80 CLAIMS OF THE INFORMAL OPPOSITION TO BARRIO ADENTRO...... 82 INFORMAL OPPOSITION CLAIM #1: UNDERMINING COMMUNITY INFRASTRUCTURE...... 83 INFORMAL OPPOSITION CLAIM #2: THE COSTS OF THE PROGRAM...... 85 OBSERVATIONS ON THE GROUND: MISIÓN BARRIO ADENTRO...... 87 THE IMPORTANCE OF NURSES...... 91 WHERE ARE THE NURSES?...... 93 STATE V. SOCIETY: THE STRUGGLE FOR REPRESENTATION OF INTERESTS...... 99 JANUARY 15, 2005...... 99 JANUARY 22, 2005...... 102 Reyes 5
CONCLUSION...... 108 WORKS CITED...... 112 Reyes 6
ACKNOWLEDGEMENTS
I would like to thank the Latin American Studies of Colby College and especially
Professor Ben Fallaw for allowing me the opportunity to write this thesis on political representation in Venezuela. Thanks to a Latin American Studies Walker Grant, I was able to conduct primary research for this study in Caracas, Venezuela throughout January 2005.
Professor Fallaw, showing much patience throughout the research and writing process, allowed me to continue in this endeavor past the period of time when even I questioned whether I could achieve my goal. Thank you.
While I was in Venezuela the help of former Colby College student Norma Rivero de
Biermeyer proved invaluable. She and her family (Herbert, Sonia and Verena) took a special interest in making sure that I had a safe and productive time while in their country. Upon my departure, Mrs. Biermeyer presented me with a gift: a whistle that she has long used in political rallies and demonstrations. I left the country with a bit of its political spirit. Separately, I thank
University of California Law Student Peter Mayburduk for the article and comments he provided me on his own research on the program of Barrio Adentro.
Here at Colby, I would like to give special thanks to Professor Armony who agreed to serve as a second reader for this thesis. Also, I thank my love Andra Ofosu and my roommates
Pawel Brodalka, Joseph Okeyo, Nicholas T. Von Mertens and Tsering Wangdi for the moral support that they have provided me as I labored throughout this academic year. Additionally, I thank the host of friends who took time to hear the numerous complaints I had of my workload and direction of my project at crucial junctures: Mark Chapman, Justin Dubois, Kevin Selby,
Osman Haneef, Brandy Lipton, Nels Leader, Ly Tran, Hugo Caraballo, Jui Shrestha among others. They allowed me time to vent before directing me back to work, often with wise advice. Reyes 7
LIST OF GRAPHS AND TABLES
Fiscal Revenue of Venezuelan Governments, 1917-1978 46
1995 Study on Venezuelans’ Values 63
Venezuela’s Domestic Growth Product, 1995-2004 67
Health Care Spending as a Percentage of 2002 GDP 72
General Statistics on Barrio Adentro, as of January 2004 75
Graph of Venezuela’s Popular, Private and Public Health Care Systems 77
OPEC Basket Prices, January 2, 2001 80 Reyes 8
ABBREVIATIONS
AGV Asociación de Gobernadores Venezolanos/ Venezuelan Governor’s Association AD Acción Democrática/ Democratic Action
CN Convergencia Nacional/ National Convergence COPEI Comisión para Organización Política y Elecciones/ Commission Organized for Politics and Elections COPRE Comisión Presidencial para la Reforma del Estado/ Presidential Commission for Reform of the State CTV Confederación de Trabajadores de Venezuela/ Confederation of Venezuelan Workers
FCV Federación Campesina de Vecinos/ Federation of Venezuelan Peasants FVE Federación Venezolana de Estudiantes/Federation of Venezuelan Students
IVSS Instituto Venezolano de Seguro Social/ Venezuelan Institute for Social Security
PDN Partido Demócrata Nacional/ National Democratic Party
MAS Movimiento al Socialismo/ Movement towards Socialism MBR-200 Movimiento Bolivariano Revolucionario—200/ Revolutionary Bolivarian Movement—200 MEP Movimiento Electoral del Pueblo/ People’s Electoral Movement MIR Movimiento de Izquierda Revolucionaria/ Revolutionary Left Movement MVR Movimiento Quinta Republica/ Fifth Republic Movement MSDS Ministerio de Salud y Desarrollo Social/ Ministry of Health and Social Development
PRV Partido de la Revolución/ Party of the Revolution
UCV Universidad Central de Venezuela/ Central University of Venezuela UNE Unión Nacional Estudiantes/ National Students Union UPM Unión Patriótica Militar/ Patriotic Military Union URD Unión Republicana Democrática/ Democratic Republican Union Reyes 9
SUMMARY
ARGUMENT AND STRUCTURE
One definition of democratic participation is a process whereby citizens influence or control those who make major decisions affecting them.1 Throughout Venezuela’s history, citizens have suffered under governments that aimed to limit their participation in the state. This research argues that the current Chávez regime, though seeking to concentrate power for itself in the executive branch, has also forged a space for democratic participation through its Barrio
Adentro program.
In its introductory chapter, this paper examines Venezuela’s political development through a comparative lens and aims to situate Barrio Adentro within the country’s unique history. First, it shows how the political models in Venezuela throughout the nineteenth and twentieth centuries compared to the generally prevailing governing strategies and movements in
Latin America. Later, it explains how Barrio Adentro fits within the current regime that aims to strengthen executive dominance and democratic participation.
This research’s second chapter provides a more nuanced and isolated study of
Venezuela’s history, culminating with Hugo Chávez’s rise to power. It demonstrates that the designs of the country’s political systems over time, crafted to limit citizen participation, caused a legitimacy crisis in the Venezuelan state. Ultimately, the breakdown of these political arrangements created the seemingly paradoxical conditions where a non-democratically inspired leader has created a system that emphasizes citizen participation.
In its third chapter, a close examination of Barrio Adentro provides an example of how the ideas of executive dominance and democratic participation are reshaping Venezuela. The program under case study, Barrio Adentro, brings Cuban doctors into Venezuela’s most
1 Sidney Verba, “Democratic Participation,” Annals of the American Academy of Political and Social Science, Vol. 373, Social Goals and Indicators for American Society, (Sep. 1967): 54. Reyes 10 marginalized communities and relies on community support to operate. Started at the national level as a presidential initiative, it attempts to replace the country’s collapsed health system with a flexible structure more finely attuned to citizens’ needs. In pursuit of this goal, however, it has displaced the traditional bureaucracy. It has also had to contend with citizen demands that are working to reshape the administration’s original blueprint.
The conclusion of this study highlights the parallels between Chávez’s “participatory democracy”, as seen through the program of Barrio Adentro, and past Venezuelan governments.
It concedes that citizens opposed to Chávez may have little recourse for participation in his administration. But it also shows that Venezuelans assumed to be docile supporters of Chávez have influence over his administration. This provides some proof that within the executively- centered state there also exists a space for democratic participation. Reyes 11
CHAPTER ONE: INTRODUCTION
FROM STRONGMAN RULE TO POPULISM AND THE CALL FOR SOCIAL INTEGRATION
Michael Coniff explains the rise of populism in Latin America as a response to “those forces hindering popular representation, social mobility, and rising standards of living for the masses”;2 issues that came to the fore with the breakdown of the social order that prevailed in the region’s cities during its colonial period. During the region’s colonial period, urban centers rooted themselves in legal traditions that imposed public authority over private matters and in notions of social solidarity that guaranteed everyone a set place in society. It was the clearly defined obligation of the church and wealthy in society to provide charity to the poor. The rise of capitalism, with its emphasis on private property rights, ended this preexisting social order.
Inequality flourished, and unlike before, the rich did not tend to society’s poorest sectors.
Concurrently, the physical layout of cities came to imitate those of Europe: fashioned for social control. These factors provided an excellent combination for the rise of figures such as
Venezuela’s Juan Vicente Gómez, dictators who under the guise of modernity could easily protect the interests of a select few citizens with repression.3 These factors also sowed the seeds of discontent that would ultimately give rise to populist movements.
At the turn of the 20th century, Juan Vicente Gómez came to dominate over all other regional caudillos in Venezuela. Himself a strongman, Gómez’s greatest contribution to the modern Venezuela was to do away with the multiplicity of individuals who imposed their will on the state through violence. As such, he fashioned the modern Venezuelan state. While his new state did not provide for citizen participation, it at least was a crude mechanism to serve the diverse interests of a select few within the state. Ultimately, larger social movements would
2 Michael Coniff, “Introduction: Toward a Comparative Definition of Populism,” in Latin American Populism in Comparative Perspective, ed. Michael L. Conniff. (Albuquerque: University of New Mexico Press, 1982), 5. 3 Ibid, 8-9. Reyes 12 form. These movements sought to gain inclusion and reap benefits from Gómez’s newly formed state.
Around Gómez’s death in 1935, Venezuela’s middle-class counterelites and modernizing establishment competed to implement their diametrically opposed visions to further state development.4 The modernizing establishment sought to achieve social and economic development without mass citizen representation. The middle-class counterelites saw mass participation as the only path to achieve social and economic development. Gathering in the
1930s under Partido Democrata Nacional (PDN), which ultimately became Acción Democratica
(AD), the middleclass counterelites would ultimately join with the military to take power in a
1945 coup. A coup against their government in 1948 would revoke their power, and return
Venezuela to a dictatorship that lasted until 1958. Around this time on the world stage, with the onset of the Cold War, socialism, populism, and ideologies that advocated allocating power to a country’s masses became less fashionable. Curtailed citizen participation or dictatorship became the only viable governance options in Venezuela. Ultimately, this dichotomy would help the modernizing establishment’s vision prevail as the only sustainable compromise to push the country forward.
THE TURN AWAY FROM POPULISM: THE BUILDING OF A CONSOCIATIONALIST DEMOCRACY
While AD’s initial unwillingness to compromise cut short its stay in power and many citizens’ hopes for increased participation in the Venezuelan state, its later willingness to forego mass citizen participation perhaps saved Venezuela from repressive military rule. When it joined forces with the military to wrest power in 1945, AD saw its support of the coup as a necessary means to an end. Soon after the coup, the party did seek to expand the ruling coalition’s base.
AD insisted on a program of social reform through mass participation. But its desire to create a
4 David Eugene Blank, Politics of Venezuela (Boston: Little, Brown, 1973), 17. Reyes 13
Mexican PRI-styled hegemonic party and its inability to work with the nation’s other political parties (Comisión para Organización Política y Elecciones, COPEI, and Unión Republicana
Democrática, URD)5 created the conditions for its overthrow in 1948. The military’s intervention in that year initiated a prolonged cessation to Venezuela’s populist experiment.
After AD and a ten-year military dictatorship, Venezuela’s parties opted less for idealism and more for regime stability. The result was a shunning of populism and the adoption of a government model that valued societal interests but limited citizen participation in the state.
Movements like AD, which adopted populism, aimed to respond to problems of social integration, economic inequality, and uneven political representation. Clearly, populist movements were forward looking and reformists. But they also sought to reclaim lost values, put society into some idealistic preexisting order. So they were backward looking. Their main principle was to “ameliorate some of the harshest aspects of the metropolitan revolution—elitist government, abandonment of the poverty—stricken, maldistribution of wealth, and rapacious capitalism.”6 Social integration, the notion of revaluing and giving use to all of a society’s members, was as much a stepping-stone as the answer to the problems these populist movements addressed. As scholar Michael Coniff explains, social integration
simultaneously satisfied the desire for organic society, addressed the social question, promised citizen participation in government, and provided a winning strategy for reform-minded groups to come to power peaceably.7
While populist parties such as AD perhaps envisioned and reserved themselves a role in steering mass movements, achieving their end goal of developing and reforming their states depended on an enlivened citizenry to provide a driving force.
5 Both of these parties formed in 1946 and represented the conservative Catholic sectors along with the middle and upper urban classes, respectively. For a full discussion, reference the section “New Political Parties” in Chapter Two of this work. 6 Michael Coniff, “Introduction: Toward a Comparative Definition of Populism,” in Latin American Populism in Comparative Perspective, ed. Michael L. Conniff. (Albuquerque: University of New Mexico Press, 1982), 13. 7 Ibid, 11. Reyes 14
Throughout Latin America, populist movements were most evident between 1920 and
1965, their rise paralleling the population booms in the region’s urban cities. 8 The large influx of people into these cities overburdened whatever mechanisms autocrats relied upon to keep the social order. Between 1936 and 1970, Venezuela’s urban centers went from housing 28.9% to
70% of the country’s total population.9 Populist parties drew on this migratory process to bolster and organize their base.
In addition to the importance of the urban setting, the multi class, electoral, expansive,
“popular” nature, and charismatic leadership of populist movements in Latin America made them unique.10 Having a base in the socially troubled major Latin American cities of the early
20th century, the movements easily became multi-class because they drew from all sectors affected in these microcosmic societies. They embraced the democratic vote as a means towards their ends of social reform, and thus encouraged citizen participation in the political process.
They were expansive because they drew energy from ever-increasing alliances. These alliances helped the parties appeal and remain relevant to their base, mostly by increasing the possibilities for more reform. True to the backward looking aspect of populism, these movements took great interest in the “popular” history of their countries. They revalued native folklore, art, and customs. As an example, in Mexico, appreciation for the country’s native cuisine and
“indigenous” art coincided with the rise in populist figures shortly after that country’s revolution.
Finally, all across Latin America, charismatic leaders who were “perceived to have special personal qualities” headed populist movements.11 These men (woman in the case of Argentina’s
Evita Perón), provided decisive leadership in a time of crises.12 Although somewhat
8 Ibid, 6. 9 David Eugene Blank, Politics of Venezuela (Boston: Little, Brown, 1973), 37. 10 Ibid, 13. 11 Ibid, 21. 12Ibid, 21. Reyes 15 predisposing these movements to the personalization of rule, these movements’ leaders did not necessarily disallow the institutionalization and the genuine democratic representation of their followers interests.
If a benign form of populism that valued inclusion did not on its own pose a significant threat, it certainly did when taken into account with other factors. One such factor was the new reality created by the rumblings of the Cuban revolution in the 1950s. Fidel Castro’s power grab scared the political right and tended to radicalize the political left. Within five years, the rise of the military-led, bureaucratic-authoritarian regime in Brazil marked the beginning of a darker era on the Latin American continent. Militaries bent on modernizing their countries around technocratic principles that barred and eliminated the perceived dangers of citizen participation swept into power across Latin America. Soon after Brazil, the populist movements of Chile,
Uruguay, and Argentina would die under the overwhelming might of those countries’ militaries.
Against this regional backdrop, AD’s early abandonment of populism and the
Venezuelan political establishment’s shift towards a politics of compromise that preserved civilian rule seems pragmatic and a politically expedient solution. to avoid a larger crisis. The political establishment’s Pacto de punto fijo (Pact of a Fixed Point) memorialized the chosen course in 1958. It forced a variant of democracy identified in political science literature as consociationalism. This democratic form has four characteristics. As scholar Richard S. Hillman explains, these are,
(1) a coalition that includes the leaders of all significant societal groups; (2) a veto vote for each societal group on policy issues vital to it; (3) representation in political and governmental office proportionate to each group’s strength; and (4) autonomy for each group in its internal affairs.”13
13 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 53. Reyes 16
Venezuela’s 1961 constitution formalized parts of this arrangement; other parts would remain an informal understanding among the pact’s participants. El pacto de punto fijo and its model of limited citizen representation would endure until 1993.
The pact’s goal was to force unity among political parties and the most important social groups. Limited representation for those citizens non-aligned with these groups was the pact’s collateral damage. Promises to share the state’s largess, symbolized by its larger oil reserves, was the compensation that citizens received for their stake in the political process. Inevitably, the pact’s success would come to depend on high oil prices and the ability of its participants to buyout opposition. In the 1980s, when the prices of this commodity tumbled, the Venezuelan parties found themselves overextended in protection of their stability model. Consociationalism proved unsustainable under these circumstances.
THE APPEAL TO DECENTRALIZATION
To preserve the system of consociationalism, the dominant parties of the late 1980s agreed to a limited program of fiscal and administrative decentralization. If the central parties had followed through with these promises of reform, perhaps they could have reaped rewards from this decision. However, their desire to cede control to lower levels of government was not genuine and at best negligible.
Decentralization describes the process whereby the central government transfers power to sub-national levels of government.14 These transfers can occur in economic, administrative, and political areas. The economic area encompasses primarily fiscal policies. Administrative, reflects how government structures itself to respond to the questions such as: At what level are certain government functions best administered or “What is the proper level for intermediate
14 Philip Oxhorn, “Unraveling the Puzzle of Decentralization,” in Decentralization, Democratic Governance, and Civil Society in Comparative Perspective, ed. Philip Oxhorn, Joseph S. Tulchin, and Andrew D. Selee (Washington: Woodrow Wilson Center Press, 2004), 7. Reyes 17 decisions? How is control and co-ordination to be maintained? How is efficiency of services to be increased?” Political decentralization implies the level of representation in the decision- making process.15 The literature on decentralization dating back to the 1950s has stressed the process’ value as “a policy option with political and economic benefits”.16 This is because it brings power to local governments where 1) it is closer to the people, promoting representation and participation 2) citizen’s preferences are better understood and 3) there is better potential for sound economic policy formulation.17
Venezuela’s governing societal groups, fixed in place by the 1958 pact, were in desperate need of reconnecting with their citizenry; yet they refused to commit to decentralization. They gambled on a limited and largely illusory decentralization effort. To illustrate, consider the parties’ approval for the direct election of governors in 1989. Though Venezuelans went to the polls for these officials in December 1989, the central government delayed the transfer of fiscal and administrative responsibilities to these governments well into the 1990s. Ultimately, the attempt at limited decentralization failed to preserve the governing parties’ position within the weakening system, promote efficiency in governance, and create the sentiment that citizens mattered in Venezuela.
THE PERSISTING CITIZEN PARTICIPATION DEFICIT
By the early 1990s, the deteriorating economic context and staggering decentralization effort awakened Venezuelans to their helplessness in the country’s political system. If
15 Norman Furniss, “The Practical Significance of Decentralization,” The Journal of Politics, (Nov. 1974): 960-968. 16 Maria Escobar-Lemmon, “Political Support for Decentralization: An Analysis of the Colombian and Venezuelan Legislatures,” American Journal of Political Science, (Oct. 2003): 686. 17 Harry Blair, “Participation and Accountability at the Periphery: Democratic Local Governance in Six Countries,” Publius: The Journal of Federalism (24(1)), 1-15; Shavid Javed Burki et al., eds., Beyond the Center: Decentralizing the State (Washington: World Bank, 1999); James Manor, The Political Economy of Democratic Decentralization (Washington: World Bank, 1999); George E. Peterson, Decentralization in Latin America: Learning through Experience (Washington: World Bank, 1997); Jan Nederveen Pieterse, “Participatory Democracy Reconceived,” Futures (33(5)): 407-22; quoted in Maria Escobar-Lemmon, “Political Support for Decentralization: An Analysis of the Colombian and Venezuelan Legislatures,” American Journal of Political Science, (Oct. 2003): 686. Reyes 18 democratic participation describes a link between the actions of citizens and the reactions of their governments, then Venezuelans were not participants in their democratic system. This growing disconnect created the optimal conditions for extra-legal solutions to recapture their position in the stagnating democratic model.
Citizens pressed for the creation of a new model that could reconfigure the pieces of the long broken state, but did not look to major parties for this task. They blamed those parties for the country’s downfall. Instead, citizens turned to figures that denounced the party establishment. In 1992, this atmosphere allowed Colonel Hugo Chávez to take a defiant stand against Venezuela’s government. He launched a coup against the republic’s president. While
Chávez did not succeed in toppling the president, he did land a deathblow to Venezuela’s party based democracy.
Democracy, outside the defunct Pacto de punto fijo, returned to Venezuela with Rafael
Caldera’s election to the presidency in 1994. A minority party coalition elected him in 1994.
Caldera was an establishment politician, but had abandoned his party to run in that year’s presidential election. One electoral cycle later, in 1998, Venezuelans would take a more daring step. They elected Chávez, the defiant colonel, to the presidency.
Chávez won on a platform that promised to reorganize the state and give Venezuelans influence in the democratic process. He derided the Venezuelan democracy constructed in the
1961 constitution, characterizing it as a “farse that they call democracy but which in reality was a dictatorship”.18 From the outset, Chávez made clear that he was something different from anything in Venezuela’s past and that he aspired to reshape the state.
CHAVISMO
18 Armando Durán, Venezuela en Llamas (Caracas: Grupo Editorial Random House, 2004), 15. Reyes 19
Under Chávez, Venezuela has acquired a new political regime: Chavismo. It revisits the populist experiment ended with AD’s overthrow in 1948. Freddy Bernal, the current mayor of
Caracas and fierce ally of President Chávez, describes this as a movement that,
…inspired by those ideals [of Latin American revolutionary Simón Bolívar] sweeps the dust from history, removes the nationalist spirit, hoists the flags of liberty and democracy, makes a call to retake the principles and values of our nationality, regains the valor of a brave people and instigates it to stand up over its disgrace, over its oppression, its stomped upon dreams, its frustrated desires, its battered honor and makes it feel again like in other times, a people, life, blood and hope…19
Like the earlier Latin American populist movements, Chavismo identifies with a forgotten past and defines itself in contraposition to the prevailing political experience. Chavismo is a reaction to a deficient democratic form of government. Unlike earlier populist movements, it is not an heir to caudillismo. Despite the fiery rhetoric, it offers not an alternative to repression, but a purer form of democracy. Though it has sprouted on the tail’s end of another resurgence in populism, labeled neo-populism in the literature, it differs from that movement because
Chavismo favors socialism over capitalism. Chavismo aims for a much deeper impact than the old styled populism, and so it is a radical and mold breaking construct.
Chavismo’s emphasis on improving the condition of the country’s underprivileged majority makes it like the radical populist regimes of the 1930s and 1940s found in Latin
America. During that period, leaders such as Argentina’s Juan Perón and Venezuela’s own
Rómulo Betancourt (AD) embraced antiestablishment rhetoric and worked to include underprivileged sectors into the fabric of the state. But in both instances, and much unlike
Chavismo, the radical populist movements stopped short of “structural changes that would have threatened powerful economic interests”.20
19 Ramón Herrera Navarro, La Revolución Chavista (Caracas: Instituto Municipal de Publicaciones, 2003), 31. 20 Steve Ellner, “The Radical Potential of Chavismo in Venezuela: The First Year and a Half in Power,” Latin American Perspectives, Free Trade and Resistance (Sep. 2001): 8. Reyes 20
Scholar Steven Ellner makes the claim that Chavismo differs from the radical populist movements in its appeal to the masses, electoral base, ideology, hegemonic quality, and embrace of the political left. He notes that Chávez’s original attempt at coming to power in a 1992 coup did not include an appeal to the Venezuelan masses; he has failed to capture the electoral support of the middle class; his political party (Movimiento Quito Republica, MVR) lacks both organization and an ideological vision; his regime does not face an organized opposition, instead enjoying the military’s support; and that Chávez has avoided anticommunist rhetoric and includes leftist in his government and party.21 But Ellner highlights only four points that make
Chavismo different than the radical populism of the 1930s and 1940s, because the movement does appeal to the support of Venezuela’s masses. In his survey on the Latin American populism of this earlier period, Coniff makes clear that “movements rarely began with the allegiance of
“all of the people” for whom they spoke, and hence they continually strove for universal representation”.22 Although Chávez appeared during a military backed coup in 1992, he ascended to office in 1998 via democratic elections. At that time, he won with the support of
56% of all Venezuelans. It would be misleading to say that standing in this contest was not an appeal to Venezuela’s masses. It is more accurate to say that Chavismo differs from the past populist movements in four ways, and that each of these differences provides it a greater potential to restructure the Venezuelan state.
Chavismo does not have a definite electoral base or well-defined ideology. It relies on the support of the country’s underclass, outside of an organized party structure. MVR, Chávez’s party, differs from the vertically structured, labor-associated parties of the earlier populist period.
It has deep roots in the leftist guerilla movements that fought against the Venezuelan state 21 Ibid 25-26; Recently The Economist has stated that Hugo Chávez declared himself a Fidelista. “Is the United States’ Nightmare of “a second Cuba” coming true in Venezuela?,” The Economist, 26 February 2005, 35. 22 Michael Coniff, “Introduction: Toward a Comparative Definition of Populism,” in Latin American Populism in Comparative Perspective, ed. Michael L. Conniff. (Albuquerque: University of New Mexico Press, 1982), 17. Reyes 21 throughout the 1960s. When it joined the electoral process in the mid 1990s, it drew in its leftist guerilla members, and attracted less militant but equally “disenchanted and marginalized members of the main establishment parties.”23 Unlike traditional populist parties, it lacks internal organization and cannot claim any from outside its organization. It relies on the support of workers in the informal economy, not organized labor unions.24 The party receives support more in opposition to the Venezuelan establishment than for any ideological vision that it offers, or consistency in its electoral base. This base is not “politically controlled” and “at any given moment…may express support for the government, just as [it] may serve to undermine its authority”.25 So long as Chavismo continues to market itself as an opposition movement, it will retain its base—one uninterested in association with establishment parties. Ultimately, this opposition stance hinders an independent programmatic vision.
Chavismo embraces socialism and faces neither a credible opposition nor military threat to dissuade it from radical leftist tendencies. Chávez has openly declared his opposition to capitalism as a developmental tool and has built a close rapport with Fidel Castro in Cuba. This opens the possibility for deeper socioeconomic changes than even the most forward-looking populist of earlier years envisioned.26 In addition, Chávez, a military man, has support from
Venezuela’s armed forces. This strong grip of the state apparatus, combined with its equally tenuous hold on its base, makes Chavismo a more radical experiment than populism—old or new.
23 Ibid, 11. 24 Steve Ellner, “The Radical Potential of Chavismo in Venezuela: The First Year and a Half in Power,” Latin American Perspectives, Free Trade and Resistance (Sep. 2001): 27. 25 Steve Ellner, “The Radical Potential of Chavismo in Venezuela: The First Year and a Half in Power,” Latin American Perspectives, Free Trade and Resistance (Sep. 2001): 27. 26 The Dow Jones Newswires have quoted Chávez saying that “if capitalism is the (wrong) choice, then what? I have no doubt, it is socialism”. “Venezuela’s Chavez: Socialism is the Right Economic Path,” Dow Jones Newswires, 25 February 2005. Reyes 22
As Chávez bid for power, Latin America also experienced a resurge in populism—albeit in a new form. The literature identifies it as delegative democracy in scholar Guillermo
O’Donnell’s vernacular, or more generally as neo-populism.27 In the delegative democracy model, presidents are charismatic leaders, rely strongly on rule by executive decree, use referendums to legitimize their authority, employ antiparty rhetoric, and speak a messianic message.28 The operating assumption of these regimes is that the democratic power of the people is fully vested in the person of one leader. This is just a shade short of a socially approved dictatorship. Neo-populists share the same qualities, but appeal to cross cutting sectors of the population. They usually do so by “holding the political elites responsible for the nation’s pressing problems.”29 In the contemporary occurrences of these populist models (Alberto
Fujimori, Peru; Menem, Argentina), presidents have used the capital accrued through their popularity to implement neo-liberal reforms.
Chávez’s regime shares similarities with the two nearly identical models of delegative democracy and neo-populism. President Chávez is a charismatic leader, even if he does not have an appeal beyond Venezuela’s underclass. His administration used the referendum to validate the 1999 constitution. And it has theoretically extended the practice to the selection of judges and legislative and constitutional initiatives. The new constitution has also strengthened the power of the executive branch. As an example, it reserves the executive branch the right to declare an economic emergency and assume extra-constitutional powers. Finally, the presidential administration frequently shows contempt for the Venezuelan “party democracy” and blames it for the country’s decay.
27 Guillermo O’Donnell, Counterpoints: Selected Essays on Authoritarianism and Democratization (Norte Dame: University of Notre Dame Press, 1999), 150-54; Kurt Weyland, “Neoliberal Populism in Latin America and Eastern Europe,” Comparative Politics (Jul. 1999): 379-401. 28 Steve Ellner, “The Radical Potential of Chavismo in Venezuela: The First Year and a Half in Power,” Latin American Perspectives, Free Trade and Resistance (Sep. 2001): 6. 29 Ibid 6. Reyes 23
The key factor that differentiates the Venezuelan government from the delegative democracy and neo-populist forms of populism is that it has not used its popularity to implement draconian economic austerity measures, or impose neo liberalism. Initially, it did take steps towards fiscal responsibility. These included not deviating from the 1999 budget despite higher than anticipated oil prices, accumulating international reserves, keeping inflation down to 20% in that year and keeping interest rates low.30 Recently, however, it has increasingly engaged in social spending, deepening its position in the natural resource (petroleum principally), health and education sectors. This is antithetical to the delegative democracies and neo-populist regimes of the 1990s. Those regimes-types “embraced neoliberalism, which was unconcerned about social inequality, and thus they stopped short of redistributive policies.”31 Chavismo is all about structural reform, and as such seems to extend beyond mere populism.
BUILDING A NEW VENEZUELAN STATE
President Chávez labels the Venezuelan state he strives to create a democracia participativa. He often speaks of its “democratic protagonist” character, where the opinions of citizens are validated throughout the governing process. In 1999, a constituent assembly granted him a constitution founded on this concept.32 The new constitution places a heavy emphasis on citizen power, the expanded use of the referendum and the “democratic protagonist” character of the reformed state.33 It defines Venezuelan democracy as “participatory, elective, decentralized, responsible to the people, pluralist, based on term limits for elected officials and with revocable mandates.”34 This definition significantly differs from that set forth in the previous, 1961, constitution: “representative, responsible to the people and guaranteeing the rotation of elected
30 Ibid 20. 31 Ibid 24. 32 This replaces the constitution of 1961. 33 Angel E. Alvarez. “State Reform Before and After Chávez’s Election,” in Venezuelan Politics in the Chávez Era: Class, Polarization & Conflict, eds. Steve Ellner and Daniel Hellinger (Boulder: Lynne Rienner, 2003), 151. 34 Ibid, 151-152. Reyes 24 public officials.”35 Critics of the Venezuelan government fear that the new emphasis on majority rule may actually be tearing whatever fabric of the democratic state remains. Of most concern are the constitutional provisions that shift previously held legislative and judicial powers to popular referendum and a constituent assembly. 36
Scholar Angel Alvarez views with apprehension the government’s use of popular referendums (now applicable for the recall of elected officials), public opinion polls, legislative, constitutional and constituent initiatives, and municipal councils.37 While Alvarez concurs with
Giovanni Sartori’s famed proposition that polls and referendum are compatible with representative democracy, he believes that the intention of the Venezuelan government is to build upon the protagonist notion of this process.38 What this means is to make the country’s citizenry the check and balance of the government, displacing self-executing counterweights within the three branches of government (executive, legislative and judicial). Whatever the
Chávez government’s intention may be, reality differs from the theory of an all-powerful citizenry.
Constituent assemblies provide an example of how the executive has a potentially greater power in reforming the state than its general citizenry. Calling a constituent assembly into existence requires 15% approval of registered voters, a 2/3 majority in the National Assembly, a
2/3 voting majority in municipal councils or an executive order. For this reason, Alvarez views with doubt the prerogative the constituent assembly can take in “transforming the state, creating a new legal order, and drafting a new constitution”.39 His concern is that while the president can call such an assembly into order through decree, the National Assembly and municipal councils
35 Ibid, 15. 36 Fared Zakaria, Illiberal Democracies (W. W. Norton & Company), 96. 37 Ibid, 154. 38 Alvarez notes President Hugo Chávez’s explanation that referendums are the closest thing to a direct democracy. 39 Ibid 155. Reyes 25 face significantly higher barriers. These, he explains, tilt the power of the constituent assembly in favor of the executive branch.
To Chavismo’s opposition (typically middle and upper class; fragmented and numerous), the movements confluence of executive power and citizen influence seems a paradoxical and unlikely possibility for a new state model. The administration and its supporters think otherwise.
As such, they are in the midst of a great effort to prove their opposition wrong.
A MODEL PROGRAM
Since coming to power, President Chávez has introduced Barrio Adentro; a multi-faceted program that brings mostly Cuban doctors into Venezuela’s marginalized urban and rural communities. Facilitated by a cooperation agreement with Cuba, Venezuela exchanges 53,000 barrels of oil per day for the services of medical professionals, teachers, sports trainers, and medicine. Within the communities, health committees composed of local volunteers assist doctors in their functions and act as liaisons to government officials. The administration developed this program outside the existing health system. In so doing, the administration has sent clear signals about the extent to which it will use its executive power to restructure the state and stimulate democratic participation. Supporters of the administration speak of this program as an “expression of what we want to create”.40 President Chávez claims this program is a prototype of principles set forth in the 1999 constitution regarding the state’s role in the health sector and the rights of citizens to participate in this area of the state. Currently, it is the largest practical example of how the presidential administration intends to give “power to the people.”41
Few Venezuelans, if any, would argue that the country’s health system did not fall into a deep state of disrepair throughout the 1990s. As the country’s economy worsened, fewer
40 Javier Arrúe, Program Coordinator at the newly created Universidad Bolivariana de Venezuela, Caracas, Venezuela, 12 January 2005. 41 This is a common slogan of the Chávez administration. Reyes 26
Venezuelans had jobs, and a greater number did not have private medical insurance. In its gravest instance, the system served as the frontline in medical care, though only having the capacity to serve as a backstop. In 1996, 80% of the population depended upon the public health system, when only 15% of all medical equipment available to public hospitals remained operational. Citizens with the ability to pay for medical services turned to the private sector, but for the great majority of Venezuelans this was simply not an option.
Soon after coming to power, in 1999 the Chávez administration merged the Ministry of
Health with the Ministry of Family Services to form the Ministry of Health and Social
Development (MSDS). This was a cautions attempt to address the pressing need for better medical care. Broadly, the new ministry governs the health sector, oversees policy design and implementation, and provides financing for activities that promote both health and social development. The Pan American Health Organization reports that since its inception, MSDS has made it a priority to “to transcend the medical focus of health to include social development.”42
But then surviving a series of opposition led strikes and an attempted coup between the years of
2002-2003, Chávez moved beyond just cautious reform attempts. The political climate required him to both affirm his government’s position and reward its base.
Chávez looked to the Venezuelan health system, a casualty of punto fijo parties’ desperate attempts to retain power in the early 1990s, a symbol of the country’s decay. The sector played a key role in the parties’ late 1980s program of decentralization, as an area in which the central government promised to transfer fiscal and administrative control to sub national governments. By the end of 1990, all but two Venezuelan states had signed agreements with the Ministry of Health that allowed for the transfer of federal funds and human resources to
42 “Venezuela,” Health in the Americas 2002 Edition Volume II (Washington: Pan American Health Organization, Pan American Sanitary Bureau, Regional Office of the World Health Organization, 2002), 561. Reyes 27 state-level control.43 Notwithstanding these agreements, as of 1993 states were still waiting for the completed transfer of authority and funds to operate in these areas. Throughout this political wrangling, Venezuela’s health system continued on its path to ruin. Barrio Adentro is Chávez’s innovation to stem the public health crises.
The findings of this research show that while Chávez has used Barrio Adentro to highlight his new Venezuela, citizens have used their affiliation with this program to pressure the administration for benefits and reshape its policy goals. The new program now operates in thousands of communities across the country. It is fast becoming the institution for participation most accessible to the greatest part of the country’s approximately 24 million people. 44 Chávez has created an opportunity for citizens to participate in the Venezuelan state.
43 “Venezuela,” Health in the Americas 2002 Edition Volume II (Washington: Pan American Health Organization, Pan American Sanitary Bureau, Regional Office of the World Health Organization, 2002), 562. 44 The recently instituted national referendums are the only other mechanism that can perhaps compare. However, participation in these is barred to the voting population of the state. As far as I can determine, there is no age barrier that would prohibit the larger part of Venezuela’s youth from taking part in Barrio Adentro initiatives. Reyes 28
CHAPTER TWO: POLITICAL HISTORY
Elected in 1998, Hugo Chávez was the first president unassociated with the major parties in the forty years since the founding of the country’s current democratic period. 45 At that time, he inherited a Venezuelan state incapacitated by years of fiscal mismanagement and framed within a political system lacking legitimacy. It was no longer able to respond to its population’s growing needs. Having pierced the country’s frayed democratic arrangement, Chávez foresaw an opportunity to make a clean break with the country’s long past of elite political management.
He claims to be in the process of creating a true, participatory democracy.
VENEZUELA’S FORMATIVE PERIOD (1500s -1936)
Venezuela’s historical development, largely informed by its colonial origins, provides the first context within which to understand the twentieth century’s political leadership forestalling the creation of a wide political space. Spain’s colonialism (especially under the Bourbon monarchs, 1700-1820) promoted the centralization of power and the use of uniform institutions, irrespective of local context. Scholars agree that the influence of the Catholic Church and specifically “Spanish Catholicism, political absolutism, and military ascendancy resulted in a society structured hierarchically by rank.”46
In his essay “Institutions”, author Douglass North argues that this organization mirrored the declining power of the Castilian Cortes (parliament) and ascending dominance of the monarchy at the time of Spain’s discovery and exploitation of territories in the new world.47 This provided Spanish colonies a political experience very much unlike that of their northern, British
45 Rafael Caldera served a second term in 1994-1998 as an independent backed by a coalition of small parties. However, his ties to COPEI (as its founder) are clear. 46 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 22. 47 Douglas C. North, “Institutions,” The Journal of Economic Perspectives (Winter 1991), 110. Reyes 29 counterparts. There, the English Crown’s persistent struggle with parliament was reflected in the
“general development in the direction of local political control and the growth of assemblies.”48
Economically, Spain’s interest differed from that of Britain and consequently contributed towards a distinctive socioeconomic formation. Spain’s economic interaction with its colonies was extractive and not fashioned on the principles of free trade, giving impetus to extra-legal courses of exchange; such as smuggling.49 North reflects in his study that this helps explain why
‘independence’ in the British colonies led towards institutions able to broker complex interpersonal exchange.50 In the Spanish colonies, bureaucracies possessed in their sole discretion the power to regulate the economic and political interactions of society. Thus, here the maximization of an individual’s political or economic goals was rewarded by “getting control of, or influence over, the bureaucratic machinery.”51
In Venezuela, the successful Wars of Independence fought between 1810 and 1821 were followed by civil wars that did not end until the late 1800s. This reflects that the Wars for
Independence were more than a fight against Spanish rule. They represented the explosion of
“civil wars between different regions with different economic priorities, conflicts among classes and races, conflicts within elites and important families, and simple confusion caused by
Napoleon’s invasion of the Iberian Peninsula.”52 Throughout this period of time Venezuela lost
“40 percent of its population, suffered enormous property damage, and saw almost all vestiges of its previous bureaucratic system destroyed.”53 The wars ruined the economic fortunes of
Venezuela’s pre-war elites, resulting in a weakened state without a clear dominant force. As in
48 Ibid, 110. 49 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 4. 50 Douglas C. North, “Institutions,” The Journal of Economic Perspectives (Winter 1991), 111. 51 Douglas C. North, “Institutions,” The Journal of Economic Perspectives (Winter 1991), 110. 52 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 5. 53 Terry Lynn Karl, The Paradox of Plenty: Oil Booms and Petro-States (Berkeley: University of California Press, 1997), 74. Reyes 30 most Spanish colonies, this would directly contribute to the failing of the United States’ exported federalist, decentralized, form of governance.
Drafters of the original Venezuelan constitution intended for ‘states’ to serve as administrative divisions. They also envisioned the separation of legislative, judicial and executive powers, as was the case in the United States. However, given the country’s historical context and the dearth in civilian leadership as a result of the Wars for Independence, this governmental structure “ensured that Venezuelans found little consensus on the issues of political legitimacy and presidential succession during most of the nineteenth century.” 54
Between 1821 and 1836 Venezuelans would redraft their constitution 21 times.55
Throughout a greater part of the 19th century, military heroes of the Wars for
Independence and regional caudillos ruled Venezuela, and vied amongst each other for power.
They were strong enough to rule states but too weak to obtain total control. This would delay the forming of a strong state.
General José Antonio Páez served as president between the years of 1831 and 1847. He had the backing of the country’s Conservative Party, composed of military men, Catholic Church leaders and landowners. His rivals, urban professionals and businessmen, coalesced into the
Liberal Party in 1840. However, as David E. Blank explains, “the two political parties functioned primarily as convenient labels under which competing, regionally based caudillos vied for national power.”56
Páez’s appointed successors, José Tadeo Monaga and his brother José Gregorio, were not loyal to the general’s interests. They imposed liberal reforms, such as debt relief and the
54 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 7. 55 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 32. 56 David Eugene Blank, Politics of Venezuela (Boston: Little, Brown, 1973), 12-13. Reyes 31 abolition of slavery in 1854. However, failing to strengthen the country’s economy, an opposition of liberals, conservatives and regional caudillos fomented against their rule.57
This coalition resulted in the 1858 overthrow of the Monaga brothers, and the start of
Venezuela’s Federal Wars (1858-1863). This period is best characterized as “a series of corrupt caudillos attempting to provide stability in the midst of anarchy, internecine warfare, and chaos.”58 Motivated by issues of economic crisis and general discontent, regional groups took arms against the weak central government and fought amongst themselves for greater power.59
These wars caused great devastation to the nations general population, an estimated 350,000 lives were lost, and the fortunes of the pre-war elites.60
Changing socioeconomic conditions would slowly propel the Venezuelan state towards centralization and the consolidation of its government apparatus. Around this time, Latin
America entered what is commonly referred to as the Gilded Age of Export Booms. Countries discovered new resources available for exports (i.e. Peru/ Guano, Venezuela/ Oil, and Central
America/ Bananas). As these export economies strengthened, they required new laws. Countries started to redraft their legal codes, specifically with the intent of attracting foreign investment.
The development of infrastructure, such as railways and communications by telegraph followed.61
These conditions invited “centralized bureaucratic control” throughout most of the region by the end of the 19th century.62 In Venezuela, as Judith Ewell explains,
57 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 8. 58 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 33. 59 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 33. 60 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 8. 61 The Cambridge Economic History of Latin America, ed. Victor Bulmer-Thomas, John Coatworth and Roberto Cores-Conde. (Cambridge University Press, 2005). 62 Douglas C. North, “Institutions,” The Journal of Economic Perspectives (Winter 1991), 110. Reyes 32
Much of the story from 1870 to the present is that of an increasing concentration of power and population in Caracas and along the north central coast. Economy, society, politics, and culture all coalesced in the capital city. The states and the state caudillos could not unite to retain local control and autonomy. They could not overcome the centripetal force that drew them to Caracas. The caudillos had to capture the central government in order to ensure attention to local problems.63
The increased importance of these urban centers, coupled with the breakdown in the traditional social order and their redesign as centers for administrative control (discussed in the section titled “From Strongman Rule to Populism and the Call for Social Integration”), made this a propitious climate for the rise of dictatorships. In his analysis of Latin American populism,
Michael Coniff illustrates this with reference to the “Porfiriato in Mexico, the Generation of
1880 in Argentina…the undemocratic “Republic” in Brazil, and the elitist parliament in Chile,” all occurring around this time.64 Those who ruled during this period had money, the backing of a privileged internal class and often North American and European capital.65
In Venezuela, the confluence of these factors is seen in General Cipriano Castro’s conquering of Caracas in 1899. The Grupo Táchira backed Ciprano in his efforts. As Terry
Lynn Karl explains, “these were autocrats from the coffee producing region of the Venezuelan
Andes.”66 Venezuela’s leadership would hail from this region from 1899 through 1945.
General Castro’s successor, Juan Vicente Gómez (1908-1935), blessed with the backing of the andino group and Venezuela’s emerging oil wealth would set a quick pace of development and centralization.
Juan Vicente Gómez, a ruthless dictator by all accounts, came to power in 1908. He is widely credited with modernizing the Venezuelan state; despite the repression and the
63 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 9. 64 Michael Coniff, “Introduction: Toward a Comparative Definition of Populism,” in Latin American Populism in Comparative Perspective, ed. Michael L. Conniff. (Albuquerque: University of New Mexico Press, 1982), 10. 65 The Cambridge Economic History of Latin America, ed. Victor Bulmer-Thomas, John Coatworth and Roberto Cores-Conde. (Cambridge University Press, 2005). 66 Terry Lynn Karl, The Paradox of Plenty: Oil Booms and Petro-States (Berkeley: University of California Press, 1997), 76. Reyes 33 concentration of power in the executive branch that characterized his regime.67 Oil provided the most reliable and significant contribution to Gómez’s undertaking. The presence of foreign oil companies propelled the development of modern ministerial posts and helped finance the formation of armed forces at the national level. Gómez was able to professionalize the national armed forces and modernize the treasury. He achieved the former by establishing academies for all branches of the military and the latter by assigning the treasury the duties of tax collection and maintaining a balanced budget.68
The improved coercive forces of the state helped solidify the state’s order. They eliminated the option of unofficial force, transforming quests for control and influence over the newly created and expanding bureaucracies into political struggles. Simultaneously, oil allowed
Gómez a source for “consolidating power in the presidency, maintaining his own rule, and enriching himself and his friends.”69 Whereas in future years the foundations laid for a strong military would ensure the integration of the Venezuelan state, the repressive attitude Gómez demonstrated towards the Venezuelan citizenry and his ill consideration of them in diffusing the oil wealth of the state would give impetus to the politicization of society.70
RISE OF MIDDLE CLASS COUNTERELITES (1920s)
The repression of the Gómez years had politicized groups, such as the Federación
Venezolana de Estudiantes (FVE). In 1928 it turned a week of student festivities into a riot against the regime. 71 This resulted in the jailing of more than 200 students, and the exiling of
67 Between 1909 and 1931, Gómez augmented the power of the president through seven successive constitutions. Judith Ewell comments that the “students at the UCV referred to course on constitutional law as mythology.” Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 48. 68 Ibid. 47-55. 69 Terry Lynn Karl, The Paradox of Plenty: Oil Booms and Petro-States (Berkeley: University of California Press, 1997), 77. 70 David Eugene Blank notes that “between July, 1919, and June, 1936, at best 7 per cent of the gross earnings of the petroleum companies had been paid to the Venezuelan government.” David Eugene Blank, Politics in Venezuela (Boston: Little, Brown 1973), 17. 71 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 74; Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 35. Reyes 34 the organizers. The FVE’s actions won the hearts of many Venezuelans and galvanized future political leaders, collectively known as The Generation of ’28. Among these were Raul Leoni
(Venezuelan president, 1964-69); Rómulo Betancourt (Venezuelan president 1945-1947 and
1959-1964; founder of Acción Democratica in 1941); Jóvito Villalba (founder of URD and president elect in 1952); and Rómulo Gallegos (president in 1948).72 These students expressed the sentiment of the urban middle-class, increasingly becoming aware of the need to create political space and promote social equality. The old Conservative and Liberal parties of the republic, most vibrant during the days of Páez (1831-1847), had long vanished. This meant that
The Generation of ’28 had to form its “own political party in the late 1930s.”73 They would get their chance upon Gómez’s death in 1935, building their support “on the basis of mobilization and leadership of politically inexperienced workers and peasants.”74
GÓMEZ’S PASSING, THE RISE AND FALL OF THE MODERNIZING ESTABLISHMENT (1936-1945)
Venezuela’s path towards democratization began in 1935 with Gómez’s death. Gómez had built a “political bridge between the caudillo system of the past and the modern bureaucratic state of the future.”75 However, it relied heavily on the concentration of power in the office of the executive and, by extension, himself. In addition, oil had contributed to “industrialists and an expanding, though small, middle class” seeking an alternative to the “rampant nepotism, corruption and repression” characteristic of the Gómez dictatorship.76 Gómez’s successors would no longer be able to govern in the style of the old caudillo.
72 David Eugene Blank, Politics in Venezuela (Boston: Little, Brown 1973),17-19. 73 Ibid, 18. 74 Ibid, 18. 75 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 69. 76 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 34. Reyes 35
Eleazar López Contreras, Gómez’s Minister of War, came to rule in 1935. He represented the ideals of Venezuela’s Modernizing Establishment. David Eugene Blank describes this movement as
…an amalgamation of new men: entrepreneurs and top professionals (many of whom were the sons of relatively recent immigrants), sons of the Andean followers of Cipriano Castro and Gómez, as well as the traditional landed and urban elites.77
They were acutely aware of the country’s need to industrialize, mostly because of the effects of the Great Depression on the country’s export and oil dependent economy. They sought to
“sponsor the social and economic development of the country and the limited and constrained extension of political participation.” 78
López Contreras carried out a series of reforms while in office. These included a 1936 constitution that gave government a central role in the country’s economic development, replacing military men with civilians in the state governorships, and expanding suffrage to about
15% of Venezuela’s population (adult, literate males) in the election of city council members and state assembly representatives—which elected the national congress, which elected the president.79 He also allowed for the return of the Generation of ’28 members.
In the mid 1930s, Rómulo Betancourt formed the Partido Democrática Nacional (PDN) in opposition to this regime. In 1936 it organized 20,000 petroleum workers and led them in a strike against the government. Soon after, López Contreras dissolved the PDN and banished its leaders from the country.80
General Isaías Medina Angarita succeeded López Contreras as president in 1941. Like his predecessor, he sought reconciliation with the Generation of ’28. PDN would return to the
Venezuelan political scene in Medina Angarita’s first year of rule as Acción Democrática (AD). 77 David Eugene Blank, Politics in Venezuela (Boston: Little, Brown 1973), 17. 78 Ibid, 17. 79 Ibid, 19. 80 Ibid, 19. Reyes 36
—Rómulo Betancourt headed the party.81 Medina Angarita was progressive. While in office he signed the 1943 Hydrocarbon Act, created an income tax, social security system and “pushed through an agrarian reform law” before he was removed from office by a military coup. His downfall was not a consequence of his policies, but rather AD and the military establishment’s disagreement with his chosen successor.82
The 1943 Hydrocarbons Act was the first legislation undertaken that reflects the changing rationale of the Venezuelan state. Increased oil activity had resulted in the spreading belief that the state “existed not merely to regulate social intercourse but also to correct the deficiencies of development through an equitable distribution of oil rents.”83 The passage of this act was important because it provided the “first significant manifestation of distinctive state interests strong enough to confront the multinationals [foreign oil companies]” and second because it decreed that “companies should not be able to earn a greater net income from the extraction of oil than that which accrued to the state [fifty/fifty].”84 The state would eventually achieve full nationalization of the industry in 1983.85
The president’s intended heir was Diógenes Escalante. At the time, Medina Agarita’s party hardliners wanted to see López Contreras retake the presidential office. AD rejected this notion, but was highly in favor of Escalantes because they thought he would promote universal suffrage. Unfortunately, Escalantes fell too ill to become president. In his place, Medina
Angarita chose his Minister of Agriculture. This was an unacceptable choice to AD, and especially to a sector of the military establishment that organized as the Unión Patriótica Militar
81 Ibid, 19. 82 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 94. 83 Terry Lynn Karl, The Paradox of Plenty: Oil Booms and Petro-States (Berkeley: University of California Press, 1997), 83. 84 Ibid, 87. 85 In 2003, Venezuela ranked tenth among top world oil producers at 2.66 million barrels per day, and sixth among exporters at 2.23 million barrels per day. “Non-Opec Fact Sheet”. Energy Information Administration. Available at: http://www.eia.doe.gov/emeu/cabs/topworldtables1_2.html. December 4, 2004. Reyes 37
(UPM). The UPM was steadily opposed to the retention of old Gómez allies in the military, which compromised their chances at a merit-based promotion. They were also sympathetic to the idea of an accelerated pace of development. Finding a political ally in AD, they moved to overthrow the Medina Angarita’s government on October 17, 1945.86
NEW POLITICAL PARTIES (1946)
The formation of two important political parties coincided with AD’s military backed rise to power. In 1946 Rafael Caldera founded the Comité para Organización Política y Elecciones
Independientes (COPEI). It had its roots in a conservative alternative, Unión Nacional
Estudiantes (UNE), to the early 1930s’ FEV movement.87 UNE’s student founders were “Roman
Catholic intellectuals” seeking to draw distance with their “more secular and leftist colleagues in the FEV.”88 In its earliest day (1946-8) COPEI maintained itself as a solidly Catholic party with a regional base in Venezuela’s Andean region.89 Following 1958, when Venezuela entered its pacted democracy phase, it would become a more centrist party—as would AD.
Under the direction of Jóvito Villalba, the Unión Republicana Democrática (URD) also formed that year. Villalba was from the Generation of ’28. However he exchanged his radical credentials for modernist ones during the 1930s, ultimately allying himself with Medina
Angarita. In the changing political context, URD represented “the urban middle-class interests seeking a government of unity and calmness rather than the tension-producing, partisan orientation of AD.”90 To its own detriment, the URD would fail to change with the times in years to come. Although it formed part of El Pacto de Punto Fijo in 1958, Villalba would soon
86 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 94-95. 87 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 48. 88 David Eugene Blank, Politics in Venezuela (Boston: Little, Brown 1973), 23. 89 Ibid, 23. 90 Ibid, 23. Reyes 38 withdraw the URD’s commitment; later he would drive its younger leadership from the party causing “new personalistic parties” to proliferate.91
FROM A REFORM DEMOCRACY TO MILITARY INTERVENTION (1945-1948)
The period that follows Medina Angarita’s overthrow is referred to as the trienio.
Between 1945 and 1948, AD (headed by Betancourt 1945-47, and then Gallegos 1948) made efforts to include human rights laws, further provisions for social legislation and direct elections in the country’s constitution.92 During this time period the party allied with the Federacíon
Campesina de Vecinos (FCV) and helped increase the latter’s membership from 6,000 in 1945 to
43,000 in 1948.93 It also helped create the Confederación de Trabajadores de Venezuela (CTV), raising its membership to 300,000. These feats raised concern that “rather than leading the peasant masses in the conquest of the land,” it was merely creating “a clientele with which to guarantee AD’s electoral dominance.”94 AD chose to delay land-reform.95 All the while, however, its rhetoric intensified and this served to alienate the “urban middle class, the Catholic
Church, and the armed forces faster than it could organize and discipline the labor and peasant unions.”96
AD minimized conflict with an expansionist policy. It sought first “to distribute oil rents to cement its political support,” and when nearing the limits of this option, picking “new battles over shares of oil rents with the foreign companies.”97 Although Betancourt was able to balance
91 John D. Martz, “Political Parties and the Democratic Crises,” in Lessons of the Venezuelan Experience, eds. Louis W. Goodman et al. (Washington: The Woodrow Wilson Press: Washington, 1995), 32. 92 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 36. 93 David Eugene Blank, Politics in Venezuela (Boston: Little, Brown 1973), 22. 94 David Eugene Blank, Politics in Venezuela (Boston: Little, Brown 1973), 22. 95 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 36. 96 David Eugene Blank, Politics in Venezuela (Boston: Little, Brown 1973), 24. 97 Terry Lynn Karl, The Paradox of Plenty: Oil Booms and Petro-States (Berkeley: University of California Press, 1997), 96. Reyes 39 the conflicting interests of AD’s multiple constituencies, his successor, Rómulo Gallegos, was far less able.98
In 1948 AD, despite winning the elections of that year, ran into serious trouble. First, the
UPM harbored suspicions that AD sought to challenge the military’s dominance. As a result, the
UPM tried to get COPEI representation within the AD government. It also wanted Gallegos to exile Betancourt. Gallegos refused both requests.99
The roots of UPM’s fears may have laid in Gallegos’ 1948 attempt to remove the army chief of staff, Marcos Pérez Jiménez. Shortly after this failure, the military responded by ordering Gallegos to reconstitute his cabinet. AD naively, and to an extent without other recourse, negotiated with the military on this account. As Scholar Steven Ellner explains, these negotiations were “merely a ruse by the military to disarm AD leaders in the crucial days prior to the coup.”100 With the approval of COPEI and URD, the military reasserted its control of the country in 1948. Power would remain in the hands of the military until 1958. General Marcos
Pérez Jiménez first led the military’s governing junta and then secured the presidency between
1952 and 1958.
Throughout Pérez Jiménez’s rule, the Venezuelan state apparatus rotted to its core.
Corruption, the personalization of politics, the prohibition of opposition parties (including AD), and expansionist programs aimed at “generating support among groups within the elite and lower classes” tended to increase the domain of the state while simultaneously undercutting its managerial capacities.101 As Venezuela’s economy began to stagnate in the late 1950s,
98 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 36. 99 David Eugene Blank, Politics in Venezuela (Boston: Little, Brown 1973), 24. 100 Steven Ellner, “Populism in Venezuela,” in Latin American Populism in Comparative Perspective, ed. Michael L. Conniff (Albuquerque: University of New Mexico Press, 1982), 145. 101 Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 37. Reyes 40 repression and subsequent opposition to the regime increased. The previously factionalized political interests of the country became more amenable towards cooperation in the joint venture of displacing the dictator.
When Pérez Jiménez tried to withdraw his commitment to elections in the year of 1958, as called for in the constitution his administration drafted in 1952, he set in motion the events that would lead to his demise. Amidst protests and violence, the dictator was forced into exile.
The military reassumed power, but also promised to hold elections. Given the instability of the country, and the fragile history of democracy, the major parties in the country (now including
AD, COPEI and URD) pledged to rule together irrespective of electoral results. The agreement that would enshrine this commitment into Venezuelan politics over the next three decades is known as El pacto de punto fijo.
PUNTO FIJO (1958)
Punto fijo accorded AD, COPEI and URD veto power in subsequent administrations. At the same time, the pact officially proscribed communist parties and made accommodations for the business community, church and military.102 As a result, punto fijo would have the effect of
“privileging the political parties, their organized constituencies, and those capitalist interests that had the potential capacity to undo the democracy.”103 In Venezuela, democracy and stability were achieved by a pact that purposely constrained policy choices and, by extension, innovation.
Venezuela’s restored democracy did not supersede the legacies of strong executive power, weak state institutions, vested interests and a generally disenfranchised citizenry. Instead the constitution of 1961 that followed the forming of Punto fijo institutionalized limited consensus and access to the political arena:
102 Ibid, 34. 103 Terry Lynn Karl, The Paradox of Plenty: Oil Booms and Petro-States (Berkeley: University of California Press, 1997), 101. Reyes 41
Believing that only the state could distribute the fruits of the nation’s patrimony and that democratic forces needed a mediator who could rise above the kinds of partisan conflicts that had destroyed the trienio, the constitution validated the tradition of highly centralized power and made the president the supreme arbiter.104
While, the payoff to the general public for the limited consensus would be a highly expansionist state (paid with oil rent), the democracy at which Venezuela had arrived would prove insufficiently expandable.
THE CREATION OF A PARTY DEMOCRACY (1958-1988)
Punto fijo had unanticipated effects on the party organizations that signed it, and later came to dominate the political scene of the country. It transformed them from grassroots participation driven parties into elite controlled bureaucracies content to perpetuate the status quo.105 Over this period, the parties (AD and COPEI) became far removed from the Venezuelan society it sought to govern. As the parties assumed increasing control of the political scene, citizens’ influence failed to extend beyond the election of the president.106 To understand how parties came to dominate the political spectrum, it is important first to understand the structure of the democratic system that they built. As Brian Crisp observes, “consensus building and protection of the democratic regime were often the primary goals taking precedence over incorporating new groups and resolving difficult conflicts.”107
The electoral law established in the country’s 1961 constitution is instrumental in this regard. The parties chose a closed-list system. Here parties determined a list of candidates and citizens’ votes counted for parties. This allowed parties to fully control the ballot. Over time these electoral laws contributed towards the construction of a stable democracy. However, it was
104 Ibid,105. 105 John D. Martz, “Political Parties and the Democratic Crises,” in Lessons of the Venezuelan Experience, eds. Louis W. Goodman et al. (Washington: The Woodrow Wilson Press: Washington, 1995), 38. 106 Michael Penfold-Becerra, “Electoral Dynamics and Decentralization in Venezuela,” in Decentralization and Democracy in Latin America, ed. Alfred P. Montero and David J. Samuels (Norte Dame: University of Norte Dame, 2004), 158. 107 Brian Crisp, “Presidential Behavior in a System with Strong Parties: Venezuela, 1958-1995,” 161. Reyes 42 one with deficits of popular representation. The electoral rules, which bonded parties to the system and produced discipline, also resulted in a rigid structure.108
Under these rules, the party leaders of AD and COPEI nominated members to the federal bi-cameral congress, state legislatures and municipal posts.109 In all these electoral contests, parties would distribute the posts according to the overall percentage of votes they received. The greater the percentage of votes, the more nominees off a parties’ list of candidates were placed in available posts.110 In the presidential contests, the stakes were higher. The party that obtained this office also appointed governors and the mayor of Caracas.111
Rómulo Betancourt (AD) became the first president following the signing of Punto fijo in
1958. His party would win two consecutive elections (five year terms). In 1968 there occurred a division in AD that resulted in the creation of Movimiento Electoral del Pueblo (MEP). This cost AD the election to COPEI (Rafael Caldera won with 29% of the vote).112 This experience served both to bolster the country’s democratic system and teach Venezuelans a valuable lesson: to not waste their votes on small parties. Despite the reintroduction of small leftist parties in the
1973 presidential election (Movimiento al Socialismo (MAS) and Movimiento de Izquierda
Revolucionaria (MIR)), Venezuelans would accord AD and COPEI approximately 80 to 90% of
108 Brazil’s open-list system provides an example opposite to that of Venezuela. Its electoral rules are permissive, limiting party control in favor of popular representation. Consequently, party discipline in Brazil is low and the price of governance is high. Barry Ames, “Electoral Strategy under Open-List Proportional Representation,” American Journal of Political Science (May 1965): 406-433. 109 Michael Penfold-Becerra, “Electoral Dynamics and Decentralization in Venezuela,” in Decentralization and Democracy in Latin America, ed. Alfred P. Montero and David J. Samuels (Norte Dame: University of Norte Dame, 2004), 158. 110 Even after separate municipal elections were established in 1988, the central committee of COPEI reserved the right to name 1/3 of candidates on all party lists. This meant that even in these local elections, citizens were choosing from among a list of candidates both nominated and ordered by elite party officials. John D. Martz, “Political Parties and the Democratic Crises,” in Lessons of the Venezuelan Experience, eds. Louis W. Goodman et al. (Washington: Woodrow Wilson Press: Washington, 1995), 38. 111 Michael Penfold-Becerra, “Electoral Dynamics and Decentralization in Venezuela,” in Decentralization and Democracy in Latin America, eds. Alfred P. Montero and David J. Samuels (Norte Dame: University of Norte Dame, 2004), 158. 112 John D. Martz, “Political Parties and the Democratic Crises,” in Lessons of the Venezuelan Experience, eds. Louis W. Goodman et al. (Washington: The Woodrow Wilson Press: Washington, 1995), 33. Reyes 43 all votes in presidential elections between 1973 and 1988.113 For most of these elections, AD and
COPEI alternated in the presidential post (though AD won consecutively in 1983 and 1988).
While this party structure provided the Venezuelan state with stability, it suffocated the grassroots origins that defined the parties formed by Betancourt (AD, 1941) and Caldera
(COPEI, 1946). When describing AD before Punto fijo, John Martz notes:
… Betancourt…believed that party offices and activities should reach the furthermost corners of the republic. If the party were properly attuned to the masses, its activities should be unending, rather than limited merely to periodic exercises in electoral democracy. Discussion of local issues, sports and social activities, printing and distribution of political literature, membership recruitment all were intended to simulate participatory democracy within the party…”114
Emulating AD’s successful model, COPEI designed its own party structure and activities similarly to what is described above.
With URD’s withdrawal from Punto fijo AD and COPEI came to dominate in the arranged government. They established relationships with labor organizations that allowed them to outsource the job of keeping in touch with Venezuelans. Their relationships with the
Federacíon Campesina de Vecinos (FCV) and the Confederación de Trabajadores de Venezuela
(CTV), proved instrumental in this regard. Party leaders turned their attention inwards, competing amongst each other for domination of the political posts AD and COPEI shared to keep their hegemony over the system.115
In the 1980s, AD and COPEI exhibited signs of fierce intra-party competition. Eduardo
Fernández moved into the position of undersecretary for COPEI in 1983, as Caldera made a second but unsuccessful bid at the presidency. In the following election of 1988, the protégé of
Caldera ran despite the party leader’s objection. At the same time Carlos Andrés Pérez (AD,
113 Ibid, 33. 114 Ibid, 36. 115 Ibid, 39. Reyes 44 president 1973-1978) fought fiercely against the opposition of sitting president Jaime Lusinchi
(1983-1988) for the party nomination.116
Noticeably, these confrontations did not involve the Venezuelan public. Instead they pivoted around the “sentiment among the party leadership”.117 As the 1990s approached, the dominant Punto fijo parties had transformed themselves into elitist bureaucracies out of touch and unconcerned with the Venezuelan reality.
VENEZUELA IN THE BOOM (1970s)
In 1973, presidential candidate Carlos Andrés Pérez (AD) campaigned for the presidential election of Venezuela on a populist platform. He promised to increase the country’s economic independence, promote development, social justice and democracy. Andrés Pérez summarized this as La Gran Venezuela. In his vision, government would use its fiscal powers to fight poverty (i.e. price controls) and expand its control on employment and other social service policies. It would reduce the country’s dependence by deepening the process of Import
Substituting Industrialization (ISI), the creation of domestic industry. He planned to do this by reinvesting in the country’s petrochemical, aluminum and steel industries while preparing to nationalize the oil industry. Andrés Pérez was aided in his ambition with the increase in world oil prices in the 1970s. Between 1972 and 1975 Venezuela saw a 419% increase in the price of oil per barrel. Terry Lynn Karl observes that the president sustained little opposition to his plans.
Largely because he promised to continue upon the path of state-directed development, if not at a greater speed, on which the parties had placed themselves. 118
Andrés Pérez was a charismatic figure who was elected on exactly those credentials, a bit of an anomaly in the impersonal system Punto fijo sought to impose. Although belonging to AD,
116 Ibid, 37. 117 Ibid, 28. 118 Terry Lynn Karl, The Paradox of Plenty: Oil Booms and Petro-States (Berkeley: University of California Press, 1997), 116-120. Reyes 45 and considered a protégé to Betancourt, he drew power to his person. In his election, Andrés
Pérez won an impressive 48.7% of the vote. Alongside AD’s ability to capture 51% of
Congress, in no small part due to Andrés Pérez, the president was given a mandate that put
Punto fijo in peril.119
After his election, Venezuela’s boom economy started to overheat. The fiscal revenue of
Venezuela in comparison to its Gross Domestic Product (GDP) rose to 40% in 1976, faster than the government
119 Ibid, 121-122. Reyes 46
FISCAL REVENUE OF VENEZUELAN GOVERNMENTS, 1917-1978 (MILLIONS OF BOLIVARES)
Government Total Average/ Year Income Vicente Gómez , 1917-35 476 25 López Contreras, 1936-40 471 94 Medina Angarita, 1941-45 971 194 Acción Democrática, 1946-48 2,337 779 Pérez Jiménez/ Junta, 1949-52 4,963 1,241 Pérez Jiménez, 1953-57 9,615 1,923 Government Junta, 1958 2,713 2,713 Rómulo Betancourt, 1959-63 16,285 3,257 Raúl Leoni, 1964-68 25,573 5,114 Rafael Caldera, 1968-73 36,952 7,390 Carlos Andrés Pérez, 1974-78 100,356 29,728 Total Revenues 228,758 45,752
Source: Banco Central de Venezuela (1987b and 1979); in Terry Lynn Karl, The Paradox of Plenty: Oil Booms and Petro-States (Berkeley: University of California Press, 1997), 117. could think of ways to productively invest. This threatened discord among Punto fijo’s consensual members: organized labor, business and other political parties. Organized labor liked the policies of the administration, which gave its members higher wages among other things. Business, however, was unnerved by the growing threat of inflation and an overheated economy. Political parties worried, and correctly so, that Andrés Pérez was ruling outside of the agreed upon pact.120
The legacy of this period would be twofold. First, it would commit government to high expenditures that it could not sustain. Second, it “created new “assignment battles” over the allocation of shares between the public and private sectors and between capital and labor.”121
VENEZUELA BUSTED (1980s)
As early as 1979-80, both the Venezuelan public and government officials sensed that the chosen political stability model of resource-based inclusion was off course. The presidential
120 Within his own party, Andrés Pérez provoked discomfort when he assigned ministers to his cabinet who were neither part of AD or COPEI. Terry Lynn Karl, The Paradox of Plenty: Oil Booms and Petro-States (Berkeley: University of California Press, 1997), 122. 121 Ibid, 119. Reyes 47 election of 1978 (which brought COPEI candidate Luis Herrera Campíns to power) was dominated by the issue of fiscal conservatism. Paradoxically, however, as Professor Judith
Ewell observes:
Fearful of the large and growing debt, the public wanted a semblance of order in the administration. In theory, they wanted the waste, corruption, and mismanagement of funds to be replaced by a sober and judicious government which could plan well and implement well. At the same time, few Venezuelans would condone a high unemployment rate, rising prices of basic consumer items, rising taxes, or heavy exchange controls.122
In short, Venezuelans wanted improvement without having to pay its required price. Effective social spending was perceived as a long overdue entitlement, and cutbacks were not viewed as the solution to a worsening condition.
For the dominant political parties, AD and COPEI, the costs of curbing the expansionist state and promoting political decentralization were too high. A reduction of the state’s economic role would have destroyed the illusion of the strong Venezuelan state cultivated by these parties.
It also would have exposed weak bureaucracies, awash in corruption. The political solution, of allowing for more political participation, was also daunting. It only promised to multiply demands on the parties and state. A long time had passed since the parties adjusted their machines to deal directly with grassroots pressures. Changes to the current system would only serve to the detriment of the overgrown, status quo parties.
THE BEGINNING OF THE END FOR PUNTO FIJO (1989)
As the 1980s came to a close, a burgeoning external debt and the inflated dependency on oil rendered inadequate the Venezuelan government’s model of political stability. Beyond the limits of further expansion, the state was unable to address the needs of a growing underclass.
The political mechanisms with which to create innovative policies were closed off by the pact
122 Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 214. Reyes 48 focused, government-sharing scheme of political elites. The country’s chosen political model, which hitherto had guaranteed stability and the continuation of democracy, had faltered.
The decline of oil prices in the early 1980s brought these issues to the fore in Venezuela.
President Jaime Lusinchi (1983-1988) systematically mismanaged Venezuela’s economy during this time. Excessive debt servicing, combined with a subsidized foreign exchange rate that depleted the treasury and deficit spending well above the means of the state during his final months in office, ensured that his successor would inherit a basket case. When he passed on the government, inflation was 100% and the country’s foreign debt stood at $35 billion.123
In 1989, Carlos Andres Pérez of AD ran again for president. He won with the votes of
Venezuelans who thought he could restore the seemingly golden era of his previous presidency.124 For Venezuelans, the expected boom would never materialize. Instead they found themselves facing austerity measures and a fast changing political context.
For Venezuelans, El gran viraje was the great surprise of Pérez’s election. In early 1989 he adopted the orthodox Washington Consensus.125 In compliance with the consensus, his administration ordered an increase in domestic petroleum prices of 100% on February 26, 1989.
It tried to shelter the public from the full impact of this decision by allowing bus companies to increase their fares by only 30%.126 Bus companies ignored the regulations and matched the
123 John D. Martz, “Political Parties and the Democratic Crises,” in Lessons of the Venezuelan Experience, eds. Louis W. Goodman et al. (Washington: The Woodrow Wilson Press: Washington, 1995), 42. 124 John Martz notes: “A poll commissioned by the Pérez team conducted in late January of 1989 showed that voters expected an improvement within six months, and nearly one-third were confident that conditions would improve within a year”. Ibid, 42. 125 The Washington Consensus was designed in 1989 by John Williamson, a former advisor to the International Monetary Fund. It calls for: a guarantee of fiscal discipline, and a curb to budget deficits; reduction in public expenditure, particularly in the military and in public administration; tax reform, aiming at the creation of system with a broad base and with effective enforcement; financial liberation, with interest rates determined by the market; competitive exchange rates to assist export-led growth; trade liberalization, coupled with the abolition of import licensing and a reduction in tariffs; promotion of foreign investment; privatization of state enterprises, leading to efficient management and improved performance; deregulation of the economy; and the protection of property rights. Richard Gott, In the Shadow of the Liberator (London: Verso, 2000), 53. 126 Ibid, 47. Reyes 49 government increase for the price of oil by increasing fares 100%.127 On the morning of February
27, 1989, the increase in prices appalled thousands of commuters who maintain employment in the city of Caracas.
Venezuelans soon protested. These protests led to the overturning and burning of buses,
“widespread looting and destruction of shops and supermarkets.”128 Unprepared for such a reaction, Andres Pérez declared an emergency under Title IX of the 1961 constitution and moved to suspend “all civil liberties” and restore order.129 What followed is generally referred to as the
Caracazo. Although the official government tallies of the people killed over the next several days is 372, non-governmental sources calculate that “over one thousand—in Caracas alone” died.130 This sealed the fate of economic liberalization in Venezuela.
There are a couple reasons why this attempt at liberalization failed. The first was a basic lack of communication. Venezuelans were not given due warning. Second, as scholar Julie
Buxton explains, Pérez blatantly ignored the implicit pact between state and society instituted in
Punto fijo. This was that “a limited form of democracy was installed with a guarantee of economic distribution to all social classes.”131 Of course, this covenant had slowly deteriorated.
But that she claims is the true reason for the uprising, not a mere reaction to neoliberalism:
…popular reaction has to be placed in a historical context. By 1988, after thirty years of successive Acción Democrática (AD) and Comité de Organización Política Electoral Independiente (COPEI) governments, annual inflation was 40.3 percent, general poverty was 38.5 percent, unemployment was reaching double digits, and real salary levels had declined precipitously.132
Punto fijo was delegitimized; the political system had reached its breaking point.
127 Ibid, 47. 128 Ibid, 45. 129 Ibid, 47. 130 Ibid, 46. 131 Julia Buxton, “Economic Policy and the Rise of Hugo Chávez,” in Venezuelan Politics in the Chávez Era: Class, Polarization & Conflict, eds. Steve Ellner and Daniel Hellinger (Boulder; London: Lynne Rienner, 2003), 113. 132 Ibid, 113. Reyes 50
DECENTRALIZATION: THE UNEXPECTED OUTCOME OF THE 1989 RIOTS
Scholar Angel Alvarez has described political decentralization as the “principal fruit” of the orthodox neoliberal reforms undertaken in Venezuela. The riots that erupted as a result of these measures forced the ruling parties to reconsider their positions on an issue they had only just begun to broach. During the administration of President Lucinchi (1983-1988), AD had considered the issue of greater inclusion in the political process. In 1984, the president formed the multi-partisan Comisión Presidencial para la Reforma del Estado (COPRE) to study possible reforms to the state. In response to this commission’s recommendations, meant to address growing popular pressure for political accountability, the ruling parties made slight provisions for increased participation. However, the unforeseen riots of 1989 took away the brakes these parties sought to impose on further reform.
COPRE delivered six recommendations to Lucinchi, and by virtue AD. The commission suggested 1) internal reform of the political parties to promote their democratization; 2) reform of the electoral system to encourage a more personal vote; 3) the direct election of governors and mayors to improve political accountability; 4) reforms to make the judicial system autonomous from politics; 5) reform of the civil service; and 6) the transfer of central government administrative responsibilities to regional and local governments.133 These suggestions were not well received by AD party leaders, specifically those that pointed in the direction of subnational elections. The president of the AD party remarked that the country was not historically prepared for the direct election of governors, and the party’s general secretary is quoted as saying, “We are not Swiss” in response to the proposed reforms. 134 As a result, these proposed reforms were
133 Michael Penfold-Becerra, “Electoral Dynamics and Decentralization in Venezuela,” in Decentralization and Democracy in Latin America, ed. Alfred P. Montero and David J. Samuels (Norte Dame: University of Norte Dame, 2004),159. 134 Ibid, 159. Reyes 51 initially voted down on the floor of Ccongress—legislators preferring to “postpone discussions until the country could reach a ‘consensus’ about the viability of the reforms.”135
The 1989 election season would provide the needed ‘consensus’ in favor of decentralization. With major parties balking at the idea of creating a more participatory political system, left-leaning parties were basically handed a battle cry. Second, decentralization provided a point of leverage for major party candidates Fernández (COPEI) and Andrés Peréz
(AD) against party resistance to their candidacies. Recall that COPEI founder Caldera did not agree with Fernández’s presidential bid and that Andrés Peréz faced resistance for AD’s nomination from Lusinchi and his allies. For strategic reasons, both candidates chose to distance themselves publicly from their party’s positions on decentralization reforms.136
This was enough to force the hands of the reluctant AD and COPEI party bosses, or cogollos. In June 1988, the legislature partially approved COPRE’s recommendations. They allowed for the direct elections of mayors, changing the closed-list electoral system to a mixed- list system. They also adopted administrative and fiscal decentralization. In each instance the major parties tried to jockey for advantage, staving off the most meaningful reforms. They did not allow for the direct election of governors, postponed the implementation of changes to the electoral law until the 1994 elections and allowed only municipal governments the right to administrative and fiscal decentralization. Penfold-Becerra notes that COPRE’s decentralization proposals were elitist calculations, a point made painfully obvious by the way major parties implemented its recommendations.137
The major parties quickly made recalculations following the riots of February 1989. This event made the political class realize that it “could no longer ignore the connection between
135 Ibid, 160. 136 Ibid, 160. 137 Ibid, 159. Reyes 52 increasing abstention in national elections and the widespread and convulsive animus exhibited during the Caracazo.”138 The political establishment responded with a deepening of the decentralization process. On April 13, 1989 Congress set the first direct elections for governors and mayors to take place the following December.139
Suddenly, the dominant parties were embracing the notion of decentralization. However, their interest in the process was self-serving. The process was being carried out de jure, but not de facto. In 1990, Congress passed the Organic Law of Decentralization. This allowed states some regulatory oversight and policy oversight in the areas of health and education. Governors, according to the 1990 law, had to petition the Senate if they sought administrative or fiscal control in areas not specified by statute. The Senate, in turn, would review each petition on a case-by-case basis. This fulfilled the objective of giving the central government “the prerogative to determine the manner in which the decentralization of services such as health care or education would proceed.”140
Andrés Pérez sided with the governors. Following their elections in 1989, COPRE set up offices to provide technical assistance to the governors in drafting decentralization proposals that the Congress was likely to approve.141 His leaning towards governors in the unfolding process of decentralization was rational. Although AD and COPEI were competing successfully on the gubernatorial level (AD’s fortunes soured in 1993, dropping from 55% of governorships in 1989 to slightly below 40%)142, the winners of these contests did not represent the party’s controlling old guard. Finding himself out of favor with these forces, Andrés Pérez was really pushing for
138 Ibid, 161. 139 Ibid, 161. 140 Ibid, 163. 141 Ibid, 164. 142 Francisco Moladi et al., “Political Institutions and Policymaking in Venezuela,” Available at: http://www.isnie.org/ISNIE04/Papers/monaldi.pdf. Reyes 53 party reform. Notwithstanding the executive’s best efforts, Congress did not approve a single petition between 1990 and 1992 that requested additional administrative responsibilities.143
On February 4 and November 27, 1992, Andrés Peréz’s administration survived failed military coups. The officers involved in the first coup, which Chávez orchestrated, noted frustration with serving a state catering to select interests. In disfavor with AD, and cogollos generally for bypassing their clients in favor of technocrats, these events provided the parties a basis upon which to seek his ouster. Congress impeached him on corruption charges in 1993.
Andrés Peréz resigned in May of that year.144
The legislature chose Ramón Velásquez to serve as interim president. Velásquez was a distinguished member of the senate who served COPRE in the mid 1980s. It is unclear whether his selection to the post was based on his past accomplishments or ideological vision. However, during his time as president (six months) he committed his office to the process of decentralization. He created the Ministry of Decentralization and the Intergovernmental
Decentralization Fund (FIDES), the latter for the purposes of funneling governors more funding for projects.145
The Ministry of Decentralization organized the Associación de Gobernadores
Venezolanos (AGV) in 1993. This organization aimed to press Congress on the transfer of both promised policy areas, such as health and education. Besides informing the public that in its opinion central government was a defeated strategy, it also insisted that,
….only the immediate transfer of budgetary revenue, fiscal authority, and administrative responsibilities to the regions would help solve the serious social, political, and administrative problems that Venezuela’s democratic regime was confronting.146
143 Ibid, 165. 144 Ibid, 165. 145 Ibid, 166. 146 Ibid, 170 Reyes 54
As Venezuela’s major political parties and economy deteriorated, the AGV would claim with greater intensity that it was the best solution for the Venezuelan people.
In the 1994 elections, both AD and COPEI saw their share of votes plummet from the historic highs of 80-90%. That year they accumulated a total of 46.3% presidential votes and
46% legislative votes. Five years earlier, these figures were 92.9% and 78.4%, respectively.
However, no other party stepped in to claim a major vote share. The number of parties increasing, Venezuela found itself with a fragmenting political system.147
Caldera was reelected president in 1994 by a coalition of small parties, led by MAS and
Convergencia Nacional (CN). He won on a platform of anti-party politics and anti- neoliberalism.148 Once in office he slowed the pace of decentralization. Penfold-Becerra speculates that like neo-liberalism, “decentralization could be interpreted as a dismantling of the central-government apparatus.”149 Believing in the need of central control for Venezuela’s quickening economic downturn, but without a majority in Congress, Caldera came to rely on decree powers to govern. The fact that Caldera’s election broke the bi-party domination of
Venezuelan politics, and that he turned to rule by decree ushered in the start of a new era in
Venezuelan politics.150
THE RISE OF HUGO CHÁVEZ
As Venezuela’s party system and economy accelerated in its downward spiral, Colonel
Hugo Chávez abruptly emerged onto the political scene. This former commander of a parachute battalion did so on February 4, 1992. At the time he provided Venezuelans hope. With the
147 Ibid, 167. 148 Rafael Caldera, of COPEI and previously president from 1968 to 1973, was the driving force behind the Pacto de Punto Fijo. It was at his home on October of 1958 that the three major parties (AD, COPEI and URD) signed the pact. Judith Ewell, Venezuela a Century of Change (Stanford: Stanford University Press, 1984), 126. However, COPEI did not lend Caldera support in 1994. 149 Michael Penfold-Becerra, “Electoral Dynamics and Decentralization in Venezuela,” in Decentralization and Democracy in Latin America, ed. Alfred P. Montero and David J. Samuels (Norte Dame: University of Norte Dame, 2004), 172. 150 Ibid, 174. Reyes 55 unexpected coup, he seemed to personalize both the need for decisive control of a deteriorating situation and a solution outside of the stagnant political configuration.
The planning for Chávez’s coup began long before 1992. One historian, Alberto Garrido, has argued that the roots of this rebellion are found in Venezuela’s 1960s guerillas.151 This is a period of time in the country’s history when Cuba-inspired insurgents sought to overthrow the country’s government. Garrido shows that one guerrilla group, Partido de la Revolución
Venezolana (PRV), and its leader Douglas Bravo, gained influence with left-wing nationalist and progressive sectors of the military after his movement’s defeat on the battlefields. The ideology
Bravo had concocted and spread was “Bolivarianismo”; or rather, “an eclectic mix of nationalist, anti-oligarchic, and populist ideas drawn from Símon Bolívar, Simón Rodríguez (Bolivar’s tutor), and Ezequel Zamora.”152 Bravo’s intent was to foment a civic-military insurrection.153
Based on these ideas, Chávez formed the Movimiento Bolivariano Revolucionario—200 (MBR
—200). Venezuela’s political and economic crisis in the early 1990s provided an opportune time for execution.
On the morning of the failed coup against the presidency of Andrés Peréz, Hugo Chávez presented himself to the Venezuelan nation via a state-sponsored television plea.154 Admitting defeat, the former commander of a parachute battalion asked to address the participants of his insurrection. These people were stationed in various parts of the country, and he needed to inform them to stop fighting. Scholar Richard Gott explains that two key phrases in his speech,
‘I alone shoulder the responsibility’ and ‘por ahora (for now)’, caught the attention of the entire nation:
151 Alberto Garrido, “La historia secreta de la Revolución Bolivariana,”; quoted in Maxwell A. Cameron and Flavie Major, “Venezuela’s Hugo Chavez: Savior or Threat to Democracy,” Latin American Research Review, (No. 3, 2001): 263. 152 Ibid, 263. 153 Ibid, 263. 154 Richard Gott, In the Shadow of the Liberator (London: Verso, 2000), 70 Reyes 56
No one in Venezuela had ever heard a politician apologize for anything before. In spite of the political and economic failures of recent years—the devaluation of the money, the bank collapses, the trials for corruption, the economic decline—no one in a position of power had ever said sorry, or accepted any portion of blame. And now here was a military officer saying he accepted responsibility for something that had gone wrong. This was entirely new.155
Inadvertently, Chávez had extended the vision of his military coup and carefully selected civilians to millions of Venezuelan citizens. This address heightened interest in him and his intentions for the country. Chávez, who had not reached too far beyond the barracks for the support of Venezuelan citizens, now had a large segment of the country’s population rallying on his behalf.
To the poor and politically marginalized sectors of Venezuelan society, fast growing throughout this period, Chávez seemed a man ready to take on the political system and redress their needs. His appeal, as journalist Howard LaFranchi describes has since remained “part tough guy, part charmer, part feudal lord.”156 Venezuelans, although remaining loyal to the principles of democracy, saw Chávez as a viable alternative to their unrepresentative party system.157
In contrast to Chávez’s new found circumstance, Andrés Pérez faced dissension within the ranks of the military and the blame of both the political establishment and the population for the country’s distress. In an emergency congressional session following the coup attempt, former Venezuelan president Rafael Caldera placed the blame for the events of February 4th squarely on the inability of Andrés Peréz to manage the Venezuelan context,
I must say to the President of the Republic…that he has the principal responsibility to make the immediate changes that the country is demanding…it would be naïve to think
155 Richard Gott, In the Shadow of the Liberator (London: Verso, 2000), 71 156 Howard LaFranchi, “Chavez Support Fragile, but Remains Intact,” Christian Science Monitor, 17 July 2001, 7. 157 Polls taken following the attempted coups of 1992, showed paradoxical results. Venezuelans favored military intervention in the absence of a referendum to shorten the president’s term. However, the majority also favored democracy. Richard S. Hillman, Democracy for the Privileged: Crisis and Transition in Venezuela (Boulder: Lynne Rienner, 1994), 46. Reyes 57
that this was an event in which a handful of ambitious men threw themselves rashly into an adventure…there was a set of circumstances…which is the serious situation in which the country finds itself.158
Though Chávez went to prison, the momentum unleashed by his failed coup destroyed the
Presidency of Andrés Peréz. On November 27, 1992, for the second time in one year, Andrés
Pérez survived a coup attempt. Naval admiral Hermán Gruber led this failed coup against the presidential administration. Participants of his force were members of Chávez’s MBR—200 that escaped capture in the February 4th attempt. The bloody assault on the government left 170 dead, compared to 14 in the first golpe.159 With 184 Venezuelan lives lost in two attempted coups, congressional and popular support for the administration dissipated.
Chávez gained his first political victory with the reelection of Rafael Caldera in 1993.
An executive order decreed by Caldera freed Chávez and the other participants of the 1992 coup attempt from prison.160 Caldera, it seems, pursued this action to accrue political support for his administration. In any event, Chávez received a running start for the 1998 elections. Within four years time, he would ask Venezuelans to give him the opportunity to remedy the economic and political distresses that plagued the country.
Having decided to pursue a democratic route to power, Chávez formed the Movimiento
Quinta Republica (MVR) with remnants of the Bolivarian Revolution and “independent civilians of no fixed ideology.”161 The party agreed that Venezuela had exhausted all available recourses under the constitution of 1961 and sought to form a new republic. Chávez had vague goals, which included securing “the well-being of the national community, to satisfy the individual and
158 Richard Gott, In the Shadow of the Liberator (London: Verso, 2000), 72-3 159 Ibid, 78 160 Ibid, 130 161 Ibid, 146 Reyes 58 collective aspirations of the Venezuelan people, and to guarantee a state of optimum prosperity for the fatherland”.162 Nevertheless, it sufficed to capture 56% of Venezuelans’ votes.
In the 1998 elections, Chávez beat his nearest opponent by 16% at the polls. Kurt
Weyland observes that Chávez coasted into office on the backs of Venezuelans who “saw a political housecleaning as the way to halt the country’s prolonged economic decline, restore growth, create employment, and overcome escalating social problems.”163 Chávez did not delay in the implementation of his plans to reform the Venezuelan republic.
On December 15, 1998 a new constitution, crafted by a constituent assembly, was submitted to the Venezuelan people. In theory, it has “empowered” citizens so that the three branches of government are beholden to their will. Venezuelans can, according to their new constitution, at any time “convoke a national constituent assembly…with the goal of transforming the state, creating a new legal order, and drafting a new constitution.”164
Critics of the constitution abound. They claim that in practice this constitution has moved Venezuela further away from a representative democracy than did the previous constitution of 1961.165 It has expanded the provisional powers of the president. The constitution allows for rule by decree for longer periods of time, in the areas of “finance and banking, landownership, and social security” and has set a framework within which the president could call for a “state of emergency for socioeconomic reasons.”166 Although Chávez has still not opted for such a strategy, a possible ‘regime of exception’ is not wholly unforeseeable.167
162 Ibid, 145 163 Kurt Weyland, “Will Chavez Lose his Luster?,” Foreign Affairs (November/ December 2001): 73. 164 Angel E. Alvarez. “State Reform Before and After Chávez’s Election,” in Venezuelan Politics in the Chávez Era: Class, Polarization & Conflict, eds. Steve Ellner and Daniel Hellinger (Boulder: Lynne Rienner, 2003), 155. 165 Ibid, 151. 166 Ibid, 159. 167 Such regimes, described by scholar Brian Lovemann, occur when “in the name of defense and constitutional order” the executive exercises legal mechanisms that allow him to temporarily void constitutional protections, rights and liberties, simultaneously elevating his authority. Brian Loveman, The Constitution of Tyranny: Regimes of Exception in Spanish America (Pittsburgh: University of Pittsburgh Press, 1993), 3-23. Reyes 59
Under Venezuela’s new constitution, the president has become the managing partner of all power accruing to the masses.
The approval of the new constitution meant Chávez had to stand for reelection in 2000.
He won with 59% of the vote. This was a 3% increase from the previous year’s election.
Irrespective of any real changes in the lives of Venezuelans, by July of 2000 Chávez had created a new slate from which to rebuild Venezuela.
APRIL 11TH AND THE “SIEGE ON DEMOCRACY”
On the morning of April 11, 2002 Chávez’s opposition, mainly a frustrated populace,
Fedecamaras (Venezuelan Business Association) and dissenting sectors of the military, joined to remove President Chávez. Although they succeeded in removing him from office for 47 hours, they ultimately failed in their attempts. They made many mistakes, many of which were revealing of their own nature and would later serve to revitalize the presidency of Chávez.
Journalist Armando Durán outlines these well:168 The first was an act of deceit. On April
12, 2002 General Lucas Rincón Romero declared to the nation that the president had resigned.
This was false. Although, Chávez had requested exile to the island of Cuba, certain segments of the opposition refused his request, bringing those negotiations to a standstill. The result of
Romero’s declaration was to create a presidential void, which in reality, did not exist. Second, was to choose Pedro Carmona Estanga, then leader of Fedecamaras, as president of the republic.
The military establishment and opposition parties had agreed to allow Catholic Cardinal Ignacio
Velasco appoint the new provisional president of the republic. In consultation with these factions, he did so on April 10, 2002, choosing Estanga (note that this was prior to any marches or the golpe). Third, once in office Estanga chose to suspend the constitution of 1999. On the morning of April 12, 2002 Estanga presented the Venezuelan nation with the Acta Constitutiva.
168 Armando Durán, Venezuela en Llamas (Caracas: Grupo Editorial Random House, 2004), 19-31. Reyes 60
This document was engineered by Estanga in the presidential palace. It allowed Estanga to close the National Assembly and give himself full control of the country. This decision provoked dissent within leaders of the opposition parties, labor unions, the military and also the
Venezuelan nation. Mostly, the Acta Constitutiva did not reflect an agreement Estanga had signed on March 5, 2002 with the leader of CTV, and backed by the Catholic Church and all political parties opposed to Chávez, titled Basis for a Pact of Governability. Within a day,
Carmona Estanga had compromised the legitimacy of his presidency and given nourishment to that of the soon-to-return Chávez.
The popular myth is that the activism of Venezuela’s barrio dwellers saved Chávez in the
April 2002 coup. Estanga did have to abandon the presidential palace as thousands of Chávez supporters threatened to invade its doors.169 There is speculation that influential Chávez allies rallied them to action. In an intercepted phone conversation, recorded on April 12, 2002, between Caracas Mayor Freddy Bernal and Chávez Minister of Defense Vicente Rangel, Bernal claimed that he instructed the city’s marginalized communities to come down with “sticks, picks and rocks, because that is what makes them (Venezuela’s bourgeoisie) shit.”170
Though this show of support was by no means negligible, there is equally strong evidence showing that dissent within the military to Carmona Estanga’s government ultimately caused the latter’s failing. Speaking from Miami on April 18, 2002, a chancellor for the botched coup government, stated “what caused the end of Pedro Carmona’s brief government were not legal or political causes, but rather the crisis of the military that presented itself.”171 This
169 Ibid, 28. 170 Ibid, 25; This is consistent with Bernal’s behavior in the days leading up to the April 11 th coup. After disappearing from official functions in the days leading up to the march, television cameras spotted Bernal leading a rally of Chávez supporters outside the RCTV media station on the day that the president was removed from office. “Freddy Bernal lidera manifestación en los alrededores de RCTV,” El Nacional, 13 Apr. 2002. Available at: http://www.el-nacional.com/nacionalfront/articulos/articulo.asp?id=7741&idSeccion=63. 171 “Rodríguez Iturbe advierte que regreso de Chávez es una tragedia,” El Universal, 18 Apr. 2002. Available at: http://buscador.eluniversal.com/2002/04/18/pol_art_18104CC.shtml. Reyes 61 statement points to the important role the military played in safeguarding the democratic rights of the country even amidst an undemocratic context; though it would also serve to show the pervasive denial that enveloped Carmona’s administration. On April 13, 2004, General of the
Army Brigade Rafael Arrieta announced that 1) the military no longer recognized the administration of Carmona Estanga, 2) was backing the constitutional line of the country, and 3) would have Chávez installed by the following day.172 True to their word, Chávez returned to lead
Venezuela on the morning of Sunday, April 14, 2002.
ONE MORE CHANCE, A WHOLE NEW GAME
The events that occurred between April 11th and April 14th changed the Venezuelan nation. First, it allowed Chávez to bolster his democratic credentials while simultaneously de- legitimatizing those of his opposition. Durán notes that from that day forward Chávez’s discourse would revolve around the following theme: “In Venezuela there exists a legitimate and democratic government. Its opposition tried to destroy it with a coup. That coup is still in progress”.173 Second, it legitimated the 1999 constitution. Venezuelans of all sectors showed discomfort with the possibility of an undemocratic transition of power; thus, committing themselves to Chávez’s rules. Chávez supporters had maintained throughout the crises that
Carmona Estanga’s government was in violation of the constitutional state.174 The powers of the military agreed. Third, Chávez could now clearly distinguish between his friends and foes. He would use this knowledge to reward the former while isolating the latter. With his opposition committed to a democratic process, Chávez has gained a lot more power in office.
CONCLUSION
172 “General de brigade del Ejército asegura que Chávez llegará a Miraflores en las próximas horas,” El Nacional. 13 Apr. 2002. http://www.el-nacional.com/NacionalFront/Articulos/Articulo.asp?id=7755&idSeccion=64. 173 Armando Durán, Venezuela en Llamas (Caracas: Grupo Editorial Random House, 2004), 29. 174 “Seguidores de Chávez denuncian la existencia de un golpe de derecha,”El Nacional. 13 Apr.2002. Available at: http://www.el-nacional.com/NacionalFront/Articulos/Articulo.asp?id=7725&idSeccion=63. Reyes 62
Though Venezuelans had the right to vote through much of the 20th century (women gaining suffrage in 1947), their influence was often submitted to an interventionist military establishment or electoral rules favoring parties and system stability. Under Punto fijo
Venezuelans watched as the material wealth of their country dissipated. When the economic imbalance became too dire, a result of party behavior, the political establishment adopted the
Washington Consensus. The prescribed draconian measures burdened the country’s population.
But the measures did not bring the parties to account for their negligence.
In the wake of failures with their attempt at neoliberal reforms, parties experimented with decentralization, the political solution to the country’s crisis. However, the major parties’ initial management of the process and Caldera’s undercutting of the institutions best poised to guide the decentralization effort resulted in both its failure and a power vacuum for the country. Chávez appeared at the right time to fill this space.
Political analyst Fareed Zakaria, as do many Venezuelans (see chart below), draws a correlation between the behavior of political parties and progressively worsening situation of most Venezuelans throughout the 20th century. In his words, the political parties that formed part of the pact for democratic stability also perpetuated cycles of “economic mismanagement, political corruption, and institutional decay” 175. He cites these as reasons why at the close of the
20th century, a majority of Venezuelans were submerged below the poverty line despite that this country had among the highest per-capita living standards in Latin America in 1980.
175 Fared Zakaria, Illiberal Democracies (W. W. Norton & Company), 97. Reyes 63
1995 STUDY ON THE VALUES OF VENEZUELANS
Venezuelans that believe country is very rich 91% Venezuelans that believe that wealth should be distributed among all without distinction or privileges 82% Venezuelans that believe oil revenues are sufficient to satisfy all of the population’s expectations 75% Venezuelans feel that they have had some benefit from oil 27% Venezuelans that support following statement: “If Venezuela were honestly administered and corruption 94% eliminated, there would be enough money for all and more” Table 3: “Estudio sobre los valores del venezolano,” in-house document, Conciencia 21, June 1995, 194-95; in (Romero 1997, 21).
The feelings of betrayal and alienation among a large portion of the citizenry were
pervasive. In 1992 only 34% of Venezuelans professed support for political parties and nearly
55% “believed that the best way to resolve the country’s problems was to organize the
population outside of the political party system.”176 These problems, as the World Bank reports,
are largely related to poverty. Between 1991 and 2000, the percentage of Venezuelans living on
less than $2 per day (poverty) jumped from 32.2% to 48.5%, and the number of those living on
less than $1 per day (extreme poverty) had risen from 11.8% to 23.5%.177
Upon coming into office, Chávez embarked on a mission to reform Venezuela in two
ways: making the state responsible with itself and to the country’s people. On the first count,
his efforts centered on reducing the inefficiencies and misallocations produced by the countries
decentralized social ministries. Through 1999, the presidential administration sought to
coordinate their efforts. As an example, his administration merged the Ministry of Health with
the Ministry of Family Services to form the Ministry of Health and Social Development
(MSDS).178 Just a few years earlier, states had been slowly gaining control of these
responsibilities. Also, at least in the early part of his tenure, he gave indications that he would
end the country’s tendency towards the politics of oil. Oil prices climbing on the eve of the new 176 “State Reform Before and After Chávez’s Election,” in Venezuelan Politics in the Chávez Era: Class, Polarization & Conflict, eds. Steve Ellner and Daniel Hellinger (Boulder: Lynne Rienner, 2003), 150. 177 “Venezuela Country Brief,” The World Bank Group, Available at: http://lnweb18.worldbank.org/external/lac/lac.nsf/Countries/Venezuela/9AEC6D72716FD7B985256D7A006B9B54 ?OpenDocument. 178 Broadly, the new ministry governs the health sector, oversees policy design and implementation and provides financing for activities that promote both health and social development. Reyes 64 millennium, his administration set caps on the amount of money it would allow itself to rent from this source.179
On the second count, of making the state more accountable to Venezuela’s people, the language of Chávez and his administration called for social justice and a just democracy. These are positions the president articulates in a pamphlet titled Cinco polos para una nueva República, and which served as his electoral platform.180 Helped by a majority coalition in Congress (Polo democratico), the Chávez administration was able to fashion and ratify through popular referendum a constitution that reflects the principles outlined in that book.
Still in 2002, the president’s reformed state remained more a legal structure with radical potential than a new political mode in Venezuela. In this year the administration sustained two debilitating strikes, a short-lived coup (April 12-14, 2002) and the initiation of a referendum movement seeking its removal. The administration survived, its opposition weakened. The question remained whether Chávez had truly embraced the idea that Venezuelans could participate in the creation of the projected state.
179 Steve Ellner, “The Radical Potential of Chavismo in Venezuela: The First Year and a Half in Power,”Latin American Perspectives Free Trade and Resistance (Sep., 2001): 20. 180 Journalist Armando Durán summarizes the propositions set forth in this pamphlet as 1) the convocation of a new constituent assembly to replace the country’s representative democracy with a participatory democracy 2) social equilibration to reach a just society, without a rich class or a poor class 3) the development of a humanist economy 4) territorial equilibration through the deconcentration of power and new public investments and 5) the defense of national sovereignty amidst the widespread trend towards globalization. Armando Durán, Venezuela en Llamas (Caracas: Grupo Editorial Random House, 2004),15. Reyes 65
CHAPTER THREE: CREATING AN OPPORTUNITY FOR REPRESENTATION
The turmoil that accompanied Chávez’s first years in office would ultimately push his administration to go beyond design and to implement a program of reform for the Venezuelan state. After the 2002 coup, Chávez was emboldened by his ability to survive several attacks on his administration and mindful of Venezuelans who rallied for their president’s reinstallation.
He would now abandon his previously cautious path of structural reform efforts in an attempt to nurture this base.
This chapter explores how these contextual occurrences have influenced the presidential administration’s actions in the health sector. It follows a four-tier succession. First, it deals with the Venezuelan health system. It specifies how the country’s health sector deteriorated throughout the 1990s; a parallel occurence to the country’s economic and political situation at that time. Second, the chapter elaborates on the creation of the administration’s Barrio Adentro program, which brings doctors into Venezuela’s most marginalized communities and relies on health committees composed of local volunteers to operate. During the 1999-2002 years the presidential administration sought to curtail the fiscal and administrative decentralization the health sector had achieved, but following the coup of 2002 became far more reformist. It proposed Barrio Adentro to replace the country’s failed medical system. This chapter then illustrates, and moves to debunk, the claims that Barrio Adentro’s formal opposition
(Venezuelan Medical Federation) and informal detractors (Venezuelan citizens unassociated with the program) have made of the program. Finally, it introduces my observations of the program in the city of Caracas made between January 1 and 24, 2005.
Overall, this chapter demonstrates that the structure of the program, outside of the conventional state institutions, is breaking a path for citizen participation. The economic rationale set aside, it has created a space in which citizens are remolding the designs of Chávez’s Reyes 66 administration for the future. Changes that have resulted from this participation are not in line with the Chávez regimes’ envisioned structure for the program. This demonstrates that the least privileged sectors of Venezuela have taken to democratic participation and are gaining influence in the process.
A BROKEN SYSTEM
There are five components to Venezuela’s public health system. These include the
Ministry of Health and Social Development (MSDS), Venezuelan Social Security Institute
(IVSS), the Institute of Social Welfare of the Ministry of Education, the Institute of Social
Welfare of the Armed Forces and the Municipal Government of the Capital City (Alcaldía
Mayor).181 On the eve of the new millennium, the health system that this structure sought to uphold required serious attention.
In the year 1999, public spending on the health sector as a percentage of GDP fell to
2.47%. This compares to 2.64% in 1995, 2.58% in 1996, 2.29% in 1997 and 2.64% in 1998.182
During these same years, the country sustained a decline of GDP in real terms, as demonstrated on the chart on the following page (the exception is 1997, which may also explain the significantly lower percentage for public expenditure that year). With the slide in GDP growth, health expenditures in the private sector increased from 1.5% in 1995 to 1.59% in 1999.183
In practical terms, these economic conditions meant that many Venezuelans were not receiving proper medical attention. Whereas in 1982 only 33.5% of Venezuelans lived under the poverty line, by 1997 this figure had increased to 67.3% (of whom half lived in extreme
181 “Profile of the Health Services System of the Bolivarian Republic of Venezuela,” Program of Organization and Management of Health Systems and Services, Division of Health Systems and Services Development, Pan American Health Organization, 2nd ed., 14 May 2001, 5. 182 Ibid, 10. 183 Ibid, 10. Reyes 67
VENEZUELA’S DOMESTIC GROWTH PRODUCT, 1995-2004
Source: Latin Focus. Available at www.latin-focus.com/latinfocus/countries/venezuela/vengdp.htm
poverty).184 As the government invested less in its public health system, a growing part of the
Venezuelan population became ever more reliant on public hospitals.
During those years, the quality of service in public hospital steadily worsened. One
Venezuelan I interviewed spoke of the value of hospitals in comparison to the service of the
1960s and 1970s. Despite the existence of “quite good” Venezuelan doctors, she noted, “nothing that was not nailed down stayed put”.185 This comment highlights a symptom of the greater problem: scarce supply. By the year 1996, 86% of the medical equipment available to the public hospital system was either not in use or defective.186 It became a common occurrence that
184 Ibid, 4. 185 Anonymous. Interview by Gabriel Reyes. Caracas, Venezuela. January 3, 2005. 186 Medical equipment constitutes: blood banks, emergencies radiology, laboratory, operating rooms, maintenance teams, oncology, gynecology, delivery room and plant. “Profile of the Health Services System of the Bolivarian Republic of Venezuela”. Program of Organization and Management of Health Systems and Services Division of Health Systems and Services Development, Pan America Health Organization, 2nd ed, 14 May 2001, 8. Reyes 68 even at the prestigious Universidad Central de Venezuela (UCV) hospital patients would have to take sheets and buy needles, pills and cotton in anticipation of their arrival.187
In the late 1990s, Venezuela’s health care system was overburdened and unable to meet the demand of its citizenry. As of 1997, only 65% of the population had some degree of medical insurance.188 IVSS covered 57% of those insured. However, as Venezuela’s economic condition worsened fewer citizens had access to the services of IVSS. In 2000, 53% of Venezuelans worked in the informal sector and, presumably, a growing majority did not pay into the social security system.189 MSDS is obligated to protect uninsured citizens. Although the above figures indicate that this would amount to 35% of Venezuela’s population, the Pan American Health
Organization reported in 2002 that “in practice, the Ministry’s outpatient network serves approximately 80% of the population”.190 Despite this, the public sector was responsible for only
34% of total drug spending in 2000.191 Of Venezuela’s 214 public hospitals, those with the
“highest problem-solving ability are located in the capital city [Caracas] and in the state capitals”.192 Even then, the occupancy rates of these hospitals remained low (53%) as of 2001; a seemingly perplexing fact when one considers the “long waiting lists for surgery and outpatient care”.193 However, it corroborates the claim that Venezuela’s health system, coming into the new millennium, was incapacitated and unable to deal with the country’s health problems.
187 Anonymous. Interview by Gabriel Reyes. Caracas, Venezuela. January 3, 2005. 188 “Profile of the Health Services System of the Bolivarian Republic of Venezuela”. Program of Organization and Management of Health Systems and Services Division of Health Systems and Services Development, Pan America Health Organization, 2nd ed, 14 May 2001, 11. 189 Peter Mayburduk is currently a law student at the University of California at Berkeley. He provided me valuable advice and contact information for my field research in Caracas, Venezuela. “Venezuela Works to Bring Healthcare to the Excluded,” Multinational Monitor, 2004 October. 190 “Venezuela,” Health in the Americas 2002 Edition Volume II (Washington: Pan American Health Organization, Pan American Sanitary Bureau, Regional Office of the World Health Organization, 2002), 562. 191 Ibid, 565. 192 “Profile of the Health Services System of the Bolivarian Republic of Venezuela”. Program of Organization and Management of Health Systems and Services Division of Health Systems and Services Development, Pan America Health Organization, 2nd ed, 14 May 2001, 12. 193 Ibid, 12. Reyes 69
Citizens with the ability to pay for medical services used the private sector, and others just did not receive care.
FIXING A BROKEN SYSTEM
1990-2002
As mentioned in the previous chapter, following the 1989 riots Venezuela’s ruling parties agreed to allow for the election of state governors and limited forms of decentralization. Health became one of the few sectors legislated for state-level control. This first attempt to address the central government’s inability to provide adequate health services failed. The political climate of that time period is much to blame for this result. Through 1996, only 13 states had achieved full control of the health care sector.194 In the remaining 10 states, the Ministry of Health and Social
Welfare (which merged in 1999 with the Ministry of Family Services to form MSDS) continued to oversee the “provision and operation” of services from its own regional bureaus.195
The period of 1993-1996, however, did see a conceptual shift. The Ministry of Health and Social Welfare started to undergo a restructuring and amplified its managerial, strategic and tactical capabilities, sharing greater operational responsibilities with civil organizations and state, mayoral and municipal governments.196 According to a 1998 Pan American Health Organization report, “what drove the reform was the commitment of all of society, the promotion of health education, and social organization for active participation in the movement toward change”.197
The next major changes to Venezuela’s health system would result from an Enabling
Law passed in 1998 and later revised in 1999. But these changes, reportedly, only served to
194 Michael Penfold-Becerra, “Electoral Dynamics and Decentralization in Venezuela,” in Decentralization and Democracy in Latin America, ed. Alfred P. Montero and David J. Samuels (Norte Dame: University of Norte Dame, 2004),173. 195 “Venezuela,” Health in the Americas 1998 Edition, Available at: http://www.paho.org/english/hia_1998ed.htm. Pg. 539. 196 Ibid, 538. 197 Ibid, 538. Reyes 70 strengthen the negative effects of the system’s financing structure.198 The arrival of President
Chávez, the constitution of 1999 and rising oil prices would result in the most complete overhaul of Venezuela’s health care system.
A HALT ON DECENTRALIZATION: THE LEGAL RECONSTRUCTION OF VENEZUELA’S HEALTH SYSTEM
Irrespective of reform efforts, the health system that President Chávez’s administration inherited in 1999 was on a downwards slide (reference the several reasons previously discussed).
Actions taken during the president’s first year in office, though innocuous at the time, would later prove instrumental to Venezuela’s health model and the process of reconstruction in this sector.
The creation of MSDS in 1999 was the first major change undertaken by the administration. This new ministry had five goals: to consolidate and classify health programs by citizens’ ages while focusing on prevention; improve referral networks and adjust the operational level of facilities according to the epidemiological profile of communities in which they operate; better outpatient facilities in an effort to strengthen comprehensive care; promote projects of comprehensive training for human resources so that they could better respond to the needs of local communities; and to develop an observation strategy to maintain awareness of health developments in the country.199
Second, the Constitution of 1999 created an entirely new framework for Venezuela’s health sector. Articles 83, 84, 85 and 86 of this constitution highlight that health is a fundamental social right, providing health care is a duty of the state that will not be privatized
198 “Profile of the Health Services System of the Bolivarian Republic of Venezuela”. Program of Organization and Management of Health Systems and Services Division of Health Systems and Services Development, Pan America Health Organization, 2nd ed, 14 May 2001, 14. 199 “Profile of the Health Services System of the Bolivarian Republic of Venezuela”. Program of Organization and Management of Health Systems and Services Division of Health Systems and Services Development, Pan America Health Organization, 2nd ed, 14 May 2001, 12. Reyes 71 and for which the participation of citizens is encouraged, and that the state has an obligation to finance a system of public health to which all Venezuelans have access. Articles 62, 70, 158,
182, 184 and 185 address the role of community participation in the country’s health sector.
Together, these articles give citizens freedom to participate in public matters, remind that the exercise of the public’s sovereignty over political matters provides it a means of participation and leadership roles, emphasize that decentralization ought to promote democracy, create local planning boards, and demand that state governments allow for greater community input in decision making.200
In the year 2000, the Venezuelan legislature passed the Health Bill. It was meant to serve as both an expansion and enforcement mechanism of the citizenry’s expanded rights to health in the 1999 constitution.201 The bill outlined nine principles on which Venezuela’s health care system in the making would operate. In sum, these bestowed on Venezuelans the right to medical services that correspond to their individual needs, mandated citizens contribution in the maintenance of the public health system (according to their ability), called for civil society to partake in the system’s design, and prohibited the state from directly charging patients in the
National Public Health System.202
In 2001 MSDS initiated its first strategic health plan. It was intended for the years 2001 to 2006. The goals of the plan were to guarantee comprehensive health care, prevent and control
200 “Marco Jurídico, Misión Barrio Adentro” Available at: http://www.barrioadentro.gov.ve/. 201 “Venezuela,” Health in the Americas 2002 Edition Volume II (Washington: Pan American Health Organization, Pan American Sanitary Bureau, Regional Office of the World Health Organization, 2002), 562. 202 The principles are actually stated as: universality (all persons entitled to health care); equity (different needs of population groups would be recognized); solidarity (all individuals and sectors would contribute towards the systems operation); uniqueness and social integration (social cohesion, awareness and organization to be fostered); free of charge services (no amount could be charged directly to patients); participation (civil society to take in active role in design and implementation of the health system); comprehensiveness (provision of preventative, curative and rehabilitation services); cultural and linguistic pertinence (health programs would consider the multicultural makeup of the state); and quality, efficacy and efficiency (all services to be provided in timely, adequate, and ongoing basis). Ibid, 562. Reyes 72 prevalent mortality and morbidity and to operate on the principles outlined in the 2000 Health
Bill.203
THE TRUE STATE OF REFORM
On the eve of the 2002 attempted coup, public spending in the health sector had decreased as a percentage of GDP. In this year, Venezuela would spend 1.8% of its budget on healthcare. As the table below shows, this figure represents the lowest percentage level of government spending on health among Venezuela’s seven comparable Latin American counterparts. Worse,
HEALTHCARE SPENDING AS PERCENTAGE OF 2002 GDP
Argentina 8.0% Brazil 5.2% Chile 6.0% Colombia 8-9% Mexico 5.5% Peru 4.4% Venezuela 1.8%
Source: “Latin America Lagging Behind in Health Care Provision”. IMS Health Online Store. Available at: http://open.imshealth.com/IMSinclude/i_article_20040105.asp.
Venezuela’s economy was shrinking. The country’s GDP contracted by 9% in 2002, inflation reached 31%, interest rates were in excess of 50% and an estimated 500,000 Venezuelans joined the unemployment rolls that year.204
The country’s economic condition made it almost irrelevant that the country was enjoying historically high oil prices. Oil contributes to about 1/3 of Venezuela’s GDP and 3/4 of the country’s exports.205 As of September 30, 2000, the price of Venezuelan oil stood at $26.31/
203 Ibid. 561. 204 As of the April coup, the country’s GDP had shrunk by 4.2%. Armando Durán, Venezuela en Llamas (Caracas: Grupo Editorial Random House, 2004), 219. 205 “Venezuelan oil workers call strike,” BBC News, 27 Mar. 2001, Available at: http://news.bbc.co.uk/1/hi/business/ 1245063.stm. Reyes 73 bbl, representing a 250% increase over the average 1999 price.206 On April 12, 2002 the price of
Venezuelan oil was $23.12/ bbl.207
There were several reasons for Venezuela’s underperformance. Some lay beyond the country’s control. In 1999, the country endured heavy rains that resulted in devastating mudslides for the north eastern state of Vargas. At least 22,000 people perished.208 Additionally, the government released figures estimating that the event destroyed 20,000 homes and left
100,000 citizens homeless.209 Within the country’s control, the passing of the 1999 constitution and its “radical elements” shook investor confidence. 210 In 2001, President Chávez decreed 49 laws that allowed the administration to push forward with land reforms and the restructuring of the country’s oil industry; these laws were not approved by the National Assembly., but their proposal served a negative enough effect.211
Throughout the years 2000 to April 2002, there was growing unrest in Venezuela. On
June 17, 2000 hundreds of the Vargas disaster’s survivors marched in Caracas to protest the government’s slow reconstruction efforts.212 On December 10, 2001, there was a national strike in which 90% of Venezuelan workers, from all sectors, failed to show for work.213 Again on
January 23, 2002, a day that marks the end of Peréz Jimenez’s dictatorship in 1958 and the birth
206 “Venezuela,” 2000 Country Reports on Economic Policy and Trade Practices, Bureau of Economic and Business Affairs U.S. Department of State, March 2001, Available at: http://www.state.gov/documents/organization/1670.pdf. 207 “Oil Prices Fall as Chávez Quits,” BBC News, 12 Apr. 2002, Available at: http://news.bbc.co.uk/1/hi/business/1925330.stm. 208 “Venezuela Flood Victims Protest Rebuilding Efforts,” BBC News, 17 Jun. 2000, Available at: http://news.bbc.co.uk/1/hi/world/americas/791673.stm. 209 “Venezuela: Rebuilding After Devastation,” BBC News, 7 Jun. 2000. Available at: http://news.bbc.co.uk/1/hi/world/americas/780261.stm. 210 “Venezuela,” 2000 Country Reports on Economic Policy and Trade Practices, Bureau of Economic and Business Affairs U.S. Department of State, March 2001, Available at: http://www.state.gov/documents/organization/1670.pdf. 211 “Timeline: Venezuela: A chronology of key events,” BBC News, 16 Feb. 2005, Available at: http://www.news.bbc.co.uk/1/hi/world/Americas/country_profiles/1229348.stm. 212 “Venezuela Flood Victims Protest Rebuilding Efforts,” BBC News, Jun. 17, 2000, Available at: http://news.bbc.co.uk/1/hi/world/americas/791673.stm. 213 Carlos García Soto, “Volver a Parar,” El Universal, 15 Dec. 2001, http://buscador.eluniversal.com/2001/12/15/opi_art_OPI6.shtml. Reyes 74 of Venezuela’s current democratic period, citizens took to the streets to reaffirm their commitment to democracy.214 Venezuelans protested twice in February of that year. Finally, on
April 9, 2002, Fedecamaras (the Venezuelan business association) declared a general strike.215
Then, April 11th occurred.
REACHING OUT TO “THE PEOPLE”
The events of April 11th-14th, described in the previous chapter, changed the Venezuelan context. In the same way that a crisis redirected the administration of Andrés Pérez in 1989;
April 11th also changed the process through which President Chávez’s administration would seek to create its “participatory democracy”. This change would have a significant impact on the presidential administration’s design of the country’s healthcare system. Gone were the days of wrangling with the legal order. The presidential administration would now focus solely on action.
President Chávez prevailed through the events of April 11th partly due to the support of
Venezuelans that emerged from Caracas’ barrio communities to rally for his return. As journalist David Adams reports, this was a “reminder to the president and his advisers of their political base”. 216 The response of the presidential administration to this firm show of support was swift. Adams describes that “emissaries were sent into the Barrio to seek out contacts”. 217
According to Adams, health and education topped all other concerns in conversations between government officials and residents of Venezuela’s shantytowns. The government moved to address this need.
214 Armando Durán, Venezuela en Llamas (Caracas: Grupo Editorial Random House, 2004), 49. 215 “Timeline: Venezuela: A chronology of key events,” BBC News, 16 Feb. 16 2005, Available at: http://www.news.bbc.co.uk/1/hi/world/Americas/country_profiles/1229348.stm. 216 David Adams, “Help for Poor Sways Voters in Venezuela,” St. Petersburg Times. 19 Aug. 2004, sec. 1A. 217 Ibid. Reyes 75
Venezuela would soon tap a 2000 Cooperation Agreement signed with Cuba. This agreement allowed Cuba to supply what has amounted to “17,000 Cuban doctors, dentists, laboratory physicians and sports trainers”.218 In his article Adams uses the words of Dr.
Fernando Bainco at the Medical College of Caracas, to sum up the program: “It began as an adventure to create social contacts. But it has resulted in an excellent instrument to combat poverty”.219
Since its inception, the Venezuelan government reports that Barrio Adentro has serviced over 18 million individuals.220 It has also spread to the poorest communities in the 25 districts that comprise the Venezuelan state. Many citizens serviced by Barrio Adentro previously lacked the level of primary care that the program affords. Government statistics, noted in the table below, state that the medical care of this program has saved nearly 6,447 lives, and has provided vaccinations to over 27,000 Venezuelans.
GENERAL STATISTICS ON BARRIO ADENTRO AS OF JANUARY 2004
218 Ibid. 219 Ibid. Dr. Fernando Bianco signed an agreement with Caracas Mayor Freddy Bernal that gave rise to the first missions of Barrio Adentro in Venezuela. 220 Freddy Bernal, the mayor of Caracas’ main municipal district, developed the concept of Barrio Adentro. President Chavez has since adopted the program on a national level. Reyes 76
Indicators For the Year 2004
18,366,628 Cases Seen
Of those, in the field 6,453,702
Number of families visited 2,189,194
Actions of nurses realized 1,586,750
Lives saved 6,447
Deliveries (birth of children) 275
Vaccines applied 27,913
Educational activities 6,074,401
Table 1: Estadísticas. Misión Barrio Adentro. http://www.barrioadentro.gov.ve/, October 16, 2004.
THE FOUNDING OF BARRIO ADENTRO
From the standpoint of the presidential administration, Barrio Adentro is a borrowed idea. Freddy Bernal, mayor of the Alcaldía mayor (formerly the federal district), first developed this program in his district. He did so in conjunction with Fernando Bianco (president of the
Physicians Association (also referred to as the Medical College) of the Federal District of
Caracas).221 When benefits of the program became evident, the program metamorphosed into a national endeavor.
This highlights a central feature of Barrio Adentro. It was not developed within the existing healthcare described earlier in this chapter. When it was transplanted onto the national level, the presidential established it without a clear institutional base. In the fall of 2003,
Edilberto Pacheco, director of the Institute for Local Development resigned from his job claiming that Barrio Adentro lacked a legal character. At that time he indicated this was the
221 Maria Isabella Salas, “Cuban Advisors Continue to Arrive in Venezuela,” World News Connection, 29 Jun. 2003. Reyes 77 reason that former Minister of Health María Urbaneja also left the administration.222 It was not until December 14, 2003 that the president finally appointed a committee to oversee the mission of Barrio Adentro.223 Overall, this created the scenario where the traditional health bureaucracy
(MSDS, etc.) had to follow, rather than lead, the president’s new program.
In a recent article, Journalist Peter Mayburduk lays out the structure of this ‘popular healthcare system’.224 At its base are the popular doctor’s offices (these are the preventative cure offices most associated with Barrio Adentro), followed by popular clinics and projected people’s hospitals. In support of the initiative, MSDS has opened IVSS hospitals to the public, as has the military. However, he notes, IVSS hospitals only make up 11% of the national medical facilities and IVSS clinics an additional 1.6%. Barrio Adentro is thus a step towards compensating for or restructuring roughly 87% of Venezuelan medical facilities inaccessible to its poor citizens.
According to Mayburduk, as of October 2004 the concept of people’s hospitals remained in planning stages. Also, only 6 popular clinics were complete. Despite the existence of 8,500
Barrio Adentro missions, merely 280 operated out of specifically designed modules, 560 more remained in construction and funds remained on reserve for the building of an additional 3,141.
GRAPH OF VENEZUELA’S POPULAR, PRIVATE AND PUBLIC HEALTH CARE SYSTEMS
222 “La problematica ética y legal de un sistema paralelo”. El Universal, 29 Sep. 2003, Available at: http://buscador.eluniversal.com/2003/09/29/ccs_art_29288B.shtml.; 223 “Barrio Adentro es ahora una misión”. El Universal, 15 Dec. 2004. Available at: http://buscador.eluniversal.com/2003/12/15/apo_art_15114B.shtml. 224 Peter Mayburduk,“Venezuela Works to Bring Healthcare to the Excluded,” Multinational Monitor, 2004 October. Reyes 78
POPULAR/ PRIVATE/ PUBLIC HEALTH SYSTEMS
People’s Hospitals Private Hospitals and Clinics Military Hospitals
Public Hospitals and Popular Clinics IVSS Hospitals and Clinics Clinics
Popular Doctor’s Offices
Barrio Adentro operates parallel to Venezuela’s existing healthcare system. It is being bolstered and shaped to replace its counterpart. However, the sheer size and expense of overhauling the Venezuelan medical system underpins an uncertainty associated with Barrio
Adentro. As this research explores, it is also the starting point for the many critiques partisan
Venezuelan citizens have of this program, mainly that it provides a greater political than economic benefit.
THE UNCALCULATED COSTS OF BARRIO ADENTRO
The costs of Barrio Adentro are not a secret that the presidential administration is trying to keep from the public. This I have gathered from speaking to a minister at the World Health
Organization/ Pan American Health Organization unit in Venezuela, and again during a speech that the Vice-Minister of Health from the Alcaldía Mayor made to a room full of committee leaders, and reading the press.225 It is just simply unknown to all parties.
225 At a meeting with Barrio Adentro community health committee leaders, a Vice-Minister of Health from Mayor Freddy Bernal’s office suggested that Barrio Adentro suffers from a problem of coordination. As an example, he noted that funding for the program originated in the Ministry of Energy and Mines. This makes it nearly impossible to answer questions such as: how many nurses does the program have? The answer to these questions, he stated, is known to whoever pays the salary. The program was still developing more regularized mechanisms for ascertaining information. 23 de Enero, Caracas, Venezuela, 22 January 2005. Reyes 79
Ambiguity on the total cost of this program arises from its structure. The presidential administration has developed it outside the institutional structure of MSDS, but borrows resources in the form of IVSS hospitals and the use of its regional bureaus. Also, the military has assumed a part of the costs by volunteering its hospitals. Additionally, the state oil company of PDVSA has under its newly appointed leadership taken a leading role in underwriting many of the president’s socially oriented projects. To calculate the total costs of this program, it is necessary first to think through the contribution each of these government branches is making to the endeavor. And this is not easy, because Barrio Adentro is not the primary concern of these entities.
In connection with the military’s proposal to allow the general public free access to its hospitals, the Minister of Defense asked the National Assembly for a $20.8 million increase in the appropriation normally allowed for the administration of these hospitals.226 This figure could represent the true estimated cost to the military of joining the Barrio Adentro model, or be an inflated figure to cover-up costs associated with the military’s core business.227 Similarly,
PDVSA claimed to have spent $3.7 billion on social and economic programs in the year 2004.228
However, the amount of this money that pertains to Barrio Adentro is not known. Estimating that in 2004 Venezuela was exporting 53,000/ bbl of petroleum a day to Cuba at prices that never
226 The National Assembly received news of the military’s decision to provide the public access to its facilities through Ministry of Defense Planning and Budget director General Wilfrredo Cruz Weffer on November 17, 2004. He said that the Minister of Defense, Jorge Luis García Carneiro, had instructed him to provide these services free of charge. Due to this plan, the Minister of Defense’s budget request for the year of 2005 was 300% in excess of its 2004 total (increasing from 20 billion bolivares to 60 billion bolivares). Dawn Gable. “Venezuelan Military Hospitals Broaden their Service to all of the Population,” V.Headline.com, 17 Nov. 2004, Available at: http://www.refusingtokill.net/Venezuela/venezuelamilitaryhospitals.htm; With the Bolivar trading at .00052 to the dollar on November 17, 2004 the requested increase was from $10.4 Million to $31.2 Million. FXHistory: historical currency exchange rates. Available at: http://www.oanda.com/convert/fxhistory. 227 The military has undergone a significant expansion and renewal under Chávez’s direction, or at least watch. The country’s army reserves have doubled to 100,000 and the military has also acquired 40 Russian Mi35 helicopters and 100,000 kalashnikov rifles since his coming to power. “A Spectre Stalks the Americas,” The Economist, 26 February 2005, 35. 228 Alan Purkiss, “Venezuela’s Chavez Aids the Poor with Social Programs, WJS Says,” Bloomberg.com, 24 Dec. 2004. Available at: http://www.bloomberg.com/apps/news?pid=100000086&sid=aCqCxWZ8tVu8&refer=latin. Reyes 80 dropped below $28/ barrel and peaked at nearly $47/ barrel, it is safe to say that this company contributed at least ¾ of $1 billion to the program (see the chart on the following page).229
Another cost to the program not calculated in the contribution of the military or bartered oil is the maintenance and training of doctors. Cuban doctors, anywhere between 13,000 and
17,000, receive $250 per month paid by the Venezuelan government. 230 Venezuelan doctors, who have shown an overwhelming reluctance to affiliate themselves with this program (only 29 have actually worked in barrios under this program), receive $600 month.231 The government has also finished sponsoring its first class of 250 Venezuelan graduates in Cuban medical schools, currently has 1,000 more Venezuelans enrolled in those schools, and has arranged for 1,200
Venezuelans to conduct their residencies in communities across the country. Administration officials describe the educational expenditures of this program as upfront costs to the greater goal of making this a long-term, Venezuelan run initiative.232
229 Venezuela is an OPEC member and sells it products in coordination with this organization. I have averaged the least possible amount could have contributed in 2004 based on OPEC basket prices ($28 x 53,000) with the highest possibility ($47 x 53,000). 230 According to a petition for funds filed by the Ministry of Finance with the National Assembly on December 1, 2004, the official number of doctors working in Barrio Adentro is 18,575. The greatest numbers are located in the states of Zulia (2,633), Miranda (2,567) and Carabobo (1,949). (Solicitud de recursos para la mission barrio adentro, ” in El Universal, 5 Dec. 2005, Available at: http://buscador.eluniversal.com/2004/12/05/ap_art_05109B.shtml); However, this number could include up to 1,200 Venezuelan medical students slated to conduct their residencies in the country’s barrios, 250 Venezuelans who have recently graduated from Cuba’s medical school, and Cuban teachers and sports trainers. The IPS-Inter Press has reported the total number of Cuban doctors as 13,000. (“Venezuela: Cuban Doctors Bring Care to Caracas Slums,” IPS-Inter Press Service/ Global Information Network, 23 Nov. 2004, Available at: http://web.lexis-nexis.com/universe/document? _m=4f58fb7ae5c9f9fd18c1d1e61fa3598&). 231 Peter Mayburduk., “Venezuela Works to Bring Healthcare to the Excluded,” Multinational Monitor, 2004 October. 232 Vice Minister of Health at MSDS Carlos Pérez. Interview by Gabriel Reyes, 11 January 2005, Caracas, Venezuela. Reyes 81
Projections made in 2004 for the inclusion of the Barrio Adentro program in the 2005
National Health Budget estimated the cost of the program at $1.3 billion. I met a representative of WHO/ PAHO three days following the president’s delivering of accounts to the National
Assembly on January 14, 2005.233 At that point, he claimed that the organization was currently petitioning the government to study the sources of financing for this program.
THE FORMAL OPPOSITION OF BARRIO ADENTRO
Venezuela’s Medical Federation (FMV) has led opposition to Barrio Adentro on both moral and legal grounds. It represents 55,000 Venezuelan physicians, 10,000 of which are unemployed.234 The agreement to bring Cuban doctors to Venezuela reached between Caracas mayor Freddy Bernal and Fernando Bianco ignores this fact, the FMV claims.235 On countless
233 Dr. Ramon Granados of WHO/ PAHO. Interview by Gabriel Reyes, 17 January 2005, Caracas, Venezuela. 234 Yensi Rivero, “Venezuela: Cuban Doctors Bring Care to Caracas Slums,” IPS-Inter Press Service/ Global Information Network, 23 Nov. 2004. 235 Maria Isabella Salas, “Cuban Advisors Continue to Arrive in Venezuela,”World News Connection, 29 June 2003. Reyes 82 occasions, the FMV has made its stance known to the Venezuelan government. As early as June of 2003, its president, Douglas Leon Natera, questioned the credentials of Cubans arriving to work as physicians in Venezuela. He took issue with the government not requiring that Cuban doctors validate their diplomas in Venezuela. Leon Natera characterized the doctors arriving from Cuba as “political agents of the government” whose goals, he alleged, are to “install (Fidel)
Castro-style communism”.236 The FMV also articulated its claims against the administration in a lawsuit it filed that year. The courts, in August 2003 awarded the FMV a favorable ruling; prohibiting nearly 50 Cuban doctors from practicing medicine in Venezuela.237
My first hand experience with the program gave me the impression that Cuban doctors were actually quite competent, disinterested in politics, mainly focused on their tasks and sometimes complicit in activities that undermined the management goals of the Venezuelan government. However, the ire of the FMV is understandable, largely because the administration has sidelined it in the development of its new health model.
A government bureaucrat explained this decision in terms of the program’s social objective. Yonis Monzin, Vice-Minister of Health at the central MSDS bureau in Caracas, stated that Barrio Adentro purposely wanted people with “social sensibilities” and “people not affiliated with unions”.238 The idea of Barrio Adentro, he explained, is to provide care in the barrios at all hours of the day. Using doctors from the federation would have placed constraints on this objective. Monzin’s account, however, understates the tumultuous relationship between the Chávez’s administration and this federation. Since the earliest days of its term, the FMV has
236 Ibid. 237“Venezuela: fallo contra medicos cubanos, ” in BBCMundo.com, 22 Aug. 2004, Available at: http://news.bbc.co.uk/hi/spanish/latin_america/newsid_3173000/3173645.stm; “Chávez defiende a médicos cubanos,” BBCmundo.com, 22 Aug. 2004, Available at: http://news.bbc.co.uk/hi/spanish/latin_america/newsid_3175000/3175193.stm. 238 Vice-Minister of Health Yonis Monzin at MSDS. Interview by Gabriel Reyes, 11 January 2005, Caracas, Venezuela. Reyes 83 pressured the administration for higher wages, threatened strikes and filed lawsuits claiming that the administration’s negations of its claims deprive Venezuelans of their constitutionally guaranteed right to health.239
Due to its visible position, the FMV and its leaders hold a dominant platform upon which to frame the grounds for opposition against Barrio Adentro. In his article, Mayburduk suggests that Venezuelans often oppose the program on four grounds. These include its licensing practices, suspected promotion of communist ideology, sustainability in the absence of foreign expertise and the giving away of Venezuelan jobs.240 This shows that FMV has gained substantial influence in molding this debate.
CLAIMS OF THE INFORMAL OPPOSITION TO BARRIO ADENTRO
In my conversation with opponents to this program, I found that their most pressing concerns slightly differed. These revolved around the possibility that Barrio Adentro was suppressing community medical efforts previously in existence, and the expenditures associated with the program.
Julio Marquez, a student of political science, expressed his wariness along these lines.
Over a traditional Venezuelan dish of rice, beans and shredded beef (un pabellon), Marquez explained to me why he could not agree with the program of Barrio Adentro.241 He was not opposed to the idea of providing medial services to the underserved. What bothers him was the way in which “the program is managed”. He pointed out that clinics in the barrios had always existed, and believed that building new modules, payments to Cuban doctors and the purchases
239 “FMV exige bs. 750 mil para medicos rurales,” El Universal, 2 Feb. 1999, Available at: http://buscador.eluniversal.com/1999/02/15/pol_art_15110DD.shtml; “FMV alerta radicalización del paro medico,” El Universal, 28 Jul. 2002, Available at: http://buscador.eluniversal.com/2002/07/28/pol_art_28113FF.shtml; “FMV solictará amparo por derecho a la salud ante el TSJ”. El Universal, 9 Aug. 2002, Available at: http://buscador.eluniversal.com/2002/08/09/pol_art_09109CC.shtml. 240 Peter Mayburduk, “Venezuela Works to Bring Healthcare to the Excluded,” Multinational Monitor, 2004 October. 241 Julio Marquez. Interview by Gabriel Reyes, 14 January 2005, Caracas, Venezuela. Reyes 84 of medicine from Cuban laboratories seemed a great waste of money. This money, he thought, could be better invested in the already existing Venezuelan public hospitals—which he pointed out, also serve the poor.
To Julietta Leon, a language professor in Caracas, the facts of the story are that prior to
Barrio Adentro 1) medical stations existed for the poor and 2) the state required Venezuelan medical students to complete a rural residency as a precondition of their training.242 To her, this program did not work better for the same reason that makes the current system operate: guaranteed safety for the medical trainees.243 She cited the example of her nephew who completed his residency in a barrio. He walked up 100 steps every time he entered the barrio without knowing if he was going to make it down alive, she claimed. 244 In her opinion, a stronger commitment of resources was needed for the existing programs.
INFORMAL OPPOSITION CLAIM #1: UNDERMINING COMMUNITY INFRASTRUCTURE
Marquez and Leon are convinced that the government is replacing valuable resources the communities possess with an inferior alternative. Dr. Rafael Mendez, spokesperson of the FMV, attests that in 1992 there were 80 clinics in the poor neighborhoods of Caracas, but that these began to close around 1997 for lack of government resources.245 Interestingly, in my visits to the barrios of Caracas I would find that the best organized Barrio Adentro operation revolved around a long standing community clinic. I would also find that the promise of a large influx of money and/ or resources to previously organized communities also raised many difficulties for the administration’s management of the program.
242 Julietta Leon. Interview by Gabriel Reyes, 5 January 2005, Caracas, Venezuela. 243 A role of the health committees in Barrio Adentro is to ensure the doctor’s well-being. 244 The city of Caracas runs east to west in a valley surrounded on both sides by steep hills. Over the years, with the onset of rural-urban migration, marginalized people have built their homes haphazardly into these hills. The infrastructure that has followed has worked around this situation, resulting in very steep streets and sidewalks that resemble large staircases. 245 Yensi Rivero, “Venezuela: Cuban Doctors Bring Care to Caracas Slums,” IPS-Inter Press Service/ Global Information Network, 23 Nov. 2004. Reyes 85
Ambulatorio Sergio Rodriguez proves this point. It is located in the barrio community 23 de Enero, Caracas Venezuela. I visited this clinic on January 10, 2005 and was given a tour by health committee leader Boris Escobar. Escobar served as a firefighter for 10 years, then as a volunteer worker for the Ministry of Health and now is a paid worker for the mayor’s office in the Barrio Adentro program. Upon learning the history of the establishment that Escobar helped run, it was clear that the administration’s program of Barrio Adentro had actually served more to augment than create the center’s capabilities and that of its leaders.
Mr. Escobar started my tour in the kitchen. Located on the second floor of the clinic, it had a capacity to cook food for 120 people on a daily basis. We then returned down a set of stairs and out towards a building adjacent to the clinic and another in the midst of construction.
Inside the constructed building, there was a woman by the name of Gisela Apetz. Ms. Apetz was a teacher of reading and writing apparently involved in the president’s Missión Robinson. She explained to me that this center was once a police station, and later used as a base for training.
Former Mayor Alfredo Pena, whom she did not remember fondly, wanted to do away with the center. Around that time, 1999 by all indications, the community rescued the center. Ms. Apetz marks this moment as the time the community made the center start working for the community.
She was clear to show me that although the center worked to back the programs of the government, it had existed before those missions were ever conceived.
Returning to the clinic, Mr. Escobar showed me rooms that doctors in the clinic use for their consultation with patients. In all, he said, the center counted on 11 Cuban doctors and 6
Venezuelan nurses. These doctors ranged from special practitioners to specialist in the fields of pediatrics, gynecology and dentistry. Impressed with the size and organization of the operation,
I inquired about its history. I soon learned that this clinic, according to Mr. Escobar, had a 50 Reyes 86 year history in serving the local community. The difference now was that all those working in the clinic were also members of the community.
Mr. Escobar’s personal dedication to Barrio Adentro emanated from his perception that he could affect the outcome of this program. I found that he had a very clear vision for the
Comites de Salud within the larger initiative. This understanding went beyond the simple formation of a body and extended towards being available for any and all emergencies that could arise, as well as taking preventative measures. The government’s most important role in committees, he felts, was to provide educational courses. He was convinced that the program of
Barrio Adentro could not, and was not, succeeding where Comites de Salud did not assume their full roles.
INFORMAL OPPOSITION CLAIM #2: THE COSTS OF THE PROGRAM
Regarding the costs of Barrio Adentro, critics cite it on two grounds. The first is that a better investment of the money used in this program could go towards revamping the previous
Venezuelan medical system. In the absence of reliable data, which investment presents the greater net present value, is not yet ascertainable. As discussed earlier, the costs are indeterminable. Furthermore, studies measuring the impact of Barrio Adentro on the health of
Venezuela’s population do not exist.246 The second basis for this complaint is that spending is intended to indoctrinate and buy political influence. I did not find sufficient evidence to fully support these claims.
Empirically, it is not clear that spending on the program of Barrio Adentro is buying
President Chávez political influence. In the recent recall referendum on his administration
(voting took place on August 15, 2004) President Chávez survived with a 59.25% yes vote. This
246 In an interview at the WHO/ PAHO in Venezuela, Dr. Ramón Granados outlined what a meaningful study would include: indicators on access, impact on mortality rates, the trend in diagnosis of new diseases, the decline of new diseases, etc. Dr. Ramón Granados. Interview by Gabriel Reyes, 17 January 2005, Caracas, Venezuela. Reyes 87 is a near identical result to his electoral victory in the 2000 election. And if President Chávez did manage to steal these elections, allegations that Barrio Adentro is buying a significant amount of political support still fall flat.
Three claims are made against the electoral outcomes. These are that exit polls showed the opposition wining the election, there surfaced a pattern of identical vote “no” (to not recall
Chávez) votes at hundreds of voting stations, and that the number of “yes” votes (to recall
Chávez) at some stations were fewer than signatures collected on petitions in those same areas.
Audits conducted by the Carter Center determined that the exit poll results were probably influenced by the environment in which the questions were asked; they also showed that the pattern of identical results also affected the “yes” votes and, upon consultation with a Stanford
University statistician, it concluded that these patterns fell well within an acceptable statistical range of probability; and generally more people voted to recall the president than when the petitions had circulated, indicating that some districts petition signers probably believed in the democratic right to a recall vote but did not want to unseat Chávez.247
While in Caracas, I heard circumstantial evidence to suggest that Chávez was barring people from voting by either disqualifying them from the registration rolls or giving out IDs to sympathetic foreign nationals. 248 If the first claim is true, then a greater percentage of voters in
Chávez’s favor would be expected—however, he only received the same percentage as he did in
2000. In this scenario, this would actually point to a decreased support among the masses for the president. If the second case is true, then it still points to the president needing to buy support above and beyond whatever the program has accrued his administration.
247Jennifer McCoy, “What Really Happened in Venezuela?,” The Economist, 4 September 2004. 248 Anonymous. Caracas, Venezuela. January 5, 2005. Reyes 88
Anecdotally, there are strong examples showing that President Chávez may be maintaining his political base through spending on programs like Barrio Adentro. Mari Elsi
Gamez, a third generation Venezuelan maid and opponent to President Chávez, provided me the most convincing account in this regard.249 She stated that with her grandmother one cannot even talk “of that gentleman”, a reference to the president. Her grandmother is a staunch supporter of the president. Gamez, however, attributes her grandmother’s loyalty to the benefits she receives from this administration. The grandmother receives therapy three times a week, is involved in both the Misión Robinson and Vuelvan Caras and as a result receives a pension of 180,000 bolivares ($93.60) per month.250 Ms. Gamez believes this typical of Chávez supporters.
OBSERVATIONS ON THE GROUND: MISIÓN BARRIO ADENTRO
The office of the Direction of Health, located on Avenida Baralt in downtown Caracas, was my gateway to the city’s barrios. It is an office within Mayor Freddy Bernal’s jurisdiction and serves as the central hub for the Barrio Adentro program in Caracas. I stumbled upon it almost by accident, and truthfully, never came to fully appreciate its importance to the Barrio
Adentro mission until well after leaving Venezuela.
Throughout my time in Caracas (January 1-24, 2005) I spent more than a few hours in the
Direction of Health’s waiting room speaking to health committee leaders and nurses; traveled to barrios with the staff worker in charge of overseeing the cities health committees; attended two city-wide meetings the office organized for health committee leaders and nurses in the program; joined a delegation of the office and a representative of the MSDS on their joint tour of a barrio; and met with the director of the Direction of Health (I was even able to accompany him to an unveiling of a statue on Caracas’ main highway where I stood just 10 feet from Freddy Bernal).
249 Mari Elsi Gamez. Caracas, Venezuela. January 3, 2005. 250 These are educational initiatives run both with Cuban expertise and in a similar fashion to Barrio Adentro. For the currency conversion, I have referenced: FXHistory: historical currency exchange rates. Available at: http://www.oanda.com/convert/fxhistory. Reyes 89
The first day that I arrived at the office (January 5, 2005), I was told to return early the following morning, at which time I could meet with the director. Though I arrived when the office opened at 8:30 a.m., I was made to wait for two hours. During this time I made general observations of my surroundings. There was a lot of staff in the office, perhaps between 20 and
30, which contributed to a hectic atmosphere. Two receptionists sat at a desk with an empty desktop except for a phone on its right hand corner.251 Staff members came in and out of the room, some wearing red shirts with the names of Freddy Bernal or Barrio Adentro across the back. Others donned casual clothing. The walls of this waiting area were painted red. One poster of President Chávez in a military suit hung behind the heads of the receptionists. Of the people waiting for service, the overwhelming majority were women.
I engaged whoever sat next to me in informal conversation, introducing myself as a North
American student interested in the program of Barrio Adentro. This sufficed to net me three interviews while I continued to wait for the director of the office. These were with two health committee leaders (Alvara Marquez and Sorocaima Marquez) and one nurse (Luz Marina
Sanchez) in the program.
Alvara Marquez is a member of the Comite de Salud in the barrio Cariquao. She was at the office that day to submit an inventory of the work her committee had carried out in the previous weeks. However, the fact that she was waiting in a rather crowded room to drop this form off indicates that there was probably more to her visit then she was willing to share. While she and I both waited, we talked about her role as a community organizer in the program.
Marquez admitted that prior to Barrio Adentro she did not take part in the available community organizations that operated in her neighborhood, mainly the Association of
251 Between 8:30 a.m. and 10:30 a.m. the phone only rang twice. One caller apparently had the wrong number because he was calling regarding an Aseo Publico. I would later try to contact this office by phone by calling the operator and asking for the number. It was not listed. Reyes 90
Neighbors. Those organizations, she said, were not ‘participatory’. I gathered from her testimony of involvement with her neighborhood’s health committee what this term meant.
The duties of the committee, and hers specifically, seemed plentiful. She explained that the health committee in her neighborhood consists of 20 members, but insisted that only about 5 of those actively participate. Their tasks preceded the arrival of the first Cuban doctor in the community, mainly because they had to petition for his placement. Once the doctor arrived, someone needed to volunteer to provide housing. Marquez agreed, and allowed the doctor to stay in her home. Presumably form this base, the doctor started to attend to patients in the morning hours and visit others in their homes during the afternoon hours.252
An essential function of the Comite de Salud is to aid the doctor both in meeting his patients, operating the clinic (especially if it’s a makeshift one) and in public health campaigns.
She noted that in her neighborhood the committee helped the doctor check the water buckets families often keep on the rooftops of their homes to collect rainwater. Mosquitoes often lay their eggs here, resulting in the proliferation of dengue. Other duties of the committee also included overseeing a kitchen capable of cooking for 250 people (part of a nutrition program) and working with Cuban sports trainers who conduct physical fitness courses for adults.
Committee members also worked to draft letters to the appropriate government agencies whenever a situation called for this contact. All of this work, Marquez noted, was time consuming but she and other members of the committee rotated their duties.
Marquez’s notion of “participatory” implied that she gains a feeling of agency through her actions. She is sometimes criticized for her zealous efforts. Members of her community, “se meten con uno” she stated, sometimes shaking her confidence.253 However, she reassured me 252 In her community, the doctor works with 300 families. She says he is supposed to deal with a maximum of 250. Despite this large demand for the doctor’s services, at the time of our conversation her community was still awaiting the construction of a proper module. 253 Translation: “start trouble with you” Reyes 91 that when the president speaks (and I can attest that his discourse is often about government funding and self help) she feels much better. In her view, her participation is essential to making this program work.
Similarly, Sorocaima Marquez views Barrio Adentro as an opportunity to make a difference for her community’s situation. S. Marquez presented me with a special case where I could appreciate that even if the president intended Barrio Adentro as a tool of political influence, it appealed to an opportunistic citzenry maybe just more interested in its benefits.
She was different from most people in the waiting room in two regards. First, she had a profession as a systems analyst. Second, she does not reside in a typical barrio dwelling.
Instead, Ms. Marquez lives in an apartment building bordering the barrio of 23 de Enero.
Notwithstanding, in May of 2004 she helped organized a Comite de Salud in her building. The purpose, she described, was to allow for an expansion of the Barrio Adentro doctor’s services.
Initially, it was hard to get tenants to accept the presence of the doctor. S. Marquez described an instance where somebody in the opposition threw paint on the doctor when he came to visit. Although these attitudes have softened, partly because the doctor has treated people fairly, it has proven a difficult task to merge the committees of the building and the barrio. She described a lot of petty resentment along the lines of “you live in the barrio and I don’t” and complaints that the doctor was spending “more time here than there”. In any case, she continues working on the endeavor because she sees a benefit for the community. Regarding the larger context of the program, S. Marquez claims to be apolitical.
Unlike either Marquez or S. Marquez, Luz Marina Sanchez of the La Vega barrio is not a health committee leader. She is a nurse. Like S. Marquez she does not claim a political affiliation with the president’s party, although she admits to liking his politics. On that day she Reyes 92 was waiting in the waiting room, like many other nurses, to fix a situation regarding her paycheck. 254 She claims to have studied nursing, but not having practiced in the field before
Barrio Adentro. After a Comite de Salud visited in her home, she became interested in the nursing component of the program. After completing a refresher course, she now works alongside the Barrio Adentro doctor as a nurse in her community. She estimated that they see about 35 patients each morning and then visit others in the afternoon.
THE IMPORTANCE OF NURSES
Sanchez’s story is important on several levels. First, it shows how communities are motivating themselves to work in this program. Second, it highlights another instance (recall
Escobar in barrio 23 de Enero) where Barrio Adentro has rediscovered latent social capital in the country’s marginalized communities. But third, and most importantly, it shines attention on a forceful group within the program: nurses.
On that day, Sanchez was in the waiting area because of the drastic political stand a group of nurses took against the presidential administration. It began in the month of August
2004, when nurses demonstrated outside of the Vice President’s office for pay. As a result the administration agreed to pay them 250,000 bolivares, the equivalent of $130 per month. 255 Three months later, in November, the nurses were still awaiting their pay. That is when a group of nurses took up a hunger strike in front of the MSDS Minister’s office in Caracas.
The minister presiding over MSDS, Roger Capella, was of the opinion that no one had ever contracted the nurses, and that they were the ones who had offered their services to the program. Nonetheless, his ministry sought an additional credit from the government and settled the 3 month debt with the approximately 2,500 Venezuelan nurses involved with Barrio Adentro.
254 On this morning Ms. Sanchez was at the Direction of Health because she had lost her identification card and could not recover her nurse’s salary. She hoped to obtain a signed statement from the director that she could take to the bank. 255 FXHistory: historical currency exchange rates. Available at: http://www.oanda.com/convert/fxhistory. Reyes 93
Through political action, the nurses earned themselves jobs, forced the MSDS to seek a credit in the order of $325,000 and gave the government an idea of what solidarity and participation cost in bolivares.256
Venezuelan nurses took a stand against the government’s original design for the Barrio
Adentro program and won. This is an important development in the program of Barrio Adentro.
One month later, dentists working in the state of Zulia would reference the event amidst their protests to MSDS for back payments.257 I would later hear leaders of the Comites de Salud reference the force exerted against Minister Roger Capella at a city-wide meeting sponsored by the Direction of Health.258 Their aim was to show that they were growing intolerant of the state’s slow pace of development and they knew of a strategy that could make the administration comply with their wishes: strike.
If the nurses’ hunger strike emboldened the masses, it has also created an area where the administration is trying to recover influence. I noticed this in the treatment and supervision of nurses.259 In the month of December the names of many nurses were left off the state payroll. A staff worker (Adriana Gonzalez) at the Direction of Health told me that in the month of
December the government purged all names or identification numbers appearing more than once.
This meant that some nurses were deprived of their pay for no other reason than having the same name as another nurse. This was explained as a necessary preventative measure. However, my visits to the Barrio Adentro missions alongside a staff worker of the Direction of Health would cause me to rethink the issue.
256 Maria Lilibeth da Corte, “Pagarán a enfermeras de Barrio Adentro,” El Universal, 11 Nov. 2004, Available at: http://buscador.eluniversal.com/2004/11/12/ccs_art_12287E.shtml; I have calculated the figure of $325,000 by multiplying 2,500 nurses times $130. 257 “Odontólogos de Barrio Adentro protestan por salaries atrasados,” El Universal, 12 Dec. 2004, Available at: http://buscador.eluniversal.com/2004/12/04/ccs_art_04262F.shtml. 258 I attended that meeting on January 22, 2005 in 23 de Enero, Caracas, Venezuela. 259 Here I must admit that I am unaware of the system of supervision that existed before January of 2004. Reyes 94
WHERE ARE THE NURSES?
On January 6, 2005, Adrianna Gonzalez and a man named Walter took me on a tour of a barrio, San Agustin, in Caracas. Adrianna Gonzalez works at the Direction of Health. She further identified herself as the person in charge of overseeing the 1,050 health committees located in the city of Caracas.260 Walter is the driver for Dr. Tomás Ramos, director of the
Direction of Health. 261
This visit to San Agustin provided me my first personal experience with the poverty that plagues an overwhelming majority of Venezuelans. Scarcely paved narrow streets, dilapidated concrete homes and shops conveyed a past of neglect. Within three hours, and a tight radius, we would visit seven popular clinics.
At the first clinic we met Cuban Doctor Amparo Bareto. Noticing the absence of the
Venezuelan nurse, Ms. Gonzalez inquired about her whereabouts. Dr. Bareto notified her that the nurse had not worked throughout the last month because she was dealing with personal business. This, however, did not deter Dr. Bareto from asking about her nurse’s pay, which was either withheld or simply not forthcoming. We were again on our way following a brief and polite exchange in which Ms. Gonzalez addressed the doctor’s inquiries. Ms. Gonzalez would later claim she recognized the lady at the street corner kiosk selling lottery tickets as the nurse who was assigned to this clinic. She criticized how the doctors in this program defended their nurses, actions which presumably were making her job harder.
At the next clinic, which was located halfway up a steep hill with many steps, we met Dr.
Ana Isa Rodriguez, a Venezuelan nurse and Comite de Salud worker Lydia de los Corbos. At
260 I can neither confirm nor deny that 1,050 committees exist in the city of Caracas. 261 Walter transported us in a fully equipped ambulance, property of the city of Caracas. As far as I could deduce from Walter’s and Ms. Gonzalez’s previous work experiences, neither of them was trained in the usage of its equipment. This instance provides a clear, if not small, example of how accounting for resources in the program of Barrio Adentro is a difficult task. Reyes 95 the time we arrived, there was no activity in the clinic fashioned with lightly colored green walls, an ample sized waiting area and one room for private consultations off to the left side. The concerns of these ladies centered on the health education program the government purports to sponsor. Dr. Rodriguez spoke of twelve conferences intended for neighborhood health promoters, none of which she could initiate for lack of a suitable space. She worried that
Venezuelans were not going to “salir del bache” (come out ahead) if this continued. “We are only helpers,” was her view. If Barrio Adentro is a government program, the minister should better coordinate activities.
There was a suggestion that nurses be redesignated with the title of health promoters.
Addressing the theme of the conversation, Ms. Gonzalez noted that President Chávez says one thing but that people do another. At this, Corbos defended her committee for doing everything that it could. Corbo said that she works at whatever hour, but that there is not much backing.
The backing of which she spoke, I would learn throughout my visits to barrios and attendance of a subsequent forum for Comite de Salud leaders, was a widespread organizational deficiency.
Next, Ms. Gonzalez and I, along with another Comite de Salud leader now joining us
(Gladys), visited a clinic that was housed in a street level cellar. The entrance to this space, which contained boilers, barrels and concrete walls that either remained unpainted or showed serious decay in paint, was poorly lit. The doctor attending to this clinic was visiting, apparently substituting for another Cuban doctor. He was young and seemingly dedicated to his task.
While our delegation talked with the doctor, patients waited on a bench set up against one of the cellar’s concrete walls. Despite taking the time to speak with us, the doctor was interested in getting back to his patients. Reyes 96
There was not a nurse working at the popular office. Ms. Gonzalez asked why the nurse assigned by her office was not present. The doctor explained that the nurse had finished her coursework, but was not licensed. He also stated that he did not bother to bring his own nurse to the clinic because he would only be there for two days. The doctor said he was unaware that one could have a nurse who was not licensed working and suggested that we go visit the nurse.
Gladys led us to the next clinic. She directed us through a series of steep, narrow streets carved into the hills that surround Caracas and where the barrio of San Agustin extends. We arrived at the clinic called “Consultorio la Junventud”, which was closed. The absence of the doctor and the nurse at this clinic was unexplained, largely because it was well before twelve and not the customary time for the doctors to make house calls. Not missing a beat however, we drove down the hill and visited another popular office.
This office was located at the end of a long dark hallway on the first floor of a tenant building. When we arrived, Dr. Tania Reyes was busy viewing patients. While we waited for her to become available, Gladys showed us the conditions under which this doctor lived. The bleak personal quarters of Dr. Reyes were located toward the back of the room where she viewed patients. Everything in the room—the bed, fridge and other items scattered about—where borrowed from members of the local community. In her brief conversation with Dr. Reyes, Ms.
Gonzalez inquired about the two nurses assigned to the office. As we often found that day, only one nurse was working and the other missing.
The next office we visited that day was the first one housed in a red brick module, such as the ones advertised on the government’s Barrio Adentro literature. The layout of these is very basic. The module has an octagonal shape and two stories. On the first level there is a waiting Reyes 97 area, one room for consultations and the doctor’s office. On the second level, reachable via stairs on the right side upon entering the module, are the doctor’s living quarters.
At this particular module, located at the top of a rather steep hill, we met Dr. Damaris
Rodriguez. There was not a nurse present in the module. When Ms. Gonzalez asked about the absence of her nurse, the doctor explained that her nurse was sick that week. Dr. Rodriguez, however, assured Ms. Gonzalez that her nurse had worked steadily for two years and elaborated on her nurse’s financial difficulties.
According to Dr. Rodriguez, this module often sees up to 70 people per day. Most she said are asthma-related cases. Her most pressing concern was that her nebulizador (a machine used to treat these patients) was neither working nor in the process of being replaced. The original machine, a vital piece of equipment for her clients, Dr. Rodriguez says came with her from Cuba. For her clients, who often walked up the hill inhaling dust on their way to the office its absence was a severe matter. Ms. Gonzalez noted her concern.
Upon leaving Dr. Rodriguez’s clinic, Ms. Gonzalez, Gladys, Walter and I headed towards our final destination on that day. This was the office of Drs. Reductilio and Arelis Gordo, a father and daughter duo. Their office was located on the second level of an apartment building overlooking a waterless, Olympic-sized swimming pool.
When we arrived, the office was quite busy with clients. As a result, Dr. Reductilio
Gordo (his daughter was not there that day) was also much occupied and not particularly enthusiastic about speaking with Ms. Gonzalez. Immediately there was bit of contention over the nursing situation in the office. Dr. Gordo assured Ms. Gonzalez that his nurse was always there, worked well and sufficed for him, his daughter and other employees of the office.262
262 He would later state that there were five people working in the office. Reyes 98
Ms. Gonzalez informed Dr. Gordo that this office was supposed to operate with two nurses. Dr. Gordo told Ms. Gonzalez that there was not enough work for two nurses in the office. Ms. Gonzalez retorted that it was neither his nor her decision to make as to how many nurses worked in his office. That, she said, is the decision of the Ministry of Health and the
Direction of Health. Exasperated, Dr. Gordo said that he was there to give assistance and would not make himself responsible if there was not enough space for two nurses. He based his argument in the likely potential for diminishing returns if two nurses operated in the already crowded space. When and if the Ministry of Health amplified the space, then he would need an extra nurse.
Prior to having entered the popular clinic where Dr. Gordo worked, Gladys had brought an interesting issue to the fore. She claimed that he was involved in an intimate relationship with the nurse that worked in that office. On the ambulance ride back to the office, Ms. Gonzalez made up her mind that the doctor’s intransigence on the nursing issue was rooted in his relationship with the nurse in his office. The problem was not that there was not space for two nurses, but that his girlfriend would not tolerate another woman working in close quarters.263
In San Agustin, I found the high absenteeism of nurses interesting. Of the seven unannounced visits to modules, we found five Venezuelan nurses missing from work. This left four of these offices without any nurses at all.264 However, it did not seem significant in terms of value lost to the operation of these offices. The Cuban doctors everywhere seemed firmly in control of the practices, and in the case of the doctor operating in the cellar almost appreciated their absence.
263 To be fair, the doctor’s argument of diminishing returns may have been plausible given the area’s crowded space and the generally limited skills of the program’s hastily trained nurses. 264 Recall that at Dr. Reyes’ office there were two employed nurses. Also, recall that one module was closed at the time of our arrival and there is a possibility that this nurse was doing house calls with the doctor. Reyes 99
Also of interest is the relationship that nurses have developed with the Cuban doctors. In the cases of Dr. Bareto and Dr. Rodriguez, irrespective of the reasons for their nurses’ absences, they had not reported this to the Direction of Health. Consequently, this could have resulted in overpaid salary expenses for the program but illicit gains accruing to the individual nurses.
Seemingly, and despite the fears of Barrio Adentro’s opposition, this indicates that communities have absorbed the Cuban doctors and that the latter are adapting to the patterns of social interaction that prevail in the local settings. Conversely, the lesson that Cuban doctors may be imparting is one of how to preserve one’s interests within a government trying to impose structure at the lowest levels of society.
There was also evidence to suggest that nurses, when at work, are working to shape the design of Barrio Adentro. The suggestion that nurses operate as health promoters undermines the government’s goals on two fronts. First, because this is a position meant to increase community participation in the program. Second, because it would result in the government having paid community members to do work that should attest to the ideal of solidarity it believes inherent in Barrio Adentro. Separately, the nurse’s influence over a Cuban doctor to deny the admittance of another nurse into his office was a also a stance against the designs of the central administration.
STATE V. SOCIETY: THE STRUGGLE FOR REPRESENTATION OF INTERESTS
The case of the nurses’ absenteeism illustrates a larger point. Simply stated, there is a brewing struggle for influence between state and society in the program of Barrio Adentro. In this particular case, nurses fought for and received paychecks. The government, conceding to this demand, is now forced by the commitment of greater resources to increase its management capacity of the program. This leads the state into a gray area: of advocating a program where power resides with the people, but of needing to impose more of its control. The surprise visits Reyes 100 hint at this tension. City-wide meetings that the Direction of Health held on January 15, 2005 and January 22, 2005 for nurses and committee leaders, respectively, make it crystal clear.
JANUARY 15, 2005
The city-wide meeting for Barrio Adentro’s nurses took place on a Saturday morning at a school auditorium adjacent to the Ambulatorio Sergio Rodriguez in the barrio 23 de Enero. Ms.
Gonzalez, one of her assistants and her father Juvenal Gonzalez presided.265 The purpose of the meeting seemed a bit unclear. From the standpoint of the Direction of Health, it seemed a convenient occasion to address the inquiries of nurses awaiting pay for their December services and other general concerns. However, from the nurses’ point of view this seemed an applicable forum to press the office on matters ranging from small particulars to the general operation of the
Barrio Adentro program.266
One nurse, particularly mad because she did not receive her pay in December, condemned the growing bureaucracy of the program. “We are working with bureaucracy, and we are going to lose this shit if we continue with this bureaucracy” she said. Another nurse, from the barrio of Cariquao, objected to the fact that the nurses’ supervisors were not members of the barrios they supervised. “They will not understand our problems and needs,” she stated.
The issue of who should supervise the nurses, it seems, had long been generating friction.
At this meeting, Ms. Gonzalez responded to the issue by proposing that the nurses be able to vote for their new supervisors. However, in response to the nurse who claimed that outside supervisors would not understand their needs, she retorted that it was necessary to undo the buddy system. And to illustrate, she shared her experience in the barrio of San Agustin.
265 Juvenal Gonzalez works for the Direction of Health and is based in 23 de Enero. He is an affable man who often introduced me as a “person from Washington” who had come to study the program of Barrio Adentro. I was quick to correct him. 266 During my conversation with S. Marquez a week earlier, she had taken a look at a flyer announcing the event for the nurses and commented that it would provide a great opportunity to “clear up the labor situation”. This took place at the Direction of Health, Caracas, Venezuela, 5 January 2005. Reyes 101
Ms. Gonzalez derided the nurse who was selling lottery tickets while she should have been working. That nurse, who was in attendance, got up and alleged that she had called Ms.
Gonzalez’s office and asked permission to take personal days. Soon after, the meeting broke down as nurses starting to have conversations among themselves, and many struggled for Ms.
Gonzalez’s attention.
Director of the Direction of Health office Dr. Tomás Ramos, who arrived as the quasi- chaotic situation escalated in the auditorium, took center stage. After getting the attention of the nurses, he reminded them that this was a mission. “It is worth more than pay, it is worth the lives of people”. He reminded the nurses that fundamentally their job was voluntary. It is a result of a political change (referencing the November decision of MSDS) that has allowed them to get paid, he stated.
Dr. Ramos then asked the nurses who had received their salaries to raise their hands, to which the overwhelming majority did. He went on to explain upcoming courses for the nurses, explaining that the first two would be of an ideological, political nature. He said that there the nurses would become politicized with this process, at which point he asked anyone who did not identify with this process to step forward. No one cared to take him up on his offer. The idea,
Dr. Ramos continued, is to change individual values for collective values, and value what is human more than the economics.
Dr. Ramos’ words transformed the previously democratic quality of the meeting. Now,
Mr. Gonzalez stepped forward to remind the nurses that division results in defeat and unity in victory. He appealed to the pride of the mostly female audience, by telling them that in this process they were becoming professionalized. Mr. Gonzalez then spoke of a meeting in the
Sucre barrio which he had recently walked in on. He alleged that a doctor and nurses convened Reyes 102 this meeting without the presence or knowledge of people from the mayor’s office. This he labeled as conspiracy. At this remark, a nurse from the barrio of Sucre got up and left the room.
As she left, Mr. Gonzalez told the audience that those who leave are not needed.
There were two visions for the future of the Barrio Adentro program at this meeting.
One belonged to the group of nurses, who saw themselves as autonomous and able to conduct their own affairs. The other was that of the government. Ms. Gonzalez, Dr. Ramos and Mr.
Gonzalez advocated state control and an understanding of the larger, government, aims for the program. Though the administration’s rhetoric diffused the sentiment of revolt in this one occasion, it was obvious that lines in the sand were drawn.
JANUARY 22, 2005
One week later, I attended the meeting for leaders of the Comites de Salud at the same location. At this meeting I was able to gain a greater sense for 1) the actual level of organization for the Barrio Adentro program and 2) the extent to which committee members went to try to make these programs work in their communities. However, in the process of making the Barrio
Adentro missions work these men and women compromised its ideals.
Many of the committee leaders reported having to rent spaces, with their own funds and those donated by the community, to house the doctors or operate clinics. One lady explained how her committee was renting and paying for a space while the ministry remained unresponsive. Another leader from the Sucre barrio told the story of how the Cuban doctor had worked out of a borrowed home for three months. The lady who owned the home then wanted to charge 200,000 bolivares ($104) per month for the use of the space.267 The committee leader said that there was a house selling for 17 million bolivares ($8840) that would work, and
267 FXHistory: historical currency exchange rates. Available at: http://www.oanda.com/convert/fxhistory. Reyes 103 challenged the bureaucrats present to start pursuing these avenues. There would be at least one other request for a proper space out of which to run the Barrio Adentro operation that day.
A leader from the La Vega barrio complained that everything that existed in the neighborhood was on account of his Comite de Salud. He said that there were 23 unemployed people working in that community’s committee. Despite this, he complained that it did not occur to the government to send food in December to the committee. He stated that in the Mercal they would rather see the food rot than giving it to the committees.268 This was a message that he wanted to get to the president, he stated. Along with the fact the doctors were working in the morning but doing nothing in the afternoons.
Then spoke perhaps the most dynamic of all speakers, Rafael Hidalgo. He was a charismatic and spirited man. He spoke of how his community was formed 30 years ago, seemingly placed there by a previous government. “Tomorrow, they always tell us” he said was the answer the community received when it inquired about its future or improvements to present living arrangements. He claimed that children in the community attended a school without a roof.269
Mr. Hidalgo explained that in his community doctors did what they were ordered to do, in response to the comments of other leaders that pointed to unruly Cuban doctors. However, he urged fellow leaders to consider that the state was also treating them poorly. He claimed that doctors in his community did not even receive chicken for their meals, just a bag of pasta.
“These doctors should receive more than what we are giving them” he argued.
Mr. Hidalgo also explained that as a leader of the health committee he was carrying a burdensome load. Part of this was coming up with the 60,000 bolivares ($31.20) per month
268 Mercal is the government supermarket that gives rationed foods at subsidized prices 269 Mr. Hidalgo joked that as a result of this school he was famous, because he often television fighting for improvements. Reyes 104 required to rent the house out of which the doctor worked.270 He said that his community had land and wanted to build.
Mr. Hidalgo expressed his support for the ideas of incentives for Comites de Salud, because in his words “we are the base of this process”. Despite working towards the government’s “revolution” with love, he also desired that the government regard his condition.
Most impressive, however, was Mr. Hidalgo’s bold plan laid out in the presence of Dr. Ramos and a Vice-Minister of Health from the mayor’s office present at the meeting. This was to charge patients a flat fee of 1,000 bolivares ($.52) per visit to cover the costs accruing to the community. Despite that this clearly violates the free service principle spelled out in the 2000
Health Bill, neither the director of the Direction of Health nor the Vice-Minister attempted to publicly dissuade him from this idea.
A few minutes later an argument erupted. It followed the incendiary speech of a committee leader from the barrio La Casona who had spoken on the issue of Cuban doctors. He prefaced his comments by saying that he was a revolutionary, but this did not mean he was going to paper over the faults of the Cuban doctors. He carried in his hand detailed accounts of what he claimed were repeated instances where the doctor had failed to serve the community.271 “Can we, as a health committee permit this?”, he asked the crowd. That is when the order of the meeting broke down.
Dr. Ramos, like he had done before at the nurse’s meeting, stepped in to diffuse the rising tension. He assured the committee leaders that the Direction of Health had organized that day’s meeting with all best intentions. It was his goal to support the committees in a more structured
270 FXHistory: historical currency exchange rates. Available at: http://www.oanda.com/convert/fxhistory. 271 He claimed that the doctor had refused to see a four year old girl suffering from poison, and that on another occasion refused to see a lady in a diabetic coma. This, he said, was done on the grounds that the doctor would not work after six o’clock. However, he informed the audience, this same doctor was later jumped at two o’clock in the morning coming back drunk from a party. Reyes 105 way. Disinformation and ignorance, he hinted, helped breed disorder. To side-step addressing the many issues raised by the committee leaders, he stated that it was important to see how his office could do things uniformly to arrive at solutions. After acknowledging the Vice Minister of
Health’s presence, Dr. Ramos asked the committee leaders in the room who had nurses to raise their hands. With the majority having shown their hands, he asked them not to give Radio
Caracas, the opposition, the impression that “my doctor does not work”. Those, he stated, are problems that the Comites de Salud had to resolve.
Again it appeared; the director made a subtle reference to the political stand the nurses had taken against the administration. In fact, and I would not realize this until much later, his concerns mirrored those of the Minister of MSDS Roger Capella on the day he conceded to pay
Barrio Adentro nurses their back-pay. On that day, Capella denounced the hunger strike as having a political character and meant to call negative attention to the program of Barrio
Adentro.272 The administration, in its mode of defense, misconstrued the genuine concerns of the leaders meant to improve the quality of the program.
Before ceding the floor to the Vice Minister of Health, Dr. Ramos informed the health committees that courses for nurses and committee leaders would be coming soon. This would make the management of the program uniform. He reminded the audience that Barrio Adentro is the rock that has kept Chávez in power. Keeping this is mind, the first who should remain stimulated were they, the integrants of this program. Regarding the call for incentives, he told them that it was more important to sustain the program and the assistance it provides. He gave statistics to show that only ¼ of the barrios currently had modules, ½ have clinical spaces and ¼ have dentists, in an effort to show individual communities his larger concerns. Regarding the
272 “Ministro asegura que cancelará deuda a enfermeras de Barrio Adentro,” El Universal, 11 Nov. 2004, Available at: http://buscador.eluniversal.com/2004/11/11/pol_ava_11A506663.shtml. Reyes 106
Cuban doctors, he urged the committee leaders to work towards keeping them so that they do not leave. He closed by saying that the sum of the program was more good than bad.
Mr. Alvarado, the Vice-Minister of Health at Mayor Freddy Bernal’s office, then spoke to the audience of committee leaders. He began by saying that this meeting seemed very important to him. He claimed that until that day the Ministry of Health was not aware of the complaints being discussed at the meeting.
Throughout the meeting, leaders of the committees had been handing Mr. Alvarado small slips of papers that addressed their particular concerns. The major themes of the questions, Mr.
Alvarado noted, revolved around medical supplies, the flow of information, Cuban doctors, the building of modules, official visits to the barrios, problems with nurses, an incentive structure for committee workers and work hours. Although he set out to provide answers, he had only a few.
The most interesting opinion that Mr. Alvarado shared with the leaders regarded the proposition for an incentive system. First, he reminded the audience that these were issues intrinsically tied to the costs of the program. Second, he questioned the logic of making committee members paid government workers. “Where is the participatory, protagonist nature of the communities?” he asked.
Largely, the dynamic of this meeting was interesting. Among the leaders who attended the meeting there was a strong feeling that the program belonged to them, evidenced by the extent to which some of them struggled to keep it afloat in their communities and the innovations they proposed. They were keenly aware of the shortcomings in the Barrio Adentro operation and were proposing solutions to fix them. Depending on the nature of the issue, the administration tried to dissuade leaders, stayed silent or asked them to assert their roles. The administration showed reluctance to have its hand forced on the issue of incentives that would in effect add Reyes 107 more workers to the state payroll. However, they remained surprisingly silent in the face of the committee leader contemplating assessing fees for consultations with the Barrio Adentro doctor.
In areas where it was beneficial to the administration, such as oversight of doctors, committee leaders were encouraged to take a more active role. This seemed almost a way to channel the influence of these leaders away from the administration and onto this foreign subgroup. Even among the more ideologically attached leaders, their interaction with the administration signaled a struggle to represent their interests versus the administration’s needs for management and control. Reyes 108
CONCLUSION
Chávez’s Barrio Adentro program is opening a space of participation for those who can tolerate the rhetoric of the administration or forgive its transgression in other crucial sectors (i.e. like the recently implemented media law, Ley Resorte, which bars violent content on television between 7 a.m. and 11 p.m., the hours when strikes against the administration are most likely to occur). It is stimulating citizen participation, even if limited to carefully selected areas in the state bureaucracy. Both the opportunity for participation and the attention paid to this area of health extends a much-needed olive branch to the Venezuelan public.
The program of Barrio Adentro highlights many themes from Venezuela’s past. Its structure, conceived outside of the state’s bureaucracies, and perhaps outside of the law, makes
Chávez appear as the strongman of the 19th century determined to impose his will on the state.
The ideals of the program, to reach into the most underserved communities of the country and mobilize their inhabitants, give it a populist tinge. And certainly, Chávez and his supporters fully embrace this populist notion, rallying around the thought that this program represents a new, participatory, Venezuela.
To opponents of Barrio Adentro, perhaps the program is evocative of the Pérez Jimenez era. It lavishly spends the state’s wealth, even if on the poor, and guts the state of its legal democratic infrastructure. The opposition that feels silenced in this administration may also say that the program is reminiscent of the party democracy. To participate, one must be in the inner circle of the ruling parties: however, the required association this time is with Chávez’s
“revolution”.
This study of Barrio Adentro is interesting, however, because it shows that even amongst the people the presidential administration purports to lead its influence is limited. There is an interplay between the executively-centered government and citizen participation. While the Reyes 109 governments, and its ideological supporters, see this program as one that epitomizes the future state that the administration seeks to create, citizens also view as it their own. The participants in the management of Barrio Adentro depend and press the government to distribute resources, but do not necessarily appreciate the encroachment of the administration. Recall the nurse that decried the “bureaucracy” of the program.
As the government moves to add structure to Barrio Adentro, it will realize that its program’s own design has limited its capacities for control. The goal of enhancing community participation is one important factor is this regard. In the barrios, people organize and reach informal agreements that do not necessarily conform to the state’s agenda. For example, the nurse who may actually be working as a health promoter with her doctor’s consent or the committee leader that is directly charging community members for the services of the Cuban doctor. Already, the fears of the administration have surfaced in this regard. Mr. Gonzalez’s denunciation of the nurse and doctor who conducted a meeting related to the program in the
Sucre barrio highlights this concern.
Certainly, this research hints at how much, or little, influence the administration has over the Venezuelan people it purports to lead; the question remains of how much influence these citizens have over the administration. And it’s first important to note that in the implementation of Barrio Adentro, the government has not had its way across the board. The case of the nurses is illustrative in this regard. Nurses joined themselves to the program forcefully, demanded pay and after having received it have sought to limit government supervision. As the administration’s decision to allow them to elect their own supervisors shows, they have gained influence over this administration. Reyes 110
In terms of a space for political representation, it seems that Barrio Adentro is opening a new ground in Venezuela. If one assumes that there are roughly 10 committee members associated with each Cuban doctor (13,000), then this program potentially provides 130,000
Venezuelans a new arena in which to press the government for their material needs. The nurses and the committee leader of the city of Caracas, as shown in this chapter, do not sit idly on this opportunity.
Barrio Adentro’s nurses have through their political action and methods of incorporating doctors into their communities forced the administration to rethink its original plans. For the
Venezuelan government, concession has resulted in an approximately $1.4 million increase to the management of the program—the cost of the nurses’ wages. Although this is small in percentage to the overall cost of the program, it is important to note that the government barters most of the expenses for this program. Thus, the government’s commitment to wages constrains its cash flow and subsequent ability to fund further activities.
Barrio Adentro is to the Chávez administration an ideological matter. This is evidenced in their countless pleas to committee leaders to work together with the administration, and not give the opposition, via Radio Caracas, fodder for criticism. However, on the ground, the program is a pragmatic matter. Citizens view it as a way to improve the quality of their lives.
Even those who consider themselves apolitical, or do not possess the stereotypical qualities of the administration’s supporters have latched on to gain these benefits. In this regard, S. Marquez relying on the services of the Cuban doctor placed in the barrio 23 de Enero provides an example.
The danger of Chávez’s “participatory democracy” is that it is participatory only for those who tolerate his administration’s rules. However, this research shows that those most Reyes 111 poised to support his rules have gained influence over the administration. This offers weighty proof that within its executively centered state the administration has created at least one opening for democratic participation. Reyes 112
WORKS CITED
Books
Alvarez, Angel E. “State Reform Before and After Chávez’s Election”. Ed. Steve Ellner and
Daniel Hellinger. Venezuelan Politics in the Chávez Era: Class, Polarization & Conflict.
Boulder; London: Lynne Rienner, 2003.
Blank, David Eugene. Politics of Venezuela. Boston: Little, Brown, 1973.
Buxton, Julia. “Economic Policy and the Rise of Hugo Chávez”. Eds. Steve Ellner and
Daniel Hellinger. Venezuelan Politics in the Chávez Era: Class, Polarization & Conflict.
Boulder; London: Lynne Rienner, 2003.
Coniff, Michael. “Introduction: Toward a Comparative Definition of Populism”. Latin
American Populism in Comparative Perspective. ed. Michael L. Conniff. Albuquerque:
University of New Mexico Press, 1982.
Dúran, Armando. Venezuela en Llamas. Caracas: Grupo Editorial Random House, 2004.
Ellner, Steven. “Populism in Venezuela”. Latin American Populism in Comparative Perspective.
Ed. Michael L. Conniff. Albuquerque: University of New Mexico Press, 1982.
Ewell, Judith. Venezuela, a Century of Change. Stanford: Stanford University Press, 1984.
Gott, Richard. In the Shadow of the Liberator: Hugo Chávez and the Transformation of
Venezuela. London: Verso, 2000.
Hillman, Richard S. Democracy for the Privileged: Crisis and Transition in Venezuela.
Boulder: Lynne Rienner Publishers, 1994.
Karl, Terry Lynn. The Paradox of Plenty: Oil Booms and Petro-States. Berkeley: University of
California Press, 1997.
Loveman, Brian. The Constitution of Tyranny: Regimes of Exception in Spanish America.
Pittsburgh: University of Pittsburgh Press, 1993. Reyes 113
Navarro, Ramón Herrera. La Revolución Chavista. Caracas: Instituto Municipal de
Publicaciones, 2003.
O’Donnell, Guillermo. “On the State, Democratization, and Some Conceptual Problems: A
Latin American View with Glances at Some Postcommunist Countries”. Counterpoints:
Selected Essays on Authoritarianism and Democratization. University of Notre Dame
Press, 1999.
Oxhorn, Philip Oxhorn. “Unraveling the Puzzle of Decentralization”. Decentralization,
Democratic Governance, and Civil Society in Comparative Perspective. Eds. Philip
Oxhorn, Joseph S. Tulchin, and Andrew D. Selee. Washington: Woodrow Wilson
Center Press, 2004.
Penfold-Becerra, Michael. “Electoral Dynamics and Decentralization in Venezuela”.
Decentralization and Democracy in Latin America. Eds. Alfred P. Montero and David J.
Samuels. Norte Dame: University of Norte Dame, 2004.
Martz, John D. “Political Parties and the Democratic Crises”. Lessons of the Venezuelan
Experience. Eds. Louis W. Goodman et al. Washington: The Woodrow Wilson Press:
Washington, 1995.
“ Venezuela”. Health in the Americas 2002 Edition Volume II. Washington: Pan American
Health Organization, Pan American Sanitary Bureau, Regional Office of the World
Health Organization, 2002.
Zakraria, Fareed. The Future of Freedom: Illiberal Democracy at Home and Abroad. New York
City: W. W. Norton & Company, 2004.
Interviews
Anonymous. Interview by Gabriel Reyes. Caracas, Venezuela. January 3, 2005. Reyes 114
Anonymous. Interview by Gabriel Reyes. Caracas, Venezuela. January 5, 2005.
Arrúe, Javier. Program Coordinator at the Universidad Bolivariana de Venezuela. Interview by
Gabriel Reyes. Caracas, Venezuela. January 12, 2005.
Gamez, Mari Elsi. Caracas, Venezuela. January 3, 2005.
Grandos PhD., Ramón. World Health Organization/ Pan American Health Organization..
Interview by Gabriel Reyes, 17 January 2005, Caracas, Venezuela.
Leon, Julietta. Interview by Gabriel Reyes, 5 January 2005, Caracas, Venezuela.
Marquez, Alvara. Interviewed by Gabriel Reyes. Direction of Health, Caracas, Venezuela, 5 J
January 2005.
Marquez, Julio. Interview by Gabriel Reyes, 14 January 2005, Caracas, Venezuela.
Marquez, Sorocaima. Interviewed by Gabriel Reyes. Direction of Health, Caracas, Venezuela, 5
January 2005.
Monzin, Yonis. Vice-Minister of Health at MSDS. Interview by Gabriel Reyes. January 11,
2005. Caracas, Venezuela.
Pérez, Carlos. Vice Minister of Health at MSDS Carlos Pérez. Interview by Gabriel Reyes.
January 11, 2005. Caracas, Venezuela.
Sanchez, Luz Marina. Interviewed by Gabriel Reyes. Direction of Health, Caracas, Venezuela, 5
January 2005.
Journal Articles
Ames, Barry. “Electoral Strategy under Open-List Proportional Representation”. American
Journal of Political Science. May 1965: 406-433.
Cameron, Maxwell A. and Flavie Major. “Venezuela’s Hugo Chavez: Savior or Threat to
Democracy”. Latin American Research Review. No. 3, 2001: 263. Reyes 115
Crisp, Brian. “Presidential Behavior in a System with Strong Parties: Venezuela, 1958-1995”.
Escobar-Lemmon, Maria. “Political Support for Decentralization: An Analysis of the
Colombian and Venezuelan Legislatures”. American Journal of Political Science. Oct.
2003: 686.
Ellner, Steve. “The Radical Potential of Chavismo in Venezuela: The First Year and a Half in
Power,” Latin American Perspectives, Free Trade and Resistance. Sep. 2001: 8.
Furniss, Norman. “The Practical Significance of Decentralization”. The Journal of
Politics, Vol. 36, No. 4 (Nov.,1974), 958-982.
North, Douglass C. “Institutions”. The Journal of Economic Perspectives, Vol. 5, No. 1
(Winter, 1991), 97-112.
Romero, Anibal. Rearranging the Deck Chairs on the Titanic: The Agony of Democracy in
Venezuela. Latin American Research Review, Vol. 32, No. 1 (1997), 7-36.
Verba, Sidney. “Democratic Participation”. Annals of the American Academy of
Political and Social Science, Vol. 373, Social Goals and Indicators for American Society,
Volume 2 (Sep., 1967), 53-78.
Weyland, Kurt. “Will Chavez Lose his Luster?”. Foreign Affairs. November/ December 2001):
73.
News Articles with Authors
Gable, Dawn. “Venezuelan Military Hospitals Broaden their Service to all of the Population”.
V.Headline.com. 17 Nov. 2004, Available at:
http://www.refusingtokill.net/Venezuela/venezuelamilitaryhospitals.htm; da Corte, Maria Lilibeth. “Pagarán a enfermeras de Barrio Adentro”. El Universal. 11 Nov.
2004. Available at: http://buscador.eluniversal.com/2004/11/12/ccs_art_12287E.shtml. Reyes 116
LaFranchi, Howard. “Chavez Support Fragile, but Remains Intact”. Christian Science Monitor.
17 July 2001, 7.
Mayburduk, Peter. “Venezuela Works to Bring Healthcare to the Excluded”. Multinational
Monitor, October 2004.
McCoy, Jennifer. “What Really Happened in Venezuela?”. The Economist, 4 September 2004.
Moladi, Francisco, Michael Penfold and Rosa Amelia Gonzalez, et al. “Political Institutions and
Policymaking in Venezuela.” Available at:
http://www.isnie.org/ISNIE04/Papers/monaldi.pdf.
Purkiss, Alan. “Venezuela’s Chavez Aids the Poor with Social Programs, WJS Says”.
Bloomberg.com. 24 Dec. 2004. Available at:
http://www.bloomberg.com/apps/news?pid=100000086&sid=aCqCxWZ8tVu8&refer=lat
in.
Rivero, Yensi. “Venezuela: Cuban Doctors Bring Care to Caracas Slums”. IPS-Inter Press
Service/ Global Information Network. 23 Nov. 2004.
Salas, Maria Isabella. “Cuban Advisors Continue to Arrive in Venezuela”. World News
Connection. 29 Jun. 2003.
Soto, Carlos García. “Volver a Parar,” El Universal, 15 Dec. 2001,
http://buscador.eluniversal.com/2001/12/15/opi_art_OPI6.shtml.
Weyland, Kurt. “Neoliberal Populism in Latin America and Eastern Europe”. Comparative
Politics. Jul. 1999: 379-401.
News Articles with No Authors
“A Spectre Stalks the Americas”. The Economist. 26 February 2005. Reyes 117
“Barrio Adentro es ahora una misión”. El Universal, 15 Dec. 2004. Available at:
http://buscador.eluniversal.com/2003/12/15/apo_art_15114B.shtml.
“Chávez defiende a médicos cubanos,” BBCmundo.com, 22 Aug. 2004, Available at:
http://news.bbc.co.uk/hi/spanish/latin_america/newsid_3175000/3175193.stm.
“FMV alerta radicalización del paro medico,” El Universal, 28 Jul. 2002, Available at:
http://buscador.eluniversal.com/2002/07/28/pol_art_28113FF.shtml;
“FMV exige bs. 750 mil para medicos rurales,” El Universal, 2 Feb. 1999, Available at:
http://buscador.eluniversal.com/1999/02/15/pol_art_15110DD.shtml;
“FMV solictará amparo por derecho a la salud ante el TSJ”. El Universal, 9 Aug. 2002,
Available at: http://buscador.eluniversal.com/2002/08/09/pol_art_09109CC.shtml.
“Freddy Bernal lidera manifestación en los alrededores de RCTV,” El Nacional, 13 Apr. 2002.
Available at:
http://www.el-nacional.com/nacionalfront/articulos/articulo.asp?id=7741&idSeccion=63.
FXHistory: historical currency exchange rates. Available at:
http://www.oanda.com/convert/fxhistory.
“General de brigade del Ejército asegura que Chávez llegará a Miraflores en las próximas horas,”
El Nacional. 13 Apr. 2002. Available at: http://www.el-
nacional.com/NacionalFront/Articulos/Articulo.asp?id=7755&idSeccion=64.
“Is the United States’ Nightmare of “a second Cuba” coming true in Venezuela?”. The
Economist. 26 February 2005, 35.
“La problematica ética y legal de un sistema paralelo”. El Universal. 29 Sep. 2003. Available
at: http://buscador.eluniversal.com/2003/09/29/ccs_art_29288B.shtml.;
“Ministro asegura que cancelará deuda a enfermeras de Barrio Adentro”. El Universal. 11 Nov. Reyes 118
2004. Available at:
http://buscador.eluniversal.com/2004/11/11/pol_ava_11A506663.shtml.
“Odontólogos de Barrio Adentro protestan por salaries atrasados”. El Universal. 12 Dec. 2004.
Available at: http://buscador.eluniversal.com/2004/12/04/ccs_art_04262F.shtml.
“Oil Prices Fall as Chávez Quits”. BBC News, 12 Apr. 2002, Available at:
http://news.bbc.co.uk/1/hi/business/1925330.stm.
“Rodríguez Iturbe advierte que regreso de Chávez es una tragedia”. El Universal. 18 Apr. 2002.
Available at: http://buscador.eluniversal.com/2002/04/18/pol_art_18104CC.shtml.
“ Seguidores de Chávez denuncian la existencia de un golpe de derecha,”El Nacional. 13
Apr.2002. Available at:
http://www.el-nacional.com/NacionalFront/Articulos/Articulo.asp? id=7725&idSeccion=63.
“Solicitud de recursos para la mission barrio adentro”. El Universal. 5 Dec. 2005. Available at:
http://buscador.eluniversal.com/2004/12/05/ap_art_05109B.shtml.
“Timeline: Venezuela: A chronology of key events”. BBC News. 16 Feb. 2005, Available at:
http://www.news.bbc.co.uk/1/hi/world/Americas/country_profiles/1229348.stm.
“ Venezuela’s Chavez: Socialism is the Right Economic Path”. Dow Jones Newswires. 25
February 2005.
“Venezuela: Cuban Doctors Bring Care to Caracas Slums”. IPS-Inter Press Service/ Global
Information Network. 23 Nov. 2004. Available at:
http://web.lexis- nexis.com/universe/document?
_m=4f58fb7ae5c9f9fd18c1d1e61fa3598&.
“Venezuela: fallo contra medicos cubanos”. BBCMundo.com. Friday, August 22, 2004. Reyes 119
Available at:
http://news.bbc.co.uk/hi/spanish/latin_america/newsid_3173000/3173645.stm. October
16, 2004.
“Venezuela Flood Victims Protest Rebuilding Efforts”. BBC News. 17 Jun. 2000. Available at:
http://news.bbc.co.uk/1/hi/world/americas/791673.stm.
“Venezuelan oil workers call strike”. BBC News. 27 Mar. 2001. Available at:
http://news.bbc.co.uk/1/hi/business/ 1245063.stm.
“Venezuela: Rebuilding After Devastation,” BBC News, 7 Jun. 2000. Available at:
http://news.bbc.co.uk/1/hi/world/americas/780261.stm.
Non Conventional Sources
“Class Notes”. Introduction to Latin American Studies. Prof. Ben Fallaw. February 6, 2002.
Other Online Sources
“Marco Jurídico”. Misión Barrio Adentro. Available at: http://www.barrioadentro.gov.ve/.
October 16, 2004.
“Non-Opec Fact Sheet”. Energy Information Administration. Available at:
http://www.eia.doe.gov/emeu/cabs/topworldtables1_2.html. December 4, 2004.
“ Profile of the Health Services System of the Bolivarian Republic of Venezuela”. 2nd ed
Program of Organization and Management of Health Systems and Services, Division of
Health Systems and Services Development, Pan American Health Organization,., 14 May
2001, 5.
“Venezuela”. 2000 Country Reports on Economic Policy and Trade Practices. Bureau of
Economic and Business Affairs U.S. Department of State, March 2001. Available at:
http://www.state.gov/documents/organization/1670.pdf. Reyes 120
“Venezuela Country Brief”. The World Bank Group. Available at:
http://lnweb18.worldbank.org/external/lac/lac.nsf/Countries/Venezuela/9AEC6D72716F
D7B985256D7A006B9B54?OpenDocument
“Venezuela”. Health in the Americas 1998 Edition. Available at:
http://www.paho.org/english/hia_1998ed.htm. Pg. 539.